Sushruta

In the Ayurvedic tradition, the sage Sushruta is known as the editor and author of the classical Ayurveda work Sushruta-Samhita and, at the same time, as the main representative of the so-called Ayurvedic surgery. By equating to modern terms, we can somewhat identify Sushruta in this field, but this branch of Ayurvedic surgery traditionally implies in Ayurveda more practical aspects which nowadays are not attributed to a surgeon, in the sense we think of one today, but it mostly refers to the sum of procedural aspects, including the aspects implying the purification of the body through the traditional means of purification which are known in Ayurveda. So, the sage Sushruta appears to us as an expert practitioner of the Ayurvedic methods of pancha-karma and simultaneously a knowledgeable practitioner of the way in which these practical ways of purification of the body could be applied to different human beings having different difficulties.

In regards to the sage Sushruta, the Ayurvedic tradition mentions the fact that he studied both the Ayurvedic art and science directly from the Great God Dhanavantari, during a retreat of his in the Himalaya Mountains. During this retreat, alongside him were other Ayurvedic sages mentioned in one of the sutras from Sushruta-Samhita, namely Aupadenava, Vaitaranya, Aurabhra, Paushakalvata, Karavirya and Gopurarakshita.

In the text of the Sushruta-Samhita, whose title means “the affirmations of Sushruta” or “Sushruta has said”, the references that are made regarding himself are made in the third person, so that it appears as if the text of Sushruta-Samhita was edited by somebody else based on the statements, the knowledge and the aspects that had been previously offered, in a certain context, directly by the sage Sushruta himself.

In the section called Uttara-Sthana, sutra 66, the sage Sushruta is described as being “the venerable son of Vishvamitra”. (“Vishvamitra sutah siman Sushrutah”). For those who have studied the historical facts regarding the names and the persons who were cited in these scriptures, it has been established that it is still difficult to identify exactly who Vishvamitra was, simply because this name is very commonly found in such writings.

What is known throughout Oriental history is the fact that a sage with this name is mentioned as being a Vedic sage, a mention which appears in Rig-Veda, with him being the author of the famous hymn suggestively called Gayatri.

The human being called Vishvamitra is described in this context as being the son of Kushika, who had been a great king of the Kaniakubja region, and regarding the son of Vishvamitra, there are mentions in other connected works, about the fact that he was a remarkable Ayurvedic practitioner. So, through the convergence of the texts of several sutras, the hypothesis that the sage Sushruta, the same one that is mentioned in Sushruta-Samhita, is most likely a descendent of the sage Vishvamitra, was put forward, so that the sage Sushruta, who is mentioned in this context, belongs to the so-called “old”, primal period of Ayurveda. In other words, he is a presence recorded as belonging to the primary, Vedic period, of the context in which this ample teaching, namely the millenary science of the Ayurveda system, was initially offered.

But, at a more attentive analysis of the text, it can be observed that there is another presence with the same name, Sushruta, which is more recent and which is described as having the same implication in the editing and recording of  Ayurvedic teachings, even having the same preoccupations, but being contemporary with the sage Agnivesha, who rigorously edited the scripture Charaka-Samhita, based on the direct teaching of the sage Atreya.

Because of this, at a certain point in time, a terminological distinction was made in which one of them was called Vriddha-Sushruta (“the most ancient”, the oldest, the ancestor, the primary one) and who is associated with the source of knowledge which was later recorded as the scripture Sushruta-Samhita, which at that time was catalogued as a complex work, covering many subjects, being considered as belonging to the class of works characterized by an exemplary completeness (a work of Tantra type). A large number of later Ayurveda works, such as Bhava-Prakasha, Niganthu, works belonging to the sage Todarananda or Tattvahandrika cite, make references to the primary text of Sushruta and they call it Sushruta-Tantra.

The expression that designates the actual title, namely Sushruta-Samhita, means “what has been taught, offered, said or affirmed by Sushruta”, so we can see that there is a certain continuity within this text and we can assume that, initially, the text of the sage Sushruta, and we now refer to that olden form of existence, Vriddha-Sushruta, was what had been called Sushruta-Tantra. Later, as time went by, the text was revised and enriched.

The original text was brought back to life probably thanks to the existence of certain aspects which as time went by had been either simplified or diminished, such that until relatively recent times it has gradually become the text which we know to be Sushruta-Samhita.

As familiarized from more traditional Ayurvedic descriptions, the beings that appear as participants, adepts, authors, co-authors, editors or the ones that have kept alive, through their direct contribution and participation, this tradition of Ayurvedic knowledge, appear as having a deep connection between one another, so that in the case of some of them this connection causes them, even in the case of a human being embodied in a different time and space, to resume, reproduce and manifest the same inclinations, the same skills, the same openness towards this initiatic Ayurvedic knowledge such that, by looking over time from the point of view of the finality of the creative effort that those human beings have made, they appear as being the one and same person.

In reality, the space-time integration or personality differences nearly do not matter anymore, because, by looking over time, even in the accepted hypothesis of the existence of two different spirits, of two different human beings that have lived in different times, their preoccupations, what they offered to the other human beings, as well as everything they accomplished proves to be perfectly coherent and convergent, so that, from the viewpoint of their participation in the lineage of traditional Ayurvedic knowledge, even if we were to admit the hypothesis that two different people existed in different historical moments, from the viewpoint of the contribution they have had to Ayurvedic knowledge, we can say that they are perfectly identifiable with one another and that they are one and the same being. Hence, going past the so-called historical perspective, which is characteristic to a researcher in the area of the most precise identification of biographical aspects, we need to understand that we can go past this frame of mind and thus highlight a particularity, unique in its own way, which belongs to the Ayurvedic spiritual tradition.

The ones that have been engaged during the years and have remained a part in this initiatory transmission of the Ayurvedic science have always been beings gifted with a certain superior, exemplary state of inner and spiritual accomplishment, which has been remarkable. For such exceptional beings, certain superior abilities that are specific to the advanced practice of Yoga were no secret, but on the contrary, were extremely accessible to them, so that the identification phenomena of the constitutive elements of the internal instrument of the consciousness (antahkarana) were, we can say, very accessible to such Yogis.

Operating with subtle specific energies of the superior consciousness (citta) was also perfectly accessible to such superior beings, who quite coherently accomplished superior identification processes in the area of their consciousness, thus facilitating the creative transfer of knowledge and specific aptitudes.

So, no matter the differences, possibly very big on the scale of history, between the one who lived and was probably a direct descendent of Vishvamitra and, later on, the one who was mentioned as a contemporary of the sage Agnivesha, both named Sushruta, we can establish that there is a very deep similarity, a resemblance that can be further advanced to the state of superior identification in the area of consciousness, thus being possible for us to assume that they are the same spirit or the same being. Such situations are not exceptions in the history of Ayurveda. Some edifying examples in this matter exist regarding the life of the great sage Jivaka or of the great sage Nagarjuna. The examples of these two great Ayurvedic sages can easily be considered as surprising, especially through the existing aspects in the historical records. We now reference some historic records regarding the sage Nagarjuna, about whom it has been said that he appeared in different manifestations throughout the years, in more different historical moments, at great distances in time, being recognized as the same great superior spirit, manifested in different human forms, in different historical moments.

In the case of the sage Sushruta, we can also establish that the historical dates that we have agree to offer us the perception of at least a double presence, one in immemorial times and another during ancient times. Hence, we are in front of the presence, most likely the same one, of the same superior, extremely rich, living and even penetrating spirit, which created and even animated this Ayurvedic knowledge in a so-called relatively big “arc over time”, which has a temporal span of several thousands of years.

This is why our internal connection, in the context of an identifying spiritual evocation, can be certainly made by relating oneself to the aspects, to the attributes, to the superior qualities that are universally valid and which this exemplary spirit, that is the great sage Sushruta, offers and illustrates through his very existence, beyond the space-time frame of a physical, concrete human manifestation.

In this regard, we can mention some of the landmark aspects through which we can identify the specific nature of the presence of this exceptional spirit, namely a great attention to the constitutive aspects of life within a living being, but also the ability to discover and make detail related aspects and various nuances of the interaction between the vital principles easy to understand.

The thorough detailing of the three vital principles (dosha) under the form of the five sub-doshas (upa-dosha) belongs to the sage Sushruta.

The teachings regarding the defining aspects regarding the existence and the manifestation of the 15 sub-dosha­­s is nowadays accessible to us thanks to the knowledge offered by Sushruta.

The sage Sushruta is the one who offered the most detail, the most descriptive aspects and even a certain subtle punctual way to identify every sub-dosha (upa-dosha) individually.

On the basis of his teachings, we can identify the presence, the manifestations, the physical expressions and the subtle energetic manifestations of these subdivisions of the doshas (sub-doshas), which are nuanced through the five tattvic subtle elements, in relation to every primary subtle vital force. This represents an aspect which is determining and defining for the spiritual profoundness and for the capacity to observe and recognize which this great sage illustrates through what he allowed to be known.

Another characteristic aspect of Sushruta is the functional, dynamic point of view on the vital manifestations. Even if nowadays the sage Sushruta is identified and recognized through his homologation as a surgeon, in fact the sage Sushruta is some kind of “functional surgeon”. He may be the one who illustrates in the most practical way a statement that has become famous in the Western mentality, namely “the function creates the organ”.

Even if this statement has been used as a starting point or as a motto to many anatomy texts nowadays, the one who best understood the essence of it and enounced it thanks to his knowledge and practice was the sage Sushruta. In reality, physiologists and anatomy specialists nowadays have not structured their dynamic viewpoint on the science of the body and on the human being based on this particular affirmation. This is still a statement looking for supporters, because modern anatomy is still a specific way of descriptive, analytic knowledge, based on certitude of the explored sensorial material support and is less an expression of a dynamic and of a functionality which is a generator of physical support.

Even though this claim exists, the approach of modern knowledge does not reflect the profoundness of such a claim. But the sage Sushruta has done it in his own way and a proof for this situation is the system of the 15 sub-dosha­s which are known in Ayurveda.

By carefully studying Ayurveda, we can observe the multitude of practical implications and applications which derive from the knowledge of the 15 sub-doshas, such as, for example, the way in which this knowledge is applied in the case of defensive mechanisms (raksha-viddhi), because the defensive mechanisms are the ones that, once we know the corresponding energetic keys, show us the way in which a constrictive mental disposition, that is fed especially by certain limiting aspects of the ego (ahamkara), can connect the subtle dimension of the being (mano-maya-kosha) to the physical manifestations (anna-maya-kosha) that exist in the body, and simultaneously show us that there is a specific concordance between some behavioural manifestations marked by a defensive reaction generated by the ego (ahamkara) and certain forms of organic contraction, which later prove to be the causes of the manifestation of certain problems of the body (sharira-roga).

This correspondence represents a genuine operational key that became accessible to us on the basis of the details that the sage Sushruta has offered, nuanced, supported and enriched with multiple examples.

The spiritual evocation of the sage Sushruta allows us to understand a large area of superior, remarkable aspects, which are durable over time and which the sage Sushruta manifested and sustained over time through the Ayurvedic teachings that he included and which remained accessible to us, especially through the scripture Sushruta-Samhita.

In the Indian popular tradition, especially among the so-called simple folks, in the rural environment, the scripture Sushruta-Samhita is maybe even better known, not necessarily in a detailed way, but it is especially known among the simple Ayurvedic practitioners.

There is another reason why the sage Sushruta is very famous in India, not necessarily well-known, in the regard that they do not necessarily study his work in detail, but nonetheless they relate to his being, so that the sage Sushruta is a landmark for them. The reason is that the sage Sushruta is considered to be a direct disciple of Dhanvantari, The One who is known as the God of Medicine or the Healing God, who protects the people from the suffering created by illness, old age, or death. In the popular view, the sage Sushruta is the “right hand” of the Great God Dhanvantari, and he appears in this way  in the perspective of the vast majority of people from the rural environment in India. This makes the popularity of the work of the sage Sushruta, of his teachings and of this particular hypostasis of Vishnu, who is Dhavantari, to be relatively widespread. Thus, even the simple folks, who maybe do not have a vast intellectual knowledge, have the inner openness to perceive Dhavantari and implicitly to constantly relate themselves to the teachings of the sage Sushruta. This is exactly what makes these open and honest people, who have a deep devotional nature (bhakti), able to find simple solutions to difficult problems in many difficult situations in life that would otherwise create greater problems or many difficulties.

One of the effects of this popularity of the sage Sushruta, who is known to be in a strong connection with the One who inspired and guided him, namely the Great God Dhavantari, is the fact that the human being who relates in an honest, direct way to Him – without necessarily having a great accumulation of intellectual nature, but  being in a deep state of devotion (bhakti) and a great inner confidence, just like a bhakti Yogi – becomes, from a certain moment onward,  capable to find by themselves, through the inspiration that is thus given by God, simple solutions to the difficult problems that have to deal with.

Even though a certain probable difficulty of life can be more or less foreseeable, the human being that understands and assimilates in the most profound way the ineffable state of occult resonance with these two great spirits, which are the Great God Dhavantari and the sage Sushruta, become capable to succeed in life, even  when things appear to be difficult.

In the work Sushruta-Samhita there are different descriptions of sophisticated surgical instruments used in ancient times. Also, classifications of the fractures, wounds, abscesses and burns are made while presenting some elaborate plastic surgery procedures, which the sage Sushruta and the Ayurvedic practitioners who were studying along with him were conducting. Numerous methods of anal-rectal surgery initiated by Sushruta and that have successfully resisted the passing of time, which have also remained relevant even  nowadays, are also presented.

The sage Sushruta described in his work the main concepts of pathogenesis. He describes the procedures for the thorough knowledge of the human body, the knowledge of the structure of the human body, bones, articulations, muscles, blood vessels, heart and nerves.

His doctrine is surprising for modern researchers and is considered to be extremely valuable nowadays. But, beside all these aspects, which have found an equivalent in the modern, actual knowledge, the sage Sushruta also makes the description, that is less known, of the so-called focus points in which the vital energy of the being is intensely manifested, these focus points being traditionally called marma­s. The marma­s represent the basis, or, in other words, the starting point for certain sciences that have later evolved under the form of acupressure or acupuncture, as they later evolved in the Chinese tradition, in the Ayurvedic tradition and also in other traditions of the world.

The sage Sushruta emphasized the importance of the fruitful conjunction of the theoretic knowledge with the practical experience and offered numerous ways to attain the skills of an Ayurvedic practitioner, especially in the case of surgical skills. For the sage Sushruta, the skill or, in other words, the ability of an Ayurvedic practitioner to wisely and skillfully use his hands represented a great quality. At the same time, this wise use of the hands ensured the Ayurvedic practitioner a very special intellectual development and even helped them reach a superior development of their intelligence.

The sage Sushruta even offers the modern scientific researchers some amazing premises for an elaborate research. Such an example is found in section 1 from chapter 15 of his work, entitled Netto-roga, in which the pathogenesis of the diseases of the fat tissue is being described.

Sushruta notices the fact that if a human being excessively consumes sweet substances, for example, carbohydrates or sugar, they are being transformed into fats and lipids, which are known in a generic way under the name snoha.

Hence, the sage Sushruta seems to be the first researcher in the world who mentioned in a writing the process by which sugars are being converted into fats. Furthermore, Sushruta mentions that the excess of fat in the body reduces the life expectancy and is an element which is contrary to the practice of the rasayana procedures. Therefore, in order to correct this imbalance, Sushruta indicates certain natural Ayurvedic cures, and such an example is the plant called guggul, regarding which it has recently been found, both in experimental studies and in clinical studies, that it has a strong hypocholesterolemic effect and that it is a good lipolytic agent. The guggul powder is able to reduce cholesterol levels by 24% and triglycerides levels by 35%, in the case of patients following a treatment for at least three months. According to clinical studies it has been shown that the administration of this plant, which has been mentioned since ancient times by Sushruta, accelerates the general metabolism and makes it possible for the cholesterol to be transformed into bile acids. It is remarkable that such an aspect has been proven by the sage Sushruta since ancient times, without all these modern explanations, which justify a truth presented thousands of years ago. Sushruta specifies that the guggul powder is mala-pitta-mudha, an expression which means “what helps the biliary secretion”. This same conclusion has been recently confirmed by a series of modern scientific researches. This is just an example of observations with a practical character that nowadays finds its justification through the numerous modern scientific researches, that have as objective the exploitation of the value of certain plants from the Ayurvedic tradition.

Starting with this example we can say that the writings of the sage Sushruta can offer many new directions in the field of contemporary medical scientific research, all these starting from the attentive study of his work, Sushruta-Samhita. This work offers a multitude of research directions of the therapeutic actions (karman) of the medicinal plants, because the sage Sushruta repeatedly suggests the fundamental idea that the plants act upon the decisive changes that intervene regarding the body, for example, some of which act even at a hormonal level. This suggestion is given indirectly by Sushruta through certain mechanisms that are linked with the intelligent control of the body. Such recommendations are numerous in the work Sushruta-Samhita.

The sage Sushruta represents a genuine model of an inspired Ayurvedic practitioner, who offered people a large number of practical ways to maintain their health and to heal the human beings who find themselves in the most difficult disease related situations. The sage Sushruta combined in an exemplary manner theoretical knowledge with practical activities and thus helped numerous human beings, both during his earthly existence and after that, through the extremely valuable knowledge that he offered to Ayurvedic practitioners over time.