‘A Curious Chirurgical Operation’

The story begins, of course, with a treacherous murder in March 1888 near the Karakoram pass. The victim was Andrew Dalgleish, a Scottish merchant operating around Leh and trading goods across the Karakoram. Dalgleish was also quite possibly a part-time British spy. This was the time of the Great Game, when Central Asia bristled with British and Russian spies trying to outwit each other for regional dominance. The British were terrified that the Russians were trying to wheedle their way into India, while the Russians were terrified that they weren’t terrifying the British sufficiently.

Dalgleish’s murderer was a bankrupt Pathan trader named Dad Mahomed.

The next summer, the British government despatched army intelligence officer Hamilton Bower to the region with a simple mission. Somewhere in the vastness of Central Asia, the vile murderer Dad Mahomed hid. Perhaps with Russian connivance. All Bower had to do was to find him and bring him back.

Bower immediately embarked on this, the most vague assignment thinkable, with alacrity. His pursuit brought him to the village of Kuchar in modern-day China. Bower later recalled:

“At Kuchar, where I halted for several days, a Turki who had been in India used to come and sit with me in my room in the straw. One day in conversation he told me about an ancient city he knew of built underground in the desert. I thought at first that he meant one of the ordinary buried cities of the Gobi Desert; but he insisted that it was something quite different, and explained that it was underground by the wish of the people that made it, not by reason of a sandstorm. He told me, also, that he and one of his friends had gone there and dug for buried treasure, but had found nothing except a book, I asked to see it, and, going away, he returned in about an hour, bringing some sheets of birch bark covered with writing in a Sanscritic character and held together by two boards. I bought them from him, and it was fortunate I did so, as they have since excited a considerable amount of interest in the learned world..."

Bower sent the manuscript to the Asiatic Society of Bengal, which at the time served as something of a clearing house for explorers, historians, archaeologists and all the other manifestations of nineteenth-century Indology. The manuscript baffled the Society’s experts. Mainly because they couldn’t read a word of it. It was written in a language they had never seen before.

To make sense of it, therefore, someone had to first decode it and then read it. And that unenviable job was enthusiastically taken up by a fascinating character called Augustus Frederic Rudolf Hoernle.

Hoernle was born to a family of German missionaries in Secunderabad in 1841. He was then educated in Germany, Switzerland and finally England. By now ordained into the priesthood, Hoernle spent an extra year in England studying Sanskrit at University College, London. Little wonder then that soon after coming to India, Hoernle switched from teaching the gospel to teaching Sanskrit and philosophy at the Jay Narayan College in Benares. It was there that Hoernle developed a relationship with the great spiritualist and reformer Dayanand Saraswati, about whom he wrote a book, Hoernle’s first one.

By the time the Bower Manuscript had arrived in Calcutta, Hoernle was principal of the Calcutta Madrasa. In addition, the British government had appointed him to look at all the manuscripts and archaeological finds arising from Central Asia. Which is how the Bower Manuscript fell into his hands and became something of an obsession for the rest of his life. Over the next decade, Hoernle began to decipher, translate and analyse the manuscript. And he began publishing excerpts in instalments starting from the mid-1890s. Hoernle arrived at the conclusion that it dated from around the late fourth or early fifth century CE. More recent scholarship suggests that it dates from around 650 CE.

It doesn’t matter which date you go with. Either way, the Bower Manuscript was a milestone. At the time it was the oldest Indian document ever found in India.

The manuscript itself, Hoernle found, was a collection of seven texts. Two were guides to fortune-telling, two were descriptions of Buddhist rituals and three were ancient medical manuals. Medical manuals of great sophistication.

The June 1895 issue of The British Medical Journal had a brief note on the finding subtitled ‘The Most Ancient Sanskrit Medical Treatise Extant’.

The note outlines some of the contents of the medical manuals: formulae for powders, medicated ghee and medicated oils; formulae for enemas, aphrodisiacs and hair washes; and treatments for children, barren women, and women with children.

The editors of the Journal seem cautiously impressed:

“No doubt many of the articles of the Hindu materia medica are of important therapeutic character and might with advantage be tested in hospitals; but a collection of complex farragos prescribed according to a fanciful and erroneous pathology is practically useless."

You can almost hear the posh voices squirm.

In one fell swoop, the Bower Manuscript confirmed everything that hitherto had been a matter of conjecture. It provided dated, documentary proof that India had a sophisticated medical tradition that went back to at least 650 CE and even much earlier. (After all there is nothing to suggest that medical manuals in the Bower Manuscript is a first edition. For all we know it could be a copy of an older original text. Thus potentially dating back this medical knowledge by many years.)

Sadly, the part of the manuscript that were medical manuals is incomplete. The complete document would have been a work of medical genius perhaps unmatched in the ancient world.

In the opening chapter, the Bower Manuscript talked of ten holy men who lived in the Himalayas, with minds of a medical bent. They are called Atreya, Harita, Parasara, Bhela, Garga, Sambavya, Vasistha, Karala, Kapya and, our old friend, Sushruta. The medical manuals of the Bower Manuscript prominently quote the works of three of these masters: Charaka, Bhela and Sushruta.

Finally, one of the most popular figures in ancient Indian science had made an appearance in a document of undisputed antiquity.

We can now say that at least by around 650 CE someone called Sushruta was widely held to be one of the great ancient medical scientists, and that some medical knowledge popular in this period was attributed to his body of work. This body of work, the Sushruta Samhita, may date as far back as 800 BCE. But must have been widely known at least by 650 CE, in order to merit mention by the authors of the Bower Manuscript.

We also know, thanks to the manuals in the Bower Manuscript, that by 650 CE, India already had a sophisticated understanding of disease and medicine. So would it be surprising to know that they also knew advanced surgical techniques? Not entirely. But what did they know? And how good were they at constructing prosthetic noses?

The Sushruta Samhita is, to put it mildly, mind-blowing. It is astonishing that while the existence of this text is taught to most Indian school children, the contents are often ignored. It describes, for instance, 76 types of eye-diseases, 121 sharp and blunt instruments used in surgery, 42 surgical processes and 700 plants of medicinal value divided into 37 groups of diseases.

In Chapter 16 of the first book of the Samhita, the Sutrasthana, the text outlines a particular surgical process.

“Now I shall deal with the process of affixing an artificial nose. First the leaf of a creeper, long and broad enough to fully cover the whole of the severed or clipped off part, should be gathered; and a patch of living flesh, equal in dimension to the preceding leaf, should be sliced off (from down upward) from the region of the cheek and, after scarifying it with a knife, swiftly adhered to the severed nose. Then the cool-headed physician should steadily tie it up with a bandage decent to look at and perfectly suited to the end for which it has been employed. The physician should make sure that the adhesion of the severed parts has been fully effected and then insert two small pipes into the nostrils to facilitate respiration, and to prevent the adhesioned flesh from hanging down."

Boom. Here was a process to restore a severed nose, written down at least 1400 years ago.

Excerpted with permission from Rupa.

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