Shastra Chikitsa (Surgical Management):
अक्रियायां ध्रुवो मृत्यु: क्रियायां संशयो भवेत्।
तस्मदाप्रुच्ह्य कर्तव्यमिश्वरम् साधुकरिणा।। -By (Su. Chi. 7/29)
As per Ayurveda, ‘Shastra-Chikitsa’ (Surgical Treatment) is carried out only for the diseases, which cannot be cured by medicines and only surgery remain the last option to save the patient’s life span and it should be done only after obtaining consent of the well wishers of the patient.
Shalya tantra (Department of Ayurvedic Surgery), an Ayurvedic surgical branch, which deals with the methods of removal of different kinds of foreign objects, such as grass, wood, stone, sand, metal, bone, hair and nail; pus, exudation, vitiated ulcer, use of caustic alkalis (ksara) and cautery (agni) and even diagnosis of ulcers/wounds.
The pre-operative procedures (purva-karma), surgical procedures (excision, incision, scrapping, puncturing, probing, extracting, draining, suturing etc.), post-operative procedures (paschat-karma), marma’s description (description about the vital points of the body), anesthesia (sangya-harana), the description of the types of bandages (patta bandhana), shastras (sharp instruments), yantras (blunt instruments), leech therapy (jalokavacharana), sira-vyadha (blood-letting) and treatment of diseases which need surgical care has also been described in this branch.
In the ancient India, surgery was principally pioneered by Ayurveda. The name of the sage-physician, Susruta, is synonymous with surgery. From his treatise ‘Susruta Samhita’, we have become aware of the thousands of years ago’s sophisticated methods of surgery that were practiced in India. Topics of intestinal obstructions, bladder stones, and the use of dead bodies for dissection and learning were taught and practiced in ancient India.
The original text of Susruta has a detailed discussion of the exhaustive range of surgical methods, which is inclusive of methods on how to deal with various types of tumors, internal and external injuries, and fracture of bones, complications during pregnancy and delivery and obstruction in intestinal loop. Susruta was the first surgeon to develop cosmetic surgery in Ayurveda. His surgical treatment for trichiasis can be reckoned with some of the modern operative techniques used for this eye disease.
The sage-physician, Charaka, School of Ayurveda Medicines, also recommended Shastra Chikitsa (Surgical Treatment) for the treatment of certain diseases, which requires immediate attention such as Arsh (hemorrhoids), Gulma (abdominal lump), Shotha (swelling) etc.
According to Ayurveda, Shalya Chikitsa (Surgical Management) is best suited, when the problem is beyond just medicinal repair. In cases such as, Arbuda (abscesses, cysts), Gandamala (enlarged lymph nodes), Arsh (hemorrhoids), Bhagandara (Fistula-in-ano), Gud-bransh (prolapse rectum), Ashmari (Renal stone/ Vesical calculas), Mutravaodh (retention of urine) and stana-rog (breast diseases), Shalya-Chikitsa (Surgical Management) is the last protocol.
The treatment would not only give faster relief to the ailing person, but also be beneficial in situations, where medical management will fall short.
The long foreign rule in India and lack of promotion stalled the progress of Ayurvedic surgery in the middle of the second millennium.