History of Technology in India, Vol. I: From Antiquity to c. 1200 A.D. v1.c21.s4.t7: Management of the Foetal malpresentation
History of Technology in India, Vol. I: From Antiquity to c. 1200 A.D. v1.c21.s4.t7
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Management of the Foetal malpresentation
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Craniotomy - In cases where there would be any necessity of using an instrument for the purpose of delivery, the enciente should be encouraged with hopes of life, before making the surgical operation. The head or skull of the child in such cases should be severed with the knife known as the circular knife (*maṇḍalāgra*) or the finger-knife (*Aṅguli-Sastra*). Then having carefully taken out the particles of the skull-bone, the foetus should be drawn out by pulling it at its chest/axillae or at the shoulder with a forcep (*Śaṅku*) of hook type. In case where the head would not be punctured and smashed, the foetus should be drawn out by pulling it at the cheeks or the eye-sockets. The hands of the foetus should be severed from the body at the shoulders when they would be found to have been obstructed in the passage and then the foetus should be drawn out. The abdomen of a child in the womb should be pierced and the intestines drawn out, in event of the former being swollen into a flatulent distension like a leather bag (for holding water), as such a procedure would remove the stiffness of its limbs, and then it should be drawn out. The bones of the thighs should be first cut out and removed, where the foetus would be found to have adhered fast to the passage with its thighs.
v1.c21.s4.t7.2
In short, whatever part of the foetus gets stuck up, the surgeon should excise it and deliver the foetus fully and protect the woman with all care. (Figs 1-20)
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(a) (b) (c) (d) (e)
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Fig. 1. Some sharp instruments mentioned in Suśruta. a. Kurapatra śastra, b. Kuśapatra Śastra, c. Sūcī Śastra (needles), d. Trikurcaka Śastra, e. Vetaspatra Śustra
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(a) (b) (c) (d) (e) (f)
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Fig. 2. Some blunt instruments described by Suśruta