Talk:Military Surgery

Introduction

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 spearhead 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 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 are 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 experts in toxicology and thaumaturgy. The physician is warned to preserve the king's 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 disease, injury, poison, and evil charms.
• The organization headed by the physician pitched its separate tents near the royal tent and flew a special flag overhead to distinguish it. In a big encampment just beside the tent of the king, the physician should be present, fully equipped. The persons afflicted with poison, darts, and disease approach him following the flag on his tent.
• The physician who is adept in his 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, clothes, 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 a curer of his army. In addition to this, he was expected to know the art of

1. How to kill hunger.
2. How to increase the power of marching.
3. How to increase the power of eyesight.
4. How to disseminate various diseases in the enemy's camp.
5. 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 smoke and other mixtures to vitiate water against his enemy.

Precautions in Military Camp

No fire, except the sacrificial one should be lit 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 lit inside.

One should collect the divine medicinal herbs that 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 the 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 several operating surgeons in the military hospital with complete equipment. Physicians who were experts in the extraction of arrows were fully equipped and coached well by the skillful teachers. Treatment in the military hospital was for three kinds of patients afflicted by:

1. Poison
2. War injuries
3. Ordinary diseases

Code of Conduct for the War

Princes and warriors were expected to possess sufficient knowledge of various branches related to military operations. War ethics of 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 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 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.

Literary References

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 military surgery under the name of 'Yuktaseniya'.

The Mahabharata, the greatest epic and war poem of the world, is full of references to the duties, work, skill, and greatness of the surgeons who attended to kings and armies. It describes in detail the various preparations to be made and precautions to be taken during wartime. When a king is at 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.

Ramayana references:

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 organization, and ethics in war is an unexplored field of research.

Other Anecdotes

The two anecdotes, one from the Ramayana and one from the Mahabharata, show how military surgeons were called to provide care and how they acted.

In the Ramayana, Susena comforted Rama, who was distressed over Lakshmana’s condition. He assured Rama that Lakshmana was not dead because his face still looked healthy and bright, not dark or lifeless. Lakshmana’s eyes were clear, and his palms were still like lotus leaves, indicating he was alive. Susena explained that Lakshmana did not show the signs of death.

In the Mahabharata, skilled surgeons were present on the battlefield. After Bhisma was wounded, many surgeons, equipped with medical tools, came to his tent to offer their help. However, Bhisma refused treatment. He told Duryodhana to reward the surgeons with money and honor but to send them away. Bhisma believed that a warrior’s greatest honor was to die on the battlefield, and he wanted to pass away lying on the arrows, considering them his bed. He also wished to be cremated with the arrows still in him, a request that was met with respect.

References

• The Caraka Samhita published by Shree Gulabkunverba Ayurvedic Society, Jamnagar, India