The Demonstration of Signs and Symptoms of Sushruta

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Foreword

It is a matter of great pleasure to write a foreword for the book on demonstration of signs and symptoms based on Sushruta’s concept, written by Prof. S. Dattatreya Rao of S.V. Ayurvedic College Tirupati, and a brilliant student of mine.

Knowledge is the fruit of labour and only if man is possessed of knowledge can he generate ideas of importance. Ideas require acceptance and adoption, if they are to exert influence. It is indispensable therefore, that knowledge and ideas be deposited in reservoirs in the form of books.

Dr. S. Dattatreya Rao did the same in depositing his knowledge and ideas in the form of a book for the benefit of students. The author has put in lot of efforts in bringing out the book on clinical demonstration of signs and symptoms based on Sushruta’s conceptions of diagnosis scattered in various chapters of Sushruta Samhita.

The Ayurvedic diagnosis is of two fold, comprising of Rogi pariksha and Roga pariksha separately. Surgical concepts of Sushruta are still relevant in the practice of surgery. The clinical diagnosis of a disease is more important for the success of any surgical procedures. Sushruta’s approach to diagnosis based on dosha-dusha, Kriyakala and shadvida pariksha of a patient for clinical diagnosis through five sense organs supported by interrogation of a patient is a unique for the practice of surgery.

The knowledge of Kriyakala and ability of Physician or a surgeon to clinch diagnosis early is of paramount importance. Early diagnosis and early intervention is the main aim of the concept of kriyakala. The subject of Shalya in class rooms and hardly any bedside clinical training is given based on classical description by demonstrating the signs and symptoms over the patient. There is a need of producing good study material on clinical methods and diagnosis in the subject of Shalya with appreciable rationality and practical bias.

The author has rightly taken up the task of writing such book for the benefit of the students. He has taken great pains to compile and collect the various scholarly commentaries and tried to compose and contrast them to elucidate the real interpretation of global resurgence of the interest towards Ayurveda. This book in English language will serve as a guide book for the students and practitioners interested in the practice of surgery.

The author of this book, Dr. S. Dattatreya Rao is a scholar, a capable teacher and a practicing surgeon. I congratulate the young author for his brilliant work and wish that many more such useful books may come out from his versatile pen.

Prologue

Sushruta The ancient Indian surgeon has given utmost importance to the clinical examination in deciding the disease pattern. Many of the signs and symptoms given in various chapters are the state of art descriptions and easy to follow. Students can practice and understand the symptoms narrated by Sushruta. The symptom complexes were the tools in the ancient time to go to such a deep understanding of the disorder. The symptoms and signs shown in various places are noteworthy and unique.

Not only the symptoms are elaborative, the signs of Sushruta Samhita are also very much impressive. The basis of diagnosis, the progress and the Prognosis was determined by the symptomatology. The pin pointed diagnosis was based on the signs of the Tridoshas vitiation and their symptoms in different conditions.

Those were the days when people use to diagnose the disorder with out any aid, and purely depending on the clinical exams. Hence Sushruta emphasized much on the use of all available five senses to understand the disease process. It is also notable that taking the history of the patient by way of interrogation, was also equally important and included as prashna pareeksha in Six ways of examination.

Here is this work an effort is made to bring in a comprehensive text on these scattered symptomatology. In surgery particularly in emergencies, the surgeon should act very swiftly as if the house is put on fire. In such a situation the correct diagnosis will be the key aspect that plays the central role in the successful management.

The total work is based entirely on the Sushruta Samhita and here and there the views from other authors are also given for the comparison. The Book comprises two sections; one will deal about the aims and scope of the book, different methods of clinical examination enumerated by Sushruta and other authors. They include the Trividha, Chaturvidha, Shat vidha and the Ashta stana Pariksha. The dasha vidha Pariksha of Charaka and Sushruta are also discussed.

In the following chapters the elaboration and explanation of these theories and the details of each and every point of the methodology of clinical evaluation for diagnosis is discussed. The different theories covered under this are Pancha lakshanas Nidana, Nidana Sthana and it’s importance, Samprapti; a special fundamental assessment of the disorder, and the sequel of events in the process of pathogenesis is also briefed. The Dosha Dhatu and Mala vignana, Agni: Antar Agni; Dhatwagni, Bhoota. Agni vyapara, Srotases, their physiological functions pathological states & manifestations, the Shat kriya kalas and their application in the treatment are discussed.

Part two deals with the details of the signs and symptoms of different surgical conditions in elaborative manner. The relevance of these signs and symptoms is emphasized. The methods of eliciting and the demonstration of the physical signs are explained. Wherever possible the graphical presentations are given either with the Photograph or drawing.

Over all, the entire book is aimed at the development of clinical methods in Ayurveda. It is also tried to incorporated certain pictures and depict of the tables wherever necessary. It is aimed at impress the student, the teacher and the researcher to stress up on the need of diagnosing the ailment before starting the treatment. It also shows the profound technique of Sushruta who has diagnosed the surgical emergencies and all surgical problems with out the aids of modern day tools like scanning and imaging.

The present work took a long time to compile and compare. I have taken many advises and suggestions from my colleagues and teachers. In spite of meticulous survey and check, there may be many mistakes and mis-presentations. I affirm that all such mistakes if brought to the light can be corrected with in all the possible way. This is an effort to enrich the literature on Ayurveda particularly in the subject of Shalya, and I anticipate, which will be hailed by all.

About the Author

Dr. Siripurkar Dattatreya Rao, born on 22nd Aug. 1958, at Nizamabad in A.P., in a traditional family. His father was a Hindi teacher in Govt. High school. His mother Smt. Gangabai inspired him from the childhood to apt for the medical profession. he carried out his High school studies from the same town, passed the SSC with distinction and joined the intermediate in the Govt. Junior college in 1972. he was selected for the BAMS course in the Govt. Ayurvedic College in Hyderabad and stood University first. Later he was one of the few students selected for the first batch of Post graduation in Shalya at Hyderabad. He did his M.D. Shalya course under the Inspiring guidance of Dr. V.S. Patil and worked over the problem of Fracture Healing.

He was appointed as lecturer in TTD’s S.V. Ayurvedic College I 1987 and Promoted as Asst. Prof in 1992. He is elevated as Professor in the Department of Shalya in 2008. He did his Ph.D. from Pune University on the Studies of histo pathological and histo chemical changes in the tissues due to the application of Ksharasutra which was first of its kind.

He has published many articles in national and international journals of repute on Shalya. He is recognized as all India expert in the Ksharasutra technique. He represented in many bodies and working groups in Shalya. He is a contributor in National text book on Shalya to be published by CCRAS. He has also contributed few other books on Ayurveda. He has 25 years of teaching experience in department of Shalya, and he is a profound practitioner of Ksharasutra. He has so far undertaken more than 20,000 surgeries on all the anorectal disorders. He traveled extensively in and out of India.

He has been awarded the D.Sc degree by the Sri Lanka Open University and he is also a winner of best research paper award in 1996 in Pune. He was awarded the Talented Practitioners award in 1998 for his achievement in Ksharasutra surgery.

He is a person with feeling of social responsibility and has bent of mind towards helping the poor and deserved. He is attached with many social movements and took part for achieving the goal of Health to all. He loves the traditional ethos and human values.