An English Translation of the Sushruta Samhita (Bhishagratna ed.)

t Eyes, ears, nose, tongue and skin.

t But this science does not take any cognisance of them, since the pain incidental to a piercing of, or an injury to, any of these extremely attenuated channels, tnust be slight in its character.

214 THE SUSHRUTA SAMHITA. [Chap. IX.

of these makes the patient thirsty and ends in his instan- taneous death (/. e , within seven days). The serum- carrying (Rasa-vaha) ducts are two in number and have their roots in (the viscus of) the heart and the serum-carrying Dhamanis (vessels). An injury to or piercing of any of these ducts gives rise to Sosha (con- sumption) and symptoms identical with those developed by a hurt to the Prana-vaha channels of the body, ending in death. The blood-carrying Srotas (channels) are two in number and have their roots in the spleen and the liver, and the blood-carrying Dhamanis (capillaries in general). An injury to any of these channels is attended with pallor, bluishness of complexion, fever, burning sensations, excessive haemorrhage, and redness of the eyes. The two muscle-carrying Srotas (ducts or channels) have their roots in the (Sndyu), nerves Tvak (serum), and the blood-carrying Dhamanis (capillaries). An injury to any of these channels is characterised by swelling, loss or atrophy of the muscles, appearance of varicose veins or may (ultimately) resu't in death. The fat-carrying Srotas (ducts) are two in number and have their roots in the region of the Kati (waist) and the Vrikkas (kidneys). An injury to any of these bring in (a copious flow of) perspiration, oily gloss of the skin, parched condition of the palate, extensive swelling (of the affected locality) and thirst. The two urine-carrying Srotas (channels) have their roots in the bladder and the penis (urethra). An injury to any of these is marked by constipation or epistaxis in the bladder, retention of urine, and numbness of the genitals. The two stool-carrying Srotas (ducts) have their roots in the Guda (anus) and the Pakvas'aya (intestines) ; an injuiy to any of these is characterised by complete retention of st;ool (in the bo\vels), accom-

Chap. I)?.] SARIRA STHANAM. ^I5

panied by a distention of the abdomen, foul smell and
intussusception of the intestine (as in a case of ententes).
The two semen-carrying Srotas (ducts) have their
roots in the breasts and the testes. An injury to any
of them leads to loss of manhood, delayed emission
of semen, or blood-streaked character of that
fluid. The two Artava- carrying Srotas (ducts) have
their roots in the uterus as well as in the Dham.anis
which carry the Artava (ovarian product). An injury
to any of these brings on sterility, suppression of
the menses and incapacity for copulation. A cutting
to the Sevan! (median raphe of the perineum) exhibits
symptoms identical with those of a case of injured
bladder or anus, described before. A physician may
take in hand the medical treatment of a case of a Srota
which has been pierced, but he shall not necessarily
entertain any hope of ultimate success. (But time
works wonders, and such a case may sometimes end in
recovery). A case of pierced duct, from which the
dart (Salya, or the like piercing matter) has been
extricated, may be medically treated (without holding
out any prospect of recovery to the friends of the
patient), according to the direction laid down under
the head of ulcer (^Vrana). 11-12.

IVIetrical Text :— The ducts emanating from the
cavity of the heart, other than the Siras (veins), Dhaman is
(arteries), and found to course through the whole body,
are called Srotas (lit. channels or currents). 13.

Thus ends the ninth Chapter of the S'arira Sthanam in the Sus'ruta Samhita which treats of the descriptions of the arteries, cucts and nerves.

Now we shall discourse on the Sdriram which treats
of the nursing and management, etc., of pregnant
women from the day of conception till parturition

(Garbhini-Vyakarana-^ariram). i.

General Rules :— An cnciente, from the first day of conception, should always cherish a clear joy- ful spirit in a clem body. She should wear clean and white garments, ornaments, &c., 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 Chaitya*, 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 agita- ting emotions of the mind should be deemed injurious. To carry a hea vy load, to talk in a loud voice and all other things which might occasion injury to the foetus, (sexual intercourse, &c.) should be refrained from. The practice of constant anointment and the cleansing of the body, &c., (with Amalaki, Haridrd, etc. —lit. cos- metics) should be given up, All fatiguing exercises should be discontinued and the rules laid down for the

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

Chap. X.] SARIRA STHANAM.

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)* well-cooked, pre-
pared 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 abound- ing 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 jdngala (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) Svadamshtra, or gruel (Yavagu) in the sixth ; and clarified butter prepared with (the decoction of) the Prithak- parnyddi group in adequate quantities in the seventh month of gestation. These help the foetal 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 decoc- tion of Vadara mixed with Vala, Ativala, Satapushpa, Palala (flesh), milk, cream of curd, oil, Saindhava salt,

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

2l8 THE SUSHRUTA SAMHITA. [Chap. X.

Madana fruit, honey and clarified butter. After that she should have an Anuvdsana (enema) made up of oil prepared with milk and decoction of the drugs known as the Madhuradi-gana. This restores the Vdyu 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 (fatsj 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 Brdhmin, Kshatriya, Vais'ya 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

ap- ^l SARlRA STHANAM. 2tg

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 (in-
voluntary) motions of the bowels and micturition and
mucous discharge from the vulva are the symptoms
which are manifest at the time {i.e., a little before) of
parturition. 4-5.

Preliminary Measures :— Rites of bene-
diction 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 discom-
fort 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

2^C THE SUSHRUtA SAMttlTA. Chap. X.]

made on the exit of the foetus 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 presenta- tion (Pratiloma) should be converted into the normal or cephalic one (Anuloma) by version* 8-9.

In the case of protracted delivery, e, g., an obstruc-
tion 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 (Kantakdri)
should be tied (round the neck or the waist) or Suvar-
chala {Atasi) or Vis'alyd (Patald) 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 butterf 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

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

t Ijrahmadcva recommends Vala-Taila instead of clarified butler.

Chap. X.] SARiRA STUANAM 2^1

of the string being tied round its neck ; then the um-
bilical cord should be severed immediately above the
ligature, ii.

Natal Rites : — Then having sprayed (the face
ofj 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 Brdhnii leaves and
Anantd, 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 Vald-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 physi-
cal 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 ofj pul-
verized Anantd 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
Lakshand ,root). On the following (fourth; day the child
should be fed on its handful of honey and clarified
butter only twice (/. ^., 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