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Surgery was widely used in Indian medicine. In the Ancient World, Indian surgeons performed the most elaborate operations. Over 121 different steel instruments were used to sew up wounds, drain fluid, remove kidney stones and to perform plastic surgery. An official punishment for adultery was to cut off your nose, so surgeons had plenty of opportunities to reconstruct and refine noses. Source of' pre-Christian era, such as the Ramayana mentions. remarkable feats of surgery as having taken place in the 65

23 legendary past. Thus we have reference to the transplantation of an eyeball; on another occasion the god Indra, rendered impotent by a curse, was cured by the transplantation of a Ram's testes The semi-legendary Jivaka, the famous physician of Buddha's day, is also reported to have performed remarkable cures involving deep surgery 24. What the best Indian surgeons could do in internal surgery was the removal of calculi from the bladder; the replacement of bowels exposed as a result of a wound, stitching the stomach wall; and Caesarean section in the case of mothers who died before giving birth. They were brilliant, however, at external operations, and their achievements in plastic surgery were unrivaled anywhere in the world until the eighteenth century, when the Indian art of rhinoplasty was studied by European surgeons. Yet the earliest Indian medical text, that of Caraka, does not mention surgical operations at all. Evidently, from the point of view of the compiler, surgery was an aspect of medicine beneath the notice of the vaidya, to be performed by 26 low caste 20 persons such as barbers. The Susruta Samhita, however, 66

devotes much space to the subject 27. From the point of view of the medical texts, the vaidya might incur grave ritual pollution. He might be compelled in his professional capacity to enter the homes of men of much lower caste than he, to touch the excreta of such people, and even to sip a few drops of their urine for diagnostic purposes. The texts do not apparently envisage purging ceremonies to expunge such impurity, and evidently the vaidyas generally took religious taboos quite lightly 28. As part of the student's training, it was not considered 鈥� improper for him to practice dentistry by extracting the teeth of dead animals 29, or to gain command of the scalpel by trying to make an incision in animals inflated bladder without cutting through it and releasing the air. 30 The taboo on contact with human corpses was so strong," however, that even the emancipated vaidya dared not infringe upon it. The practice of dissection of corpses 'had to fight against all the rules of archaic hygiene' (Zimmer 1948: 175), and, against a taboo based essentially on many generations of practical experience, it could not win. Susruta did the best he could to train his apprentices, by placing a new corpse in a basket in a 67

running river for a week. Thus, if we are to believe the textbook, the flesh disintegrates so that it may be removed by scrubbing with a long, stiff brush to expose the intestines, which may thus be studied without physical contact. This method may have been followed in practice, because the texts show more accurate knowledge of the lower viscera than of the brain and lungs, which are covered by bones and would not be rendered visible by such treatment. This is as far as the vaidya dared to go in the study of anatomy. No doubt he supplemented his knowledge by examining the bodies of those accidentally or judicially killed, 31 as 32 well as corpses on the battlefield. It would have been theoretically possible for him to hire the untouchables who served as executioners and cremation attendants to dissect corpses for him, but we have no record of this being done. Nevertheless there are accounts, all from texts of the earlier period, which show that the dissection of a corpse was not wholly unknown. 33 Ancient Indian doctors had no clear knowledge of the function of the brain, and believed with many ancient peoples that the heart 68

was the seat of intelligence. They realized, however, the importance of the spinal cord, and knew of the existence of the nervous system, though it was not properly understood. The progress of physiology and biology was impeded by the taboo on contact with dead bodies, which much discouraged dissection and the study of anatomy, although such practices were not completely unknown. Despite their inaccurate knowledge of physiology, which was by no means inferior to that of most ancient peoples, India evolved a developed empirical surgery. The caesarian section was well known, bone setting reached a high degree of skill and plastic surgery was developed far beyond anything known elsewhere at the time. Ancient Indian surgeons were expert at the repair of noses, ears and lips, lost or injured in battle or by judicial mutilation. In this respect Indian surgery remained ahead of European until the 18th century, when the surgeons of the East India Company were not ashamed to learn the art of rhinoplasty from the Indians. The Arthasastra ascribed to Kautilya, in its section on the detection and punishment of serious crime, recommends that the bodies of those dying in suspicious circumstances 69

should be preserved in oil for examination as to the cause of death, and refers to the examination of the contents of the stomach for traces of poison. A remarkable story concerning the emperor Asoka, occurs in a collection of Buddhist legends which exists in both Sanskrit and Chinese versions. We are told that Asoka in his later years took a young wife, Tisyaraksita, who made amorous advances to the crown prince Kunala, who indignantly rejected her, though he did not report his stepmother's evil conduct to his father. Soon after this, Asoka was taken seriously ill with a rare disease involving the most unpleasant symptoms. Tisyaraksita feared that if he died Kunala would come to the throne and punish her for her immoral behavior, and so she decided to restore Asoka to health at all costs. She told him that if he would grant her whatever boon she desired she would cure him, and he put himself entirely in her hands. She ordered a search to be made for a sick man with exactly the same symptoms as the king. When one was found he was brought to her in her private apartments, and she killed him on the spot. She cut open his stomach and found that it contained an 70

enormous worm. She treated the worm with strong arid pungent substances such as pepper and ginger, but it was unaffected. At last she tried onions, and these killed it. So she fed Asoka with large quantities of onions, which for obvious reasons are not normally eaten by high caste people. The worm was eliminated, and the emperor was cured. This story, incredible though it may be, surely indicates that in some circles. The drastic means used by the wicked queen to discover the cause and cure the king's illness indicates that ideas prefiguring modern scientific methods of investigation and experiment were at work. Nevertheless, the ineluctable taboo on contact with the dead prevented the development of anatomical knowledge, and it was not until 1835 that a vaidya strongly influenced by western ideas, Pandit Madhusudan Gupta, had the temerity to dissect a corpse (Keswani 1970-357). The complete ignorance and uncertainty of even the best educated Indians. of earlier times about the nature and functions of the various organs of the body is hard to realize nowadays. The interior of the body was almost as mysterious as the centre of the earth, which was the realm of wonderful snake spirits, nagas, who 71

dwelled in cavernous realms lighted by precious stones of unimaginable radiance. The body too contained a mysterious serpent power, kundalini, which could be raised by yoga from its seat at the base of the spine to pass through the vein susumna in the spinal cord, progressing through the six centers of force (cakra) to the topmost sahasrara, when the adept achieved highest bliss and immeasurable supernatural power. The fantastic doctrines of later yoga were questioned in the latter part of the nineteenth century by a young ascetic, Dayananda Sarasvati, who once on his wanderings came upon a corpse floating on a river, and decided to cut it open to examine the cakras. He found that they did not exist (Farquhar 1915- 106); and as a result of this and other practical experiments he founded a reformed Hindu sect, the Arya Samaj. Nevertheless, the practitioners of Hatha yoga, in India and elsewhere, still teach the reality of kundalini, susumna, the cakras, and sahasrara, though the more sophisticated claim that they are psychic entities, and not made of solid matter. 72