It is believed that the general art of surgery owes its origin and development to military surgery. The traditional name for it is Salya-Sastra which means the extraction of the spear head or arrow-head. The word Dhanvantari, who is the God of surgery, has the same significant derivation. The practitioners of the school of surgery are called Dhanvantariyas.
Inception of Surgery
Surgeons are the people who have the practical experiences in the art of aspiration, purification and healing of abscesses. The name Salya has its military origin. The Aryans were a genre of heroic people who were joyful of war and military conquests. Their history and mythology is full of the echoes of battles and military victories over either the barbarian hordes of foreigners or aboriginals or the armies of rival tribes and neighboring kings.
The art of surgery was developed at a very early age of the history. The palaces of all the ancient kings were intrigued with the conspiracies of potential rivals to the throne. Hence the fear of his food and drink being secretly poisoned was more in the case of every king. Hence the king had a physician and surgeon all the time in his palace in order to get immediate protection from any kind of poison and disease. These duties became all the more important during the war period.
Duties of a Military Surgeon
As per Susruta
Susruta describes the duties of the military surgeon. Here it is specified how a king should be protected by a physician when he is accompanied by the army and busy in fighting his battle:
- The enemies defile the road, the water, the shade, the food, the corn and the fuel. The physician should find that out and purify them.
- The physician and the family priest both should be expert in toxicology and thaumaturgy. The physician is warned to preserve the kings food, drink, path etc being poisoned by the enemies and to purify these things from such contamination. It was his duty to protect the king's important persons from the dangers of the disease, injury, poison and evil charms.
- The organisation headed by the physician pitched its own separate tents near the royal tent and flew a special flag overhead to distinguish it. In a big encampment just besides the tent of the king, the physician should be present, fully equipped. The persons afflicted with poison, darts and disease approaches him following the flag on his tent.
- The physician who is an adept in his own art and is conversant with other sciences, is honored by the king and experts.
As per Kautilya
Kautilya also refers to the duties of the military surgeons. He was expected to treat and protect the infantry, horses and elephants from diseases, epidemics, food, troubles etc. He should protect his army when it is suffering from a disease, pestilence or famine. He should look after a great portion of its infantry, cavalry and elephants when diseased or when not sufficiently strong or in distress.
Kautilya further describes how the king and his battling men must be enthused, supported and given first aid treatment by the surgeons equipped with instruments, apparatuses, antidotes, ointments, cloth and women taking proper care of the food and drink services. Physicians with surgical instruments, machines, remedial oils and cloth in their hands and women with prepared food and beverages should stand behind, uttering encouraging words to fighting men. The physician was liable to be a spy. He was a creator of disease in the opposite army and curer of his own army. In addition to this he was expected to know the art of
- How to kill hunger.
- How to increase the power of marching.
- How to increase the power of eye sight.
- How to disseminate various diseases in the enemy's camp.
- How to poison air, water and trees.
The detailed description of these and many other fair and foul means used in war is described by Kautilya.
Having applied these remedies to secure the safety of himself and his army, a king should make use of poisonous smokes and other mixtures to vitiate water against his enemy.
Precautions in Military Camp
No fire, except the sacrificial one should be lighted during the day. The fire should blaze well protected in the artificer's chamber as well as the lying-in-chamber. Having caused admittance in the house, the fire should be lighted inside.
One should collect the divine medicinal herbs which may help the revival of consciousness, the extraction of arrows, the restoration of normal color and the joining of bones. The medicinal herbs that helped extraction of arrows and the healing of the wound gave the normal coloration to the scar and helped the revival of consciousness are found to be collected and stored for war purposes.
Treatment in Military Hospitals
There were a number of operating surgeons in the military hospital with complete equipment. Physicians who were expert in the extraction of arrows, were fully equipped and coached up well by the skillful teachers. Treatment in the military hospital was for three kinds of patients afflicted by:
- War injuries
- Ordinary diseases
Code of Conduct for the War
Princes and warriors were expected to possess sufficient knowledge of various branches related to military operation. War ethics of the ancient times were of very high order. The chivalry of that age certainly did not neglect to include an organization similar to the present red-cross society, to extend surgical and medical relief to those injured in battle irrespective of the side to which the ailing belonged. That is a permanent observance that if a wounded opponent is in one's own territory or if he comes to one's house, he should be treated and when the wounds have fully healed up then only he should be allowed to go.
If a Brahmana, desiring peace on both the sides, intervenes between the armies drawn close, then there should be no fight. In the same way, the physician may take the place of a Brahmana. You should not kill an adversary who is not fighting, who has hidden himself, who has his hands folded, who has come for refuge, who is fleeing away or who is off his guard.
War was so common that military science had become an important branch of university education. We find its mention in the Vedas about the persons approaching expert Gurus to learn this branch of knowledge. In the later times, we find Taxila having 103 princes at a time as students in its military school. The Susruta Samhita, the great treatise on surgery and medicine, devotes an entire chapter to the military surgery under the name of 'Yuktaseniya'.
The Mahabharata, the greatest epic and war poem of the world, is full of references of the duties, work, skill and greatness of the surgeons that attended on kings and armies. It describes in detail the various preparations to be made and precautions to be taken during the war time. When a king is on war he should store up articles, viz., oil, fat, honey, ghee and medicines. He should especially gather all the medicines, roots, and the four kinds of healers viz, toxicologist, surgeon, physician and thaumaturgist.
The best among the monkeys, being fruit-eaters took with them these divine roots and fruits and the divine medicines
Those monkeys having picked up all medicinal herbs, fruits and roots, made him keep them and spoke these words.Those mighty demons who desired a fight, sallied out all the six of them having anointed their bodies with all the medicinal herbs and perfumes.
Ramayana is also a rich store of references on this subject. References regarding kinds of medicinal herbs specially used for war-wounds are found in Ramayana. The subject of war-injuries, medical organisation and ethics in war is an unexplored field of research.
The two anecdotes, one from Ramayana and one from Mahabharata, given below will give the true conception of the clinical examination the military surgeon was doing and how the surgeons were called for surgical aid and the manner in which they behaved.
Susena addressed this excellent speech consoling Rama who was agitated owing to the grief of Laksmana's illness. He ensured Rama that Laksmana was not dead because his face is neither disfigured nor turned dark or lustreless. His face bears a lustrous and pleasing appearance. His palms are like lotus-leaves and his eyes are brilliant. He consoled Rama disapproving the appearance of dead.
The presence of great and skilled surgeons and physicians on the battlefield behind the lines is clear from the anecdotes in the Mahabharata, wherein we find that a great number of surgeons skilled in operative measures and equipped with many kinds of instruments and apparatuses poured into the tent where the wounded general Bhisma lay. They offered to treat him. But the heroic Bhisma asked Duryodhana to give generous and befitting presents of money to the surgeons and pay them honor and send them away. Bhisma wanted no sort of treatment. He considered that the greatest boon for a Ksatriya is death on battlefield and he wanted to covet it. He wanted to die with these arrows on which he was sleeping like lying on a bed. He even wanted to be cremated with those arrows on. His this last demand was applauded with grace.
- The Caraka Samhita published by Shree Gulabkunverba Ayurvedic Society, Jamnagar, India