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While Ayurveda is often synonymous with herbal remedies, ancient Indian texts such as the Sushruta Samhita reveal a highly developed surgical tradition. Contrary to common misconceptions, classical Ayurveda integrated meticulous surgical protocols with medical expertise, spiritual mindfulness, and practical precision to ensure effective treatments.

Surgery in Ayurveda was never performed impulsively. The surgeon ensured all instruments were prepared and in optimal condition, with trained assistants offering crucial physical and emotional support. Transparency was fundamental—patients and their families were thoroughly briefed on risks and possible outcomes, especially in complex cases such as ectopic pregnancies or urinary calculus. Honesty was paramount, and surgeons were duty-bound to disclose potential complications in clear, authoritative terms.

Preoperative preparations were equally detailed. Patients fasted before surgery, a practice echoed in modern medicine, and operations were scheduled in alignment with favourable planetary positions—a testament to Ayurveda’s emphasis on cosmic harmony. The surgical room underwent purification, fumigated with medicinal herbs to maintain sterility. Before making the first incision, surgeons performed prayers, reinforcing the holistic nature of Ayurvedic surgery.

Pain management in ancient Ayurvedic procedures relied on herbal-infused wines—an early form of anaesthesia—while assistants ensured optimal patient positioning before the operation began. Ayurveda identified eight primary surgical techniques: excision, incision, scarification, puncturing, probing, extraction, drainage, and suturing. These were carried out with over 120 specialised instruments, including 20 sharp tools designed for precision work.

Suturing was regarded as a critical component of surgery, requiring careful spacing to prevent wounds from gaping open or causing unnecessary pain. The distance between stitches was optimised to ensure both structural integrity and patient comfort, reflecting an advanced understanding of wound healing.

Postoperative care was just as thorough as the surgery itself. Patients recovered in clean, well-ventilated spaces with carefully prescribed diets and medication. Bandaging techniques varied depending on climate, with different approaches tailored for hot and cold conditions. Beyond medical treatment, Ayurvedic philosophy saw the surgeon as a guardian of the patient’s wellbeing, embodying a paternal role that extended beyond technical expertise.

As interest in integrative medicine grows, these ancient protocols highlight Ayurveda’s comprehensive approach, which merged surgical skill with compassionate care and environmental mindfulness. Far from being limited to herbal therapies, Ayurveda offered a sophisticated and scientifically grounded system of surgery—one that continues to inspire modern medical thinking.

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