An English Translation of the Sushruta Samhita, Vol. II — trans. Kaviraj Kunja Lal Bhishagratna (1911)

Tha diet* for the next three months should consist of (meals taken with) milk diluted (and boiled) with an equal quantity of water or with the soup of flesh of animals of the JAngala group seasoned with the juice of acid fruits. During the next three months it should consist of light and wholesome meals. This rule observed for a year brings about a cure. 22.

lYIemorable Verse -.—Skilled physicians should prescribe boiled milk and the soup of the flesh

* The use of water is forbidden during these nine months.

Daring ihe first six months, drinking, washing, etc., should be done with milk or the soup of Jangala animals. After this period, the said purposes should be served with half.diluleJ milk or meat-soup seasoned with the juice of acid fruiis. Water may be used during the period of the ne.xt three months. — Dallana.

Vagbhata following Charaka says: —

The patient should live only on milk for six months. After this period, he should live on porridge (Peya) boiled with milk ; and fjr the next three months he should live on boiled S'yama-rice with milk, or with the soup of meat seasoned with the juice or acid fruits and mixed with clarified butter and a small quantity of salt.

The water of tender and green cocoanuts is used in cases of Udara in place of pure drinking water with benefit. — Ed.

Chap. XIV.] CHIKITSA STHANAM. 4O3

of animals of the Jdngala group as food and drink in all cases of Udara and use these as Asthapana measures and as purgatives as well. 23.

Thus ends the fourteenth Chapter in the Chikitsita Slhanam of the Sus'rula Samhita which deals with the treatment of Udara.

CHAPTER XV.

Now we shall discourse on the (surgical and medical) treatment of the cases of difficult malpresentation of the foetus and of difficult labour (Mudha-Garbha\ i.

The extraction of a foetus, acting i^in the womb) as an obstructing Salya (foreign matter lodged in the body), is the most difficult of all surgical operations, inasmuch as actual contact or actual manipulation is the only means accessible to a surgeon in the region of the pelvic cavity, the spleen, the liver, the intestines and the uterus. All surgical acts in respect of the foetus or the enceinte, such as lifting up, drawing down, changing of postures (version), excision, incision, the cutting oflimbs and section, pressure, the straightening and the perforating of the abdomen, could not be done othenvise than by actual contact of the hand, which may sometimes prove fatal to the foetus or to the enciente. Hence the king should be first informed (as success in these cases is often uncertain) and all acts should be performed with the greatest care and coolness.

We have stated before that the foetus is generally presented in cases of difficult labour in eight different postures or forms. The obstruction of the child in the passage of parturition (Garbha-Sanga) may be effected in three different ways, owing to its head, shoulders or hips being presented in a wrong way and held fast in the passage. Every care should be taken and no pains spared to bring a child alive into the world, which is not already dead in the womb. The sacred verses (Mantras), possessing of the virtue of bringing out the foetus, should be recited in the hearing of the enciente in the case of a dbap. XV.] CHIKITSA STHANAM. 4O5 failure in the first attempts at effecting parturition. The mantras are as follows. 2,

Metrical Texts :— 'O thou beautiful damsel, may the divine ambrosia' and the Moon god with Chitra bhanu and the celestial horse Uchchaih-Sravas take their residence in thy room ; may this water-begotten nectar, help thee, O lady, in swiftly casting off thy womb. May the Sun, the Vasavas and the Wind-god (Pavana) in the company of the saline Ocean give thee peace. The incarcerated beasts have been freed from their fastenings and binding chords. The Sun god has freed his rays of light. Freed from all danger, come, O, come, O child, and rest in peace in these precincts," 3.

Proper and useful medicinal remedies should also be employed for the delivery of the child.

Postures of the Foetus:— In the case of the foetus being dead in the womb, the enciente should be made to lie on her back with her thighs flexed down and with a pillow of rags under her waist so as to keep it a little elevated. Then the physician should lubricate his (own ) hand with a compound consisting of earth, clarified butter and (the compressed juice of) S'allaki, Dhanvana and S'dlmali and inserting it into the passage of parturition (Yoni) should draw out the dead fcetus (downward with the hand). 4.

In the case of a leg-presentation (Sakthi), the foetus should be drawn downward by pulling its legs. In case where a single leg (Sakthi) is presented, the other leg of the fcetus should be expanded and then it should be drawn downward.

In the case of the presentation of the buttccks(Sphik) i breech presentation), the buttocks should be first pressed and lifted up and then the fcetus should be drawn downward by the legs. In the case of a loDgitudilial

406 THE SUSHRtJTA SAMHITA. [Chap. XV.