Susruta Samhita - Mandhata Global

406 THE SUSHRtJTA SAMHITA. [Chap. XV.
presentation (the child coming stretched cross-wise) like
a belt and arrested in the passage, its lower extremities
should be pushed upward with the hand and the child
should be drawn out with its upper part {viz., the head,
etc.), thus pointed downward, and brought straight into
the passage of parturition. In a case of the head being
hung back a little on one side, the shoulder should be
lifted up by pressing it (with the hand) after chafening
it, so as to bring the head at the door of the passage
and the child should be drawn straight downward.
Similarly in the case of the presentation of the two
arms, the shoulder should be lifted up by pressing it
(with the hand) and, the head being brought back to
the passage, the child should be drawn downward.
The remaining two kinds of false presentation Mudha-
garbha) previously described (in the eighth Chapter of
the Nidana Sthana) should be considered as irreme-
diable. The applications of instruments (Sastra) should
be the last resort when such manipulatory measures
would fail. 5.
Metrical Text : —But even in such irremediable
(Asddhya) cases, surgical operations should not be made
if the foetus could be detected alive in the womb, as
such a course (as the cutting of the foetus, etc.) would
fatally end both as regards the child and its mother. 6.
Operations involving destruction of
the Foetus—Craniotomy : -In cases where
there would be any necessity of using an instrument for
the purpose of delivery, the enciente should be en-
couraged (with hopes of life) before making the surgical
operation. The head or skull of the child in such
cases should be severed with the knife known as the
Mandalagra or the Anguli-^astra ;
then having carefully
taken out the particles of the skull-bone (Kapala),