Surgery is usually seen as a modern science. We associate it with machines, sterile gloves and complex equipment. But long before today’s hospitals existed, people were already cutting, stitching and treating serious injuries in organised ways. In ancient India, surgery was not only practised, it was taught, documented and regulated. One of the clearest records comes from the Sushruta Samhita, a medical text written more than two thousand years ago.
The text is attributed to Sushruta, a physician whose name shines mainly because of this work. What makes the Sushruta Samhita so famous, is its strong focus on surgery. While many old medical texts deal mostly with medicines and theories, this one spends time on practical aspects how to operate, how to train and what tools to use.
यत्र शस्त्रप्रयोगः स शल्यतन्त्रम्।
yatra śastra-prayogaḥ sa śalya-tantram
Sukta from Sushruta Samhita means a discipline in which surgical instruments are employed is called Śalya Tantra (surgery).
Sushruta, who was famous around the 6th century BCE, is hailed as the founding figure in the history of surgery. His work the Sushruta-samhita has systematically organized ancient Indian surgical science also known as shalya tantra. This text describes many pioneering procedures that testify to high skill and resourcefulness, including advanced plastic surgery such as rhinoplasty, removal of a dead fetus and lithotomy for bladder stones.
Apart from these specific procedures, Sushruta had established practical techniques of human dissection for detailed anatomical study. His work was much further-reaching than this particular field of surgery. The Sushruta-samhita is also an important source on Ayurveda including toxicology, pediatrics and pharmacology. Sushruta accomplished both being a skillful practical surgeon and being a scholarly encyclopedist, and his unified approach to medicine has endured through many centuries.
Surgery according to Sushruta, was not to be attempted casually. The text makes it clear that a surgeon had to be trained properly and for a long time. Students were advised to practise before operating on real patients. They learned how to make cuts on vegetables, how to stitch leather and how to handle animal tissue. They were also expected to study the human body closely. This approach shows ancient surgeons understood the risks involved. A mistake could mean serious harm. Skill mattered as much as knowledge.
Instruments without Guesswork
One of the most interesting parts of the Sushruta Samhita is its description of surgical instruments. Sushruta divided them into two main groups, first is sharp tools for cutting and second is blunt tools for holding, probing or extracting. The text also mentions more than a hundred instruments, including different versions of the same tool.
Most of these instruments were made of iron. The text repeatedly says they should be strong, well-shaped and suited to their task. A badly made instrument, could worsen a patient’s condition warned by Sushruta.
Tools for Cutting
Among the cutting instruments was the Vṛddhipatra, which worked much like a scalpel. It was applied to soft tissue in order to make precise and controlled cuts. Another tool used for curved incisions and for draining an abscess was the Mandalāgra, which had a rounded edge.
The text describes a saw-like instrument known as the Karapatra for severe bone injuries. In complex circumstances, when it was necessary to remove damaged bone this tool was employed. It captures the reality of treating wounds in an era before modern painkillers and antibiotics were invented.
Holding and Examining
Surgery was more than just cutting. In many procedures, objects had to be carefully examined or removed without making significant incisions. Surgeons used blunt tools for this. The doctor used a tool called the Eṣaṇī to look at wounds and fistulas. This tool was very thin. It helped the doctor see what was going on under the skin. The doctor wanted to know what was happening before they decided what to do to help the person. This way the doctor did not have to cut much.
The Sandamśa forceps were very useful. They were used to hold onto blood vessels and to pull out teeth that were bad. The surgeon also used these forceps to remove things that were not supposed to be, in the body and to grab onto tissue. There were different kinds of forceps. Some of them were made to handle things carefully and others were made to grip things very tightly. The Eṣaṇī and the Sandamśa forceps were tools for the doctor to use. Tubular tools called Nāḍī Yantra were used to examine internal passages such as the rectum or urinary tract. These instruments allowed surgeons to treat areas that could not be reached by hand.
Stopping Bleeding and Closing Wounds
Bleeding was one of the greatest dangers in ancient surgery. One method used to control it was cauterisation. For this purpose, surgeons used a heated rod called the Śalākā. It was applied carefully to stop bleeding or treat stubborn lesions.
Wound closure were taken seriously. Sushruta described suturing materials made from plant fibers, animal hair or sinew, as well as various kinds of needles (Sūcī) for stitching wounds. This demonstrates a clear understanding that appropriate closure promotes better wound healing.
Cleanliness Despite the Absence of Germs
Earlier people were ignorant of bacteria, but ancient surgeons were aware of the importance of cleanliness. Surgeons are advised by the Sushruta Samhita to protect wounds while they heal, clean their instruments and practice good personal hygiene. It also provides advice on post-operative care and diet. Observation was served as the foundation for these guidelines. Surgeons would have eventually observed that patients who had clean wounds recovered more quickly.
Surgeons were cautioned not to perform procedures that were superfluous or beyond their scope of practice. Pride and recklessness were discouraged. A surgeon was expected to act in the patient’s interest not to show off skill.
Scientific Progression and Why It Still Matters
In recent years, claims have appeared suggesting that modern surgery directly uses instruments invented in ancient India. While such claims attract attention, historians urge caution and demean Indian glorious history. Modern surgical tools are made with advanced materials, precise engineering and strict safety standards. They are the result of centuries of global scientific progress.
But the ancient instruments described by Sushruta share basic functions with modern tools. Recognising this difference does not weaken ancient achievements, it simply keeps history honest. The real importance of the Sushruta Samhita lies in its approach. It shows that surgery in ancient India was organised, taught and guided by rules. Instruments were designed carefully, training was essential and ethical behaviour was expected.
Today the text is studied not as a medical manual, but as a historical record. It reminds us that long before modern hospitals, people were already trying carefully and thoughtfully to heal the human body. Ancient Indian surgery does not need dramatic claims to earn respect. Its value lies in what it shows us about skill, responsibility and the long human effort to reduce suffering.
