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Mother and Child Care in Traditional Medicine
Therapeutics During Pregnancy
The physical and psychological disorders of
a pregnant woman are no different from any other
individual as the doshas and dooshyas of
the body remain the same. However, the principles of
management differ as teekshna, katu and strong
medicines would harm the foetus. Thus the choice of drugs
for the disorders occuring during pregnancy should be
restricted - they must be mrudu (mild), sheetha
(cold) madhura (sweet) and hrudya
(pleasing). But when mother's life is in danger then she
should be saved by the use, if necessary of drastic
measures and pungent drugs, even if it may be harmful to
the foetus (Ash. San. Sha. 2/62-63). If the
disease is acute and/or serious emetics can be given
followed by the use of sweet and sour substances mixed
with anulomaka drugs (carminatives). All the
pacifying drugs should be mrudu, (i.e.) mild and
be given along with food or drinks. In short, in the
words of Charaka, the pregnant woman should be
treated with all the care as when carrying a pot filled
with oil. Just as the slightest oscillation of the pot
causes spilling of oil, the slightest excitement to the
pregnant woman can initiate complications like abortion
etc. (Cha. Sam., Sha. 8/22).
The treatment in a pregnant woman depends on the month of
gestation as well as the severity of the disease.
Conditions
during Pregnancy and their treatment
- Body pain and joint
pain
- Dizziness
- Weakness (Paandu
roga/anemia)
- Nausea, vomiting,
morning sickness
- Swelling / oedema
- Night blindness
- Blurred vision
- Worms
- Piles
- Constipation
- Diarrhoea
- Fever
- Jaundice
- Measles
- Itching in the vulva
- Excessive vaginal
discharge (white/red)
- Burning sensation
while urinating
- Convulsions
- Pain in the abdomen
- Head ache
- Insomnia
- Kikkisa
(Striae gravidarum)
We have made an attempt to
outline some of the most common conditions and diseases
that are encountered during various stages of pregnancy.
We have also tried to give the causes, treatments and
preventive measures for the various conditions.
Some of
the medications* which can be administered in the common
ailments of pregnant women
- Body
pain/Joint pain
External application of Dhanvantra thaila,
Sahacharadi thaila, Visha garbha thaila, and
other Vaatha hara thailas is recommended.
- Dizziness
The suggested medicine is the swarasa of
shathaavari (Asparagus racemosa).
However it is essential that the root cause of
dizziness should be detected and treatment given,
as it may have various causes, like paandu,
general weakness or toxaemia.
- The medications given
here are based on the suggestions made by Aayurvedic
Vaidyas in a meeting held at Aalandi
(see Appendix II). The reader is advised to
consult an Aayurvedic Vaidyas, for any
ailment. This is NOT meant to be used as a
"manual" for treatment.
- Paandu
rogaOne of
major disturbing conditions during pregnancy is
paandu, or anemia during pregnancy. Aayurvedic
aachaaryaas have recognised this condition
and prescribed adequate medication, also taking
care not to cause any side effects which are
often seen during the administration of iron
supplement in the form of ferrous sulphate and
folic acid. This iron supplement does not find a
good compliance with the pregnant woman as it
increases the vomiting sensation and nausea and
also causes constipation in many women. To avoid
such reactions it is advised to take the
necessary iron supplement in a form that is most
suitable for her body and also in combination
with other drugs which help in controlling such
reactions.
Some of the combinations
in practice are:
- Lohasavam with
Draksharishtam (Draksharishtam acts
as a mild laxative)
- Dhaatri loha -
In this preparation, there is lot of aamalaki (Phyllanthus
emblica) which controls the nausea and
constipation. There is also some yashtimadhu
(Glycyrrihiza glabra) and guduchi (Tinospora
cordifolia) which also help in alleviating
the side effects
- Punarnava
mandooram - Punarnava (Boheavia
diffusa) acts as diuretic and hence helps to
prevent any retention of urine or oedema which if
often seen in pregnant woman especially at the
end of the second trimester and in the third
trimester
- Nausea
and vomiting
All the
classics have mentioned excessive salivation and
nausea etc. morning sickness) as symptoms of
normal pregnancy. Sushrutha has included
pregnancy also while describing the nidaana
of chardiroga (i.e). Vommiting. Madhukosha
commentary says that vaayu being pushed
upward by foetus gets provoked and causes
vomiting.
There are three specific
causes for this garbhaja chardiroga
- Vaatha Vaigunya
- Dauhrida -
avamaanana or non fulfillment of dauhrudya
- Garbha nimittha
or due to the foetus
Power of laaja
(puffed rice) with honey can be given, as it is the best
among anti-emitics. However the cause for vomiting is to
be checked, since vomiting may be a symptom for some
other disease.
- Sopha
(Oedema/Swelling)
This is another common condition. The treatment
here is two fold - oral medication : Decoction
of roots of varshabhoo (Boheavia
diffusa) mixed with paste of devadaaru
(Cedrus deodara) and moorva
(Mardensia tenacissima) or only devadaaru
with honey can be given.
External application - Sudation/fomentation with
hot water should be done. A paste of chandana
(Santalum album), madhuka (Glycyrrhiza glabra),
usheeram (Vetiveria zizanioides), naaga puspha,
tila (Sesamum indicum), ajasringa, manjishta
(Rubia cordifolia), root of ravi
and Punarnava (Boehavia diffusa), is
beneficial
- Night
blindness
Flowers of agasthi (Agathi grandiflora)
can be given. Nutritive food also should be
given.
- Blurred
vision
This
generally occurs as a secondary symptom in
conditions of paandu, so it can be cured
by treating paandu. Some "Loha"
preparation should be given.
- Worms
Vidanga (Emblica ribes) in the
dose of 3 grams with honey is suggested Pregnant
women are prone to have worm infestation because
they have dowhrudya which often results in
the desire for mud, ash etc.
- Piles
Untreated constipation may also be one of the
causes for piles in pregnant woman. Preparation
like Abhayarishtam and Dantyaarishtam
are advised. If constipation is the cause then it
should be rectified. Siddha vaidyas advise
Nathai odu bhasma or Nathai kari lehyam
(The preparations of snail shell and snail flesh)
- Constipation
Constipation is another common condition
during pregnancy. If the constipation is mild, draaksha
(Vites vinifera) and dry rose buds can be
given. If the constipation occurs due to Udavartha
during the eighth month of pregnancy and is not
relieved either by use of anuvaasana basthi(oils
medicated with the drugs of madhurangana)
or by intake of substances which are unctuous and
vaathahara, then it should be considered
as incurable. Nirooha basthi is given as a
next step of treatment.
Constipation may be caused due to the iron
supplement. So while administering any loha
preparation, we have to augment it with drugs or
preparations which would prevent constipation.
- Udavartha is a
variety of vaatha raga where in the vaayu
(flatus), faeces and urine have an upward
movement (unlike the normal movement which is
downwards0, this is due to downwards), this is
due to prathiloma (moving in the opposite
direction) of vaatha. This is generally caused
due to vegadhaarana (control of urges)
- Diarrhoea
Diarrhoea or athisaara can be due to a number
of reasons. This can be due to the use of
incompatible foods, eating before the digestion
of the previous meal, over eating, indigestion,
vega dhaarana (control of urges),
consumption of hard or solid substances (eg.
seeds, uncooked pulses and grains), excessives tharpana
(satiation) and langhana(emaciation),
eating uncooked roots and tubers, polluted water,
water, heavy and abhishyandhi dravyas, and
also hunger, grief or fear. In conditions of aama,
paachana drugs (like Ashta choornam) should
be given (Kas. Sam., Khi 10). A
decoction of bilwa (Aegle marmalos),
mustha (Cyperus rotundus), dhaanyaka
(Corriandum sativum)and jeeraka (Cuminum
cinimum)can be used.
- Fever
This is the most troublesome diseases in a
pregnant woman. The foetus is also affected due
to transfer of heat of fever from the mother to
the foetus. Fever may be due to - excessive
hunger, exertions, abhyanga, massage,
dryness, heat, retention of normal faeces,
improper use of snehana, swedana and agni
karma psychological strain, climbing on
mountains and smell of grass and flowers
(pollen).
Before the fourth month, the lady is advised a
fast for one day (fasting is contraindicated in
pregnancy as a general rule, but during jwara
(fever) it can be advised for a day), followed by
liquid diet (rice gruel) free from fat and salt.
After the doshas have subsided, cereals
with soups should be prescribed. advised meat
soups and milk. Pungent diet and drinks, exercise
and sudation should be avoided. No medicine need
be given.
During and after the fourth month medicines
should be given only after considering the month
of pregnancy and the doshas involved and
their degree of vitiation. Lekhana karma
and other such measures which make the body light
should be done after considering properly - the
complications of the disease, stamina and tolerance
of the woman and the month of gestation.
A decoction of mustha (Cyperus rotundus),
parpataka (Mollungo pentaphylla), chandana
(Santalum album) and sunti (Zingiber
Officinallis) can be given.
- For details on Aama
please refer section on aama Chapters III,
Aayurvedic Principles of Food and Nutrition Part
I, LSPSS Monograph II
- Jaundice
For treating jaundice the juice of bhooaamalaki
(Phyllanthus nirun) with honey and sugar
can be given or guduchi (Tinosposa
cordifolia), katuki (Pipcorrhiza kurrpa), chirata
(Swertia chirata) and daaruharidra
(Berberis aristata) are given in the form
of decoction.
- Measles
A decoction of nimba (Melia azadirachta),
dhaanyaka (corriandrum sativum), guduchi(Tinosposa
cordifolia) and patola (Trichosanthus
dioica) should be given.
- Itching
in the Vulva
A paste of haridra (Curcuma longa), nimba
(Azadirachta Indica) and chandanam can
be applied twice daily.
- Excessive
vaginal discharge
Some amount of discharge (Both as mucous and
bleeding)is normal during pregnancy but when it
is recurrent and excessive, medical advice is to
be taken immediately. The case for the discharge
should be properly investigated and required
treatment should be given. The flowers of silk
cotton tree (Bombax malabaricum) should be
fried in ghee and taken with sugar early in the
morning.
- Burning
sensation during micturition
Gokshuradi choornam with warm water,
or just the decoction of gokshura be
should given.
- Convulsion
(aakshepa)
Convulsions may occur as a complication
of garbhajanya vishamayatha. She should be
given internally, a mixture of lime juice, bida
lavana (rock salk) and saindhava lavana
or a decoction of agnimantha (Premna
latifolia) and varuna (Crataeva
nurvala). It can also be treated according to
the doshic predominance In the later stages of
pregnancy ghrutha seka (sprinkling with
ghee) is advised. The seka can be hot or cold
according to the condition of the disease.
- Pain
in the abdomen
Pain in the abdomen may be to various
reasons, the actual cause should be detected and
treatment given. The decoction of yashtimadhu
(Glycyrrhiza glabra), shunti (Zingiber
officinale) and devadaaru (Cedrum
deodara) can be given to give relief. If the
pain is due to accumulation of gas, then she is
given garlic boiled in milk or Hingwashtaka
choornam or Lavana Bhaskaram. She can
also use more of asafoetida in her diet to avoid
accumulation of gas.
- Headache
A paste of dhaanyaka (Corriandrum
sativum) in milk is applied externally Here
also the causative factors should be detected and
avoided.
- Insomnia
Buffalo's milk can be given and externally abhyanga
over the head can be done.
- Kikkisa
(Striae gravidarum)
Stiriae gravidarum is defined as the
lines which appear on the abdominal skin,
especially around the umblicus due to the
stretching of the skin caused by the growing
foetus.
The Aayurvedic view is that the growing
foetus displaces all the doshas upwards
and reaching the chest region produces burning
and itching sensations. The result of this
itching are the linear lines on the abdomen.
Internally she can be frequently given butter
treated with the madhura gana drugs, in
the dose of 10 ml (approximately). Externally,
the paste of chandana (Santallum album)
and usheera (Vetiveria zizanioides)
or the paste of kutaja bark (Holarrhena
antidysentrica), seeds of arjaka (Orthosiplion
pallidus), mushta (Cyprus rotundus)
and haridra (Curcuma longa) can be
applied. Irrigation of the abdomen and breasts
should be done with decoction of patola (Trichosanthes
dioica), nimba (Azadirachta indica),
manjishta(Rubia cordifolia) and surasa
(Occmim sanctum).
One should avoid scratching to avoid
disfigurement of the stretching skin. If the
itching becomes irresistable then the powders of
kutaja, arjaka mustha, haridra, patola, nimba
manjishta, surasa etc. should be
rubbed or paste of chandana should applied will
suppress itching sensation due to its coolness.
Local
Traditions
It is interesting
to note that rural and tribal people are not only
competent enough in diagnosis and care during pregnancy
but are equally good in the management of diseases and
conditions during pregnancy. A comprehensive list of
conditions encountered during the various stages of
pregnancy and their treatment have been given earlier.
All the conditions (barring a few) are managed by them
with locally available drugs. While most of their
practices are healthy and should be encouraged, some are
irrational and risky and should be discouraged. Some
others are interesting and need further study.
Oil massage and hot water bath is advised for body pain
in Tamil Nadu, Kerala and Karnataka. The report from
Uttar Pradesh advises fomentation with hot water boiled
with ajamoda (Apium graveolens). In Gujarat
it is reported that warm water with leaves of shigru (Moringa
olifera) is more useful. Dizziness and nausea are
managed by oral administration of powder of dhanyaka
Corriandrum sativum) with sugar in Uttar Pradesh and
Tamil Nadu. Similarly juice of tulasi (Ocimum
Sanctum) is also used with sugar. Lemon juice is
widely used in Tamil Nadu and Karnataka. Some people in
Tamil Nadu also take ginger in the form of chutney.
Weakness and anemic conditions are managed by intake of
powder of badam (almonds) with milk. Ghee, milk,
fruits and nourishing food is also advised in Uttar
Pradesh, Tamil Nadu, Gujarat. Decoction of cardomom seeds
and aniseeds, chutneys and pickles made of gigner,
mint leaf and leaves of thiruvatchi (Bauhinia
Tomentosa) were also given. Siddha Vaidyas
prescribed the chutney made of thiruvatchi leaves
in conditions where the pittham is vitiated and
also when there is nausea and anorexia (9). Barley water
and tender leaves of taadphal tree (Borassus
flabelifer) with palm jaggery is advised
for oedema in Tamil Nadu. Both of them are mutrala (diuretics)
and help to reduce the fluid retention. For conditions
like night blindness and blurred vision there were no
significant responses. In conditions of worm infestation
the woman is given a decoction of jyothismathi (Cordiospermum
lelicacabum), in Tamil Nadu and Karnataka.
Piles was treated by intake of flesh of snails in Tamil
Nadu. Siddha vaidyas widely used preparations of
the flesh of snail and the shell of snails. The general
advise for relief from constipation is to include green
and leafy vegetables and fruits like plantains (8). While
in parts of Kerala and Tamil Nadu oral dehydration
is resorted to in diarrhoea, in Tamil Nadu it was
also reported that milk boiled with garlic (in the form
of lasuna ksheera paakam) is given. Also butter
milk rice is given and chillies and greens are avoided. Lasuna
ksheera paaka acts as a good aama paachana/
and agni deepana drug. The practice of avoiding
chillies and leafy vegetables is good.
Decoctions of Trikatu (Gingiber offcinale,
Piper longum and Piper nigrum) and Tulsi are
given in Kerala and Tamil Nadu for fever. Jaundice
seems to be very common and field groups were well
experienced in treating it. Bhooamalaki (Phyllanthus
niruri) used in Tamil Nadu and Karnataka. Also ghruthakumari
(Aloe vera) and bringaraja (Eclipta alba) are
used in Orissa and Tamil Nadu
Washing with salt water, decoction of haritaki
(Terminalia chebula) or plain hot water is advised
for itching in the vulva in Kerala and Tamil Nadu. In
Orissa it is advised to apply ghee locally. For excessive
vaginal discharge a decoction of ani seeds and tender
coconut was advised in Tamil Nadu. The woman was advised
to drink barley water and decoction of gokshura
(Tribulus terrestris), in conditions of
burning sensation while micturition. Gokshura
being mutrala (diuretic) relieves the
burning sensation.
Pain in the abdomen is teated by giving decoctions of dhanyaka
or decoction of fresh ginger with palm jaggery.
Externally castor oil or coconut oil is applied over the
abdomen. In cases of head ache, a paste of tender coconut
and breast milk is applied on the forehead in Kerala and
Tamil Nadu. The woman is advised to take more milk
(preferably buffalo's milk) at night, apply lime juices
or oil on the head, in Tamil Nadu to get relief from
insomnia. Buffalo's milk being "guru"
induces sleep. Applying lime juice and oil cools then
system and induces sleep.
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