Shastra Avacharana Adhyaya – 8th Chapter of Sushruta Samhita

Abstract

Sushruta Samhita is written by Acharya Sushruta. He is worldwide known as “The Father of Surgery”. Sushruta Samhita is the oldest Ayurvedic text on medicine and surgery. It is one of the three great treatises in Ayurveda. It is considered one of the best and oldest learning books for Surgery. Sushruta Samhita contains hundreds of chapters and has described a thousand types of diseases. In this article, we will discuss Shastraavcharniya Adhayaya which is the eighth chapter of Sushruta Samhita (Sutra Sthana).

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Introduction

In this chapter, Shastraavacharniya various types of Shastra are mentioned in detail that can be used for surgical procedures. The function of Shastras, Shastra grahan vidhi, shapes, measurement, and demerits of Shastra is also mentioned. The methods of sharpening blades are also described properly. Various anushastra and shastra nirmana are also mentioned in this chapter.
We will get to learn various types of classical surgical tools which became the basis of modern surgical tools.

Types of Shastra

Shastra are 20 in number which are given below:

  1. Mandalagra (round-head knife)
  2. Karpatra (bone saw)
  3. Vridhipatra (scalpel)
  4. Nakhshastra (nail parer)
  5. Mudrika (finger knife)
  6. Utapalapatra (lancet)
  7. Ardhadhar (single-edged knife)
  8. Suchi (needle)
  9. Kushapatra (Paget’s knife)
  10. Atimukha (hawk bill scissors)
  11. Shararimukha (pair of scissors)
  12. Antarmukha (curved bistoury)
  13. Trikurchak (trocar)
  14. Kutharika (axe-shaped knife)
  15. Vrihimukha (trocar)
  16. Ara (awl)
  17. Vetaspatra (scalpel)
  18. Badish (hook)
  19. Dantshanku (tooth scater)
  20. Aishani (sharp probe)

Functions Of Shastras

Given below are the various functions of Shastra:

  • Mandalagra and Karpatra are used for Chendan and Lekhan Karma.
  • Vridhi patra, Nakhshastra, Mudrika, Utapala patra and Ardhadhar are used for Chedan and Bhedan Karma.
  • Suchi, Kushayantra, Atimukhi, Shararimukhi, Antakmukhi and Trikurchak are used in Vistravana Karam.
  • Kutharika, Vrihimukha, Ara, Vetaspatra and Suchi are used in Vedhan Karma.
  • Badish and Dantshanku are used in Aharan Karam
  • Aishini is used for Anulomana and Suchisivan.

Shastra Grahana Vidhi (Methods of Holding Shastra)

Given below are the methods of holding these sharp instruments while conducting any surgical procedure:

  • Vridhipatra Shastra should be held from Vrinta (handle) and Phala (blade).
  • The above-given method should be used for holding the sharp instrument meant for the incision (bhedan).
  • Vridhipatra and Mandalagra should be used by slightly raising the hand and should be used for the purpose of scrapping (lekhan).
  • The instrument used for Vistravana should be held at the tip of the handle.
  • Visravana should be done with the help of Trikurchika Shastra.
  • Vrihimukha Shastra should be held in the palm with the thumb and index finger.
  • One should hold Kutharika in the right hand and hold it with the thumb and strokes should be given with the middle finger when the thumb is released.
  • Ara, Karapatra and Esani should be held from the root. Other instruments are held accordingly depending upon their use.

Shastra Akriti

The shape of the instruments is described with the help of their names.

Shastra Pramana (Measurement Of The Instrument)

Nakha Shastra and Eshani are 8 angula in length.

The size of Mudrika should be equivalent to the first phalanx of the index finger.

Shararimukhi Shastra should be six angula in length.

The rest of the other Shastras should be six angula in length.

Shastra Sampat

A good Shastra should have the following signs which are mentioned below:

  • Sugrahani – It should be easy to hold or should have a good grip.
  • Sulohani – It should be made with a good metal (iron/steel)
  • Sudharani – It should have good blades.
  • Surupani – It should have a pleasant appearance.
  • Susamahata Mukhagrani – The initial part of the sharp instrument should be well placed.
  • Akaralani – It should not have serrated edges.

Shastra Dosha (Demerits)

Given below are the 8 demerits of surgical instruments:

  • Vakra Dhara – It should not have bent cutting-edge.
  • Kuntha Dhara – It should not have a blunt cutting edge.
  • Khanda Dhara – It should not have a broken cutting-edge.
  • Khara Dhara – It should not have a rough cutting edge.
  • Ati Sthula – It should not be very big or thick.
  • Atyalpam – It should not be very small.
  • Atidirgha – It should not be very long.
  • Atihrsva – It should not be very short.

The instrument with the doshas mentioned above should not be used. But, Karpatra can be used as it is rough and hard and is used for cutting bones.

Dhara Pramana

Given below is the Dhara of various instruments depending upon their working:

  • Bhedana Karma – The Dhara of the instrument should resemble the size of a masoor (lentil).
  • Lekhana Karma – The Dhara of the instrument should resemble the size of half a masoor (lentil).
  • Vyadhana and Visravan – The Dhara of the instrument should resemble the size of a kaishika (thickness of a hair).
  • Chedan Karma – The Dhara of the instrument should resemble half of the size of a hair.

Badish and Dantashanku both are curved from the front. Tikshana Kantaka (having a sharp, thorned face), Prathama yava patra mukha (having face similar to a juvenile leave of barley) and Gandupada akara mukhi (having shape and mouth similar to an earthworm) are three types of Esani.

Shastra Payna

Various ways of sharpening instruments include:

  • Kshara – Sharpening in alkali
  • Udaka – Sharpening in water
  • Taila – Sharpening in oil

The instruments sharpened in alkali are used to remove foreign bodies and for cutting bones.

The instrument sharpened in water should be used for cutting and tearing muscles.

The instruments sharpened in oil are used for vedhan (puncturing the veins).

Nisana (Sharpening)

In order to sharpen the blades of instruments a rough stone is used whose color resembles black gram. In order to keep the blades of instruments stable one should use the pod of Shalmali fruits.

The Right Time To Use Surgical Instruments

The right time to use surgical instruments is when the blade is sharpened enough to cut the hair and if it is of considerable size and held properly by the surgeon.

Anushastra

Various types of Anushastras are mentioned below:M

  • Bark of bamboo
  • Rock crystal
  • Glass
  • Corundum stone
  • Leech
  • Fire
  • Alkali
  • Nail
  • Goji leaves
  • Harshrighar leaves
  • Shak leaves
  • Karir
  • Hair
  • Fingers

Uses Of Anushastra

Anushastra is used in the following conditions:

  • Anushastra is used in children and in people who are afraid of sharp instruments.
  • They are used when there is an absence of sharp instruments during the surgical procedure.
  • Nails should be used for aharan (extraction), chedan (excision), bhedan (cutting).

Shastra Nirmana

The intellectual physician should take the instruments manufactured from pure, strong and hard iron. All these instruments should be prepared by experienced and skilled blacksmiths.

Conclusion

There are a total 20 types of Shastra that are used for surgical procedures. The shastra with dosha should not be used in surgeries. They should have a particular sharpness and should have a proper measurement. In the absence of proper Shastra, Anushastra can be used for surgical procedures.