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Rhinoplasty And Congenital Megacolon By Acharya Sushrutha


By Dr Regina
In 1792 an Indian bullock cart driver named Cowasjee and 4 different Indian sepoys (Tilangas) who served the British had been captured by Tipu Sultan’s troopers at Srirangapatna. Their nostril and a hand had been lower off as a punishment for serving the enemy. They had been despatched again to the British Military the place Cowasjee turned a pensioner of the East India Firm.
Learn – Acharya Sushruta: Work, Samhita, Legacy, Amazing Facts

Historical past

Just a few months later, a British commanding officer whereas interacting with an Indian service provider observed an uncommon scar on his brow. On enquiring about it he got here to know that the service provider had his nostril lower off as a punishment for adultery. His severed nostril was reconstructed by a Maratha surgeon belonging to the Kumhar caste (a caste traditionally related to pottery). The commanding officer discovered the surgeon and requested him to reconstruct the nostril of Cowasjee and the 4 sepoys.

In 1793, the surgeon carried out the nostril reconstruction process on Cowasjee close to Pune, which was witnessed by two English medical doctors, Thomas Cruso and James Findlay on the Bombay Presidency. Ten months after the surgical procedure, an artist James Wales painted a portrait of Cowasjee which confirmed his newly reconstructed nostril and the remnant scar on his brow. This process was first reported in The Madras Gazette dated August 4, 1794. This detailed process was additionally printed within the Gentleman’s journal, London in October 1794. The Europeans who had no real interest in the Indian surgical procedures till then, had been fascinated on the success of the surgical procedure. Attributable to its uniqueness, this process got here to be generally known as ‘the Indian methodology’.

This surgical methodology, which was saved as a secret and practised in India for hundreds of years, is only one among the many lots of of procedures and methods which has been defined systematically within the Indian classical textual content, Sushruta Samhita, written by Acharya Sushruta.
Learn – Sushruta’s 8 Types Of Surgical Procedures – Astavidha Shastra Karma

Technique of Nostril reconstruction by Sushrutha

Sushruta Samhita Sutrasthana, Chapter 16, Verses 27-31 –

The leaf of a tree is lower within the form of the nostril. This piece of this leaf is positioned on the affected person’s cheek. The cheek muscle is lower to the identical dimension and the flap is raised. This tissue is straight away positioned on the mutilated nostril. The nostril must be scraped to trigger bleeding earlier than the tissue is positioned over it. Correct bandaging is finished whereas inserting two tubes (one for every nostril). Powders of Crimson Sandalwood, Licorice and so on. is sprinkled over it. A cotton swab is positioned and Sesame oil is sprinkled over it. The affected person is subjected to inside oleation utilizing ghee adopted by therapeutic purgation in accordance with the doctor’s recommendation. As soon as the nostril has healed, the surplus tissue is lower off for shaping the nostril. The identical process was used for the reconstruction of mutilated lips, however with out the insertion of tubes.

The approach carried out on Cowasjee by the Maratha surgeon was a modified methodology of Sushrutha’s methodology of Rhinoplasty.
Learn – Methods Of Surgical Training Elaborated In Ayurveda

Baddha gudodara

Dr. Harald Hirschsprung was the primary paediatrician in Denmark. He was appointed because the chief doctor in Queen Louise Kids’s Hospital, Copenhagen when it opened in 1879.

Between 1880 and 1885, Dr. Hirschsprung famous some similarities between the medical circumstances of two sufferers. The primary toddler had an absence of spontaneous bowel actions. Such a medical situation was not recorded wherever beforehand. The second case additionally had an identical presentation. Enemas got every day and laxatives had been used as therapy. He continued to deal with the affected person with out having sufficient information in regards to the situation. However the youngsters didn’t survive. Post-mortem was carried out which revealed that the rectum was narrowed, bowel loops had dilations and bowel partitions had been thickened.
Learn – Rectal Prolapse – Causes, Treatment, Useful Herbs

Dr. Hirschsprung introduced his findings in 1886 on the Berlin Convention of the German Society of Paediatrics. He has been acknowledged as the primary particular person to write down about this situation. Since then, the illness got here to be generally known as ‘Hirschsprung’s illness’ or ‘congenital megacolon’.

Dr. Hirschsprung held this title till a paper was printed in 2011, which acknowledged that Acharya Sushruta had talked about an identical situation referred to as ‘Baddha gudodara’, many centuries in the past in his e-book Sushruta Samhita.

‘Baddha’ means obstruction, ‘guda’ means rectum or anus and ‘udara’ means stomach distension. Baddha gudodara is a situation talked about in Sushruta Samhita Nidana sthana, chapter 7, verses 17-18. This situation happens as a consequence of purposeful obstruction of the rectum as a consequence of accumulation of doshas, meals, hair, stones and so on. Fecal matter will get gathered inside the lumen of the gut. This causes feces to be eradicated with nice issue and in small portions. The a part of the stomach between the center and umbilicus turns into distended. The affected person vomits supplies with a fecal odor.
Learn – Charaka Udara Roga Chikitsa – 13th Chapter

In Nidana Sthana, chapter 14, Sushruta mentions that this situation is incurable however has additionally talked about an in depth palliative surgical process. By an stomach incision made under the umbilicus, 4 finger breadths left to the median hairline, 4 finger breadths of loops of the massive gut must be pulled out. The gut is opened after cautious examination, to take away any supplies inflicting obstruction. The gut is then bathed in ghee and honey, changed again in its superb web site and the wound is closed by suturing.
Learn – Guda Marma: Anatomical Location, Effect Of Injury

A quick comparability
Congenital megacolon in accordance with fashionable medication Baddhagudodara in accordance with Sushruta
Attributable to failed migration of colonial ganglion cells throughout gestation Attributable to deraged Vayu, which will be understood as faulty neuromuscular power or faulty nerves
Constipation Passing of stools with issue and in small portions
Swelling of the stomach Distension of stomach, within the area between the center and umbilicus
Vomiting a inexperienced or brown substance Vomitus with a fecal odor

From the above references, it may be concluded that ‘Baddhagudodara’ talked about within the historic textual content Sushruta Samhita intently resembles ‘Hirschsprung’s illness’ or ‘congenital megacolon’ described by Dr. Hirschsprung.
Learn – Constipation Causes, Ayurvedic Treatment, Home Remedies

References

1. Jalaludheen, Syyed Mohammed. Define of Salyatantra. Varanasi, Chaukhambha Sanksrit Sansthan, 2014.

2. Mukherjee, Nayana Sharma, et al. “A NOSE LOST AND HONOUR REGAINED: THE INDIAN METHOD OF RHINOPLASTY REVISITED.” Proceedings of the Indian Historical past Congress, vol. 72, 2011, pp. 968–977., www.jstor.org/steady/44146788.

3. Roed-Petersen Ok, Erichsen G. The Danish pediatrician Harald Hirschsprung. Surg Gynecol Obstet. 1988 Feb;166(2):181-5. PMID: 3276016.

4. Frenckner B. Pionjär för pediatrisk forskning – omtyckt kliniker, mindre värderad föreläsare [The man behind the syndrome: Harald Hirshsprung. A pioneer in pediatric research – a popular clinician but less valued lecturer]. Lakartidningen. 1983 Nov 30;80(48):4664-5. Swedish. PMID: 6363841.

5. Raveenthiran V. Information of historic Hindu surgeons on Hirschsprung illness: proof from Sushruta Samhita of circa 1200-600 BC. J Pediatr Surg. 2011 Nov;46(11):2204-8. doi: 10.1016/j.jpedsurg.2011.07.007. PMID: 22075360.

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