Yogyasutreeya Surgical training in Sushrut period
- 1. WELCOME
- 3. 姻奪温姻恰則佺
- 4. Introduction Acharya sushruta explained about yogyasutreeya in sutrastana, prior to that initial chapters of sutrastana he talks on ayurveda utpatti, shalyatantra pradhanyata, guru, shishya, adhyayana kaala. In later chapter about sushruta samhita in nut shell. Then in Aa谷奪mUh奪r aboutmu誰, m谷klM端q誰 and m其iM端q誰, qualities of surgeon. In the 6th chapter he elaborately explains about Gicr誰, in 7th chapter rl則 , zx則 their qualities and uses. I think the Idea of Sushruta behind this type of frame work of chapter is, first made student aware about what he is going to learn in future like in Aa谷奪mUhr Akrr ,where in context of m谷klM端q誰 he says one should avoid incisions over qq誰xjl, but about qq誰 he talks in detail in shareera sthana .
- 5. r奪ar: M端i誰urM端q誰hxqrar奪ar iixS竪zM端q誰prx奪 r奪a i奪l r奪arm谷puii|| c蔵端 x x9/3 Before operating on patient directly one should practice surgical procedure on models which are similar to the human body structure.
- 6. ELIGIBILITY FOR r奪ar: Akaixu誰zx則j誰qmzwr r奪arM端Ur奪i巽| xl奪W短SwN奪短krSwc M端q誰mjqmSz奪i巽| xoW短卒i奪mrM端ir奪ar M端q誰xur奪ar奪 pui||x.x.9/3 The student though has understood the science fully should be made a fit for advising treatment, he should be instructed the practical methods of xl奪W短S mlcM端q誰 N奪短SlS A孫ukzx則M端q誰. Though a person having well theoretical knowledge if he does not do r奪arprx he is unfit for medical practice.
- 7. N奪短Slr奪ar(Excision) i則,mwmT端ssoM端slSM端則mx脱u誰 M端M端M端誰M端 m谷piwN奪短kruz奪wl巽Sz誰r奪i巽, EiM端i誰lmM端i誰ll c奪mSz奪i巽; Aim: To know application of force to excise different types of tissue with different surfaces and resistances. Model: pushpa phala, alabu, kalindaka, trapusa, kushmanda, Ervaruka, karkaruka,
- 8. p奪Slr奪ar (Incision) Sioxim谷x奪uM端m谷piwSM端m臓短mh奪誰 wp奪賊r奪ar;Aim: To know about the thickness of the wall which is to be penetrated. Consistency of the fluid inside. Model: water filled leather bag and bladder of the animals filled with mud or materials of various consistencies.
- 9. s奪Zlr奪ar (Scraping) xU奪qh cq誰hrii奪 s奪Zrxr; Aim: To scrape the area with delicate balance of knife avoiding injury to underlying structures. Model: Dead animal skin with hair or animal skin with warty transformations as seen over joints.
- 10. u奪krr奪ar (Puncturing) qimzxUximsls奪wc u奪krxr; Aim: To penetrate into vessel, gaining dexterity to enter the vessels with precision and accuracy. Model: Vessels of dead animal, lotus stem.
- 11. Lwhr奪ar(Probing) bh奪mW短iM端孫u奪hlslszwM端so qZ奪wu奪wrxr; Aim: To trace the path with least resistance. Model: On worm eaten hollow pieces of dry wood, Bamboo stem, Dried Alabu.
- 12. AW短Uhr奪ar (Extraction) mlxoqoosuT端sqqimzSli奪wuW短 r誰xr; Aim: Go to the base or behind the object and pull out. To appreciate the optimum grip and force and to remove the foreign body causing least damage to the surrounding structures. Model: bimbi, bilva, Jack fruit, teeth of the dead animals.
- 13. ux谷uhr奪ar(Dainage) qkcN短孫奪msmi奪zsqsT端sM奪端 ux谷urxr; Aim: To make superficial incision not to going beyond skin. Model: surface of shalmali coated with bee wax.
- 14. xulr奪ar (Suturing) x造qblux則lir奪qScq誰lir奪其 xurxr; Model: thin - thick cloth or leather, thin - thin cloth or leather, thick - thick cloth or leather. Aim: Approximation of edges and suturing the wound.
- 15. olklr奪ar (Bandaging) mxiqrmwβ｜m谷irβ｜暫uz奪w奪w olklr奪ar; Aim: 14 types of bandaging to suit the wounds at different locations of the body. Model: Tying bandages round the specific limbs and parts of dummies.
- 16. Aal造Ur奪ar qSw qxZhQ奪短wual造Ur奪ar, Aim: Application of pratisaraniya kshara and different types of agni karma To Appreciate kshara and agni dagdha lakshanas. Model : flesh of animals.
- 17. M端h誰xlkolklr奪ar qScq誰qxm奪zwimsls奪wc M端h誰xlkolklr奪ar Aim: Reconstruction of tissue Model : On skin, soft muscle or flesh, stem of lotus lily.
- 18. mQ短lr奪ar ESM端mh誰bO短m袖誰x谷奪ixrsoqZS w c l奪則m谷hkloxiu谷hoximQ短lr奪arqi|| x.x.9/4 Aim : Proper insertion of bastinetra into the opening. Maintain same pressure throughout the process of basti pranidhana. Model: Pitcher containing water with lateral opening, Alabu.
- 20. CURRENT DAY PRACTICE: SIMULATION: It is process of designing a model of a real system and conducting experiments with this model for the purpose either of understanding the behavior of system or of evaluating various strategies for the operation of system. CLASSIFICATION OF SIMULATIONS Model-based simulation Computer-based simulation Hybrid simulation
- 21. MODEL-BASED SIMULATION: MODEL: A three-dimensional representation of a person or thing or of a proposed structure, typically on a smaller scale than the original. This is mainly based on physical models. Procedures commonly include wound closure urinary catheterization, Vene puncture and I.V. infusion.
- 22. COMPUTER-BASED SIMULATION: Computer simulations are more realistic simulations in which computers create illusions of reality (VR). VR combines a convincing representation of an organ system or body region with the means to work with that image as if it really existed.
- 23. HYBRID SIMULATION: Hybrid simulators combine physical models with computers, using a realistic interface. This avoids some of the technical difficulties associated with reproducing the feel of instruments and human tissue.
- 24. BENEFITS OF r奪ar: LuqSwq奪kur奪arW奪誰短wrjuk| S狸ur奪wr奪arM端u誰h奪 l m谷q遜i M端q誰x|| ixqi巽M端脱zsqlucN短l巽zx則造UalM端q誰x| rxr r則奪W短xkqr誰i則 r奪arxqcU奪i巽||x.x.9/5-6 The student who has been made fit by the use of the things which are suitable for practical training, does not get confuse in the profession. Hence, students who desire to expert in zx則造UalM端q誰 should do practical work on similar models.
- 25. CONCLUSION: Sushrutas method of training and practice of surgery acceptable till date. Sushruta designed experimental surgery to arouse active interest in the subject and to give a permanent mental impression of the basic surgical procedures. Sushrutas concept still remains valid ,application may differ.