Prasuti Tantra (Text Book as per CCIM Syllabus)

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The book is written according to the curriculum framed by the Central Council for Indian medicine for Prasuti tantra subject (Paper-I) for BAMS graduates. Part-A and B of the syllabus are given separately.

Each topic is provided with Ayurvedic and modern concepts simultaneously.

Relevant slokas are given in Devanagari in each topic at appropriate places along with references.

All the literature, which is relevant to Obstetrics and Gynecology available in Ayurvedic classics, was consulted while preparing the book for authenticity and to bring conclusion of each topic.

To make the things easy to the students one annexure is given at the end, containing important Ayurvedic formulations useful in Prasuti tantra.

One Glossary of Sanskrit terminology is given along with probable equivalent medical terminology at the end. Back index of Ayurvedic as well as Modern aspects is given for easy reference at the end.

Pictorial representations and charts are also given at appropriate places for easy understanding of concepts.

Dr. Bharati Kumaramangalam passed BAMS from S.V. Ayurvedic Medical college, Tirupathi in 1994 and did her Masters degree in Prasuti tantra of Ayurveda from Banarus Hindu University under the able guidance of Prof. Premavati Tewari, Ex, dean, faculty of Ayurveda, Banaras Hindu University, Varanasi. She also did Diploma in Nutrition and Health Education courses in Yoga, Sanskrit and Hindi. She is doing her Ph. D in the National Institute of Ayurveda, Jaipur.

At present she is working as Research Officer (Ayurveda) in Central Council for Research in Ayurveda and Siddha for seven years. Earlier to her joining in the council she served as Lecturer/Physician, in the Dept. of Prasuti tantra and Striroga in S.D.M. college of Ayurveda, Hassan and S.J.S. Ayurveda College, Chennai for three years.

Dr. Bharati dealt several Clinical Research projects on Alpartava, Raktapradara, Rajonivritti lakshana, Vandhyatva, Vyanabala vaishamya, Slipada, Tamaka swasa, Medoroga, Vishamajwara (Prophylactic and curative) etc.

The author presented several clinical and scientific papers at Regional, National and International seminars.

She had more than 20 publications in standard journals and also published several articles in newspapers.

Author also had given guest lectures at various prestigious institutions and radio talks.

She published a book in Telugu 'Bhallatakamritam' and Translated 'Bopadeva satakam' into English which is under publication.

Since vedic period there has been continuous tradition of teaching and learning of Ayurveda in India through GURUKULA system. Sanskrit was the common language adopted and medium of academic activities in those days. The great thoughts of Acharyas have also been recorded which contains pearls of wisdom for natural science, life a science etc. and we are still, enjoying by adopting the same through its implementation in our day to day way of life to maintain the traditional Indian knowledge and culture.

The science of life and art of living Ayurveda and its way of disease management has become a noble profession. Those who pay full devotion to this profession could reach the top of the human service and hence who opts for Ayurvedic learning has to cultivate an aptitude for hard work from the very beginning with devoted and dedicative mind.

This text book is a comprehensive volume of Prasutitantra with entire syllabus prescribed for the Bachelor of Ayurveda Medicine and Surgery designed by CCIM for the universities of India. Instead of searching materials from here and there the prospective Ayurvedic students can confidently depend upon ‘Textbook of Prasutitantra’ as a text and leading force. Thos book is designed and arranged in an applicable manner which can be found beneficial not only by the students of B.A.M.S. course but also by all Ayurvedic scholars, Physicians and allied subjects learners.

As a matter of great appreciation I can assure that all aspects of Obstetrics with references to Ayurveda (Prasutitantra) have been brought out briefly well with six chapters as two parts as in 350 pages, which covers a vast area varying from ancient Indian Prasuti Tantra to up to date modern aspects of obstetrics with necessary illustrations and references.

Whole heartedly it can be mentioned that this book could be of much use and will definitely meet the requirements to all Ayurvedic students and surely welcomed by all Ayurvedic lovers.

I have immense pleasure to recommend this book to all Ayurvedic students and to those who are interested to learn about Obstetrics with reference to Ayurvedic science i.e. Prasuti Tantra.

In Ayurvedic classics, while dividing the Ashtanga chikitsa’ topics related to Obstetrics and Gynecology are described under the heading of Koumarabhrityaka by Charaka, Kumaratantra by Susruta, Koumarabhritya by Kashyapa, where as Vagbhata given the name Bala chikitsa. Socio-cultural system prevailed during early centuries was treated lady as merely a machine of reproduction. In the changed scenario of modern era, Obstetrics and Gynecology emerged as a specialized entity and it is well established that female body is different from male body in respect to reproductive system. During pregnancy female body has to endure lot of physiological changes and if left uncared leads to the maternal, fetal, neonatal mortality and morbidity.

Anatomically and physiologically there are differences between male and female. Female pelvic anatomy is different from male pelvis and female has extra physiological functions than male such as menstruation, fertilization, carrying of fetus and its delivery. Due to these specific functions of the reproductive system, female is more vulnerable to serious disorders too. The aim of creating a healthy progeny with high qualities (Eugenics) can be fulfilled if care starts before conception itself. The diet and lifestyle of mother influences the metabolic imprinting of the fetus inside the uterus. Hence it is highly essential to study the reproductive tract disorders and antenatal care, labour management etc., under the separate heading ‘Obstetrics and Gynecology’.

In the field of Prasutitantra and Striroga extensive Research is needed since this branch does not find much place in classics with its proper identity and detailed intensification and explanations, as the needed information of Prasutitantra and Striroga are scattered in the classical texts here and there. This leads to considerable difficulties to the needy scholars, students and physicians for their day to day needs. Hence it is felt to bring out a comprehensive compilation text according to CCIM syllabus, under the heading ‘Text-book of Prasutitantra’ to minimize the referral task and to have consecutive knowledge of Obstetrics and Gynecology with reference to the Ayurveda for Ayurvedic Samhitas.

In the present endeavor I tried to bring all the topics related to Prasutitantra from the classics and placed according to the curriculum framed by Central Council for Indian Medicine. Some of the topics framed in the syllabus are purely modern aspects and are necessary to learn obstetrics in a comprehensive manner. Thereby, short description about the relevant modern topics also been given. In most of the instances, an attempt has been made to throw light on the significance of concepts described in classics. The subject for this text has been collected and translated in consecutive order, with summarized opinions and treatment both in classical and modern aspects.

This book consists of two parts, A and B, part-A deals with Anatomy of female genital tract, physiology of menstruation, conception, antennal care, fetal disorders, pregnancy complications. Part-B deals with the Labour process, management and complications of Labour with their management, Lactation and related disorders, Safe motherhood, Family Welfare etc.

Part-A contains four chapters and Part-B two chapters. One Annexure has been given at the end, as a ready reckoner of useful Ayurvedic formulations of Obstetrics for students. For clarification and easy reference of students, few illustrations also have been provided.

An attempt to write this book has been made Inspite of ignorance about the subject and insignificant knowledge of language and hope all of the readers will bear with me for any drawbacks and will provide an impetus to me for taking up more such work in future. Since this is my first step in this direction, inexperience is the cause of any variations and mistake occurred in this work and I apologize for the enumerable short comings of this work.

Medicine being inevitable tool for maintaining creatures, emerged parallel to creation or even before-hand. (S.S.Su. 1.6). Maharsi Caraka says that Ayurveda (the science of life) is beginningless and eternal (C.S. Su. 30.25) and emphasies that there is no substance which can not be used as drug (C.S. Su 26.11). it can be presumed that prehistoric man derived his medicinal substance from vegetables, animals and minerals more so from plants and this very system continued even in later ages. (C.S. Su. 1.69).

Ayurveda is said to be saswata, as there has never been any break in continuity of this tradition, which has come down to us in present times, albeit some change in the form and content has taken place from age to age but the eternal motive and instinct to protect from miseries and diseases has not changed.

As in Rgveda and Atharvaveda sufficient medical substance is available, hence, in ayurvedic classics it is mentioned as upanga (section) (S.S. Su 1.6) or upaveda (A.S. Su 1.10) of Atharvaveda or even Rgveda (Bhagvata. 3.12: 37-38). Though Caraka has not explicitly mentioned it upaveda of Atharvaveda, yet, has shown inclination towards it because of its extensive dealing in medicine (C.S. Su. 30.21). This confusion seem to have arisen due to eternity of ayurveda just like other Vedas and also all these having been said to be preached by Lord Brahma, Probably because of this Maharsi Kasyapa has enlisted Ayurveda as fifth veda rather more important than other four and has equated ayurveda as thumb while other four Vedas as four fingers of hand, because Ayurveda maintains physical and mental health and only physically and mentally healthy person can listen, understand, read and preach other Vedas (Ka. S. Vi. 1/10).

During vedic period the medicine was mostly magico-religious one, its exact systematization has come up during samhita-kala of ayurveda, wherein for clinical or practical application it is divided under eight branches. Due to destruction of human population by natural calamities, epidemics, other diseases as-well-as carnivorous animals, which was already less in comparision to available natural resources and land, augmentation of population was a dire necessity. The ayurveda or its patrons were patronized by king's, to whome birth of their legal heir i.e. Kumara was extremely desired. Inspite of recognition of importance of raja, sonata, rakta, or artava for fertilization the woman was considered only as a field (ksetra), her place in society was for delivery of a child (prajananartha mahabhaga…etc.), as she nourishes, maintains and then delivers the offspring, any psycho-somatic condition can influence, the achievent, growth and development etc. of the child. In other words Kumara or child being more important, thus being a pivot entire physiopathologies of woman have revolved around it and the anga is named as Kaumarabhrtya or Kumarabhrtya.

In earlier days the ayurvedic education was imparted mainly in gurukula system, the deciples used to live with the teacher, learn theory and practice of ayurveda. With the passage of time this system of education specially in 20th century changed. Governmental, university and private institutions started education of ayurveda under the banner of these eight branches, however, pattern of teaching of modern medicine influenced the teaching pattern of ayurveda also and certain other subjects as a distinct specialities came into existence, yet the status of Kaumarabhrtya remained unchanged rather mother dominated and the department became the Prasutitantra at certain places. There was no uniformity in curriculam and minimum standard of facilities. During last few decades of twentieth century vat change in research and education scenario of ayurveda took place after establishment of CCRAS (Central council for research in ayurveda and siddha) and CCIM (Central council of Indian medicine).

CCIM has now taken full hold of ayurvedic education by fixing norms for minimum facilities in any institutions, qualification of teachers, specific curriculum of every subject and one uniform degree. In this process prasuti tantra with stri-roga and Kaumarabhrtya or bala roga have attained independent status.

Until the man invented scripts and method of scribing, the information was transmitted through acts, hints or verbal communication, however after the scripts sheets or stones realizing them the most potent, pertinent, permanent and practical method of transmission of knowledge from one generation to the other or from person to person are the written records. The advent of papers and method of publication has made us available ancient ayurvedic classics, but then these deal with entire ayurveda and to collect the matter concerning a particular subject one has to scan whole classic, that too, not one but almost all available books; which becomes practically impossible for a student specially at a graduate lable. The books on specific subjects are actually boon to students and teachers. The attempt made by Dr. Bharati is a bold. Praiseworthy in that direction. Dr. Bharati has proved that academics and research are the two sides of the same coin, as she being engaged in research activity at a responsible high post could find time to study the books both ancient ayurvedic and contemporary books of modern subject and then cribe in a manner intelligible to students. Discription of subject not mentioned in ayurvedic classics from modern medical literature has enhanced the value of the book many fold. Addition of specific recipes to be used in treating the cases is a noteworthy attempt; not done so for by any author. I congratulate her for this endeavour and hope that her journey in this direction would not halt here, she will very soon complete the book on striroga and many more in this and other subjects. I wish her all success in life.