Sushruta Samhita, Sutrasthana 1.4
Shalya tantra pradhana — Shalya Tantra is the foremost (Pradhana) branch because it acts quickly and decisively where all other treatments are insufficient. The surgeon who can remove a Shalya (foreign body, tumour, or diseased tissue) in minutes achieves what months of medical treatment cannot. This is the unique power of surgery — and its unique responsibility.

The 120 classical surgical instruments

Sushruta Samhita, Sutrasthana 7 documents 120 Shastra (sharp instruments) and Yantra (blunt instruments/appliances) in precise categories: Swastika (cruciform — for exploring wounds), Sandamsha (forceps — 20 types), Tala (shield-like — for protection), Nadi (tube/probe — for fistula), Shalaka (probe rods), Upayantras (accessory instruments). The descriptions include dimensions, shapes, metals, and specific uses — sufficient detail that surgical historians have reconstructed several instruments.

Eight types of surgical incision (Ashtavidha Shastra Karma)

Charya (incision), Bhedana (puncture), Lekhana (scarification), Sravana (drainage/bloodletting), Sivana (suturing), Aharya (extraction — of foreign bodies, calculi, foetal parts), Visravana (evacuation — of fluid), Esana (probing). Each of these eight is documented with specific instruments, techniques, and post-operative care.

Rhinoplasty — the oldest documented nose reconstruction

Sushruta Samhita, Sutrasthana 16 documents the reconstruction of a severed nose using a pedicle flap from the cheek or forehead — the procedure performed on individuals who had been punished by nasal amputation. The description is sufficiently precise that British surgeons who encountered it in India in the 18th century (Gentleman's Magazine, 1794) were able to replicate it — this direct transmission led to the development of modern rhinoplasty techniques. The classical documentation is the oldest known surgical description of tissue flap reconstruction.

Linganasha Chikitsa — cataract couching

Sushruta Samhita, Uttarasthana 17 documents the Shalakakarma (needle operation) for Linganasha (blindness from lens opacity — classical cataract description). The procedure: a specially designed needle (Jalamandala Shalaka) is introduced through the lateral sclera, and the lens is displaced downward from the visual axis, restoring functional vision. This is the oldest documented cataract treatment in any medical tradition.

Modern significance
Shalya Tantra's historical significance is now well-established in medical history scholarship. The Rockefeller Foundation's history of surgery (Zimmermann, 2013), Harold Ellis's 'A History of Surgery' (2009), and multiple papers in the Journal of the Royal Society of Medicine document Sushruta's contributions as foundational to the global surgical tradition. The Indian rupee note historically featured Sushruta's image alongside Dhanvantari — reflecting his cultural and scientific status.
Shalya Tantra today
Modern Shalya Tantra in India is practiced as Ayurvedic surgery — a specialty combining classical procedures (Ksharakarma, Agnikarma, Jalaukavacharana, wound management) with modern surgical principles. BAMS surgeons with MS (Ayurveda) qualifications perform procedures in AYUSH hospitals and clinics. The field is most active in: haemorrhoid management (Ksharakarma), fistula-in-ano treatment (Ksharasutra — classified as superior to conventional surgery in multiple Indian clinical trials), and wound management using classical healing preparations.