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Indian Medicine (Medicin), translated by C. G. Kashikar c11: IV. Theory of Development and Gynaecology

Indian Medicine (Medicin), translated by C. G. Kashikar c11

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IV. Theory of Development and Gynaecology

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§ 39. Menstruation and Conception¹:—The menstruation begins at the age of 12 and stops at the age of 50 years (Su 3. 3.11; AS 2.1.196; AHr 2.1.7; Bhāv 1.1.16). With regard to the male race the age of 16 years forms the earliest limit for the attainment of puberty which extends to 70 years at the most (AS). Yet it has been recommended to a young man to marry² a 12 years' girl at the age of 21 and to create at the age of 25 a son from a wife of 16 years, because they then are fully developed and create strong progeny. If at the time of procreation the father is less than 25 and the mother less than 16 years' old, the foetus dies in the womb or if at all it is born it does not live long or remains crippled, weak and sickly (AS 2.1.195; AHr 2.1.9; Su 3.10.54 f.). In the selection of a wife, it is to be seen that no contagious or hereditary diseases exist in her family (asancārirogakula— AS). Manu 3.7 mentions special families in which haemorrhoid, consumption, dyspepsia, epilepsy, white or black leprosy prevail.

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The conception depends upon the coincidence of sperm and menstrual blood. Mention is also made of the sperm of women, yet it is expressly stated that it has no influence in the formation of the foetus (AS 2.1). Sperm is the juice (chyle-rasa) consisting of the food properly digested and transferred into the marrow. As butter is contained in the milk or sugar in the juice of sugarcane, so the sperm is contained in the sperm-keeping substratum (kalā) which pervades the whole body and particularly in the marrow, the testicles and the nipples. The menstrual blood also results every month from the chyle. The vāta drives out from the hymen the blackish and smell-less blood collected during a month through both the vessels of uterus (Su 1.14.1 f.; 3.4.13 ff.; 2.2.1 f.; AS 2.1.195; 198; AHr 2.1.7). In order to create a normal foetus, the sperm and menstrual blood must be clean i. e. must be of normal condition. The sperm is not capable of generating, if it is deranged by the doṣas or by impure blood, whereby it becomes thin, frothy, brown, scanty, painful, flowing slow, yellow, too plentiful, does not sink in water etc. As far as its smell is concerned, incurable impotency is to be diagnosed if the sperm smells like urine or faeces. The law-books also prescribe a test of potency before marriage by which it is ascertained among other things that the sperm sinks in water (Nārada 12.10). The menstrual blood can have defects similar to male sperm. Nutritive and sweating remedies, specific diet and douches are particularly recommended for cure, while in the case of women it is laid down to use pastes and cloth or cotton (picu) which are inserted in the vagina, as well as cleansing with water. The sperm capable of generating is fluid, frothy, sticky, heavy, plentiful, sweet, whitish, resembling honey in smell and colour or of the colour of butter or oil. The menstrual blood is pure if it resembles the blood of hare or lac-colour and leaves no stains in washed clothes (Su 3.2.3-17; AS 2.1.196 f.; AHr 2.1.10-19). Excessive flow of blood during or after the menses is called asṛgdara, pradara (§ 49).

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In the period suitable for conception (ṛtu) the face of the woman is full (slender-AS, AHr) and clean, her body, mouth and gums become moist, she is desirous of her husband, is lovely, her body and her eyes are sunk down, her hair fly around, her arms, breast, hips, navel, thighs, genitals, buttocks are in a palpitating movement and she has strong desire for enjoyment (Su 3.3.7 f.; AS 2.1.198; AHr 2.1.21 f.). The twelve nights after the beginning of menses excluding the first three form the period suitable for conception, and the child will be a male one if the conception takes place on even days i. e. 4th, 6th, 8th, 10th or 12th day, and a female one if on odd days i.e. 5th, 7th, 9th or 11th (Su 3.2.28-30; 3.3.6; AS 2.1.199; AHr 2.1.27 f.) According to a more rigorous conception, the eleventh night is also prohibited (AS, AHr); one should indeed wait for four days more after the course of menses in order to aim at excellent sons (AS). On the other hand, there is a reference to a 16 days period suitable for conception (AS, Bhāv 1.16, Ḍallaṇa on Su 3.3.6). It corresponds with the statement of law-books (Manu 3.46; Yājñ 1.79) and is therefore original. Of the 16 days, 12 days remain by subtracting four days of menstruation, and out of these 12 days first three days are again to be avoided. The sperm arrived during the bleeding in the uterus is compared with an object thrown in flowing water which is swept away by the stream.

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If the conception takes place on one of the first three days, the child dies at or after the birth, or becomes at least crippled or short-living (Su 3.2.31). After the period of ṛtu, the uterus does not allow the sperm to penetrate, just as the lotus closes itself at the end of the day (Su 3.3.9; AS 2.1.198). On the first three days of the menses the woman should remain chaste, should neither bathe nor adorn herself, should lie on a low bed of Darbha-grass, should take nothing more than some milk-pap, for which she must use her flat hand, earthen vessel or leaf as a plate and observe other abstinences (Car 4.8.5; Su 3.2.25; AS 2.1.198; AHr 2.1. 23-25 ). Every violation of the discipline laid down for her would injure her progeny. Her child would be lethargic if she sleeps by day, blind if she uses eye-ointment, suffering from eye-disease if she weeps, leper if she anoints her body with oil, mad if she speaks too much, deaf if she hears a loud noise (Su 1. c.; Bhāv 1.1.17 ). When after the course of three days she has taken the usual cleansing bath, has worn fresh clothes and ornaments, it is to be seen that she immediately gets to see her husband, because her son will resemble the first man whom she sees after her bath. A ceremony (*putriyavidhi*) intended for obtaining male progeny precedes the matrimonial cohabitation which corresponds to the *garbhādhāna* of the Smṛtis and Gṛhya sūtras. The mantra RV 10.184.1 is recited there at that time ( Cf. Speijer, *Jāta-karma* p.

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18 ). A *ṛtvij* places in her vagina an oblation for Prajāpati ( Car 4.8.9-10; Su 3.2.25; AS 1. c.; AHr 2.1.28 ff. ). The husband should ascend the matrimonial bed first, with the right foot, the wife with her left foot. At the time of generation the menstrual blood is dissolved ( by the heat produced ) just as the butter melts in fire ( Su 3.2.36 ). The sperm is of watery quality and the menstrual blood of fiery quality; yet other elements (earth, atmosphere and wind) are also contained therein. In the union of husband and wife, wind expels from the body the heat (produced by the contact of her organs), by the connection of heat and wind the sperm comes out following the pleasant feeling (*harṣa*), arrives in the uterus and is united with the menstrual blood. Thus the foetus is created when the spirit (*jīva, cetanādhātu*), quick as wind and impelled by his deed in an earlier birth (*karman*), enters it as the sixth element. If the sperm preponderates a male child is born, if the menstrual blood prevails a female child is generated, if both of them exist in equal quantity a creature incapable of generation (*napuṃsaka, klība*) is born. Moreover, the generation of female progeny rests on odd days, because on these days the menstrual blood increases in quantity ( Su 3.3.3-5; Car 4.2.11 ff.; 22 ff.; 4.4.7 f.; 2.2.201; 2.1.199; AHr 2.1.5 ).

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Triplets and groats are generated if the sperm and menstrual blood are divided internally by air and thereby an equal number of souls is received in the uterus. Twins are considered as an abnormality, so Dallana on Su. says that a penance must be observed at the birth of twins. Various weaklings and sexual abnormalities are created by deficiency of the sperm or defective quality of the sperm or womb or unnatural voluptuousness of parents and other irregularities (Su 3.2.37 ff.; Car 4.2.17 ff.; AS 2.2.203-5). Generally born deficiencies of every kind can also originate from sins in a previous birth or sins of the parents (Su 3.2.52; 58 etc. Cf. § 3).

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(1) Cf. here as well as for the following paragraphs, Vullers, *Altindische Geburtshilfe* (Janus 1, 226-56, Breslau 1846); Fasbender, *Entwicklungslehre, Geburtshilfe und Gynaecologie* (Stuttgart, 1897 pp. 300).
(2) Similarly Manu 9.94. On the child-marriage, see *Recht und Sitte*, § 17.

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§ 40. Pregnancy :— The following symptoms appear after the conception : weariness, atony, looseness of limbs— particularly of the thighs, a feeling of heaviness, palpitation of the heart, salivation, nausea, thirst, goose-skin, palpitation in the vulva, retention of the sperm as well as of menstrual blood. The pregnancy is known by the following signs : vomiting, nausea, desire for sour food, dislike for fragrance, heaviness in limbs, closing of eye-lids (by weariness), sleepiness, yawning, swooning, black colour of the skin around the nipples and the lips, swelling of the feet, creation of breast-milk and swelling of the breasts, appearance of hair on linea alba below umbilicus, abnormal appetite etc. (Car 2.22;4.9; Su 3.3.13-15; AS 2.2.202; AHr 2.1.35 f.; 50-52; Bhav 1.1.23). The menses cease, because the canals leading menstrual blood are stopped by the foetus, so that the same is directed partly downwards to the placenta (*apara*), partly upwards to the breasts which, therefore, become full and raised (Su 3.4.24; AS 2.2.202).

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That the pregnant woman bears a son is known from the fact that milk is created first in her right breast, that her right eye becomes bigger, that she starts walking with the right leg, her desire in pregnancy tends mostly to food, drink and other things with masculine designations, dreams of blue or white lotus-flowers, mangoes and other things of masculine designations, the foetus stands on the right side, she does not desire her husband and so forth. From the opposite symptoms one should anticipate a female foetus: the woman in this case also likes dance, music, singing, fragrance and wreath of flowers (AHr). If the body of the woman is arched forward in the middle, while at the same time there is a combination of both the above-mentioned types of symptoms, she bears an impotent or a hybrid (*napumsaka, kliba*). If both the sides of the body are raised, the middle part has gone deep, so that the body has a form of a watertrough (droni) deepened in the middle, then she bears a twin (Car 4.2.28 f.; Su 3.3.34; AS 2.2.204; AHr 2.1.69-72). After pregnancy is sure the ceremony pumsavana takes place in order to aim at a son according to the Gṛhya sūtras¹ under the pusya constellation when three or four drops of milk mixed with an extract of Ficus Indica and other herbs are dropped in the right nostril of the woman as a snuff. She is not to let the fluid flow out. If the husband desires a daughter, he puts the fluid in the left nostril of the woman (Car 4.8.20; Su 3.2.32;

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AS 2.1.200; AHr 2.1.37-42). Herein are included, according to the Gṛhya sūtras² the usages which aim at the prevention of a possible abortion (garbhasthāpana) particularly if after the signs of pregnancy menses occur from the fourth month onwards or there is acute pain in the bladder, lateral parts, hips and entrance of the vagina. The woman should be made to lie down on a soft and cool bed with the head a little sunk down; a wet clothpiece with certain substances applied to it should be inserted in her vagina and urinal canal; her lower body between the navel and the genitals should be smeared with certain fluids and she should be made to have a cold tub bath. She should also pull on clothes which are made wet with juice of milky trees; she should carry "important herbs" on head and in the right hand, should take milk or butter prepared with it, and use internally and externally "animating herbs" in general (Car 4.8.33 f.; AS 2.1.200; AHr 2.1.41 f.). Danger threatens the foetus, if the desires of the pregnant woman are not attended to. Analogous to the development of organs (indriya) in the third or fourth month, the life-sensation occurs in the foetus, it begins to palpitate and to carry longings for all that (according to the belief in the theory of the rebirth of the soul) it experienced in the previous life.

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This condition is called dvaihṛdayya ('twoheartedness') or dohada² in relation to the two hearts of the mother and the foetus which stand connected with each other through the canal mediating the feeding of the foetus, whereby similar movements and desires occur in both the hearts. Therefore, one should not refuse to the woman the fulfilment of her desires, otherwise the deranged vāta will pervade the body and thereby the foetus would come out either in an expired condition or as a child which is humpbacked, lame, dwarflike, weakminded, or otherwise abnormal. On the other hand, by satisfaction of her desires she will beget a strong and long-living son (Car 4.4.16-19; Su 3.3.18; AS 2.2.202 f.; AHr 2.1.52-54).

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The pregnant woman must generally live very cautiously. She should avoid over-exertions, sexual intercourse, fasts and too strong a purgative, sleep by day and keeping awake by night, grief, ascending a carriage, anxiety, sitting ( on the floor ), untimely blood-lettings, suppression of natural excretions and the like. In a diseased condition her foetus has also to suffer in the same organs in which she has to suffer (Su 3.3.16 f.). From the first day of her pregnancy upto the confinement the woman should always be in fair disposition and clean in body, should adorn herself with ornaments and white clothes, perform expiating and fortune-bringing ceremonies, worship gods, Brahmans and respectable persons, touch nothing dirty or deformed, avoid what smells bad or looks bad, should not hear exciting speeches, should not eat dry, stale, stinking or moist food, should not go out, should not go into an empty (abandoned) house or temple, a burial place, or under a tree, guard herself from anger, terror and carnal lust, should not carry heavy load, should not speak excessively loudly and should avoid ( generally ) all what could injure the foetus. She should also not anoint or smear herself often or should not be physically tired and should observe the same rules as in menstruation (Cf. § 39). Her seat or bed should be soft, not too high, provided with a back and not too narrow. Her diet should be stimulating, fluid, predominantly sweet and prepared in an appetite-stimulating manner (Su 3.10.3). Similar list of injuries of the foetus (garbho paghātakara) is found in Car 4.4.18 and 4.8.16; AS 2.3.206. If the woman is quarrelsome, her child will be suffering from epilepsy; if she is a drunkard it will be thirsty or weak in memory or unsteady; if she eats buffalo-flesh with zest it will be warlike, red-eyed and hairy; if she likes to eat sweet things it will suffer from diabetes, will be dumb and shapelessly thick; if she likes to eat pungent things it will be weak, poor in sperm or childless and the like ( Car l.c.; AS 2.3.206 f.; Su 3.3.19–28 ). The desires of the pregnant woman ( see above ) can also have favourable effect on the foetus. Thus the child will be wealthy and genteel if the woman has a desire to see a king; virtuous and holy if she has a desire for solitude (Su l.c.). Diseases of the pregnant woman should be treated only with mild, sweet, cooling and agreeable remedies. Vomiting substances, purgatives, blood-letting and such severe remedies are to be avoided; because the pregnant woman is like a vessel full of oil which is not to be allowed to waver (Car 4.8.23). For each month of pregnancy a particular diet is prescribed, the main part of which consists of milk along with ghee, butter-milk and cream. In the eighth or ninth month the woman must take an oily enemeta in order to throw out old excrements from the body and to bring about a favourable birth-wind (peristalsis). Then a piece of cotton soaked in oil should be inserted in the vagina in order to make the vaginal passage smooth ( Car 4.8. 25; Su 3.10.4; AS 2.3.208; AHr 2.1.59-68). The birth takes place in the 9th, 10th, 11th or the 12th month (Sn 3.3.30), to speak accurately in the period commencing with the first day of the ninth lunar month to the end of the year (Car 4.4.25; AS 2.2.203; AHr 2.1.66).

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(1) Hillebrandt, Ritualitteratur, § 9. (2) l.c. § 10., cf. also Kassika Sutra 35.12 ff. (3) Luders, Sanskrit dohada, Gotting. Nachr. 1898, 2-5; Aufrecht, Dohada, ZDMG 52,p.763; Jolly, Sanskrit dohada, desihrdayya, IF, 10,213-15. Bohtlingk explains Dohada from doha + da = causing milk-secretion i. e. "desires for that which produces milk" ( ZDMG 55, p. 98 ).

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§ 41. Embryology :- To the theory of conception laid down in § 39, it is to be added that according to the principles of philosophy the soul entering the womb is an emanation of the Universal being ( cf. § 37 ). Just as at the destruction and creation of the world the Creator, the Universal being ( brahma ), the omnipotent original spirit that causes everything, the eternal, the fountain-head, the highest, the unexpanded being, first creates the atmosphere at the creation of the world, and then successively the four remaining elements, (wind, fire, water and earth) with highly developed qualities ( guna ), similarly while entering into the human body, he first receives in himself the atmosphere, then the wind and the remaining elements with highly developed qualities. This whole process of reception of qualities, however, is completed in an infinitely short time (Car 4.4.7-8; cf. Yajn 3.67-74; Visnu 96, 51 ). In the first month the foetus is a collected small mass covered with the five elements. In the second month it becomes a solid ball, a ( lengthwise ) flesh-excrescence, or a round ( a half globe-formed-Dallana, " Budlike "-Bhoja ) mass ( arbuda ). Cold, heat and wind bring about its development. Further it becomes a male, female or a neuter (napumsaka).

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In the third month the body develops in five directions (AS) : [1] bones, [2] arms, [3] head, [4] seats for all the organs excluding things like teeth and symptoms of puberty which develop only after the birth, and [5] all senses. From wind are created the feeling, the sense of feeling, hoarseness, action, the expansion of the elements (of the body) and the movements: from fire the colour, sight, light, digestion and warmth: from water the taste, the sense of taste, coolness, softness, smoothness and moistness; from earth the smell, the sense of smell, weight, solidity and form. The phenomena that appear in the world also appear in men (Car 4.4.8-10; cf. Yājñ 3.75-78). With the creation of senses coincides also the development of the power of discrimination, the occurance of child's movements and the desires of the pregnant woman. See above § 40. According to Su 3.3.18, this takes place in the fourth month. In the fourth month all parts of the body and the heart take a definite shape and the foetus becomes fixed. In the fifth month flesh and blood increase to a greater extent than in other months according to Caraka, which accounts for the general weakness of the woman in this month. The soul also becomes more animated in this month. In the sixth month hair on the head and body, nails, bones, sinews, arteries etc. are formed, the vigour and complexion of the foetus also increase.

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This is why, according to Caraka, vigour and complexion of the woman become particularly faded in this month. In the seventh month the foetus is provided with all limbs and is endowed with all requirements of existence (so that a child born in this month is capable of living, even though on account of early birth it may not live long-Aruṇadatta on AHr 2.1.58). The woman, therefore, becomes particularly fatigued in this month. In the eighth month the vitality (ojas) is led sometimes from the mother to the child, sometimes from the child to the mother through the canals carrying chyle. On account of this interchange of vitality, the child born in this month may not be capable of living, the mother as well as the foetus are sometimes bright, sometimes depressed and the mother's life is also in danger. In order to avoid delivery in this month, an oblation of flesh and rice is offered to the demon Nairṛta. Regarding time of birth see § 40 (Car 4.4.11-24; Su 3.3.30; AS 2.3.202 ff.; AHr 2.2.49-66; cf. Yājñ and Viṣṇu l. c.). The aforesaid theory of development, even though predominant (cf. also Garbhopaniṣad in Deussen's 60 Upaniṣads, p. 608), is not the only one. Thus Su 3.3.32 mentions the views of more ancient writers according to whom the head takes form first, because organs of senses are rooted in it; or the heart, because it is the seat of intelligence and the soul; or the navel, because through it the human body develops;

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or the hands and feet, because the movements of the foetus start from them; or the middle of the body, because the generation of all limbs depends on it. These different views are, however, not approved by Suśruta, because all limbs exist in germ in the beginning, and are not visible in the undeveloped foetus on account of their small size. The development is compared to the fibres, flesh, kernel and marrow of a mango which become visible only in the ripe fruit, or to a bamboo tree that develops from a bamboo shoot. Cf. Car 4.6.21.

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During pregnancy the foetus is in the uterus, turned towards the back of the mother, the head above, hands folded on the forehead, with bent body, lying on the right side (of the mother) if it is male, on the left if female, in the middle if impotent. When the mother sleeps it sleeps, when she rises it rises, for the foetus is not independent. Since the conception the feeding and animation of the foetus are maintained by the vessels conducting the chyle (rasa) and pervading the whole body of the mother, when one part of the diet of the woman which is turned into chyle feeds her own body, another part forms the milk in her breasts and a third part feeds the foetus and makes it grow. When the body of the foetus is developed, a vessel is connected to its navel, the placenta (aparā) is connected to the vessel and to it the heart of the mother. Then the essence of the food flows from the heart of the mother to the placenta through the veins, from there to the navel (of the foetus) and then to the internal body of the foetus after being digested by the (digestive) fire of the same and it nourishes the elements and component parts of the foetus (Car 4.6.23; AS 2.2.203 ff.; Su 3.3.31; 3.5.42; Bhoja in Ḍallaṇa l. c.). The foetus excretes neither wind nor urine nor faeces, because it does not take for itself any food except the chyle which is free from impurity and because it has no wind inside the body. It does not cry, because its mouth is stopped by placenta, the throat is filled with phlegm and the passage of the wind is blocked. Breathing, movements and sleep coincide with the corresponding actions of the mother (Su 3.2.53-55; AS 2.2.204).

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From the mother are created the blood, flesh, fat, marrow, navel, heart, liver, spleen, kidneys, bladder, rectum, intestines, anus, lungs, retina, peritonium, omentum, i. e. the soft parts of the body. From the father are created the hair, beard, nails, teeth, bones, vessels, sinews, nerves, sperm, i. e. the hard parts of the body. From the soul which is united with the sperm and menstrual blood while entering the uterus, are created the life, the knowledge of self (*ātman*), mind, senses, pleasure and pain, love and hatred, intelligence and recollection and other mental powers (Car 4.3.12-14; Su 3.3.33; AS 2.5.220; AHr 2.3.4-8). According to Suśruta liver and spleen are generated from the blood when it is boiled by the bodily heat which is kindled by the wind in the intestines (*samāna*). The lungs are created from the froth and the stomach (*uṇḍuka*) from the secretion of blood. From the essence (*prasāda*) of blood and fat the kidneys are created and from the essence of flesh, blood, phlegm and fat the testicles are created. According to AS intestines are created from the essence of blood and flesh. According to Su an essence of blood and phlegm is boiled by the bile when the wind is also present and by this boiling in the uterus are created the intestines, the anus and the bladder. The wind accompanied by heat opens canals for itself and penetrates into the flesh and produces muscles all over; it also forms the veins and sinews after it has received fatty stuff from the fat. The heart consists of an essence of phlegm and blood. It resembles a blooming lotus-cup which is opened when man is awakened and closes when he sleeps. It is especially the seat of intellectual activity (Su 3.4.25-31; AS 2.5.222 f.).

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§ 42. Obstetrics and Care of the Confined Woman :— At the birth the foetus is moved by the birth-peristalsis and comes out of the vagina with head below, then the placenta comes out when it is separated from the heart of the mother (Car 4.6.24; Su 3.5.45; AS 2.2.204). The rules for the treatment of labour are laid down in the chapter prescribing the rules for the construction of the "house for the confined woman" (*sūtikāgṛha, sūtikāgāra*). The Sūtikāgṛha is a room 8 *hasta* (*hasta* = 1½ foot) long and 4 *hasta* broad. It should be constructed from different kinds of wood according to the caste of the woman. The bed of the woman should consist of the same wood, the walls should be whitewashed, the door should be on the east or on the south side, the household furniture should be ample and conveniently distributed (Su 3.10.5; AS 2.3.209; AHr 2.1.73 f.). Fire, water, a mortar, privy, a bath-room and a kitchen (or cooking implements) should also be there. Butter, oil, honey, different kinds of salts and medicines, sharp iron knife (for operation) etc. as well as many respectable and expert women who have often delivered, and

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Brahmans knowing Atharvaveda should be present there (Car 4.8.33). The fire corresponds to the sūtikāgni of the Grhyasūtras which particularly serves for the removal of evil spirits¹. The pregnant woman should be brought in this room in the ninth month or even before the beginning of the same on an auspicious day with gifts to the Brahmans and to the cows and with other ceremonies. There she should wait for her delivery and should take suitable diet. At the smallest retention of urine or constipation she should use suppository ( Car 4.8.33; AS 1. c. ).

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The approach of delivery is known by the following symptoms : relaxation of limbs, fatigue in the eyesight and in the eyes, looseness and feeling of loosening of the bonds of the breasts, sinking of the belly and a feeling of heaviness in the lower abdomen, stinging in the breasts, bladder, hips, sides and back, pain and twitching in the genitals, loss of appetite, expectoration, evacuation and passing of urine and mucus discharge from the vagina. Then begin the birth-pains and discharge of uterine liquid. As soon as the birth-pains begin, an amulet is tied to her (AS, AHr), blessings are given to her, fruits with names of male race are given in her hand, male children are kept around her, she is anointed and bathed with warm water and is given to drink a large quantity of rice-gruel. She should lie on a low and soft bed, with bent thighs and curved back, with the face turned upwards. The bed should be covered with cushion and a red bull-hide (AS). There should be four experienced and courageous women of advanced age and with clean clothes before whom she may not feel shy, who have cut their nails and who cheer her with friendly words. Then fragrant powder should be given her repeatedly to smell; she should be perfumed and anointed with lukewarm oil particularly on the genitals, whereby the coming out of the foetus with head below is expedited.

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That the turning of the foetus has resulted, is known from the fact that it is loosened from the heart of the woman, comes in the belly and reaches the neck of the bladder, whereby pains become more frequent ( Car, AS, AHr ). According to Car, AS, AHr she should then be placed on her bed and should try to press out the foetus while one of the women encourages her. Different views are held on the point whether, in case the delivery does not take place even after the pains, she should get up and pound corn in a mortar with a pestle, evidently in order to intensify the pains by these severe movements. Car and AS express their opinions against it, because the pregnant woman must always avoid severe physical exertions and because she is particularly sensitive at the time of delivery and her life is in danger. Instead of that Car, AS, AHr recommend going around and yawning. The untimely pressure without preceding pains is bad and injures the mother as well as the child, which thereby comes in the world crippled or sickly. The woman should first press gradually, then rather forcibly and at last when the foetus comes out very strongly, until the delivery is effected. While she presses, the women around should gladden her by saying: "born, born a good son".

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If the foetus remains stuck (Su, AS, AHr), the vagina should be smoked with the skin of black serpent or with the piṇḍita plant, or a root of hiraṇyapuṣpī should be tied around her hands and feet, or she should hold certain plants in her hand (Car 4.8.36; Su 3.10.11; AS 2.3; AHr 2.1.83). Similar procedure takes place if the placenta does not come out³. Thus a woman should examine the confined woman in order to ascertain if the placenta has come out or not (Car). If it has not come out, one of the women should press her forcibly above the navel with the right hand, should seize her back with the left hand and should shake her thoroughly. Then she should press her on the hips with her heels, should clasp her buttocks and should press them together with all strength. Then she should put into her throat a braid of hair or a finger with hair⁴ twisted around. The vomiting effected hereby can also be caused by giving certain vomiting and other substances causing nausea, such as urine. Smoking of the vagina and douches in the same, rubbing the genitals with pungent substances, oil-clysters, smearing the forehead with the milk of wolf, or rubbing the heels and hand-palms with lāṅgalī root, eating certain medicines like e. g. a decoction of various plants in which the detached right ear of a living male donkey is dipped, pulling out of the placenta with the hand after oiling the same and cutting the nails, and other remedies are also prescribed (Car 4.8.40; Su 3.10.21; 17;

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AS 2.3.209-12; AHr 2.1.74-91).

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The woman should, according to Suśruta, be anointed with balā oil and smeared with a decoction of herbs removing vāta. If any disease (doṣa) has still remained in her, she should be given to drink on the same day pepper (pippalī), pepper-root and other pungent stuffs powdered and mixed with sugar-water. This should be pursued for 2 or 3 days until the spoilt blood is removed. When the blood is purified, she should be given to drink for three days oil- or milk-pap prepared with vidārigandhā. Then she should be given, according to the condition of her vitality and digestive power, rice with deer-sauce prepared with corn etc. When she has taken this diet for one and a half month, the restrictions in relation to her diet and mode of living are stopped, and she is no more considered as sūtikā. According to some, this is so when menses appear again (Su 3.10.16). Her body is also anointed and is covered with long piece of cloth in order that vāta may not enter her body and harm it. Anointing of the body, smearing, baths etc. are in general recommended to the woman along with strength-giving food and drink. Such care of the woman is necessary, lest difficult or even incurable diseases may threaten her (Car 4.8.47 f.; AS 2.3.212 f.; AHr 2.1.94-100 f.).

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(1) Hillebrandt, Rituallitteratur, § 13. Cf. Oldenberg, Die Religion des Veda, pp. 337 f. (2) So even at present, e. g. Bose, The Hindoos as they are, 22. (3) Cf. Hillebrandt, l. c. § 13. (4) So even at present, cf. Chevers, A Manual of Medical Jurisprudence for India, 769.

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§ 43. Care of the New-born :— Immediately after the birth the child should be cleansed with egg-kernel and rock-salt, and butter should be given in its mouth. Hereafter proceed the acts which correspond to the "life-giving" ceremonies (āyuṣyāni) of the Gṛhya sūtras¹ and which aim at the enlivening of the child fatigued by the act of birth and sprawling helplessly. Two stones are rubbed on the ears of the new-born, the ear-roots are moisted with cold or warm water, Balā oil is applied to the child, a piece of cloth moisted with butter is placed on its head, a saying expressing the desire that it may live for a hundred years is uttered in its right ear (Car 4.8.46; Su 3.10.12; AS 6.1.170; AHr 6.1.1-4). According to Car (l. c. 40) the cleansing of the child takes place only after the life-giving ceremony, and the giving of salt and butter serves as an emetic (pracchardana). When the child is awakened, the umbilical cord should be tied eight (four-AS, AHr) fingers away from the navel with a linen thread and it should be cut with a sharp knife. Then the end of the thread should be hung loose around the neck of the child (in order to obstruct the flow-Dallana) (Car 4.8.44; Su; AS l. c.; AHr 6.1.5). If the navel of the child is painful, it should be rubbed and a powder should be sprinkled on it. If the umbilical cord is not properly treated, painful crookedness of the body, gasping for breath and other diseases

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(Tetanus ? see below) are caused. The child is, therefore, to be treated with ointments that are mild and appeasing vāta and pitta, with smearings, sprinklings and butter. Hereafter the ceremony of jātakarman¹ is to be performed. Honey and butter are to be given to the child to eat according to direction, then in the same manner the right breast of the mother is to be given first to drink, then a pitcher is to be placed near its head with recitation of mantras. This is according to Car 4.8.46. According to Su 3.10.13-15 the child should be aroused with cold water, then the jātakarman ceremony should be performed and then it should be made to lick mixture of honey, butter, (root of) anantā, brāhmī-juice and powdered gold which should be put in its mouth with the small finger. Hereafter Balā oil should be applied to it, and it should be washed with a decoction of trees yielding milk, or with fragrant water or with water made hot with heated gold or silver, or with a lukewarm decoction. Since the milk comes in the woman only after three or four days, the child is given to drink honey and butter mixed with anantā consecrated with sayings (mantras), three times on the first day, butter prepared with lakṣmaṇā on the second and third day, then (on the fourth day) mother's milk with honey and butter as much as can remain on the palm of the hand, two times a day. Thereafter, according to AS, AHr, the child should be allowed to drink as much milk as it desires. From AS 6.1.170 f. and AHr 6.1.6 f. it is also to be gathered that after the washing or bathing of the child, its lips, tongue and throat should be wiped off with the small finger of the right hand covered with a piece of cotton cloth, whereupon the feeding of the child with a small quantity (hareṇu-mātra) of honey and butter mixed with a paste of certain plants follows, in order to give the child intelligence, long life and strength, corresponding to the medhājanana of the Gṛhya sūtras³. The clothes and the bed of the child should be soft, light, clean and fragrant (Car 4.8.46; AS 6.1; AHr 6.1.25).

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A series of further performances is aimed at the protection of the child and the woman from demons⁴. Thus the physician should spread over the room with twigs, the child should also be fanned with the same, mustard and other corns should be spread in the room and the room should also be filled with their smoke, a fire-offering should be made two times a day, a pestle should be placed before the door prior to the naming ceremony (see below), a bundle of certain twigs and of plants which are called rakṣoghna ('demon-killing') should be tied on the upper threshold of the door and also on the body of the child, the (abovementioned) fire should be maintained, a Brāhmaṇ should perform atonements and say prayers for ten days, the women as well as friends and relatives should keep a watch for ten or twelve days and the room should be enlivened with songs and music and provided with food, drink etc. and cheerful persons (Car 4.8.49; AS 1. c.; Su 3.10.29). These customs are to be observed especially on the sixth night (AHr 6.1.21; AS 172). This corresponds to the still existing cult of Ṣaṣṭhī, "the Goddess of the sixth" which is attributable to the Tetanus frequently occuring on this day or a little later¹ in consequence of the defective separation of the umbilical cord.

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On the tenth day or on the day after the 10th night or on the 12th day the woman is allowed to rise from her bed and the ceremony of naming (nāmakaraṇa) takes place which is described in a manner similar to that in the Gṛhya sūtras². Along with the popular name, the child receives another name which is derived from the constellation at the time of its birth. At times it receives only the latter (Car 4.8.49; Su 3.10.24; AS 6.1.172; AHr 6.1.22 f.). In the fourth month the child is nicely adorned and is taken out of the room in order to worship the gods, corresponding "the first going out" (niṣkramaṇa, niṣkramaṇikā) of the Smṛtis and Gṛhya sūtras³. In the fifth month the child is placed on the floor with the utterance of a saying in which the earth is called upon to protect it like a mother. In the sixth month the first feeding of the child (annaprāsana) is observed as is laid down in the Gṛhya sūtras⁴. With this ceremony begins the weaning off of the child. In the 6th to 8th month, a physician should make a hole in its ears, in the case of a boy in the right first, and in the case of the girl the left, whereupon jewels fixed in a golden ring are hung on the ears. When the child has got teeth, it should gradually be weaned off, and milk (of goat and other animals), light substantial food and sweets etc. should be given to it (AS 6.1.173-5; AHr 6.1.28-40). Su 3.10.52 (cf. AS 1. c. 175) also speaks of the instruction to be imparted to the male children according to their status as soon as they have reached the requisite age and also speaks of their marriage. See § 39.

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The toys of the child should be coloured, making noise and entertaining. They should not be heavy, should not have a sharp edge, should not be penetrable in the mouth and should not be dangerous to his life or frightening him ( Car 4.8.62 ). Precautions should be taken not to frighten a child, or not to threaten it with demons even though it is disobedient, even though it cries or does not wish to eat, lest it might be taken possession of by the *graha*- the frightful disease-demon of the child ( cf. § 50 ). One should also not wake the child suddenly or handle it violently, as such a course may disturb the tridosas of the body and stop the natural secretions. One should seek to cheer it in hundredfold ways. One should not always allow it to lie on the ground, lest it might get crookedness of the back. One should guard it against wind, Sun, lightning, rain, shadow of a house, evil plants, demons and other dangers, and should tie an amulet on it. Children's diseases (cf. § 50) should be warded off with mild remedies. Purgatives are to be completely avoided except in difficult cases ( Car 4.8.63-64; Su 3.10.41-45; AS 1. c. 173-6; AHr 6.1.42-50 ). Car 4.8.58 ( cf. AS 173 ) also speaks of the construction of a special room for the child (*kumārāgāra*) by an expert architect. It should be protected from wind, but there should be free ventilation on one side. It should be well endowed with furniture, water, cooking place, should be clean, free from insects, bright and nice etc.

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(1) Hillebrandt l. c. § 14. (2) According to MN 2.29 and the Grhya sutras the Jatakarman, on the contrary, takes place before the cutting of the placenta. See Speijer, jatakarma, 47, Hillebrandt l. c. According to Ward in Chevers l. c. 769 even at present the ceremonies taking place after birth, yet before the cutting of placenta use to continue for two hours. (3) Hillebrandt l. c. (4) Cf. Hillebrandt l.c. (5) Crooke, *Folklore of Northern India* ( London 1896 ) 1, 131. (6) Hillebrandt §§ 15. 17. (7) l. c. § 19. (8) l. c. § 20.

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§ 44. The Wet-nurse :- The mother's milk is recommended as the best food for promoting growth and nourishment. If it is not healthy, a wet-nurse should be engaged (AHr 6.1.15). The wet-nurse (*dhātrī*) should be of the same status in society as that of the child, of middle stature, neither too thin nor too fat, healthy, of good behaviour, free from blameable inclinations, not greedy, not crippled or crooked or of frightful appearance, clean, loving, belonging to good family, not of low caste or of inferior occupation, reliable, of elegant dark complexion, chaste, one whose child is living and is of male race and healthy, and who has plentiful and healthy milk. Her

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breasts should not be too raised, or should not hang loose and low, should not be too thin or too full, possessing good nipples from which the child can suck without trouble. The effect of raised breasts is that the mouth of the child opens wide (which may cause dislocation of jaw); the loose breasts would cover its nose and mouth, so that it may suffocate. Signs of healthy milk are that it mixes with water when put in it, is cold, clean, thin, ( white ) as a shell, does not produce bubbles or threads (in water), does not float on the surface or does not sink. By such milk the child grows and nourishes and becomes healthy and strong (Car 4.8.51 f.; Su 3.10.25; 31; AS 6.1.172). Bad milk floats on water, is dark-red, dry, frothy, light, not satisfying the child, causing diseases of vāta, having sour aftertaste, constipating etc., if it is affected by vāta. It produces yellow stripes in water, is black, blue or copper-red, causing diseases of pitta, very warm, bitter, sour and pungent in aftertaste etc., if it is affected by pitta. It sinks in water, is very white, sweet, of saltish aftertaste, sticky, causing diseases of kapha etc., if it is affected by kapha ( Car 4.8.54; Su 3.10.31 f.; AS 6.2.177; AHr 6.2.2-4 ). Defective feeding of the mother or of the nurse is considered as the chief cause of such derangement of the doṣas ( Su 3.10.32; AS 1. c. ). Milk is the sweet extract of the digested food which is gathered in the breasts from the whole body (Su 2.10.16). The mother's milk can entirely dry up by vehement passions like anger, grief, sensual love and also by unhealthy food and drink. In order to increase the milk the woman should eat barley, wheat, rice, flesh of swampy animals, sour gruel, garlic, fish, vegetables, spirituous drinks with the exception of rum, milk, flesh-broth, and the like. Evasion of exercise and cheering are also recommended ( Su 3.10.30; AS 6.1.172; Car 4.8.51 ).

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Bad milk causes various diseases which an expert physician knows by symptoms. If the child has got pain in any part of body, it always touches the same again and again, and cries if others touch it. In headache it closes the eyes and cannot hold the head straight. In heart-disease it bites the tongue and lips, breathes with difficulty, closes the fists and looks upwards. If the bowels are defective, there is retention of urine and constipation, vomiting, flatulence, tremor in body, the child becomes pale, bites mother's breast, its back becomes crippled and its belly swells. In diseases of bladder the urine is retained with pain and there is thirst, uneasiness, rolling of eyes and senselessness. If the whole body is suffering, the child cries unnaturally ( Su 3.10.33-36; AS 6.2.277; AHr 6.2.5-8 ). Cough, difficulty in breathing, fever and vomiting are caused if the suckling baby drinks excessively thick milk from too full a breast from which no milk comes out. Therefore, such milk should be avoided (Su 3.10.29; AS 6.1.172). The bad milk of the mother or the nurse should be "purified" by different medicines. An emetic and purgative are particularly recommended; the patient must also take a specific diet (Car 4.8.49f.). Medicine is given to the mother and the child if the child is fed only with mother's milk or with mother's milk and rice. It is given to the child if it is fed only with rice. The child takes the medicine mixed with butter or sugar, or it is applied to the mother's breast as a paste which the child sucks, or the lip of the child (kṣīrapa) is smeared with it. In fever the child should not be allowed to the breast in order to pacify its thirst. Purgatives, enemata, and vomitings are also inadmissible except in danger of life. In certain cases nourishing and perspiring remedies, anointings, cold baths etc. are prescribed. Thus a painful swelling of the navel, denoted as tuṇḍī should be treated with hot poultice, the inflammation of the anus with ointment and medicines of rasāñjana (Su 3.10.37-44; AS 6.2.177; AHr 6.2.9-19). Particularly bad is the disease kṣīrālasaka ("milk-tympany"): the child gets diarrhoea which is watery, bad smelling and frothy, passes white-yellow and sticky urine, suffers from fever, nausea, thirst, vomiting, flatulence in stomach etc. The treatment chiefly consists of emetic to be given to the wet-nurse or mother as well as to the child (AS 6.2.128f.; AHr 6.2.20-24 ).

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The first application of the child to the breast takes place in a ceremonial manner. The mother or nurse having sweet, plenty and pure milk should bathe on an auspicious day of the lunar month and apply toilets to herself, should wear a white clean garment, should carry with her certain tonic herbs, should turn her face towards the east, should let the child drink the previously washed right breast with its face turned towards the north, after some milk from the same is let out. At that time a saying is to be uttered which expresses the desire that the child may obtain a long life by drinking the milk contained in both the breasts, as the gods obtained the same by the use of ambrosia ( Car 4.8.57; Su 3.10.25-27; AS 6.1.172 ). According to AHr 6.1.15 f. the child should have not only one, but two nurses.

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In case the breast-milk is not available, the child should be given goat's milk or cow-milk, not much at a time, according to AS, with the addition of certain roots. After six months the rice-diet commences. See above § 43 (Su 3.10.48 f.; AS 6.1.173)

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§ 45. Abortion :— Premature births are brought about by food or drink that is too heavy, warm or pungent, particularly by flesh and intoxicating drinks, insufficient feeding, fasts, indigestion, unaccustomed physical exercise, sexual intercourse, violent movements, riding in a fast going carriage, running, stumbling, tumbling, falling in a grove or a well, sitting in an uncomfortable posture, wandering by night, suppression of natural excretions, anger, grief, anxiety, fright, sudden hearing or looking, diarrhoea, emetic and purgative, abortive things and other injuries (Car 4.4.18; 4.8.22; Su 2.8.3; AS 2.3.106; AHr 2.1.44-47; 2.2.22). The foetus comes out either as an unripe fruit, or withered or expires in the womb (AHr 1. c.). As the fruit which is devoured by worms or is shaken by the wind falls down before time, so the foetus comes before time if it is loosened from the connection (with the mother) in consequence of some injuries; in a normal birth the foetus is loosened from the placenta at the expiry of its time like a ripe fruit which is loosened from its stalk. Abortion in the beginning of pregnancy is called garbhavicyuti, garbhavidrava. If the pregnant woman menstruates on account of defective retention in the first two or three months, it is clear that the foetus will not remain, for in this period it does not become firm (Car 4.8.24; Su 2.8.7-9; AS 2.4.214; MN 456). In the disease of female genitals which carries the name putraghni ("killing the son" § 49), the flow of blood (raktasamsrāva) is considered as the cause of death of the foetus (Su 6.38.13). According to Su and MN such early births extend to the fourth month. On the other hand, an abortion in the fifth or sixth month when the body of the foetus has already become firm, is denoted as garbhapāta (Su 4.8.10; MN 418). Others take the period of garbhapāta to begin with the fourth month (Car 1.c.; Bhoja in citations). The phenomenon of abortion according to Su, AS is that the loosened foetus comes out of the womb and deranges the intestines. The derangement of nervous energy in the lower abdomen causes violent pains in the neck of the bladder, abdomen, sides and the vagina; it causes constipation and retention of urine and kills the foetus while it is still young and drives it out (Su 2.8.3; AS 2.4.216).

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If, on the contrary, the foetus is developed and dead, the womb looks stretched, tight and cold as if there were a stone inside. The pain is very violent, the foetus does not move, there appear no birth-contractions and there is no excretion from the vagina; on the contrary there is giddiness, thirst, difficult breathing and exhaustion, the eyes are sunk, the woman feels herself very uncomfortable, wavers around, gets convulsions, is partly unconscious and fatigued, cries, cannot sleep by day and night on account of difficult breathing, snorts, feels pain in taking breath and becomes cachectic. By these signs the death of the foetus is known (Car 4.8.26; AS 2.4.216; AHr 2.2.22-24). Su 2.8.9 mentions as symptoms the cessation of child's movements and birth-throes, a blackish pale colour of the face, stinking breath and pricking pain.

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Similar symptoms appear if the foetus does not grow on account of the disease of the placenta and deficient feeding caused thereby. In this case it is called *upaviṣṭaka* when it neither grows nor reduces, *upaśuṣkaka* or *nāgodara* when it is reduced and the lower part of the abdomen of the mother becomes smaller, and *līna* when it does not throb and does not move (AS 2.4.184 f.; AHr 2.2.14-18; Car 4.8.26-27). Here (i.e. in the case of the *līna* foetus) the case apparently seems to be that of abdominal pregnancy. When people say that the child has been carried away by *Naigameṣa*, the case seems to have been that of a false pregnancy (Su 3.10.57; AS 2.4.216; Bhāv 2.4.184).

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