Introduction

Sutika in Sanskrit means “to produce” or “to yield” means a woman is termed as sutika, when she gives birth to a baby . She is also called as nava prasuta , prasutika , prasuta , sadya prasuta , janayitri[1] . A woman who has just given birth to a child followed by expulsion of the placenta is called as sutika , only after expulsion of placenta the woman can be termed as sutika[2]. In modern medicine puerperium is the period following child birth during which the body tissues , especially the pelvic organs revert back approximately to prepregnant state both anatomically and physiologically [3]. This is a face of regaining the lost strength after the strenuous and lengthy process of child bearing and labour , by regulating the dietics and mode of life and undergoing specific procedure and medication . The ahar , vihar and oushadi followed during this kal is termed as Sutika Parichariya . In all our classical text this sutika parichaiya is mentioned in detail ,also modern text has also explained this topic .

AIM-The aim of this study is to review the classical text dealing with sutika parichariya and understand the significance of sutika parichariya 

METHEDOLOGY-

A literary review of sutika parichariya mentioned in classical text is done . Relevant chapters of bruhatrayee and laghutrayee are reviewed along with relevant commentaries  . Morden literature dealing with puerperal regimen was also reviewed and compared .

Sutika kal – Acharya chrak has not mentioned specific kal as sutika kal in his Samhita . Archarya shusharuta in his sharirsthana has mentioned adyardha masa or 45 days to be termed as Sutika kal[4].acharya vaghbhata has mentioned one and a half month or artava darshan that is female getting her first , menstrual cycle after labour to be termed avastha sutika which represents normalcy of genital tract[5]. As per kashyapa the sutika kal is set to be for 6 months , as dhatus like rakth will resume to their original state by this time so pathaya ahar & vihar should be considered till this time[6].As per bhavprakash and yogratnatkar 4 months is considered as sutika kal after delivery of mudha garbha- which is associated with invasive techniques and trauma{7}.Modern medicine suggest that the puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks,when the uterus becomes regressed almost to nonpreganant size.

Sutika paricharya-care of women during the sutika kal is termed as sutika parichariya which involves ahar , vihar and oushadi . all classical text has mentioned sutika parichariya in their respective Samhitas . It involves the following concepts

• Dhatu paripurnata
• Stanya utpatti and stanya sampat
• Garbhashya shuddhi    
• Prevention of complications
• Punarnavikarana

Harita’s view [14]

For rakth and yoni shodhan internal administration of lodra , arjun , kadamb , devdaru , bijaka and karkandhu should be given for purification of blood and vagina.

Diet regiman –

1st day-fasting

2nd day-nagara and haritaki with guda in the afternoon kullatha yusha.        

3rd day-yavagu mixed with panchakola.

4th day-yavagu mixed with chaturjataka.

5th day-cooked shali or shashtrika rice.

mangalya  karma [Raksha karma ] - karma Raksha both sutika and baal has been described to stop the infection

Bhavprakash has given very short description that the puerperal woman should use congenial diet and mode of life . Give up exercise , coitus ,anger and cold air. She should use unctuous, light, congenial diet and daily sudation and massage for 1 month with full alertness . Also, to reduce the abdominal girth after delivery mathita [butter milk] mixed with powder or paste of kanajata should be used for 8 weeks .[15]

Discussion

Modern medicine also involves following principles for normal puerperium

• To restore the health of the mother
• To prevent infection
• To take care of breast
• Motivate mother for contraception .

Also, high calories , adequate protein , plenty of fluids , minerals and vitamins are given to the mother .

Discussion :

Sutika parichariya according to different achariyas can be classified under three phases.[16]Phase of agni deepiti and vaataniyaman [from day 1 to 7 days].     

1. As sutika agni is manda , agni depan is the need of treatment for few days immediately  after delivery which may be needed prior to the administration of brimhana drugs . The drugs which are used instantly after delivery are agni vardhak by their nature
2. Use of any Sneha out of ghrita , taila , vasa or majja, mixed with panchakola churna is advised . If Sneha is contraindicated then one can use laghupanchmoola khasaya or panchakola churna with ushna gudodaka . Use of snehana is to suppress vata and  reinforce the agni
3. Agni here indicates  dhatvagni promoting the metabolism of the body e.g. lytic action hyper trophied uterine musles .
4. Uttama rasa produces uttma staany which depends on quality of agni; hence agni vriddhi is indicated 

• Phase of sadahrana poshan and dhatu vriddhi [7 – 12] yava , kola kulattha yusha or mamsarasa , laghu , annapana is advised according to kula , desha , satmyaata with enough Sneha and lavan , amla dravyas . This form of food helps to replenish the dhatu , escalate the ojas .
• Phase of brimhana and punar navinikaran [rejuvenation]

Advised for the usages of mamsa rasa and brihaniya dravyas. Beside all these,one should use grita,tail or kwatha which are prepared by using jeevaniya or brimhaniya or Madhura or dravyas.hridhya vatahara and laghu annapana should be given for consumption. this might act as dhatu vardhak and helps to maintain proper lactation.

Local treatment

Abyanga,udavartan and parishekha and avagahan can be practiced., Abyanga is recommended by using tail bala in nubja position which might help to restraint vitiated vata, spiraling the abdominal muscles and explusion of remnant doshas.Parishechana by using kwath prepared by vaytahar dravyas act as vedanahar and kledahara. udar patta bandhan i.e. rapping the abdomen with long clean cloth ,which in turn helps abdomen to retrive its normal position and there is no accumulation of vata in vacant sites. Dhumapana as rakshoghana and vedanahara is mentioned by using kushtha,guggulu and agru.

Conclusion

Ayurveda is a science which was there to help humans in every aspect of their life . Sutika prichariya mentioned long back by our Achariy as is very scientific and the ahar, vihar and oushadi mentioned fulfill our aim of regaining strength and achieving proper physical, physiological, psychological and emotional balance in the body of the female.