Sushruta Samhita Sharira Sthana Chapter 10 (Garbhini Vyakarana): Kshirapa, Kshirannada, Annada and the Child Who Must Not Be Frightened

इस लेख को हिंदी में पढ़ें: सुश्रुत संहिता शारीर स्थान अध्याय 10: गर्भिणी व्याकरण और बच्चे की सँभाल

📖 24 min read · Classical text study · Sushruta Samhita, Sharira Sthana 10

Sushruta Samhita Sharira Sthana Chapter 10: What Garbhini Vyakarana Covers

The Sharira Sthana of the Sushruta Samhita is the section on the body. It has ten chapters. The first nine go from the elements a person is made of, through conception and the growth of the garbha, to the skin, the bones, the marma points, the vessels, venesection and the dhamani channels. The tenth, Garbhini-Vyakarana, is where the body stops being a subject of anatomy and becomes someone's child. The translation's own heading describes it as being about "the nursing and management, etc., of pregnant women from the day of conception till parturition". The text itself goes further than that heading. After the birth it spends ten pages on the newborn, the wet-nurse (dhatri), the mother's milk (stanya), the stages of feeding, how a small child is to be carried, soothed and kept safe, and it ends with four compounds for children and the words "Here ends the Sarira Sthanam".

We read the chapter in the second volume of Kaviraj Kunja Lal Bhishagratna's English translation, where it runs over printed pages 216 to 238. This edition prints the English with occasional Sanskrit words in brackets and no Devanagari, so every quotation below is the translator's English, and every Sanskrit word we add is a gloss we name as ours. Paragraph numbers are the ones printed in that translation. Sanskrit editions number the verses differently, so a "para 38" here will not match a verse 38 elsewhere.

Most of what the chapter says about pregnancy and birth is already covered on this site, in articles built on Charaka's parallel chapter. So this reading follows the thread that is new: the kumara, the child, from the first feed to the first rice. That thread turns out to be the most humane part of the chapter. It is also the part whose details most often line up with what paediatric guidance says today, and in two places line up against it.

The Chapter in Its Own Order, and Where Each Part Is Already Covered

Garbhini-Vyakarana has sixty numbered paragraphs in this translation, and they fall into three blocks. The first block is the pregnancy. Para 2 lists the conduct expected of the pregnant woman from the day of conception, para 3 gives a diet for the months of the garbha, and the same paragraph sets out the lying-in room, the sutikagriha. Charaka's version of all this, in far more detail, is the subject of our article on Charaka's garbhini paricharya, and Sushruta's own account of how the garbha forms is in our reading of Sharira Sthana 3, Garbha Vakranti. We do not repeat either here.

The second block, paras 4 to 19, is the birth and the days after it: the signs that labour is near, the attendants, the first cleaning of the newborn, the cord, the birth rite, and the mother's diet for the month and a half that follows. Charaka covers the same ground, and our article on Charaka's sutika paricharya reads it closely. Two short parts of this block matter to the child's thread, and we take them below: the timing of the first feeds (paras 13 and 14) and the silk and branches of the newborn's first days (para 20).

The third block, paras 20 to 60, is the child. It opens with the newborn's room and the naming, moves to the wet-nurse and the milk, then to the three kinds of child and how each receives medicine, then to handling and safety, then to education, and it closes with a series of clinical passages and a final verse of compounds. The wet-nurse's qualities and the test of milk in a bowl of water belong, on this site, to the Charaka article above and to our reading of Sushruta's Nidana Sthana chapter on milk, which already explains that test. The signs the chapter attributes to the grahas of infancy are deferred by Sushruta himself "later on in the Uttara-Tantra", and our reading of the nine Bala Grahas covers them.

What is left, and what no article of ours has discussed, is the chapter's practical picture of a small child: how it is classified, how medicine reaches it, when its food changes, and how the adults around it are to behave. That is this article.

Kshirapa, Kshirannada, Annada: Three Kinds of Child, Named by What They Eat

Para 29 is the paragraph on which the whole child's section turns, though it looks at first like a note about amounts. It divides children into three kinds. There is the child "living on milk alone". There is the child "fed both on milk and (boiled) rice", which the translator marks with its Sanskrit name, Kshirannada. And there is the child "living on solid food only". The Sanskrit names for the other two follow the same pattern: kshirapa, the milk-drinker, from kshira, milk, and annada, the food-eater, from anna, food. The translation prints only the middle name and gives the other two in English, so we name them here as the standard terms, not as words read off this page.

What is striking is the axis. The chapter does not divide childhood by age in months or by size or by teeth. It divides it by diet, and takes the diet as the fact that decides everything else. A kshirapa is one kind of patient, a kshirannada another and an annada a third, and the paragraph gives each its own route and its own measure. The months appear only indirectly, in the sense that a child moves from the first kind to the second when rice is added in the sixth month (para 40), and from the second to the third when milk is finally left behind.

Milk, milk with rice, and rice alone: the three kinds of child in para 29 are named by what they eat.

There is a quiet logic in choosing food over age. Age is a number that says little about a particular child. Diet says exactly how that child's body is being built at that moment, which is how the classical texts think about growth in any case: the body is made from what it eats, one dhatu nourishing the next, and a body built wholly of milk is simply a different thing from one built of milk and rice. The three names put that idea into the vocabulary itself. To call a child a kshirapa is to describe what it is made of.

The same three names carry through the rest of the chapter: paras 36 and 37 give a separate compound for each kind, which we do not reproduce, and para 40 marks the step from the first kind to the second. Once the reader has the three names, the child's section reads less like a list of instructions and more like one idea applied three times.

The Medicine Follows the Milk

The use to which para 29 puts its three kinds is the most original idea in the chapter. It asks a practical question: when a small child needs a medicine, who should take it? And it answers by following the food.

For the child living on milk alone, the medicine is given through milk and ghee, and the wet-nurse takes the same medicine as well. For the kshirannada, the translation says, "the medicine should be administered both to the child and its wet-nurse". For the child on solid food only, the medicine goes to the child "and not to the nurse". Paras 30 and 31 add a further step for the youngest: the nurse's own skin at the breast is to be spread with the paste, so that the child takes it in while feeding.

Put side by side, the three rules are one rule. Whatever reaches the child reaches it by the road its food already travels. If that road runs through another person's body, the medicine goes through that body too. When the road changes, the medicine changes with it. It is a strikingly physical way of thinking about a small child, and it is consistent with the chapter's view that a nursing child and its nurse are, for these purposes, one system: paras 26 and 27 say that the nurse's own food and conduct reach the child through her milk, and ask the physician to look after the milk and not the child alone.

We give the logic and stop there. The paragraph also gives amounts for each kind of child, and the paragraphs around it name the conditions for which medicine is given. Both are left out on purpose. The amounts belong to a physician of that tradition, and the conditions belong to a clinical reading that this article is not. What survives the omission is the structure, and the structure is the interesting part: a rule about routes, not about medicines. It is description of a classical text, not instruction, and any question about what a child or a nursing mother takes belongs with a qualified practitioner.

The First Four Days: Sushruta's Timing, and What Modern Guidance Changes

Paras 13 and 14 contain the chapter's most exact observation, and the place where a modern reader has to be most careful. The translation reads: "The milk in the breasts of a newly parturient woman sets in three or four days after parturition owing to the dilation of the orifices of the milk ducts". Sushruta's timing is close to what mothers and midwives describe today. The milk usually "comes in", in the everyday phrase, within the first few days after the birth, and he gives it a cause in the language of his own anatomy: the channels open.

What he does with that observation is the part that has changed. Because the milk has not yet "set in", the chapter feeds the newborn something else for the first days: honey and ghee mixed with herbs on the first day, a medicated ghee on the second and third, honey and ghee again on the fourth, and only from the evening of the fourth day the breast, after the mother "should first squeeze off a quantity of her milk". The birth rite of para 12 adds honey, ghee, the juice of brahmi and a trace of gold, given on the ring finger.

Why read the passage at all? Because it is a record of careful watching. Someone noticed, correctly, that the mother's milk changes on the third or fourth day, and built a practice on that observation with the ideas available. The practice is now known to be the wrong conclusion from a right observation, which is why we quote the timing and repeat the feeds only as history.

Anna in the Sixth Month: A Classical Date That Still Holds

Para 40 is one sentence long, and it is the chapter's clearest point of agreement with modern practice: "In the sixth month of its birth the child should be fed on light and wholesome boiled rice." This is the step at which a kshirapa becomes a kshirannada, the milk-drinker a milk-and-food-eater, and it is the same step that Indian households still mark with a rite of first rice, annaprashana.

The date is close to the one that infant-feeding guidance gives today. The World Health Organization's advice is to begin complementary foods at six months of age while breastfeeding continues. The sixth month of life begins at five completed months, so the two dates are not identical, but they sit within weeks of each other, and they agree on the point that matters: milk alone at first, then food added to milk, not food instead of it. The chapter's three names already contain that sequence. A kshirannada is by definition a child who still drinks milk.

The word the translation uses for the first food is also telling. The rice is to be "light and wholesome", laghu and hita in the vocabulary of the classical diet, and nothing is said about quantity, flavour or richness. The first food is chosen for being easy, not for being strong. Here, as in the handling rules below, the chapter's instinct is toward gentleness.

Krodha, Shoka and the Absence of Vatsalya: Milk and the Mind

Para 24 is about milk that fails, and its first sentence is not about food at all. "The loss or suppression of the milk in the breasts of a woman is usually due to anger, grief, and the absence of natural affection for her child". In the classical vocabulary those are krodha, anger, shoka, grief, and the absence of vatsalya, the tender affection of a parent for a child. The translation's English carries no Sanskrit here, so these are our glosses, but they are the standard words for exactly these states.

The order of what follows is what makes the paragraph worth reading slowly. Before any food is named, the translation says, "her equanimity should be first restored". Only after that comes a list of foods. The mind comes first in the sentence and first in the sequence. Whatever one thinks of the foods, the paragraph's structure says that a mother's state of mind is the first thing to attend to, and that no diet is expected to work around an anxious or grieving mind.

Still water: para 24 asks that a mother's equanimity be restored first, before anything else.

This is not an isolated idea in Sushruta. Our reading of his Nidana Sthana chapter on milk discusses a verse in which the sight, touch and thought of the child set the milk flowing through affection, the positive image of which para 24 is the negative. And modern lactation science describes a let-down reflex that is known to be sensitive to stress, so the classical instinct that the mind and the milk are connected is not a strange one. We do not push the comparison further than that. The paragraph is a description of a classical view, not instruction for anyone.

The list of foods that follows is left out: a list of foods for milk is exactly the kind of passage that gets lifted out of a classical text and sold. What we keep is the order, equanimity first.

Silk, Branches and a Name on the Tenth Day

Para 20 describes the newborn's first surroundings, and it is written with care for comfort. The baby is to be "wrapped up in silk" and laid on a bed "covered with a silken sheet". It is to be fanned with branches of four named trees: pilu, nimba, badari (the jujube) or parushaka. A thin pad, a pichu, soaked in oil is kept on its head. The room is fumigated with vacha and mustard to keep away evil influences, the floor is strewn with sesame, mustard and linseed (atasi), and a fire is kept burning in the room.

Silk and a leafy branch: para 20 wraps the newborn in silk and fans it with branches of named trees.

Some of this belongs to a world of spirits and protective rites that the chapter takes for granted. Much of it, read plainly, is about keeping a newborn warm, soft, quiet and untroubled by insects: silk against the skin, a moving branch for air, a fire for warmth, strong-smelling seeds on the floor. The text weaves the rites and the practical care into the same sentence; we describe them together and repeat none of them as practice.

Para 21 is the naming. "On the tenth day of its birth the parents having performed the necessary rites of benediction and celebrated the occasion with suitable festivities, shall give the child a name of their own choice or one determined by its natal asterism". The rite is namakarana, and the asterism is the nakshatra of the birth. What catches the eye is the order of the two options. The parents' own choice comes first, and the name drawn from the stars is the alternative. For a text so full of rites, it leaves the most personal decision in the chapter to the family.

Handling a Child Without Fright

Para 38 is the passage we would quote if we could quote only one. It is a short set of rules for how adults behave around a small child, and every one of them is about the child's comfort and feelings.

"A child should be so handled or lifted as not to cause any discomfort." "A baby should not be scolded, nor suddenly roused up (from sleep), lest it might get awfully frightened." It should not be lifted suddenly or put down suddenly, the text goes on, since sudden movements disturb its vata, the principle of movement in the body. It should not be made to sit before it can sit steadily by itself, since, the translation warns, that may leave its back bent. And then the sentence that gives the passage its warmth: "Lovingly should a child be fondled and amused with toys and play-things."

Then comes the reason. A child "unruffled by any of the above ways becomes healthy, cheerful and intelligent as it grows older." The word that carries the passage is "unruffled". Every rule in the list is a way of not startling a child: no harsh voice, no sudden waking, no sudden lifting, no forcing a stage of growth before its time. The text regards fright as something that happens to the body, not merely to the mood, and it asks the adults around the child to arrange things so that fright does not happen.

None of this is advice from us, and it is not instruction on how to raise a child. It is a classical text's description of how a child ought to be handled, written a very long time ago, and it happens to read as one of the kindest passages in the Sharira Sthana.

Two Texts, One Rule: Charaka's Toys That Cannot Enter the Mouth

The rule against fright is not Sushruta's alone. Charaka's parallel chapter, Jatisutriya, the eighth chapter of the Charaka Samhita's Sharira Sthana, has a passage on the child's room and its toys, and it arrives at the same place by a different road. We read it in Gabriel Van Loon's English translation.

Charaka Sharira Sthana 8.63 is a specification for toys: "Toys for the child should be variegated, sound-producing, beautiful, not heavy, without sharp ends, those which cannot enter into the mouth, are not fatal or terrifying." Read slowly, the list is remarkably practical. Colour and sound are there to hold attention. "Not heavy" and "without sharp ends" are about the child not being hurt. "Those which cannot enter into the mouth" is a rule about size, about toys too large to be put in the mouth, and it sits in the list as naturally as the rule about colour. The last words return to feeling: not "terrifying".

The very next verse, 8.64, is the plainest statement of the principle in either text: "Frightening the child is not proper." It goes on to name the habit it is aimed at. When a child cries, will not eat or wants someone else, it is not to be quietened by being scared with the names of rakshasas, pisachas or Putana, the demons of the nursery. Every Indian reader knows the habit, and Charaka rules it out by name.

Two classical texts that disagree about a great deal agree about this. Sushruta states it as a rule of handling and Charaka as a rule of toys and of speech, and both arrive at the same line: a child is not to be governed by fear.

Rain, Sun, Lightning and the Inner Room

The rest of para 38 and all of para 39 are about keeping a small child safe from its surroundings. The child is to be guarded "against any exposure to the rains, the sun, or the glare of lightning". It is not to be put under a tree or a creeper, in low ground, or in lonely houses. The verse after it adds that a child is not to be left alone in an unclean place, nor under the open sky, nor on uneven ground, nor exposed to heat, storm, rain, dust, smoke and water.

An inner room out of the rain: paras 38 to 40 keep a small child in shade and shelter.

Para 40 completes the picture: "A child should always be kept in an inner apartment of the house". Much of the list is the plain sense of a hot, wet climate. A baby cannot move itself out of the sun, cannot cover itself in a storm and cannot climb out of water, so the adults are asked to think for it. The inner room is cool, shaded and enclosed, and the child is kept there.

The lonely house, the shade of a tree and the "evil stars" of the same paragraph belong to the chapter's world of grahas, the malign influences on infants that Uttara Tantra 27 and the chapters after it describe, and we leave them to the article linked above. The rest of the list is plain sense: shade, shelter, cleanliness and company.

Para 39 also says what a child drinks. "Milk is congenial to the organism of a child", it begins, and where the mother's milk is not enough, it allows the milk of a cow or a she-goat. This is the second place where modern guidance differs. Paediatric advice today does not give unmodified cow's or goat's milk as a baby's main drink before the first birthday. The chapter's instinct, that a kshirapa needs milk above all, is the part that stands.

The Dhatri in Sushruta's Version: Facing North and East

The wet-nurse, the dhatri, is a major subject in both texts, and on this site she is covered in detail in the Charaka article above, together with the test of milk in water. Sushruta's version, in para 22, has three details of its own that are worth recording.

The first is the list of qualities. She is to be of middle height and middle age, in sound health, even-tempered, "not fickle, ungreedy", neither too thin nor too heavy, and "of an affectionate heart, and with all her children living". The second is the seating. When the child is first given to her, it is laid on her lap "wrapped in a clean and untorn linen", with its face turned to the north while the nurse looks to the east, and it is given the right breast first. Charaka's verse 8.58 has the nurse take the baby "with his face towards the east". Both texts give the right breast first. The third is the blessing spoken over the first feed, in which the nurse is addressed as a "beautiful damsel" and the four oceans are asked to fill her milk: "may the four oceans of the earth contribute to the secretion of milk", so that the child may live long, "like the gods made immortal with drinks of ambrosia".

Para 23 adds that a child passed from woman to woman may find the mixed milk unsuited to it: the chapter wants one steady source of milk and one steady person. The rest of the dhatri passage we leave to the article that already reads it in full.

Prasha: The Four Gold Compounds That Close the Chapter

The last paragraph of Garbhini-Vyakarana, para 60, is a set of four compounds to be given to a child by licking, a form the text calls prasha. Each of the four includes powdered gold, suvarna, with other ingredients, and the verse attributes general benefits to them.

This passage is worth naming because of what it has become. The practice sold today as suvarna prashana, or "swarna prashan", is usually traced in popular writing to the Kashyapa Samhita. The Sushruta Samhita has gold in the child's first rite, in para 12, and again here in the chapter's closing verse. The classical background of the modern practice is therefore wider than its usual single citation.

We describe the verse and do not reproduce its ingredients or repeat its claims as claims. No classical verse is evidence that a preparation is safe or useful for a child today, and nothing on this page, and nothing we sell, relates to this practice. Any question about giving any preparation to a child belongs with a paediatrician or a qualified practitioner. The fact worth recording is simply where the Sharira Sthana chooses to end: not on anatomy, but on a child being fed.

What We Leave Out of Sharira Sthana 10, and Why

Garbhini-Vyakarana is a long chapter, and much of it is clinical. We have left out every passage whose purpose is to direct a physician's hand, and we list them here so that the omission is visible rather than silent.

• The pregnancy regimen of paras 2 and 3, including the month-wise diet and the lying-in room, which the text assigns by social order. It is covered, from Charaka, in the article linked at the top.
• The labour and the first hour, paras 4 to 12: the attendants, the measures for a slow delivery and the handling of the cord. These are obstetric instructions and belong with the Charaka article and with trained professionals.
• The mother's clinical passages, paras 17 to 19, which concern the days after the birth when something has gone wrong.
• The child's clinical passages, paras 28 to 35, which read the signs of a child's distress and name the measures for each; and the amounts of para 29.
• The ages of marriage and of first pregnancy, para 43 and the verses after it, which reflect the society of their time. The age of marriage in India today is set by law at 18 for women and 21 for men.
• The passages on a pregnancy at risk, paras 45 to 59, with their month-by-month milk preparations, which are clinical in every line.
• The ingredients of the four compounds of para 60, described above.

What remains is the part of the chapter that is about a child's ordinary life: its food, its route of care, its room, its handling and its name. That is enough for one reading, and it is the part the chapter itself presents most warmly.

Sushruta's Sharira Sthana, Chapter by Chapter

With chapter 10 the Sharira Sthana ends, and on page 238 of the translation it says so in as many words: "Here ends the Sarira Sthanam". It seems right to close with the whole section in view. This is the order of its ten chapters, with our reading of each where we have one.

A closed bundle: chapter ten ends with the words "Here ends the Sarira Sthanam".

Read in order, the ten chapters make a single arc. They begin with what a person is made of, pass through the making of a body in the womb and the mapping of the grown body, and end with a newborn being wrapped in silk, fed, named and handed toys. For an overview of the whole Samhita, including the sections that follow, see our guide to the Sushruta Samhita. The care of children is also one of the eight classical branches of Ayurveda, kaumarabhritya, which our article on the eight branches places in context.

What Sushruta Samhita Sharira Sthana 10 Does Not Say

A close reading should say what it did not find as clearly as what it did. We did not find, anywhere in this chapter, a statement that any food, compound or practice is needed by every child, or that any of the chapter's preparations should be given without a physician. The compounds of paras 36, 37 and 60 are presented inside a physician's text, for a physician's judgment. We did not find the words kshirapa and annada printed in this translation; they are the standard Sanskrit names for the first and third kinds of child, and we have said so where we used them. We did not find any claim that the chapter's timings are exact for every mother: "three or four days" is itself a range.

We also did not find, and did not look for, support for any product. The chapter is about people in one of the most delicate stretches of life, and the only honest way to write about it on a site that also sells things is to keep the two entirely separate. The section below does that.

An Adult's Own Morning Shelf, Kept Apart From This Chapter

The classical texts that describe a day, the dinacharya, begin it with cleaning the teeth and washing the face. Our own shelf has a few plain things for that part of an adult's morning, and we describe each one only by what it is, what form it comes in and how it is packed. We make no connection between them and anything written above.

More to Read on This Topic

Shop All Ayurveda Hub Products →

Frequently Asked Questions