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

PrOgTIOSiS ; — The enceinte who violently tosses her head in agony (at the time of parturition) and the surface of whose body becomes cold, compelling

58 THK SUSHRUTA SAMHITA [Chap. VIII.

her to forego all natural modesty, and whose sides and abdomen arc covered with nets of large bluecoloured veins, invariabl)' dies with the dead child locked in her W(jmb, The death of the frjetus in the womb may be ascertained by the absence of movements of the ftetus (in the womb) or of an)- pain of child-birth, by a brown or yellow complexion of the cnccinta, cadeverous smell in her breath, and colic pain in the abdomen and its distension owingto the continuance of the swollen and decomposed child in the womb. 8-9.

The death of a child in the womb may result from some emotional disturbance of its mother, (such as caused by bereavement or by loss of fortune during pregnancy) ; while an external blow or injury (to the womb) or an\' serious disease of the mother may also produce the like result. A child, moving in the womb of a dead mother, who had just expired (from convulsions etc.) during parturition at term, like a goat (Vast/imAra) should be removed immediately by the Surgeon from the womb (by Caesarean Section) ;* as a delay in extracting the child ma\- leads to its death 10-: i.

* Csecsarean Section means incision of the uterus through the abdominal walls and extrication of the foetus therefrom. Operation like this upon a dead subject requires no skill of a surgeon. Any one can do it without the help of any anilomical knowledge. In modern times, when the mother's life is in peril, and the expulsion of the foetus becomes nearly impossible, by the natural passage, owing to an existenee of deformity either in the parturient canal or in the forms and structures of the foetus, to save both mother and child this operation is principally undertaken.

The eviJence of similar attempts, in ancient India, is found recorded in passages like what we have just translated and that the operation was practised on living subjects, there is not the least doubt about it. This custom is still preserved in Central Africa, and it is possible that the Egyptians like Hindu philosophy and religion learnt this also from the Hindus. "Felkin," says "Baas in his History of Medicine p. 70 "saw a case of the Csesarean operation in Central Africa performed by a man. At one stroke

Chap. VIII.] XIDAXA STHANAM. ^0

Additional Text :— The bladder is ruptured, the dead child lies like a weight upon the placenta and is pressed upward on the spleen, liver and gall bladder. The mother shivers and is oppressed with tremor, dryness of the tongue, dyspnrea and perspiration. She complains of a cadaverous smell in her breath and stands in danger of imminent death. By these symptoms a physician shall know the death of the child in the womb. This portion is partly recognised by Brahmadeva and is totally rejected by Jejjadacharya as spurious.

an incision was made through both the abdominal walls and the uterus. The opening in the latter organ was then enlarged, the haemorrhage checked by the actual cautery, and the child removed. While an assistant compressed the abdomen, the operator then removed the placenta. The bleeding from the abdominal walls was then checked. No sutures were placed on the walls of the uterus but the abdominal parietes were fastened together by seven figure-of-eight sutures, formed with polished iron needles and threads of bark. The wound was then dressed with a paste prepared from various roots, the woman placed quietly upon her abdomen, in order to favour perfect drainage, and the task of the African Spencer Wells was finished. It appears that the patient was first rendered half unconscious with banana wine. One hour after the operation the patient was doing well. And her temperature never rose above loi F. nor her pulse above io8. On the eleventh day the wound was completely healed, and the woman apparently as well as usual."

When we read this evidence of Felkin, we are reminded of the operative steps as described in our own ancient book of Surgery from which modern surgeons have been able to borrow the operation of rhinoplasty. It is a great pity that while in Africa the same practice is still retained intact, we in India by spurious attempts and disgraceful contortions, substitutions of false readings and dismal knowledge of grammar and rhetoric try to prove in the face of strong evidence that in ancient India Cesarean Section was at'empted only on cases where one "might not perspire."