Teaching Anatomy

To obtain proficiency, skill and speed in various surgical procedures, Sushruta had devised various experimental modules. For example, incision and excision are to be practised on vegetables and leather bags filled with mud of different densities; scraping on hairy skin of animals; puncturing on the vein of dead animals and lotus stalks; probing on moth-eaten wood or bamboo; scarification on wooden planks smeared with beeswax, etc. (Su.Su.9/4)

The Sushruta Samhita mentions the role of a student in the dissection: ‘A pupil, otherwise well-read, but uninitiated, in the practice (of medicine or surgery) is not competent to take in hand the medical and surgical treatment of disease. (Su.Su.3/48-50,53)

Embryology

Evidence from Sushruta Samhita indicates that Hindu surgeons of prehistoric India not only had considerable knowledge about various congenital diseases, but also their treatment. The Samhita describes the sequential development of the structures of the foetus. (Su.Sha.3/15)

Sushruta has mentioned in one of the chapters of Sharira sthana that the foetus develops seven layers of skin, naming each layer and the specific diseases which may affect that layer in adult life. (Su.Sha.4/4)

He was also aware of diseases by genetic inheritance. He mentions many congenital defects acquired from parents and those resulting from indulgences of the mother during pregnancy. Therefore, he advises her to avoid exertion for the perfect development of the foetus. (Su. Sha.3/13)

Developmental and heredity concepts were known to Sushruta. He has given a rudimentary account of human epigenetic development in his book. He also attaches importance to neuroembryology in the Sharira sthana section. What astonishes much more is the proficiency he accomplished just by mere observation, which is possible in present day only with the aid of investigations and ultrasonography. (Su.Sha.3/13)

Gross Anatomy

The knowledge of circulation of vital fluids through the body was known to Sushruta in 6th century BC itself. Also, he seems to have possessed knowledge of the arteries, which were described as ‘channels’. (Su.Sha.9)

Sushruta was well aware of the urinary stones, their varieties; the anatomy of urinary bladder along with its relations is well recorded in the chapter on urinary stones. (Su.Sha.9)

Sushruta had an in depth understanding about various procedures which represents the equivalent of modern techniques used in plastic and reconstructive techniques and thus implies a good knowledge of human facial anatomy. Sushruta delineated five anatomical divisions (Mandalas) of the eye: eyelashes, eyelid, sclera, choroid and the pupil. (Su.U.1/15)

 He described 101 number of marmas (vital spots) in the body which causes fatal result on injury, either sudden death or subsequent deformity. The detailed anatomical landmark of each and every marma was described by Sushruta. (Su.Sha.6)

Acharya has given the shape of the uterus and how the embryo resides in the uterus during its development. (Su.Sha.5/55,57)

He performed surgeries in the antiquity era itself covering most of the branches viz. general surgery, ENT, urology, orthopaedics, paediatric surgery, plastic surgery, orodental surgery, obstetrics and gynaecology.

Skeletal Anatomy

Sushruta deserves the credit of classifying skeletal injuries into groups in respect of their anatomical variation, prognostic values and ensured proper management even before discovery of Roentgen X rays. He classified bones based on dissections as flat bones, small cubical bones, cartilages, thin curved bones and long bones. Classification of this accuracy shows he was a keen observer and could apply anatomical knowledge gathered into practice. (Su.Sha.5/22)

He had a thorough knowledge on types of fractures, dislocation, sprain, their healing process which helped in successful management with proper rehabilitation. Various devices were also designed by him in management of bone injuries. (Su.Ni.16)

Neuroanatomy

Acharya Sushruta has included elementary neurosurgery in his conspectus: “Ten nerves maintain the functions of the body by carrying impulses of sound, touch, vision, taste, smell, respiration, sighing, yawning, hunger, laughing, speech, and crying . . .” “A pair of nerve each responds to sound, touch, vision, taste, and smell.” (Su.Sha.9/5)

“Two nerves lower down at the back of ear (vidhura) which if cut produce deafness; a pair of nerves inside the two nostrils which if cut cause anosmia;a pair of nerves below the end of the eyebrow which if cut causes blindness.”— Susruta Samhita. (Su.Sha.6/28)

Sushruta considered the head as the centre of all functions. (Su.Sha.3/30)

Through exquisite dissections, he described the nerves in detail and envisaged their physiologic importance. (Su.Sha.7)

He has also explained in various chapters of his book on neurological disorders like hemiplegia, epilepsy, fainting, stiff neck and many more. (Su.Ni.1)

Importance

Acharya sushruta has given immense importance to the surgical procedures for he believes that in order to treat a disease properly one needs to know the anatomical structures within the body in detail. For the same he gives the method of dissection and the way it should be done. (Su.Sha.5/58-60)