Sexual intercourse during pregnancy, riding on horseback, etc., or in any sort of conveyance, a long walk, a false step, a fall, pressure on the womb, running, a blow, sitting or lying down on an uneven ground, or in an uneven posture, fasting, voluntary repression of any natural urging of the body, partaking of extremely bitter, pungent, parchifying articles, eating in inordinate quantities of Sákas and alkaline substances, dysentery (Atisára), use of emetics or purgatives, swinging in a swing or hammock, indigestion, and use of medicines which induce the labour pain or bring about abortions, and such like causes tend to expel the faetus from its fixture. These causes tend to sever the child from the uterine wall with its placental attachment owing to a kind of Abhighátam (uterine contraction) just as a blow tends to sever a fruit from its pedicel. 2.
The faetus, thus severed and dislodged from its seat, excites peristalsis not only in the uterus, but induces a sort of constant, spasmodic contraction of the intestinal cavities (Koshthas), producing pain in the liver, spleen, etc. The Apána Váyu, thus obstructed through the spasmodic contraction of her abdomen, produces any of the following symptoms, viz. a sort of spasmodic pain in the sides, or in the neck of the bladder, or in the pelvic cavity, or in the abdomen, or in the vagina, or Anáha (tympanites with obstruction, etc.) or retention of urine, and destroys the faetus, if immature, attended with bleeding. In case the faetus continues to develop and is brought in an inverted posture at the entrance-to the vaginal canal, and is impacted at that place, or if the Apána Váyu gets disordered and consequently cannot help the expulsion of the same, such an obstructed faetus is called Mudha garbhah. 3. Classification and Symptoms:-Cases of Mudha-gaibha may be roughly divided into four different classes such as, the Kilah, the Pratikhurah, the Vijakah and the Parighah. The sort of false presentation in which the child comes with its hands, legs and head turned upward and with its back firmly obstructed at the entrance to the vagina, like a stake or a kila, is called Kilah. The sort of presentation, in which the hands, feet and head of the child come out, with its body impacted at the entrance to the vagina, is called Prathikhurah. The type in which only a single hand and the head of the child come out (with the rest of its body obstructed at the same place), is called the Vijakah. The type in which the child remains obstructing the head of the passage in a horizontal position, like a bolt, is called the Parighah. Certain authorities aver that, these are the only four kinds of Mudhagarbha. But we can not subscribe to the opinion (which recognises only four kinds of false presentations), inasmuch as the deranged Váyu (Apána) can present the faetus in various different postures at the head of the vaginal canal. Sometimes, the two thighs of the child are first presented, and sometimes it comes with a single leg flexed up. Sometimes the child comes with its body, bent double, and thighs drawn up, so that only breech is obliquely presented. Sometimes the child is presented, impacted at the head of the passage with its chest, or sides, or back. Sometimes the child is presented with its arm around its head, resting on the side, and the hand coming out first. Sometimes only the two hands are first presented, the head leaning on one side; sometimes the two hands, legs and the head of the child, the rest of the body being impacted at the exit in a doubled up posture. Sometimes one leg is presented, the other thigh being impacted at the passage (Páyu). I have briefly described these eight sorts of presentation of which the last two are irremediable. The rest should be given up as hopeless if these are attended with the following complications viz., deranged sense-perception of the mother, convulsions, displacement or contraction of the reproductive organ (yoni) a peculiar pain like the after-pain of child birth, cough, difficult respiration, or vertigo. 4.
As a fruit, fully matured, is naturally severed from its pedicel and falls to the ground and not otherwise, so the cord, which binds the foetus to its maternal part, is severed in course of time, and the child comes out of the uterus ( into this world of action ). On the other hand, as a fruit, worm-eaten or shaken by the wind or a blow, untimely falls to the ground, so will a fœtus be expelled out of its mother's womb, before its time. For four months after the date of fecundation, the faetus remains in a liquid state, and hence its destruction or coming out of the womb goes by the name of abortion. In the course of the fifth and sixth months the limbs of the foetus gain in firmness and density, and hence, its coming out at such a time is called miscarriage. 5-7.
Prognosis: - The enceinte who violently tosses her head in agony (at the time of parturition) and the surface of whose bod)' becomes cold, compelling her to forego all natural modesty, and whose Bides and abdomen are covered with nets of large blue-coloured veins, Invariably dies with the dead child locked in her womb. The death of the foetus in the womb may be ascertained by the absence of movements of the fetus (in the womb) or of any pain of child-birth, by a brown or yellow complexion of the cuceinta, cade-veroiis smell in her breath, and colic pain in the abdomen and its distension owing to the continuance of the swollen and decomposed child in the womb. 8-9.
The death of a child in the womb may result from some emotional disturbance of its mother, (such as caused by bereavement or by loss of fortune during pregnancy); while an external blow or injury (to the womb) or any serious disease of the mother may also produce the like result. A child, moving in the womb of a dead mother, who had just expired (from convulsion-etc.) during parturition at term, like a goat (Vastamára) should be removed immediately by the Surgeon from the womb (by Caesarean Section); * as a delay in extracting the child may leads to its death 10-11.