Introduction: Neonatal emergencies remain a major cause of early mortality, particularly in low-resource settings. Ayurveda describes immediate life-restoring measures under the concept of Pranpratyagaman, literally meaning “restoration of life force”. Classical text of Kaumarbritya mention specific procedure to revive a non-crying or unconscious neonate soon after birth. [1] This study aims to explore and present the Ayurveda principles and practices of Pranpratyagaman as an emergency management approach. Methods: A classical literary review was conducted using primary Ayurveda sources including Charak Samhita, Sushrut Samhita, Ashtang Hridaya and Kashyap Samhita. Relevant verses describing immediate neonatal revival measures were collected, translated, and analyzed. [1-3] The procedure were interpreted in the context of modern neonatal resuscitation principles. [4-5,16] Results: Ayurveda texts recommend sequential steps for neonatal revival, including clearing airway obstruction, gentle stimulation, warming, sprinkling of warm or medicated liquid, tactile stimulation, and administration of mild herbal preparations to stimulate respiration and consciousness. Procedures such as Utsadana (gentle rubbing), Pramarjana (wiping), and nasal or oral stimulation are described as methods to activate Prana Vayu. [1-3] These steps correspond conceptually to airway management, thermal care, and tactile stimulation in contemporary neonatal resuscitation . [4-5,16] Discussion: Pranpratyagaman, reflects an organized, stepwise approach aimed at restoring vital functions immediately after birth. The emphasis on airway clearance, warmth, and stimulation demonstrates remarkable similarity to modern neonatal resuscitation protocols.

Introduction:

The neonatal period is the most important vulnerable phase of life and contributes significantly to infant mortality worldwide. [4] Birth asphyxia, defined as failure to, initiate or sustain breathing at birth, is a major cause of neonatal death. [4]

Modern neonatal resuscitation protocols emphasize airway clearance, stimulation, thermal regulation, and assisted ventilation when necessary. [4, 5,16]

Ayurveda’s classics, especially under Kaumarbritya, describes procedures to revive a newborn who does not cry after birth, termed Pranpratyagaman- restoration of the life force. [1-3] Ancient Ayurveda scholars recognized the importance of immediate postnatal interventions and described systematic measures to stimulate respiration. [1]

Material and Methods:

Study design

Literary review of classical Ayurveda texts and modern neonatal resuscitation literature.

Sources

Primary texts

1. Kashyapa Samhita. [1]
2. Charak Samhita. [2]
3. Sushruta Samhita. [3]

Secondary sources

1. WHO neonatal resuscitation guidelines. [4]
2. Neonatal resuscitation Program recommendation. [5]
3. Standard pediatric literature. [6]

Methodology

1. Identification of references related to neonatal revival in classical texts. [1-3]
2. Compilation of described procedures.
3. Conceptual analysis using Ayurveda’s principles.
4. Comparative evaluation with modern neonatal resuscitation protocols. [4,5,16]

Results

Concept of Pranpratyagaman

Prāṇapratyāgaman refers to restoration of respiration in a newborn who fails to cry or breathe after birth. [1]

Respiration is governed by Prāṇa Vayu, as described:

Prāṇa Vayu resides in the head and heart and sustains intellect, senses, and mind. [2]

Classical Description of Neonatal Revival

Kashyapa Samhita

If the newborn does not cry, the mouth and throat should be cleaned, cold or warm water should be sprinkled, and sound should be produced near the ears. [1]

Sushruta Samhita

If the newborn does not cry, the airway should be cleaned and stimulation should be done using aromatic substances. [3]

Charaka Samhita

After birth, the physician should protect the newborn by providing warmth and protection from cold and wind. [2]

Sequential Steps of Prāṇapratyāgaman

1. Airway Clearance

2. Tactile Stimulation

3. Auditory Stimulation

4. Thermal Regulation

5. Aromatic Stimulation

Comparative Analysis with Modern Neonatal Resuscitation

Ayurveda’s Procedure and Modern Equivalent

Airway suction. [4]

Tactile stimulation. [4]

Sensory stimulation. [4]

Thermal protection. [4]

Conceptual respiratory stimulation. [5]

Discussion:

The concept of Prāṇapratyāgaman described in Ayurveda classics reflects an early understanding of neonatal resuscitation principles.[1–3] The procedures outlined by Kashyapa, Sushruta, and Charaka emphasize airway clearance, tactile stimulation, thermal protection, and sensory activation, which correspond closely to the initial steps of modern neonatal resuscitation protocols.[4–7] In Ayurveda, respiration is governed by Prāṇa Vayu, and obstruction by Kapha in the upper respiratory passages is considered a major cause of delayed breathing.[1,2] This concept is comparable to modern understanding of airway obstruction by mucus, amniotic fluid, or meconium leading to birth asphyxia.[6,8] The classical instructions to clean the mouth and throat, sprinkle water, rub the body, and produce sound near the ears indicate a systematic sensory and tactile stimulation approach to initiate respiration.[1–3] Modern neonatal resuscitation guidelines also recommend drying, stimulating, and clearing the airway as the first steps for a non-breathing newborn.[4,5] Studies have shown that timely basic resuscitation measures can prevent a significant proportion of neonatal deaths, particularly in low-resource settings.[9–12] The non-invasive nature of Ayurveda's techniques makes them potentially useful in community births and primary healthcare centers where advanced equipment may not be immediately available.[13–15]
However, severe cases of birth asphyxia require advanced interventions such as positive pressure ventilation, oxygen therapy, and neonatal intensive care.[4,5,16] Therefore, Ayurveda's methods should be viewed as complementary to modern neonatal resuscitation rather than as substitutes.[17–20] Integration of traditional knowledge with contemporary medical protocols may enhance culturally acceptable and holistic neonatal care.

Conclusion:

Prāṇapratyāgaman represents a systematic and rational approach to neonatal resuscitation described in Ayurveda's classics.[1–3] The procedures, including airway cleansing, tactile stimulation, thermal protection, and sensory activation, show remarkable similarity to the initial steps of modern neonatal resuscitation.[4–7] This reflects the advanced observational knowledge of ancient Ayedurva's scholars regarding neonatal physiology.

The non-invasive and easily applicable nature of these measures makes them particularly relevant in community settings and resource-limited environments.[9–12] However, modern resuscitation techniques remain essential in cases of severe birth asphyxia.[4,5,16]
An integrative approach combining Ayurveda's principles with evidence-based neonatal resuscitation protocols may contribute to improved neonatal outcomes and culturally sensitive healthcare delivery.[17–20]

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