Yantras are the blunt instruments and Sastras are the Sharp instruments that are considered as two important aspect of the Surgery. Surgical equipment have been identified as one of the main factors contributing to an infection outbreak following surgery, even in most successful cases. The Surgeons in the ancient time consist of good number of surgical instruments. Acharya Susrutha mentioned 20 types of Sastras.1Acharya Vagbhata mentioned 26 kinds of Sastras.2Haritha mentioned 12types of Sastras in HarithaSamhitha.3Palakapya mentioned 10types of Sastras in Hasthi Ayurveda(Treatment for Elephants).4

MATERIALS FOR INSTRUMENTS:

Acharya Susrutha says – ‘A Wise Surgeon should get the instruments made of pure iron and with sharp edges by an expert blacksmith who is skilful and experienced in his craft’.5 Acharya Charaka mentions to cut the navelcord of the newborn ardhadhara type of instrument made of gold, or silver or iron.6Yogarantakara mentioned a cautery of gold, to burn fistulous track around the anus.7

EDGES FOR SHARP INSTRUMENTS

Four different types of edges:8

• Masuri : Bhedana(incision) Eg: Vridhipatra, Nakhashastra
• Ardha masuri : Lekhana(scraping)           Eg :Mandalagra
• Kaishiki : Vyadhana(puncturing) Eg :Kutharika
• Visravana (draining) Eg: Kushapatra.
• Ardha Kaishiki : Chedana( excision) Eg :Vriddhipatra.
• But Acharya Vagbatta mentions as a Masuri

TYPES OF SASTRAS ACCORDING TO VARIOUS ACHARYAS:

Table no. 1 - Types of Sastras according to different Acharyas

TEMPERING OF SHARP INSTRUMENTS (SHASTRA PAYANA):

1)           Three types of tempering for sharp instruments:9

• Kshara payana : for chedana of shara, shalya and asthi.
• Udaka payana : for chedana, bhedana and patana of mamsa.
• Taila payana : for sira vyadhana and chedana of snayu.

2)           Acharya Vrudha Sharangadhara mentions about Payana of arrow heads with paste of Pippali, Saindhava and Kushta with Gomutra and heated to red hot. In another instance he mentions about smearing Sastras with Panchalavana, Sarsapa and Madhu and heat them in furnance followed by dipping in water. When the color resembling those of a peacocks feather are displayed then the burning is adequate.10

3)           Muni Sukracharya mentions the Payana of swords in Brihat Samhita. A milk from mare, a camel and an elephant, mixture of fish bile, deer milk, horse milk, goat milk, blended with toddy and then with Arka Ksheera, Aja sringa, Paravatha sakrut is fit for piercing stone.11

GOOD AND BAD QUALITIES OF SURGICAL INSTRUMENTS:

Acharya Susruta mentioned it should have a well-made handle, affording a firm grasp, it should be made of iron of good quality, it should have fine edge, a pleasant shape and a well finished point.

Acharya Susruta points out eight defects of the instrument – they must not be bent, or blunt, or broken, or jagged, or too thick, or too thin, or too long, or too short.12

Acharya Vagbatta also mentioned same defects.13

METHOD OF HOLDING SURGICAL INSTRUMENTS:

• Vruddipatra has to be held in Sadharana Bhaga i.e, junction between Vrunta and Phala. Other Shastras used for Bhedana should be used in the same manner.
• Vruddhipatra and Mandalagra have to be held in supine position most frequently for Lekana karma.
• Trikurchika, Soochi and Kusapatra which are used for Visravana have to be held at the terminal part of the Vrunta specially when operating on – Bala, Vrddha, Sukumara, Naari, Raaja and Raja Putra.
• Vrihimukha has to be held between the thumb and forfinger in such a way that the handle is completely covered by the palm.
• The handle of the Kutharika Sastra has to be held in the left hand and the stroke should be given by the middle finger with the help of fore finger of right hand such that movement is under the control of the thumb.
• Aara, Karapatra and Esani should be held at their Proximal end.

NISANA – SHARPENING OF THE INSTRUMENTS:

• According to Acharya Susruta – For sharpening the blade of the instruments a smooth stone slab of the color of masha varna(black gram) is used.
• For keeping the sharpened blade a pod of Shalamali fruits ( with silk cotton inside) should be used.
• SASTRA KOSHA – INSTRUMENT BOX:
• To preserve the edges of the cutting instruments, a case made of wood of Salmali(Bombax Malabaricum) was used.14
• It should be of 9Anguli width and 12Anguli length and compact, It should be made either from ksauma(linen – linseed), patra(thick and durable dry leaves), oma( wool), kauseya(silk), dukula(inner bark of trees) or mrudu charma(soft leather) bound with string. Well stiched with inner compartments for instruments kept wrapped in wool, its mouth should be clipped tightly with wire.15

ANCIENT INSTRUMENT CASE

DETAILED DESCRIPTION OF SASTRAS:

SIX ADDITIONAL INSTRUMENTS BY ACHARYA VAGBATTA :

1. SARPASYA – THIN BLADED CURVED SCALPEL : It has a blade of half anguli and is used for excision of polyps in nose and ears.(fig a)
2. SHALAKA – SHARP PROBE, CATARACT NEEDLE :It is made up of copper with two edges. It is used for vyadhana karma of linganasha (matured cataract).(fig b)
3. KARTTARI – SURGICAL SCISSORS : It is similar to household scissors, used for Chedhana ( Excision) of Snayu ( tendons), sutra (thread) and kaca ( hair).(fig c)
4. KURCHA – NEEDLE CLUSTER FOR PRICKING : It is bundle of 7 to 8 needles fixed on a single circular platform. All needles are cylindrical; 4Anguli in length and is used for kuttana (pricking) in nilika (bluish pigmentation of the body), vyanga( hyperpigmentation on face) and kesasatana (alopecia).(fig d)
5. KHAJA – CHURNER : Application end has eight spikes loaded on a circular platform. It is half Anguli diameter and is meant for blood – letting from the nose by churning with both hands.(fig e)
6. KARNAVEDHANI – EAR LOBE NEEDLE : It is suchi of 3Anguli length for puncturing the ear lobes, its tip resembling the shape of bud of yuthika ( jasmine) and one third of it being hollow.(fig f)

DISCUSSION:

The nomenclature of surgical instruments has evolved over time. Ancient surgeons closely observed nature and named instruments based on the resemblance of their shapes to animals, birds, or natural objects, such as Aatimukha and Shararimukha Śastras. In contrast, modern surgical instruments are often named after the scientists or surgeons who developed them, such as Kocher's forceps, Babcock's forceps, and Mayo's towel clip.

Acharya Sushruta emphasized that Śastras should be made from pure and strong iron. Modern metallurgy has further enhanced instrument quality by incorporating elements such as carbon, chromium, nickel, and silicon, resulting in stainless steel that is corrosion-resistant, durable, and capable of retaining a sharp cutting edge.

Several Śastras described by Sushruta, including Mandalagra, Vriddhipatra, Karapatra, Soochi, Badisha, and Eshani, continue to have similarities with modern surgical instruments and remain relevant in present-day surgical practice. Some instruments are used in modified forms; for example, Karapatra resembles the modern Gigli saw used for bone cutting.

The methods of handling surgical instruments described by Sushruta, such as pencil grip, fingertip grip, and palm grip, are remarkably similar to modern surgical techniques. He also stressed the importance of maintaining sharpness, proper storage, and appropriate indications for each instrument. The resemblance between ancient and modern surgical instruments highlights the advanced surgical knowledge of ancient Ayurvedic scholars and their lasting contribution to the field of surgery.

CONCLUSION:

Acharya Sushruta was one of the earliest surgeons to provide a systematic and detailed description of surgical instruments and their applications. His concepts regarding the design, quality, handling, maintenance, and indications of Śastras demonstrate a profound understanding of surgical science. The wide variety of instruments described in the classical texts reflects the advanced nature of Ayurvedic surgery and provides flexibility in instrument selection according to the surgical requirement. The striking similarities between several classical Śastras and modern surgical instruments further emphasize the scientific relevance of Sushruta's contributions. His pioneering work laid the foundation for the development of surgical instrumentation and operative techniques, justifying his recognition as the "Father of Surgery."

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