Chapter X - The nursing and management of pregnant women

Now we shall discourse on the Sharira which treats of the nursing and management, etc., of pregnant women from the day of conception till parturition (Garbhini-Vyakarana-Sharira). 1.

General Rules:—

An enciente, from the first day of conception, should always cherish a clear joyful spirit in a clean body. She should wear clean and white garments, ornaments, etc., engage herself in the doing of peace-giving and benedictory rites and live in devotion to the gods, the Brahmins and her elders and superiors. She should not touch nor come into contact with unclean, deformed or maimed persons, and should forego the use of fetid smelling things, avoid dreadful sights and painful or agitating sounds and the use of dry, stale and dirty food as well as that prepared overnight. Long and distant walks from home, resorts to cremation-grounds or to a solitary retreat, or to a Caitya^[1], and sitting under the shadow of a tree should be absolutely forbidden (to her during the period of gestation). Indulgence in anger, fright or other agitating emotions of the mind should be deemed injurious. To carry a heavy load, to talk in a loud voice and all other things which might occasion injury to the fetus, (sexual intercourse, etc.) should be refrained from. The practice of constant anointment and the cleansing of the body, etc., (with Amalaki, Haridra, etc.—lit. cosmetics) should be given up. All fatiguing exercises should be discontinued and the rules laid down for the guidance of a woman in her menses should be strictly adhered to. The couch and the bed of a pregnant woman should be low, soft and guarded on all sides by a number of soft pillows or cushions. The food should be amply sweet, palatable (Hridya),^[2] well-cooked, prepared with appetising drugs and abounding in fluid substances. These rules should be followed up till delivery. 2.

Special regimen during the period Of Gestation:—

During the first three months of pregnancy an enciente should partake of food abounding in sweet, cool and fluid articles. Several medical authorities recommend a food made of Shashtika rice with milk, to be given to her specially in the third month of gestation, with curd in the fourth, with milk in the fifth and with clarified butter in the sixth month of pregnancy. Food largely composed of milk and butter, as well as relishing (Hridya) food with the soup of the flesh of jangala (wild) animals should be given to her in the fourth, food with milk and clarified butter in the fifth, adequate quantity of clarified butter prepared with (the decoction of) Shvadamshtra, or gruel (Yavagu) in the sixth; and clarified butter prepared with (the decoction of) the Prithak- parnyadi group in adequate quantities in the seventh month of gestation. These help the fetal development. For the purpose of restoring the Vayu of her body (nervous system) to the normal course and condition and for the cleansing of the bowels, the enciente should be given an Asthapana (enema), composed of a decoction of Vadara mixed with Vala, Ativala, Satapushpa, Palala (flesh), milk, cream of curd, oil, Saindhava salt, Madana fruit, honey and clarified butter. After that she should have an Anuvasana (enema) made up of oil prepared with milk and decoction of the drugs known as the Madhuradi-gana. This restores the Vayu to its normal course and condition, which brings on an easy and natural parturition unattended with any puerperal disorders. Henceforth up to the time of delivery the enciente should have liquid food (Yavagu) made up of emollient substances (fats) and soup of the flesh of Jangala animals (deer, etc.). If treated on these lines the enciente remains healthy and strong, and parturition becomes easy and unattended with evils. An enciente should be made to enter the lying-in chamber in the ninth month of her pregnancy and under the auspices of happy stars and propitious lunar conditions. The chamber of confinement (Sutika- griha) in respect of a Brahmin, Kshatriya, Vaishya and Sudra mother should be raised on grounds respectively possessed of white, red, yellow and black soils, and made of Vilva, Vata, Tinduka and Bhallataka wood. Couches should be made of these woods respectively in cases of the different social orders. The walls of the room should be well-plastered and the furniture (necessary accessories) should be placed tidy in their proper places. The door of a lying-in chamber should be made to face the south or the east, and the inner dimensions of the room should be eight cubits in length and four in breadth. Religious rites for warding off the visitation of evil spirits and malignant stars should be undertaken at (the door of) the room. 3.

Signs of imminent parturition—(M.—T.):—

A looseness of the sides of the abdomen and untying of the umbilical cord of the child (from the cardiac cord of its mother) and a perception of the characteristic pain at the waist would indicate the approach of the time of delivery. A constant and severe pain at the waist and the back, constant (involuntary) motions of the bowels and micturition and mucous discharge from the vulva are the symptoms which are manifest at the time a little before) of parturition. 4-5.

Preliminary Measures:—

Rites of benediction should be performed for the safety of the enciente in her travail and she should be made to pronounce benedictory Mantras surrounded by male babies on all sides. A fruit with a masculine name should be given in her hand. Her body should be anointed with oil and washed with warm water and she should be made to drink largely a gruel (Yavagu) made of articles (which exert a beneficial virtue at the time). Then she should be laid on her back on a soft and sufficiently spacious bed, her head being placed on a pillow and her legs slightly flexed and drawn up. Four elderly ladies with paired finger-nails and skilled in the art of accouchement and with whom she feels no delicacy, should attend and nurse her at the time. 6.

Then after having gently lubricated the mouth of the parturient canal along the natural direction of the pubic hairs (Anuloma) (so as not to create any discomfort in the part) one of them (elderly ladies) should address the enciente as follows:—“O fortunate damsel, try to bear down the child, but do not make such an attempt in the absence of real pain.” On experiencing an untying of the umbilical cord of the child, the enciente should gently make such urgings, whenever she will experience pain in the pelvic, pudendal and pubic regions and in the region between the neck of the bladder and the pelvis. Deep urgings should be made on the exit of the fetus out of the uterus, and after that deeper urgings should be made during the passage of the child through the canal until delivery. 7.

An urging (made by the enciente) in the absence of any real pain may lead to deafness, dumbness and deformity of the jaw-bones of the child or subject it to attacks of cough, asthma, consumption, etc., or lead to the diseases of its head, or to the birth of a haunch- backed or deformed child. A case of abnormal presentation (Pratiloma) should be converted into the normal or cephalic one (Anuloma) by version^[3]. 8-9.

In the case of protracted delivery, e.g., an obstruction of the child at the vagina,—the vagina should be fumigated with the fumes of the slough (cast-off skin) of a cobra (snake) or with the fumes of Pinditaka (Madana) or the roots of Hiranyapushpi (Kantakari) should be tied (round the neck or the waist) or Suvarchala (Atasi) or Vishalya (Patala) should be tied round the hand (wrist) and leg (ankle) of the parturient woman. 10.

Post-parturient Measures:—

The shreds or membranes lying on the body of the child should be removed immediately after its birth and its mouth should be cleansed with clarified butter and rock-salt. Then a linen pad soaked in clarified butter^[4] should be applied on the head of the new-born baby. Then the umbilical cord, after having been slightly drawn out, should be ligatured with one end of a string at a point eight fingers apart from its navel, the other end of the string being tied round its neck; then the umbilical cord should be severed immediately above the ligature, 11.

Natal Rites:—

Then having sprayed (the face of; the baby with cold water, the post-natal rites should be performed unto it. After that the baby should be made to lick an electuary composed of honey, clarified butter and the expressed juice of Brahmi leaves and Ananta, mixed with (half a Rati weight of) gold dust and given with the ring-finger of the feeder. Then the body of the child should be anointed with Vala-taila and it should be bathed in an infusion of the barks of Kshiri trees, or in the washings (decoctions) of drugs known as the Sarvagandha (Eladi group), or in water in which red-hot gold or silver bar has been immersed, or in a tepid decoction of Kapittha leaves, according to the nature of the season, the preponderance of the deranged Doshas in its body and according to its physical conditions. 12.

Diet for the Child— (M.—T.):—

The milk in the breasts of a newly parturient woman sets in three or four days after parturition owing to the dilation of the orifices of the milk ducts (galactoferous ducts). Hence the baby should be fed thrice daily (morning, noon and evening) on a handful (child’s own hand) of clarified butter and honey mixed with (a Rati weight of) pulverized Ananta roots sanctified with Mantras on the first day; and on the second and third days the child should be fed on clarified butter prepared with the Lakshana (root). On the following (fourth) day the child should be fed on its handful of honey and clarified butter only twice (i. e.,) in the morning and at noon). (From the evening of fourth day) the mother should first squeeze off a quantity of her milk and then give the child her breast. (This rule should be observed at the time of tending the child every day). 13-14.

Treatment of the mother:—

The body of the mother should be anointed (after parturition) with the Vala-Taila and treated (both internally and externally) with a decoction of Vayu-subduing drugs (such as the Bhadra-Darvadi group, etc.). If still there be any abnormality in the condition of the Doshas (the discharge of vitiated blood i e., lochia), the mother should be given to drink a luke-warm solution of treacle mixed with powders of Pippali, Pippali roots, Hasti-pippali, Citraka and Shringavera, and the medicine should be continued for two or three days or longer, (if necessary), till the disappearance of the vitiated blood (lochia). When the discharge gets normal (i e.,) on the appearance of healthy lochia), the mother should be made to take for three days a gruel (Yavagu) prepared with the decoction of the drugs constituting the Vidari-Gandhadi Gana and mixed with (a good quantity of; clarified butter or a Yavagu prepared in milk. After that a meal of boiled Shali-rice and a broth made from the meats of Jangala animals boiled with barley, Kola and Kulattha pulse, should be prescribed for her, taking into consideration the strength and the condition of her appetite (Agni or digesting power). The mother should observe this regimen of diet and conduct for one month and a half (after delivery). After this period she may be at liberty to choose any food to her liking and revert to her natural mode of living. According to several authorities, however, a woman does not regain her natural temperament of body till the reappearance of the healthy menstruation (after parturition). 15.

A strong but newly delivered woman, born and bred up in a Jangala country should be given to drink, for three or five nights, either oil or clarified butter in an adequate quantity with an after-potion consisting of the decoction of drugs constituting the group known as the Pippalyadi Gana. She should be daily anointed with oil, etc. If, however, of delicate health, she should be made to take, for three or five nights in succession, a medicated Yavagu (gruel) as described in the last para. Thenceforth a diet of demulcent properties should be prescribed for her and her body should be regularly washed with a copious quantity of tepid water. A mother, after parturition, should forego (for a considerable time) sexual intercourse, physical labour and indulgence in irascible emotions,^[5] etc. 16

Memorable Verses:—

Any disease acquired by a newly delivered mother (Sutika) by her injudicious conduct of life soon lapses into one of a difficult type (hard to cure); and it becomes incurable if it be due to too much fasting. Hence a wise physician should treat her with such measures as are natural and congenial to her temperament, the time, the place and the nature of the disease, so that she may not be afflicted with any evil effect. 17.

A placenta retained in the uterus causes constipation (Anaha) of the bowels and distention of the abdomen (tympanites). Hence in such a case her throat should be tickled with a finger covered with hair; or the exterior orifice of the vagina should be fumigated with the fumes of the cast-off skin of a snake, Katuka, Alavu, Kritavedhana and mustard seeds mixed with mustard oil. In the alternative, a plaster of Langali roots should be applied to the palms and soles of her hands and feet; or the milky juice of Snuhi tree should be applied over her scalp; or a compound made of pasted Langali roots and Kushtha mixed with either wine or the cow’s urine should be given her for drink. A Kalka either of Shali roots or of the drugs constituting the Pippalyadi Gana mixed with wine (Sura) should be given her for the purpose In the alternative, an Asthapana (enema) of white mustard seeds Kushtha (Kuda), Langali, and the milky juice of Maha- vriksha, mixed with Sura-manda should be prescribed. (If the above measures fail) an Uttara-Vasti (uterine douche) prepared with the aforesaid drugs and boiled in mustard oil should be applied; or else the placenta should be removed by the hand lubricated with an oleaginous substance and with the nails clipped off. 18.

Makkalla and its Treatment:—

The lochia of a newly delivered woman whose organism has become excessively dry on account of profuse use of absorbants or deranged by any other causes,—the lochia being obstructed in its exit by the local Vayu,—gives rise to Granthis (nodules) which may appear below the navel, on the sides of the pelvis about the region of the bladder or of the pubis. Severe piercing pain (Shula) is felt about the region of the navel, the stomach and the bladder and a sensation of pricking with needle and cutting pain in the intestines. At the same time the abdomen becomes distended with the retention of urine. These are the symptoms of Makkalla. In such a case, a decoction of the drugs of the Viratarvadi Gana mixed with a powdered compound of the Ushakadi Gana should be given her. In the alternative, a potion of carbonate of potash (Yavakshara) dissolved in tepid water or in clarified butter; of rock-salt dissolved in the decoction of the Pippalyadi Gana; of a compound made of the powdered drugs of the latter Gana with Sura-manda; of the powders of cardamom and Panca-kolas dissolved in the decoction of the drugs of the Varunadi Gana; of the powders of pepper and Bhadradaru dissolved in the decoction of the Prithakparnyadi Gana; or of pulverized Trikatu, Caturjataka and Kustumburu mixed with old treacle; or of simple Arishta, should be prescribed. 19.

Management of the Child:—

The baby being wrapped up in silk should be laid on a bed covered with a silken sheet; it should be fanned with the branches of a Pilu, Nimba, Vadari, or Parushaka tree. A (thin) pad (Pichu) soaked in oil should be constantly kept on the head of the child, and its body should be fumigated with the fumes of drugs (eg., Vaca, mustard, etc.) potent enough to keep off the (evil) influences of demons and evil spirits. The same drugs should be tied round the neck, hands, legs and head of the infant and the floor of the lying-in room should be kept strewn over with pounded sesamum, mustard, linseed (Atasi). A fire should also be kept kindled in the chamber. Measures laid down in the chapter on the nursing of an Ulcer- patient (chapter IX. Sutra.) should be observed in the present case as well. 20.

Then on the tenth day of its birth the parents having performed the necessary rites of benediction and celebrated the occasion with suitable festivities, shall give the child a name of their own choice or one determined by its natal astrism, etc. 21.

Lactation and selection of a wet- nurse:—

For the healthy growth of the child a wet- nurse should be selected from among the matrons of its own caste (Varna), and possessed of the following necessary qualifications. She should be of middle stature, neither too old nor too young (middle-aged), of sound health, of good character (not irascible or easily excitable), not fickle, ungreedy, neither too thin nor too corpulent, with lips unprotruded, and with healthy and pure milk in her breasts which should neither be too much pendulent nor drawn up. It should be carefully observed that her skin is healthy and unmarked by any moles or stains, she being free from any sort of crime (such as gambling, day-sleep, debauchery, etc.). She should be of an affectionate heart, and with all her children living.

She should be of respectable parentage and consequently possessed of many good qualities, with an exuberance of milk in her breasts, and not in the habit of doing anything that degrades woman in life. A “Shyama” girl possessed of the aforesaid qualities makes a good wet-nurse. A child nursed at the breast of a woman with upturned or unprominent nipples is apt to be deformed (Karala) in features, while extremely pendulous (large and flabby) breasts may suffocate the child by covering its mouth and nostrils. Having chosen a wet-nurse of the commendable type, the child with its head well-washed should, on an auspicious day, be laid on her lap wrapped in a clean and untorn linen. The face of the child should be turned towards the north, while the nurse should look to the east at the time. Then, after first having a small quantity of the milk pressed out and the breast washed and consecrated with the following Mantras (incantations) the child should be made to suck her right breast. 22.

Metrical Texts:—

“O, thou beautiful damsel, may the four oceans of the earth contribute to the secretion of milk in thy breasts for the purpose of improving the bodily strength of the child. O, thou with a beautiful face, may the child, reared on your milk, attain a long life, like the gods made immortal with drinks of ambrosia”. 22.

A child nursed at the breast of any and every woman for want of a nurse of the commendable type, may fall an easy prey to disease, owing to the fact of the promiscuous nature of the milk proving incongenial to its physical temperament. The milk of a nurse not being pressed out and spelled off at the outset may produce cough, difficulty of breathing, or vomiting of the child, owing to the sudden rush of the accumulated milk into its throat choking up the channels. Hence a child should not be allowed to suck in such milk. 23.

The loss or suppression of the milk in the breasts of a woman is usually due to anger, grief, and the absence of natural affection for her child, etc. For the purpose of establishing a flow in her breast, her equanimity should be first restored, and diets consisting of Shali-rice, barley, wheat, Shashtika, meat-soup, wine (Sura), Sauviraka, sesamum-paste, garlic, fish, Kasheruka, Shringataka, lotus- stalk, Vidari-kandi, Madhuka flower, Shatavari, Nalika, Alavu, and Kala-Shaka, etc., should be prescribed. 24.

Examination, etc., of milk:—

The breast- milk of a nurse or a mother should be tested by casting it in water. The milk which is thin, cold, clear, and tinged like the hue of a conch-shell, is found to be easily miscible with water, does not give rise to froths and shreds, and neither floats nor sinks in water, should be regarded as pure and healthy. A child fed on such milk is sure to thrive and gain in strentgh and health. A child should not be allowed to take the breast of a hungry, aggrieved, fatigued, too thin, too corpulent, fevered, or a pregnant woman, nor of one in whom the assimilated food is followed by an acid reaction, or of one who is fond of incongenial and unhealthy dietary, or whose fundamental principles are vitiated. A child should not be given the breast until an administered medicine is assimilated in its organism, lest this should give rise to a violent aggravation of the pharmacological action of the medicine, as well as of the deranged Doshas (Vayu, Pitta, etc.), and the refuse matters (Malas) of its body. 25.

Memorable Verses:—

The Doshas (Vayu, Pitta and Kapha) of a wet-nurse are aggravated by ingestion of indigestible or incompatible food, or of those articles which tend to derange the Doshas of the body, and hence her milk may be vitiated. A child, fed on the vitiated milk of a woman, vitiated by the deranged Doshas owing to injudicious and intemperate eating and living, falls an easy prey to physical disease, An intelligent physician in such a case should devise means for the purification of the milk as well as of the deranged Doshas which account for such vitiation (inasmuch as the medication of the child alone will not produce any satisfactory effect). 26-27.

Infantile diseases and their Diagnosis:—

A child constantly touches its diseased part or organ and cries for the least touch (by another of that part of its body). If the seat of disease be its head, the child cannot raise nor move that organ and remains with its eyes closely shut. A disease seated in its bladder gives rise to retention of urine, thirst, pain and occasional fainting fits. A retention of urine and stool, discolouring of complexion, vomiting, distention of the abdomen, and gurgling in the intestines indicate the seat of the disease to be its Koshtha (colon). A constant crying (and the child’s refusal to be consoled) would signify that the diseased principle (morbiferous diathesis) extends all through its organism. 28.

Treatment of Infants:—

Medicines laid down under the head of a particular disease should likewise be prescribed in the case of its appearance in a child or an infant; but then only the remedies of mild potency and those which do not tend to disintegrate the bodily fat and Kapha should be given in adequate doses (according to age, etc.) as mentioned hereafter and administered through the vehicle of milk and clarified butter, to a child living on milk alone, while the nurse also is to take the same medicines as well.^[6] In the case of a child fed both on milk and (boiled) rice (Kshirannada, i.e., living on both solid and liquid food) the medicine should be administered both to the child and its wet-nurse. In the case of a child living on solid food only, decoctions (Kashaya) etc. should be given to the child and not to the nurse. Medicines to the quantity of a small pinchful may be prescribed for a suckling who has completed its first month of life. Kalkas (medicated pastes) should be given to a child fed on both milk and rice to the size of a stone of a plum-fruit (Kola), and the dose for a child fed on rice (solid food) only being to the size of a plum (Kola).^[7] 29.

Metrical Texts:—

In the case of any disease of a child nursed at the breast, the breasts of the nurse should be plastered with the pastes of drugs recommended by physicians for the particular malady (instead of giving the drugs to the child), and the child made to suck the same. The use of clarified butter is not beneficial to a child on the first day of an attack of Vatajvara (fever due to the derangement of the bodily Vayu), within the first two days of an attack of Pittaja fever, and within the first three days of that of Kaphaja fever. But the use of clarified butter may be prescribed for an infant fed on milk and boiled rice, or on boiled rice alone, according to requirements. 30-31.

In case of fever a child should be given no suck at all, lest the symptoms of thirst might develop. Purgatives, Vastis, or emetics are forbidden in the disease of children, unless the disease threatens to take a fatal course. 32.

If the local Vayu aggravated by the waste of brain- materials (Mastulunga), bends down the palate bone of a child attended with an excessive thirst and agony, clarified butter boiled with (the decoction and Kalka of) the drugs of the Madhura Gana, should be used both internally and externally, and the patient should as well be treated with spray of cold water (to stimulate him). The disease in which the navel of a child becomes swollen and painful, is called Tundi. It should be remedied by applying fomentations, medicated oils, Upanahas, etc., possessed of the virtue of subduing the Vayu. A suppuration of the anal region (Guda-paka) of a child should be treated with Pittaghna (Pitta-destroying) measures and medicines. Rasanjana used internally and externally (as an unguent) proves very efficacious in these cases. 33–35.

Infantile Elixirs:—

Clarified butter cooked with (the decoction and Kalka of) white mustard seeds, Vaca, Mansi, Payasya, Apamarga, Shatavari, Sariva, Brahmi, Pippali, Haridra, Kushtha and Saindhava salt should be given to an infant fed exclusively on milk. Clarified butter prepared with (the decoction and Kalka of) Madhuka (Yashtimadhu), Vaca, Citraka, Pippali and Triphala should be given to an infant fed both on milk and (boiled) rice (solid and liquid food). Clarified butter boiled with (the decoction and Kalka of) Dashamula, milk, Tamara, Bhadradaru, Marica, honey, Vidanga, Draksha and the two sorts of Brahmis should be given to an infant fed on (boiled) rice (solid food) By these the health, strength, intellect and longivity of the child is improved. 36-37.

A child should be so handled or lifted as not to cause any discomfort. A baby should not be scolded, nor suddenly roused up (from sleep), lest it might get awfully frightened. It should not be suddenly drawn up nor suddenly laid down, lest this should result in the derangement of its bodily Vayu. An attempt to seat it (before it has learnt to sit steadily), may lead to haunch-back (Kyphosis). Lovingly should a child be fondled and amused with toys and play-things. A child unruffled by any of the above ways becomes healthy, cheerful and intelligent as it grows older. An infant should be guarded against any exposure to the rains, the sun, or the glare of lightning. He should not be placed under a tree or a creeper, in low lands, and in lonely houses or in their shades (caves); and it should be protected from the malignant influences of evil stars and occult powers. 38.

Metrical Texts:—

A child should not be left (alone) in an unclean and unholy place, nor under the sky (uncovered place) , nor over an undulating ground, nor should it be exposed to heat, storm, rain, dust, smoke and water. Milk is congenial to the organism of a child, i e., it is its proper food Hence in the absence of sufficient breast-milk, the child should be given the milk of a cow or of a she-goat in adequate quantities. 39.

In the sixth month of its birth the child should be fed on light and wholesome boiled rice. A child should always be kept in an inner apartment of the house, and religious rites should be performed on its behalf for the propitiation of evil deities, and it should be carefully guarded against the influences of evil stars. 40.

Symptoms when a malignant star, etc., strikes:—

The child looks frightened and agitated, cries, becomes unconscious at times, wounds himself or its nurse with its teeth and finger-nails, gnashes its teeth, crooks, yawns, or moves its eye-brows with upturned eyes, vomits frothy matter, bites its lips, becomes cross, passes loose stool mixed with shreds of mucus, cries in an agonised voice, becomes dull in complexion, becomes weak, does not sleep in the night, does not suck the breast as before, or emits a fishy, bug-like or mole-like smell from its body—these are the general symptoms exhibited by a child under the influence of a malignant star or planet which will be specifically described later on in the Uttara-Tantra 41.

Education and Marriage:—

The education of a child should be commenced at a suitable age and with subjects proper to the particular social Varna or order it belongs to. On attaining the twenty-fifth year he should marry a girl of twelve. A conformity to these rules, is sure to crown him with health, satisfaction, progeny and a capacity for fully discharging the religious rites and paying off his parental debts. 42.

Metrical Texts:—

An offspring of a girl below the age of sixteen by a man below twenty-five is usually found to die in the womb. Such a child, in the event of its being born alive, dies a premature death or else becomes weak in organs (Indriyas). Hence a girl of extremely tender age should not be fecundated at all. An extremely old woman, or one suffering from a chronic affection (of the generative organ), or afflicted with any other disease, should not be likewise impregnated. A man with similar disabilities should be held likewise unfit. 40–44.

A fetus, on the point of being miscarried on account of the above-mentioned causes, produces pain in the uterus, bladder, waist (Kati), and the inguinal regions (Vamkshana) and bleeding. In such a case, the patient should be treated with cold baths, sprays of cold water and medicated plaster (Pradeha) etc., at the time, and milk^[8] boiled with drugs constituting the Jivaniya group, should be given to her for drink. In case of unusual movements of the fetus in the womb, the enciente should be given a drink of milk boiled with the drugs of Utpaladi Gana, for soothing and making it steady in its place. 45.

A fetus being displaced from its normal position produces the following symptoms, viz, pain or spasms in the back and the sides (Parshva), burning sensation, excessive discharge of blood and retention of urine and feces A fetus changing place or shifting from one place to another, swells up the abdomen (Koshtha). Cooling and soothing measures should be adopted in such cases. 46.

Medical Treatment:—

In a case of pain under the circumstances, the enciente should be made to drink a potion consisting of milk boiled with Maha- saha, Kshudrasaha, Madhuka flower, Shvadanstra and Kantakari, mixed with sugar and honey. In the case of retention of urine, the patient should be made to drink a potion of milk boiled with drugs known as the Darvadi Gana (mixed with sugar and honey). In the case of Anaha (retention of stool attended with distention of the abdomen), a potion consisting of milk boiled with asafetida, Sauvarchala salt, garlic and Vaca (mixed with honey and sugar) should be given. In cases of excessive bleeding, linctus made of the powdered chamber of a Koshthagarika insect^[9], Samanga, Dhataki flowers, Navamalika, Gairika, resin and Rasanjana, or of as many of them as would be available, mixed with honey, should be licked. In the alternative, the bark and sprouts of the drugs known as the Nyagrodhadi Gana mixed with boiled milk should be administered, or a Kalka of the drugs of the Utpaladi group mixed with boiled milk should be used, or a Kalka of Shaluka, Shringataka and Kasheru mixed with boiled milk should be given. As a further alternative, the enciente may be made to eat cakes made of powdered Shali rice with the decoction of Udumbara fruit and Audaka-kanda, mixed with honey and sugar. A piece of linen or a plug soaked in the expressed juice of the drugs of the Nyagrodhadi group should be inserted into the passage of the vagina. 47.

In a case of pain unattended with bleeding, the enciente should be made to drink a potion composed of milk-boiled with Madhuka (Yashtimadhu), Devadaru and Payasya; or with Ashmantaka, Satavari and Payasya; or with the drugs of the group of Vidarigandhadi Gana; or with Vrihati, Kantakari, Utpala, Shatavari, Sariva, Payasya and Madhuka (Yashtimadhu). These remedies speedily applied tend to alleviate the pain and make the fetus steady in the womb. 48.

After the fetus has been steadied by the aforesaid mesaures, a diet consisting of (boiled rice and) cow’s milk, boiled with the dried tender fruits of Udumvara, should be prescribed for the patient. In the event of miscarriage, the patient should be made to drink a Yavagu (gruel) of the Uddalaka rice, etc., cooked with the decoction of the Pachaniya group (Pippalyadi) and devoid of all saline and fatty matter, for a number of days corresponding to that of the month of gestation. Old treacle mixed with the powdered drugs of the Dipaniya group (Panca-kola), or simply some Arishta (Abhayarishta, etc.), should be given, in the event of there being pain in the pelvis, bladder and abdomen. 49.

The internal ducts and channels (Srotas) stuffed with aggravated Vayu lead to the weakening (Laya) of the fetus and, if the state continues, it leads even to its death. Hence the case should be treated with mild anointing measures, etc., (Sneha-karma, etc.,) and gruels made of the flesh of the birds of the Utkrosha species and mixed with a sufficient quantity of clarified butter, should be given to her. As an alternative, Kulmasha^[10] boiled with Masha, sesamum and pieces of dried (tender) Vilva fruit should be given her, after which she should be made to drink, for a week, honey and Maddhvika (a kind of weak wine). At the non-delivery of the child even after the lapse of the full term of gestation, the enciente should be made to thrash corn with a pestle in an Udukhala or mortar (husking apparatus) or should be made to sit or move (on legs or by conveyance), on an uneven ground. 50.

Atrophy of a fetus in the womb should be ascribed to the action of the deranged Vayu. This is detected by the comparatively lesser fulness of the abdomen of the enciente and slow movement of the fetus in the womb. In such a case, the enciente should be treated with milk, with the Vrimhaniya (of restorative and constructive properties) drugs, and with meat- soup.^[11] 51.

A combination of ovum and semen affected by the deranged Vayu in the womb, may not give rise to a successful fecundation (living impregnated matter), but leads to a distention of the abdomen (as in pregnancy), which again, at any time, may disappear of itself. And this is ascribed by the ignorant to the malignant influence of Naigamesha (spirits). Such an impregnated matter, sometimes lying concealed in the uterus, is called Nagodara, which should be treated with the remedies laid down under the head of Lina-Garbha (weak fetus). 52.

Now we shall discourse on the management of pregnancy according to the months (period) of gestation.

Metrical Texts:—

The following receipes, such as,

1. Madhuka (Yashtimadhu), Shakavija, Payasya, and Devadaru;
2. Ashmantaka, black sesamum, pippali, Manjishtha, Tamra-valli and Shatavari;
3. Vrikshadani, Payasya, Lata (Durva), Utpala and Sariva;
4. Ananta, Sariva, Rasna, Padma, and Madhuka (Yashtimadhu);
5. Vrihati, Kantakari, Kashmari, sprouts (Shunga) and barks of milk-exuding trees (as, Vata, etc.), and clarified butter)^[12];
6. Prishni-parni, Vala, Shigru, Shvadanshtra and Madhuparnika;
7. and Shringtaka, Visa (stalks of lotus), Draksha, Kasharu, Madhuka (Yashtimadhu), and sugar;

should successively be given with milk^[13] to an enciente, from the first to the seventh month of her gestation, in the case of a threatened miscarraige or abortion. 53.

An enciente should be made to drink milk boiled with the roots of Kapittha, Vrihati, Vilva, Patola, Ikshu and Kantakari, (in case of impending or threatened miscarraige) in the eighth month of her pregnancy. In the ninth month (and under similar conditions), the potion should be made up of Madhuka (Yashtimadhu), Ananta-mula, Payasha and Sariva. In the tenth month (and under similar conditions), a potion consisting of milk boiled with Sunthi and Payasya is beneficial, or, in the alternative, may be given a potion made up of milk with Sunthi, Madhuka (Liquorice, and Devadaru. The severe pain would vanish and the fetus would continue to develop safely in the womb, under the aforesaid mode of treatment. 54-57.

A child born of a woman, who had remained sterile (not-conceived) for a period of six years (Nivritta- prasava)^[14] after a previous child-birth, becomes a shortlived one. 58.

Application of mild emetic medicines, (though forbidden in the case of a pregnant woman), may be resorted to, in the case of a fatal disease, (even in that stage). A diet consisting of sweet and acid things should be prescribed for her, so as to bring the deranged Doshas to the normal state; mild Samshamaniya (soothing and pacifying) medicines should be applied and food and drink consisting of articles mild in their potency, predominently sweet-tasting and not injurious to the fetus, should be advised and mild (external) measures not baneful to the fetus should be resorted to, according to the requirements of the case. 59.

Memorable Verses:—

The growth, memory, strength and intellect of a child are improved by the use of the four following medicinal compounds, used as linctus (Prasha), viz.,

1. well-powdered gold, Kushtha, honey, clarified butter and Vaca;
2. Matsyakshaka^[15] (Brahmi), Shankha-puspi, powdered gold, clarified butter and honey;
3. Arkapuspi, honey, clarified butter, powdered gold and Vaca;
4. and powdered gold, Kaitaryyah (Maha-Nimba), white Durba,^[16] clarified butter and honey. 60.

 

Thus ends the tenth Chapter of the Sharira Sthana in the Sushruta Samhita, which treats of the nursing and management etc. of pregnant women.

Here ends the Sharira Sthana.

Footnotes and references:

[1]:

Caitya—is a haunted or diefied tree, or according to others a Budhistic monastery.

[2]:

“Hridya” here means the diet in which there is an abundance of Ojo-producing (albuminous) properties.

[3]:

The various forms of (Pratiloma) abnormal presentations have been described under Mudha-Garbha Nidana (Nidan-Sthana—Chap. IX.) and their treatment is to be found in Chikitsa-Sthana—Chap. XV.

[4]:

Brahmadeva recommends Vala-Taila instead of clarified butter.

[5]:

Fifteen kinds of emotions as described in the thirty-ninth chapter of the Chikitsa-sthana.

[6]:

Milk and clarified butter being congenial to the constitution of infants should be used as vehicles for drugs in their cases but, these are not necessary in the case of the nurse.

[7]:

According to several other authorities, the dosage in the case of children is to be regulated as follows:—

In the case of a child, one month old, drugs should be given in the form of an electuary through the vehicle of milk, honey, syrup, clarified butter, etc,—the dose being one Rati (about two grains) at first, and gradually increased by a Rati a month, till it completes one year. After this time the dose is to be one Masha (about twenty grains) for each year of age till he is fifteen.

This dosage, however, does not apply in the present age.—Ed.

[8]:

Jivaniya drugs two Tolas, milk sixteen Tolas and water sixty-four Tolas, to be boiled and reduced to sixteen Tolas, i.e., to weight of the milk.

[9]:

There is a kind of insect which makes its chamber with earth generally under the ceiling or on the walls. This earth should be used.

[10]:

“Kulmasha” may mean either Kulattha pulse or half boiled wheat, barley, etc.

[11]:

The panicle “ca” in the text signifies the use of any other constructive tonic.

[12]:

Chakradatta reads “Visam” (stalks of lotus) instead of “Ghrita” (clarified butter).

[13]:

If a conception does not occur in a woman for a period of more than five years after a child-birth, she is called Nivritta prasava.

[14]:

Sivadasa also says that powders of these drugs should be given with boiled milk, but he adds that some authorities recommend the? ae drugs to be boiled in milk according to Kshira-paka-vidhi.

[15]:

Some, however, explain Matsyakshaka to be Dhustura; others again say it is a kind of red-flowered shrub grown in the Anupa country.

[16]:

The word “Shveta,” in the Text, may either be adjective to “Durva” and mean “white” or it may mean white Vaca or white Aparajita or white Durva.