MOTHER AND CHILD CARE IN TRADITIONAL MEDICINE

( By LSPSS )

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Disorders Of The Foetus And Concluding Remarks

There are conditions in which, the improper diet and regimen of the mother, does not lead to garbhapaatha or garbhasraava, but becomes a chronic disorder and causes some deformity or intra uterine death at later stages of pregnancy. These are not very easily detected. Today we come across, various conditions like uterine moles, tubal pregnancies, vesicular moles and abdominal pregnancies Aayurvedic Aachaaryaas have described some conditions which have very similar signs and symptoms, though there may be variance in the causes and pathogenisis that have been described.

Signs and symptoms of abdominal pregnancy

Here is an exerpt from a obstetric book to show this point:

If the foetus dies after reaching a size too large to be absorbed it may undergo suppuration, calcification, mummification or adipocere formation. When the gestation sac adheres to the intestines, infection to the gestation sac and suppuration may occur. Eventually the abscess ruptures and if the patient does not die from septicaemia foetal parts may be extruded through the abdominal wall or more commonly through the bladder or rectum. In some, gestation may go on to term when a spurious labour ensures and the foetus dies, the liquor gets absorbed and the abdominal enlargement decreases. Mummification and formation of a lithopeodian occasionally ensue and the calcified products of conception may be carried for years without producing symptoms (6).

A few of such conditions are described below :



  1. Garbha Shosha

    Either due to non-availability of proper diet (nourishment to the foetus) or vaginal discharges (bleeding) after conception the foetus may suffer from sosha (emaciation or dryness). Such a foetus attains its proper growth or maturity after a long time and the woman delivers it after prolonged delay.

    According to Sushrutha, this is due to the affliction by vaayu - the foetus gets dried up, does not fill the mother's abodomen properly and quivers very slowly. The symptoms of this condition are as follows:-



    1. The size of the foetus is small and underdeveloped
    2. The quivering of the foetus is very mild.
    3. The fetal heart sounds are also very mild.

    Treatment



    1. The use of rooksha (dry) articles and those vitiating vaatha are to be avoided
    2. Bruhmaneeya (anabolic) drugs, milk and meat soup should be used.
    3. Milk treated with madhuyashti (Glycyrrhiza glabra), fruit of kaashmari (Gmelina arborea) with or without saareeva (Hemindesmus indicus) and mixed with sugar should be taken.


  2. Upavishtakam

    After the fourth month of pregnancy (i.e after the attainment of saara by the foetus. If due to the intake of pungent and hot (ushna and teekshna) aahaaras, the mother has bleeding or any other type of yonisraavam (vaginal discharge), it may lead to the improper growth of the foetus and the delay in delivery. This condition is termed as Upavishtaka

    Treatment
    Ghruthas which are generally given to treat afflictions of bhutas (semi divine beings) are prescribed o treat upavishtaka e.g. Vacha-ghrutha, guggulvaadi- ghrutha, mahapaishachika ghrutha. Also ghrutha medicated with jeevaneeya, bruhmaaneeya, madhura and vaathahara drugs can be given. Milk and meat soups medicated with the above groups of drugs or just milk and meat soups can be given without medication.


  3. Naagodara/Upashushka

    If the woman observes fasts, eats stale food, does not take fatty or oily substances and uses other vaatha vitiating articles, the foetus gets dessicated and does not grow. This foetus remains in the uterus for a very long time and does not quiver. This entity is termed as naagodara.

    Treatment
    The treatment for naagodaram is same as that of Upavishtakam.


  4. Leena garbha

    Due to obstruction in the srothases and due to vaatha the foetus becomes "leena"(clung or adhered). This foetus remains in the uterus for very long duration and gives rise to various complications.

    Treatment


    1. She should be treated with mild and predominantly unctuous sudation, emesis and purgatives, because strong emetics etc. Are likely to harm the foetus.
    2. Bruhmana gruels should be given
    3. The women should be kept happy.


Concluding Remarks *

As we had already outlined in the earlier chapters the local communities appear to have a very sound knowledge in the area of diagnosis of pregnancy. In other areas like the care of the pregnant woman and management of diseases during pregnancy there is a wealth of knowledge and several healthy traditions. However, knowledge is incomplete in some areas and it can be supplemented by inputs from ISMs. Certain practices have been identified which deserve to be investigated in greater detail.

However, it is most important that we need to examine and understand Lok Swaasthya Paramparaas free of any biased ideas. There are still a large number of "educational" pamphlets and material prepared by various government agencies that are now in circulation which reflect a Western ethno-centric bias. Some of them label several of our peoples practices are superstition, because of such a biased view point - namely the failure to look at the practices also from the point of view of our own scientific traditions. For example a point of view of our own scientific traditions. For example a pamphlet on Nutrition published by one of our prestigeous research institution has devoted a chapter to "Care of the pregnant woman". It says that - "There are other pregnant woman who believe that foods like egg, meat, pappaya etc. are "hot" foods and causes abortion..... All these beliefs have no scientific basis"(13).

Such short sighted attitudes prevail not only among academicians and researchers but they also seem to prevail among community health workers who presumably have a much more thorough and intimate knowledge of local practices and customs etc. For example a well known book that is meant to educate health workers states that "a lot of people believe that there are many kinds of foods that will hurt them or that they should not eat when they are sick. They may think of some kind of foods for "hot" sicknesses and "cold" foods for cold sicknesses. They may also avoid some foods which they have "pittham" or they may believe that many foods are for a mother with a new-born child. These beliefs may do more harm than good" (14).

The above examples have been good to illustrate the fact that all these evaluations and educational material have been produced with a high degree of ethno-centric bias. It would be necessary to rid ourselves of this limitation and understand these practices also from the point of view of our own scientific traditions, if we are to build on the strengths of these practices.

Since the material is continued in Part II a detailed overall conclusion will be given later; only some remarks are now presented.

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