Sushruta Samhita

The Suśrutasaṃhitā is of great historical importance because it includes historically unique chapters describing surgical training, instruments and procedures. The oldest surviving manuscript of the Suśrutasaṃhitā is MS Kathmandu KL 699, a palm-leaf manuscript preserved at the Kaiser Library, Nepal, dated to 878 AD.

History

Date

The most detailed and extensive consideration of the date of the Suśrutasaṃhitā is that published by Meulenbeld in his History of Indian Medical Literature (1999–2002). Meulenbeld states that the Suśrutasaṃhitā is likely a work that includes several historical layers, whose composition may have begun in the last centuries BCE and was completed in its presently surviving form by another author who redacted its first five sections and added the long, final section, the "Uttaratantra." It is likely that the Suśruta-saṃhitā was known to the scholar Dṛḍhabala (fl. 300–500 CE), which gives the latest date for the version of the work that has survived into the modern era.

In Suśrutasaṃhitā - A Scientific Synopsis, the historians of Indian science Ray, Gupta and Roy noted the following view, which is broadly the same as Meulenbeld's:

"The Chronology Committee of the National Institute of Sciences of India (Proceedings, 1952), was of the opinion that third to fourth centuries A. D. may be accepted as the date of the recension of the Suśruta Saṃhitā by Nāgārjuna, which formed the basis of Dallaṇa's commentary."

The above view remains the consensus amongst university scholars of the history of Indian medicine and Sanskrit literature.

Hoernle's view

The scholar Rudolf Hoernle (1841–1918) proposed in 1907 that because the author of the Śatapathabrāhmaṇa, a Vedic text from the mid-first-millennium BCE, was aware of Sushruta's doctrines, Sushruta's work should be dated based on the composition date of Śatapathabrāhmaṇa. The composition date of the Brahmana was itself unclear, added Hoernle, but he estimated it to be about the sixth century BCE. However, Hoernle's view was based on the unexamined assumption that the ideas about the human skeleton in the Suśrutasaṃhitā preceded those of the Brāhmaṇa. He seems never to have questioned this assumption.

Hoernle's date of 600 BCE for the Suśrutasaṃhitā was challenged by intervening scholarship over the last century. This scholarship was summarized by Meulenbeld in his History of Indian Medical Literature.

Central to the problem of chronology is the fact that the Suśrutasaṃhitā was the work of several hands. The internal tradition recorded in manuscript colophons and by medieval commentators makes clear that an old version of the Suśrutasaṃhitā consisted of sections 1-5, with the sixth part having been added by a later author. However, the oldest extant manuscripts include the sixth section, called "The Later Book" (Skt. Uttara-tantra). Manuscript colophons refer to the whole work as "The Suśrutasaṃhitā together with the Uttara-tantra," reinforcing the idea that they are a combined work. Thus, it does not make sense to speak of "the date of Suśruta." Like "Hippocrates," the name "Suśruta" refers to the work of many authors working over several centuries.

Further views on chronology

As mentioned above, scores of scholars have proposed hypotheses on the formation and dating of the Suśrutasaṃhitā, ranging from 2000 BCE to the sixth century CE. These views have been gathered and described by the medical historian Jan Meulenbeld.

Authorship

Sushruta or Suśruta (Sanskrit: सुश्रुत, IAST: Suśruta, lit. 'well heard', an adjective meaning "renowned") is named in the text as the author, who is presented in later manuscripts and printed editions a narrating the teaching of his guru, Divodāsa. Early Buddhist Jatakas mention a Divodāsa as a physician who lived and taught in ancient Kashi (Varanasi). The earliest known mentions of the name Suśruta firmly associated with the tradition of the Suśrutasaṃhitā is in the Bower Manuscript (4th or 5th century CE), where Suśruta is listed as one of the ten sages residing in the Himalayas.

After a review of all past scholarship on the identity of Suśruta, Meulenbeld concluded that:

As is obvious from the foregoing, it is rather generally assumed that we owe the main part of the Suśrutasaṃhitā or an earlier version of it to a historical person called Suśruta. This assumption, however, is not based on uncontrovertible evidence and may be illusory. The text of the Suśrutasaṃhitā does not warrant that the one who composed it was a Suśruta. The structure of the treatise shows without ambiguity that the author, who created a coherent whole out of earlier material, attributed the teachings incorporated in his work to Kāśirāja Divodāsa...

Religious affiliation

The text has been called a Hindu text by many scholars. The text discusses surgery with the same terminology found in more ancient Hindu texts, mentions Hindu gods such as Narayana, Hari, Brahma, Rudra, Indra and others in its chapters, refers to the scriptures of Hinduism namely the Vedas, and in some cases, recommends exercise, walking and "constant study of the Vedas" as part of the patient's treatment and recovery process. The text also uses terminology of Vaiśeṣika, Samkhya and other schools of Hindu philosophy.

The Sushruta Samhita and Caraka Samhita have religious ideas throughout, states Steven Engler, who then concludes "Vedic elements are too central to be discounted as marginal". These ideas include the use of terms and same metaphors that are variously pervasive in Buddhist and Hindu scriptures – the Vedas, and the inclusion of theory of Karma, self (Atman) and Brahman (metaphysical reality) along the lines of those found in ancient Hindu and Buddhist texts. However, adds Engler, the text also includes another layer of ideas, where empirical rational ideas flourish in competition or cooperation with religious ideas. Following Engler's study, contemporary scholars have abandoned the distinction "religious" vs. "empirico-rational" as no longer being a useful analytical distinction.

The text may have Buddhist influences, since a redactor named Nagarjuna has raised many historical questions, although he cannot have been the person of Mahayana Buddhism fame. Zysk produced evidence that the medications and therapies mentioned in the Pāli Canon bear strong resemblances and are sometimes identical to those of the Suśrutasaṃhitā and the Carakasaṃhitā.

In general, states Zysk, Buddhist medical texts are closer to Sushruta than to Caraka, and in his study suggests that the Sushruta Samhita probably underwent a "Hinduization process" around the end of 1st millennium BCE and the early centuries of the common era after the Hindu orthodox identity had formed. Clifford states that the influence was probably mutual, with Buddhist medical practice in its ancient tradition prohibited outside of the Buddhist monastic order by a precedent set by Buddha, and Buddhist text praise Buddha instead of Hindu gods in their prelude. The mutual influence between the medical traditions between the various Indian religions, the history of the layers of the Suśruta-saṃhitā remains unclear, a large and difficult research problem.

Sushruta is reverentially held in Hindu tradition to be a descendant of Dhanvantari, the mythical god of medicine, or as one who received the knowledge from a discourse from Dhanvantari in Varanasi.

Manuscripts and transmission

The oldest known manuscript of the Sushruta Samhita is preserved at the Kaiser Library, Kathmandu, Nepal as manuscript MS Kathmandu Kaiser Library 699. A microfilm copy of the MS was created by Nepal-German Manuscript Preservation Project (NGMCP C 80/7) and is stored in the National Archives, Kathmandu. The partially damaged manuscript consists of 152 folios, written on both sides, with 6 to 8 lines in transitional Gupta script. The manuscript has been verifiably dated to have been completed by the scribe on Sunday, April 13, 878 CE (Manadeva Samvat 301).

Much of the scholarship on the Suśruta-saṃhitā is based on editions of the text that were published during the nineteenth and early twentieth centuries. This includes the important edition by Vaidya Yādavaśarman Trivikramātmaja Ācārya that also includes the commentary of the scholar Dalhaṇa.

The printed editions are based on the small subset of surviving manuscripts that was available in the major publishing centers of Bombay, Calcutta and elsewhere when the editions were being prepared – sometimes as few as three or four manuscripts. But these do not adequately represent the large number of manuscript versions of the Suśruta-saṃhitā that have survived into the modern era. Taken together, all printed versions of the Suśrutasaṃhitā are based on no more than ten percent of the more than 230 manuscripts of the work that exist today.