Author: Sascha Kress

Black pepper, apart from being a culinary favourite, is an essential part of the Ayurvedic system of medicine and is widely used for the treatment of various ailments. There are several potential health benefits of black pepper for the body and brain, and many of them come from the black pepper compound, piperine: it acts as an antioxidant, pain killer and improves breathing. Oral administration of black pepper is also popular for reducing arthritis, asthma, upset stomach, bronchitis, bacterial infections and several other disorders. Some studies show that the application of black pepper on the skin reduces measles, nerve pain and itchy skin. Piperine also assists in cognitive brain functioning, boosts nutrient absorption and improves gastrointestinal functionality.

Pepper: Importance in Ayurveda

In Ayurveda, black pepper is known as Maricha. According to Dhanwanthari Nighantu and Raja Nighantu, yet another variety of maricha is known as swetha maricha (white pepper). The plant is identified by various names based on the morphological and sensory characteristics: it is called ‘vellajam/vallijam’ as the plant is a climber, ‘vrutha phalam’ as the fruits are round in shape, and ‘shirovrutham’ as the fruits have a minute cup on the top. The pepper plant is also called Ooshanam, theekshnam, rooksham, katukam, veeram etc. to describe its sharp pungent qualities.  As per Bhojana Kutuhalam, a book based on principles of dietetics and culinary art, Maricha is katu (pungent) and bitter to taste, laghu (light), teekshana (pierching/strong), sookshma (enters deep) in quality, undergoes pungent taste conversion after digestion, hot in potency and balances kapha and vata. It is known to cure jantu santanan nashanam (intestinal worm infestation), hrudrogahara (heart diseases), improves ruchikaraka (taste perception), treats shwasahara (respiratory disorders) and vishama jwara (recurrent fever), and cures disorders due to Vata dosha. It is an avrushya (anaphrodisiac) and also could induce periods when consumed orally by women. Black pepper extracts the fat deposition by blocking fat cell formation and therefore useful in obesity management. In Ayurveda, black pepper, long pepper and ginger are often used together in equal proportions in a preparation known as “trikatu”, a Sanskrit word meaning “three acrids”.  Out of 370 compound formulations listed in the Handbook of Domestic Medicines and Common Ayurvedic Remedies, 210 contain either trikatu or its individual ingredients. According to Ayurveda, the three acrids collectively act as kapha- vatta-pitta-haratwam (correctors of the three humors (doshas) of the human organism).

Author: Dr. Akhila K. Adisser

Note: The information and claims shared in this blog express the authors view or opinion.

Sushruta Samhita

Sushruta Samhita is an excellent reference for anatomy and surgery and also deals with the concept of creation, Shristi Utpatti krama (theory of cosmic evolution). Sushruta Samhita explains that the union of sperm (Shukra) and ovum (Aartava) does not guarantee the creation of life, and that a superior agent in the form of soul (Atma) is also necessary. The physiological, pathological, and therapeutic aspects of Tridosha theory of Ayurveda is described along with the types of sleep (Nidra) and dreams (Swapna).  The importance of time factor (kala), physiology of the human body (circulation of blood, formation of urine, etc.), pathology (description of various diseases, their causes, diagnosis, symptoms, treatment and diet), classification of diseases (Adhyatmika, Adhibhoutika and Adhidaivika vyadhis), toxicology, methodical surgeries (pre-operative- Purva-karma, operative- Pradhana karma, post-operative- Paschat karma measures) are documented in Sushruta Samhita. Before conducting the surgery on a human body, acharya Sushruta emphasises that the procedures be practiced on artificial objects like: excisions (Chedana) on fruits and vegetables, incisions (Bhedana) on urinary bladders and internal organs of dead animals, scraping (Lekhana) on animal skin covered with hairs, extraction (Aaharana) on pulp of the fruits, suturing (Sevana) on thick piece of cloth and bandaging (Bandhana) on full sized human figured made of clay.

Acharya Sushruta also explains the distinct types of surgical instruments (yantras and shastras), methods of sterilization, 8 types of surgical procedures (ashta vidha shastra karma), 60 types of management of wounds (Shashti upakrama). He also covers in in detail about the anatomy and location of veins and arteries (siras), nerves, soft tissues, etc (dhaminis), vital organs (marma). Special treatments like fire and alkali cauterization (agnikarma), blood-letting (rakta mokshana) and venesection (sira vyadha) are also explored along with grafting.

Anatomical studies

Sushruta Samhita insists on comprehensive and extensive learning of both theoretical and practical aspects of medical profession, especially surgical knowledge if one needs to provide service to the mankind in the form of a capable doctor. The Sarirasthana is made up of 10 chapters regarding the study of human anatomy in which it is mentioned that:

‘The different parts or members of the body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, any one desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully, observe, by dissecting it, and examine its different parts.’

Dissection

Due to the restrictions of the religious laws of that time, Acharya Sushruta had to develop methods that would allow him to work within the confinement of the law.

‘Therefore, for dissecting purposes, a cadaver should be selected which has all of whose parts of the body present, of a person who had not died due to poisoning, but not suffered from a chronic disease (before death), had not attained a 100 years of age and from which the faecal contents of the intestines have been removed. Such a cadaver, whose all parts are wrapped by any one of “munja” (bush or grass), bark, “kusa” and flax, etc. and kept inside a cage, should be put in a slowly flowing river and allowed to decompose in an unlighted area. After proper decomposition for seven nights, the cadaver should be removed (from the cage) and then dissected slowly by rubbing it with the brushes made out of any of usira (fragrant roots of plant), hair, bamboo or “balvaja” (coarse grass). In this way, as previously described, skin, etc. and all the internal and external parts with their subdivisions should be visually examined’

He considered the study of a dead human body essential for understanding the human anatomy. In Sushruta Samhita, the dissection of a dead body was initially conducted by Acharya Sushruta and was followed by his students as a tool to understand the anatomy. As mentioned in Sushruta Samhita, medical students should learn the art of dissection in the body of a puspaphala (a type of gourd), alavu (bottle-gourd) or ervaruka (cucumber) prior to dissecting a human body. Sushruta monitored the dissection and preservation of the dead body with ultimate precision because of which all the minute details of the cadavers were recorded. The documentation included the organs, tissues, blood vessels, nerves, bones and joints along with their structure, quantity, shape, size, capacity, location and dimensions. This information was considered to be mandatory to become a surgeon.

The beginning of plastic surgery

Modern-day reconstructive surgery or plastic surgery is the improvised version of the surgery conducted by acharya Sushruta for repairing the nose of a person cut for adultery during that time. This implies that Acharya Sushruta had a good knowledge of the human facial anatomy. The procedure he followed for the surgery was:

‘First the leaf of a creeper, long and broad enough to fully cover the whole of the severed or clipped part, should be gathered; and a patch of living flesh, equal in dimension to the receding 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 affected and then insert two small pipes into the nostrils to facilitate respiration, and to prevent the adhered flesh from hanging down. After that, the adhered part should be dusted with [hemostatic] powders; and the nose should be enveloped in Karpasa cotton and several times sprinkled over with the refined oil of pure seasmum’.

Piercing of the earlobes and consequent enlargement of the hole was a ritual in ancient India to ward off evil. This practice led to tearing of the earlobes. Acharya Sushruta reconstructed the pedicle flap by grafting a piece of skin taken from the adjacent area and reattaching it without hampering the vascular supply.

‘A surgeon well versed in the knowledge of surgery should slice off a patch of living flesh from the cheek of a person so as to have on its ends attached to its former seat (cheek). Then the part, where the artificial ear lobe is to be made, should be slightly scarified (with a knife) and the living flesh, full of blood and sliced off as previously directed, should be adhered to it (so as to resemble a natural ear lobe in shape). The flap should then be covered with honey and butter and bandaged with cotton and linen and dusted with the power of baking clay.’ Again, such a procedure would necessitate a good working knowledge of human anatomy of the facial region including blood supply.’

Acharya Sushruta also treated cataract as he studied the eye and delineated the five anatomical divisions of the eye: eyelashes, eyelid, sclera, choroid and the pupil.

Author: Dr. Akhila K. Adisser

Note: The information and claims shared, opinions and views expressed, belong to the author.

Anatomical study in ancient India and importance of Sushruta Samhita

Anatomical knowledge in ancient India was derived principally from animal sacrifice, chance observations of improperly buried human bodies and examinations of patients made by doctors during treatment. The Vedic philosophies form the basis of the Ayurvedic tradition, which is one of the oldest known systems of medicine. Two sets of texts form the foundation of Ayurvedic medicine, the Sushruta Samhita and the Charaka Samhita. The Sushruta Samhita provided important surgical and anatomical information of the understanding of anatomy by Indians in the 6th century BCE. Healing traditions were part of the medical practices and are still tied to the current knowledge of the medical sciences, particularly anatomy. As one of the oldest civilizations, India is rich in such history and tradition, which includes significant contributions to our understanding of human morphology. The basics for modern Indian ayurvedic medicine are found in ancient texts written around 4000 years ago. The developmental history of ancient India can be divided into three periods: the Vedic (c. 1500–500 BCE), Brahmanic (600 BCE–1000 CE) and Mughal (1000 CE until the 18th century).

The Vedic philosophies were compiled in the Vedic period and form the backbone of the ayurvedic traditions. Hindu religion is derived from the four Vedas, which are the oldest religious texts in Sanskrit. These Vedas contain rituals, hymns, incantations and also focuses on various health and medicinal practices. In the scriptures, Ayurveda consists of eight parts (ashtanga) which includes major surgery (Salya), minor surgery (Salakya), treatment of diseases of the body (Kayaacikitsa), demonology (Bhutavidya), healing of diseases of children (Kaumarabhrtya), toxicology (Agadatantra), elixir (Rasayana) and aphrodisiac (Vajikarana). Sushruta Samhita and Charaka Samhita, two sets of ancient texts, form the foundation of Ayurveda.

Acharya Sushruta and the origin of Sushruta Samhita

Acharya Sushruta is regarded as the ‘Father of Indian Surgery’ because of his prolific contributions to the science of surgery as he took surgery in medieval India to admirable heights. Acharya Sushruta was a famous physician and surgeon in the sixth century BC who was known for his surgical wisdom, practices and tools. Sushruta Samhita is therefore, a text on his work on surgery, use of instruments and types of operations: a text which is still significant in the modern era. The text also reveals that Acharya Sushruta gained knowledge of the human body by both inspection of the surface of the human body and human dissection. To expand his understanding, Acharya Sushruta had to overcome several barriers pertaining to the Hindu rituals followed for cremation of a body.

According to Hindu tenets, the human body is sacred even in death and therefore, no body above the age of 2 years should be violated by the knife and must be cremated in their original condition. Acharya Sushruta was able to study anatomy in human bodies as he was able to bypass this rule by scrapping off the skin and flesh without the dissector touching the corpse. His anatomical description of the human body included over 300 bones which could be due to the large number of child cadavers used for his study as many of the bones would not have fused. Thus, Acharya Sushruta offered an in-depth understanding of bones, muscles, joints, and vessels that surpassed the knowledge of the time.

Sushruta Samhita is arguable the oldest surgical textbook which literally translates to (that which is well heard). The Sushruta Samhita is divided into two parts: Purva-tantra and Uttara-tantra. The Purva-tantra is further divided into Sutrasthana (basic medical science and pharmacology), Nidana (disease processes), Sarirasthana (embryology and anatomy), Chikitasathanam (surgical procedures and post-operative management) and the Kalpastham (toxicology), totalling 120 chapters: the healing arts were divided into 5 parts which included the Rogaharas (physicians), Shaylyaharas (surgeons), Vishaharas (poison healers), Krityaharas (demon doctors), and Bhisagatharvans (magic doctors).

Author: Dr. Akhila K. Adisser

Note: The information and claims shared, opinion and views expressed, belong to the author.

Health benefits of black pepper

Black pepper is identified as a spice globally and is recognized by the heat it provides to the food when consumed orally. Black pepper is recommended for neurological, broncho-pulmonary and gastrointestinal disorders, (including dyspepsia, flatulence, constipation and hemorrhoids). The hot flavor is itensified when the pepper is consumed freshly. The alkaloid present in the pepper, piperine, stimulate the skin as well as the tongue. Thus, they were traditionally used as local anaesthetics as they act by depleting the sensory nerves of the body and in turn, causes desensitization of pain receptors. Black pepper along with long pepper were traditionally used to treat a broad range of gastrointestinal problems by increasing the protective gastrointestinal mucous secretion. This formulation of black pepper with long pepper was targeted to improve the digestibility of food and thus, used for the treatment of acute and chronic gastrointestinal conditions. Black pepper may also facilitate nutrient absorption by decreasing inflammatory conditions at the site of absorption. Other health benefits established after thorough research on black pepper include its anti-bacterial, anti-colon toxin, antidepressant, anti-fungal, anti-diarrhoeal, antimutagenic, antispasmodic, anti-thyroid and hepatoprotective properties.

Home remedies with black pepper

Daily diet

Black pepper could be used as a part of daily diet along with honey or clarified butter (ghee) for up to two grams a day. Black pepper could also be used to sprinkle over soups, added to fruit juices, smoothies or as an excellent substitute to red chilli.

Topical application

As mentioned in the Charaka Samhita, black pepper is used externally in the form of paste and cream for treating various skin-related diseases. External application of black pepper and coconut oil is known to cure itching. The pepper fruit powder is made into a paste with water and applied to the skin to improve blood circulation. Liniments flavoured with pepper oil are used for their heat-generating effect producing a counter-irritant effect. The pepper oil is also used in treating eczema, leucoderma and itching skin disorders. Brushing or gargling with black pepper powder and salt relieves tooth pain and has scraping effects which help in maintaining good oral hygiene. Hair loss caused by scalp ringworm could also be treated by applying black pepper with onion and salt.

Internal consumption

The ayurvedic formulation involving black pepper, ginger and long pepper (trikatu) along with ghee, rock salt and black salt is used to stop vomiting sensation and cure viral fevers. Black pepper is also orally consumed with asafoetida and ghee during dysentery. Jaggery and curd with black pepper is an ideal combination for treating chronic cold while black pepper with honey and ghee is for cough. Consuming crushed black pepper with a pinch of salt cures throat pain and consuming black pepper powder mixed with ghee and salt with rice cures indigestion. Black pepper with curd rice reduces the burning sensation of the urinary tract while a mix of milk, turmeric and black pepper powder cure cold and cough. An equal quantity of pepper, mint, tamarind and cardamom with salt tends to relieve stomach aches.

Side effects of black pepper

As black pepper is hot, it increases pitta and therefore, consumption of black pepper by people with gastritis or sensitive stomach should be avoided. Men with fertility issues should avoid consuming black pepper as it is anaphrodisiac and could induce more fertility problems. Pitta dominant people may be allergic to black pepper and could cause vomiting, diarrhea, abdominal cramps and watery eyes. Excess consumption could also cause abdominal pain, vomiting, burning sensation in the bladder, etc. Black pepper consumption should be monitored in women during pregnancy, lactation and in children.

Author: Dr. Akhila K. Adisser

Note: The information and claims shared in this blog express the authors view or opinion.