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Medical students today practise suturing on silicone pads before they touch a patient. The idea is old. A Sanskrit surgical text, the Sushruta Samhita, gives a whole chapter to training on models: fruit, leather bags, lotus stems and a cloth doll. This post covers what the text is, how old it is, what it says about training and surgery, and what any student, not only a future doctor, can take from it. It is history, not medical advice.
What is the Sushruta Samhita, and how old is it?
The Sushruta Samhita is a compendium of medicine and surgery in Sanskrit, named after the teacher Sushruta. Its date is debated. Some recent articles give very early dates; a 2024 review in Plastic and Reconstructive Surgery Global Open places Sushruta around 600 BCE. Specialists who work on the manuscripts are more cautious. Lisa Brooks, writing in History of Science in South Asia (2026), calls it "an early first-millennium Sanskrit surgical treatise", and the Suśruta Project, led by Dominik Wujastyk, describes it as composed "two millennia ago".
The manuscripts help. Brooks's edition draws on three Nepalese manuscripts, including "a palm leaf manuscript dating from 878 C.E., one of the earliest extant Sanskrit palm-leaf manuscripts of any genre." The text was copied and revised over centuries; the most widely cited printed edition, from 1938, was published with the 12th-century commentary of Dalhana.
How did the Sushruta Samhita train surgeons?
Chapter 9 of the first section (Sutrasthana) is about practical training. In Kaviraj Kunja Lal Bhishagratna's 1907 English translation, the teacher is told that a pupil who is "otherwise well read, but uninitiated into the practice" is not competent to treat patients. The chapter then lists a model for each skill:
Incisions: cuts on a gourd, watermelon or cucumber, in both upward and downward directions.
Opening a cavity: a full water-bag, the bladder of a dead animal or a leather pouch filled with slime or water.
Scraping: a piece of skin with the hair left on.
Venesection: the vein of a dead animal, or a lotus stem.
Probing: worm-eaten wood, a bamboo reed or the mouth of a dried gourd.
Extraction: pulling seeds from fruit such as bael or jackfruit, and teeth from the jaw of a dead animal.
Suturing: pieces of cloth, skin or hide.
Bandaging: a full-sized doll made of stuffed linen.
Inserting tubes: a pitcher full of water, or the mouth of a gourd.
The idea is to match a safe model to each skill. Modern simulation training follows the same logic: practise one skill at a time on something safe, then combine them.
What does the text say about rebuilding a nose?
Chapter 16 of the same section describes repairing a severed nose. In Bhishagratna's translation, a leaf is cut to the size of the missing part, a patch of living flesh of the same size is sliced from the cheek, its edges are scarified, and it is attached to the nose. The surgeon bandages it and inserts two small pipes into the nostrils so the patient can breathe and the new tissue does not sag.
Later Indian practitioners used a forehead flap instead. The PRS Global Open review describes how British surgeons in Poona saw such an operation in 1793, and how a letter in The Gentleman's Magazine in London in October 1794 brought the "Indian method" to European surgeons. Joseph Carpue performed the first English operation using it in 1814.
Did Sushruta's school study anatomy?
The PRS Global Open review notes that the text describes softening a body in river water for seven days so that its layers could be examined in turn, unusual at a time when many cultures forbade dissection. A 2026 study by Kenneth Zysk, also in History of Science in South Asia, traces this dissection passage through the manuscripts and argues that a similar gentle method in 12th-century Latin texts from Salerno probably came from Ayurvedic sources via Arabic translation.
What can a student learn from Sushruta's way of teaching?
The core idea of chapter 9 is that reading is not enough: a skill has to be practised, in parts, on something that can take mistakes. The same holds for a physics derivation, an organic mechanism or a long calculation.
Split the skill. Sushruta lists incision, suturing and bandaging separately. Split a hard topic the same way: for a mechanics problem, practise free-body diagrams on their own before full problems.
Find a safe model. Practise on low-stakes material first: a past paper you will not be graded on, a problem whose answer you can check.
Then combine. Only after each part is reliable, do full timed problems.
This is close to what psychologists call deliberate practice, explained in our post on Ericsson and deliberate practice. For the other great Ayurvedic text, see our post on Charaka and the Charaka Samhita.
If an idea in biology or physics is easier to understand by watching it than by reading it, the Fermi Simulation Lab has interactive simulations for ideas easier to see than read, a safe place to try things before an exam.
Try it this week: pick one skill you keep getting wrong, break it into three parts, and practise each part on its own five times.
