Old Medical Practices - How did they do it?

For people who have smugly believed that brain surgery, kidney treatments, curing cataract, rhinoplasty (nose job in simpler words), vaccines and other such treatments demonstrate our greatest advancements in medical science, it’s time to think back. Literally.

It has something to do with a 4000 years old skull that was found by archaeologists in Turkey. A human skull that had a one inch-by-two inch incision—and displayed signs of tissue re-growth. Dead human beings do NOT re-grow tissues. Not a bit. So not only did the ancient human being had his skull drilled and survived, had the hole not been drilled at all, he would have probably died 5-10 years earlier. (Not that it makes much of a difference from here and to us, but it obviously did to our ancient ancestor).

Sushruta Samhita

Now this procedure of drilling holes in the skull is called trepanning. And no, this isn’t some cavemen style skull cracking. Trepanning is creating a very precise hole in the skull mostly to release the pressure inside the skull due to building up of fluid inside during brain trauma. If this fluid is not released, the brain might get compressed resulting in death. This medical practice is followed even today. Just that the process is quicker and more precise; also, less painful. And has to be. Imagine trying to drill a hole through a wooden block with the help of an obsidian rock. Now imagine using the rock to drill hole through the skull. Yes, you need tremendous skill on the doctor’s part and tremendous patience and tolerance on the patient’s part. But what strikes one the most about trepanning is the sheer simplicity and brilliance of the idea, and the understanding of the co-relation of cause, effect and cure by the ancients.

Trepanning is but the tip of the ice-berg. Sushruta Samhita, a Sanskrit treatise on surgery attributed to Sushruta, a physician from 6th century B.C.E. Varanasi, and one of the three foundational texts of Ayurveda (Indian traditional medicine), was written in 3rd-4th century B.C.E. and describes medical procedures of pediatrics, geriatrics, diseases of the ear, nose, throat and eye, toxicology, aphrodisiacs and psychiatry among others. The text is divided into 8 parts namely—chhedya (excision), lekhya (scarification), Bhedya (puncturing), Esya (exploration), Ahrya (extraction), vsrya (evacuation), and sivya (suturing). One of the most notable descriptions in Sushruta samhita, also considered to be one of Sushruta’s greatest achievements was rhinoplasty where he tried to restore the mutilated noses of the patients through plastic surgery. There are evidences to suggest that not only was Sushruta successful in these operations, he was famous so much so that people from outside India travelled both to get the treatment as well as watch the treatment. The surgical practice is described in meticulous details and the same basic practices are amazingly followed today as well. It is a bit unnerving to find that the surgical procedures followed even today are at most a combination of the 8 divisions described in the ancient text, nothing more.

Not only does the treatise expound on the methods of surgery, it gives tips on practicing as well. For example, it is advised to practice “incisions and excision on vegetables and leather pouches filled with different densities of mud, 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”, and so on.

If Sushruta was the father of surgery—spanning simple (relatively) cataract surgeries to complex surgeries involving the ano-rectal regions—Charaka was the one who studied the effect of herbs extensively. Charaka-samhita forms the second part of Ayrveda. It is said the details with which Charaka has described the herbs and their effects of human health can be obtained only through intuitive knowledge. The variety of herbs that are described span the entire nation and it is humanly impossible to analyze all the plants as accurately as described. There is another school who believes that Charaka-samhita was not a work of a single person, but a collection of texts written by different people throughout three centuries.

Edward Jenner might be called the father of vaccination but the credit belongs to the physician Dhanwantari of India. In 1000 B.C.E., Dhanwantari devised a simple way of curing small pox—essentially what Dr. Jenner ‘discovered’ more than 2500 years later.

Root Canal surgery? We have enough archaeological evidence (a Jordanian soldier, to be more specific) to show that this was being performed as early as 200 B.C.E. And so were tracheotomies and incubations.

So much for advancements. At least the ancients didn’t have the human genome decoded. Or maybe they did, but we don’t have the evidence yet.

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