Charaka Samhita: World’s first physician

The west is fond of proclaiming Hippocrates (460 – 377 BC) as the father of medicine, but way before him in 500 BC Maharishi Charaka wrote the famous Charaka Samhita or Physicians’ Handbook. The Charaka Samhita went into great detail to describe human anatomy, pathology, diagnostic procedures, and treatment for various diseases. Charaka defined eight major medical disciplines of Ayur Veda: Shailya Chikitsa (surgery), Shaalakya Chikitsa (head, eye, nose, throat), Kaaya Chikitsa (mental health), Kaumarbhrutya Chikitsa (pediatrics), Agada Tantra (toxicology), Rasaayana Tantra (Pharmacology), Vaajeekarna Tantra (reproductive medicine). Charaka also described the functions of the heart and the circulatory system in great detail. The Charaka Samhita was widely translated in various languages and Charaka was a respected medical authority in both the Arab and Roman empires.

The Caraka Saṃhitā  or "Compendium of Caraka" is an early Ayurvedic encyclopedia on medicine. It is believed to be the oldest of the three surviving ancient treatises of Ayurveda. It is central to the modern-day practice of Ayurvedic medicine; and, along with the Suśruta Saṃhitā or "Compendium of Suśruta," it was an important source of medical and life understanding and practice in antiquity.

The work of Charaka is datable to the period 100 BCE -- 100 CE. However, the text of the Carakasaṃhitā, written in Sanskrit, was re-edited after Caraka, by one Dṛḍhabala, and this is the version transmitted in manuscript to modern times. It is probably datable to the Gupta period, 300-500 CE.

Sanskrit charaka is a term for a wandering religious student or ascetic.

There are several legendary accounts of the origins of medical science in South Asia. According to one, the serpent-king Śeṣa, who was the recipient of Ayurveda(Ayurveda), once visited the earth and finding it full of sickness he became moved with pity and determined to become incarnate as the son of a Muni for alleviating disease; he was called Charaka because he had visited the earth as a kind of spy or cara; he then composed a new book on medicine, based on older works of Agniveśa and Atreya pupils (Agniveśakr̥te tantre Charaka pratisaṃskr̥te)

The extant text has aṣṭāṅga sthāna (eight sections), totalling 120 chapters. These 8 sections are

1. Sūtra sthāna (30 chapters),

1. Nidāna sthāna (8 chapters),

1. Vimāna sthāna (8 chapters),

1. Śārīra sthāna (8 chapters),

1. Indriya sthāna (12 chapters),

1. Cikitsā sthāna (30 chapters),

1. Kalpa sthāna (12 chapters) and

1. Siddhi sthāna (12 chapters).

17 chapters of Cikitsā sthāna and complete Kalpa sthāna and Siddhi sthāna were added later by Dṛḍhabala (5th century). The text starts with Sūtra sthāna which deals with fundamentals and basic principles of Ayurveda practice. Unique scientific contributions credited to the Charaka Saṃhitā include:

• a rational approach to the causation and cure of disease

• introduction of objective methods of clinical examination

“Direct observation is the most remarkable feature of Ayurveda(आयुर्वेद), though at times it is mixed up with metaphysics. The Saṃhitā emphasizes that of all types of evidence the most dependable ones are those that are directly observed by the eyes. In Ayurveda successful medical treatment crucially depends on four factors: the physician, substances (drugs or diets), nurse and patient. The qualifications of physician are: clear grasp of the theoretical content of the science, a wide range of experience, practical skill and cleanliness; qualities of drugs or substances are: abundance, applicability, multiple use and richness in efficacy; qualifications of the nursing attendant are: knowledge of nursing techniques, practical skill, attachment for the patient and cleanliness; and the essential qualifications of the patients are: good memory, obedience to the instructions of the doctors, courage and ability to describe the symptoms.

The most celebrated commentary on this text is the Carakatātparyaṭīkā "Commentary on the Meaning of the Caraka" or the Ayurveda Dīpikā, "The Lamp to Ayurveda" written by [Cakrapāṇidatta] (1066). Other notable commentaries are Bhaṭṭāraka Hari(ś)candra's Carakanyāsa (c.6th century), Jejjaṭas Nirantarapadavyākhyā (c.875), Shivadasa Sena'sCarakatattvapradīpikā (c.1460). Among the more recent commentaries are Narasiṃha Kavirāja's Carakatattvaprakāśa and Gaṅgādhara Kaviratna's Jalpakalpatāru (1879).

"The Caraka (Vol I, Section xv) states these men should be, 'of good behaviour, distinguished for purity, possessed of cleverness and skill, imbued with kindness, skilled in every service a patient may require, competent to cook food, skilled in bathing and washing the patient, rubbing and massaging the limbs, lifting and assisting him to walk about, well skilled in making and cleansing of beds, readying the patient and skilful in waiting upon one that is ailing and never unwilling to do anything that may be ordered."

Surgery: 300 different types Operations, and 125 Surgical Instruments::

The ancient Indians were also the first to perform amputation, cesarean surgery and cranial surgery. Sushruta as early as 600 BC used cheek skin to perform plastic surgery to restore and reshape human nose, ears, and lips with incredible results. In his treatise, Shushruta Samhita, he classified surgery into eight types:

aaharya (extracting solid bodies),
bhedya (excision),
eshya (probing),
lekhya (sarification),
vedhya (puncturing),
visravya (extracting fluids), and
sivya (suturing).
Shushruta describes the details of more than 300 operations such as extracting solid bodies, excision, incision, probing, puncturing, evacuating fluids and suturing. Ancient Indians were also the first to perform amputations, caesarean and cranall surgeries with 42 surgical processes. He worked with 125 kinds of surgical instruments including scalpels, lancets, needles, catheters, etc. Sushruta even devised non-invasive surgical treatments with the aid of light rays and heat. Sushrata & his team conducted complicated surgeries like cataract, artificial limbs, cesareans, fractures, urinary stones and also plastic surgery and brain surgeries.

Chanakya's Arthashãstra describes post-mortems, and Bhoja Prabandha describes brain surgery, successfully performed in 927 AD by two surgeons on King Bhoja to remove a growth from his brain. Usage of anesthesia was well known in ancient India medicine. Detailed knowledge of anatomy, embryology, digestion, metabolism, physiology, etiology, genetics and immunity is also found in many ancient Indian texts.