REVIEW STUDY OF YANTRA, SHASTRA AND ASHTAVIDHA …

www.wjpps.com │ Vol 10, Issue 4, 2021. │ ISO 9001:2015 Certified Journal │

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Patil et al. World Journal of Pharmacy and Pharmaceutical Sciences

REVIEW STUDY OF YANTRA, SHASTRA AND ASHTAVIDHA

KARMA IN STREE ROGA AND PRASUTI TANTRA

W.S.R.GYNAECOLOGY AND OBSTRETICS

Veena Jawale1

and Sonam Bhauso Patil2*

1Professor and HOD,

2PG scholar

Dept. of Prasuti Tantra & Stree Roga, S. G. R. Ayurvedic Collage, Solapur.

ABSTRACT

Importance of Ayurveda is increasing day by day and people are

looking towards Ayurveda as an alternative to contemporary medicine.

AYUSH department is conducting post graduates specialization in

various surgical branches like gynaecology and obstretics. Wide

description is available in Ayurvedic classics regarding various

surgical instruments (Yantra, Shastra) used in different branches of

Ayurveda for carrying out clinical examination; medical and operative

procedures. Hasta (Hand)[1]

is considered as the Pradhantamam yantra

because surgical instruments are in many ways simply extension of

human hand. Surgical instruments such as forceps, dilators, speculums

etc are similar to the 101 Yantras and 20 Shastras mentioned in Ayurveda e.g., Samdansha

Yantra, Naadi Yantra, Shalaka Yantra, Mandalagra Shastra, Vetasapatra Shastra, Suchi,

Shararimukha Shastra etc. To perform various procedures in Stree Roga and Prasuti Tantra,

use of blunt and sharp instruments are described in detail. In this article we have discussed

about those Yantras (Blunt instruments) and Shastras (sharp instruments) and various Shastra

karmas with modern surgical procedures used in prasuti tantra and stree roga in co relation

with gynaecology and obstrectics.

KEYWORDS:- Ayush, Yantra, Shastra, Shastra karma.

INTRODUCTION

Ayurveda is one of the oldest science of disease, rather a complete therapeutic science. The

traditional literatures of Ayurveda encompass many evidences related to the utility of shalya

WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES

SJIF Impact Factor 7.632

Volume 10, Issue 4, 1605-1616 Review Article ISSN 2278 – 4357

*Corresponding Author

Sonam Bhauso Patil

Professor and HOD Dept. of

Prasuti Tantra & Stree Roga,

S. G. R. Ayurvedic Collage,

Solapur.

Article Received on

19 Feb. 2021,

Revised on 11 March 2021,

Accepted on 31 March 2021

DOI: 10.20959/wjpps20214-18788


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chikitsa in various health ailments. Acharya sushruta, the father of surgery described many

concepts of surgery and application of shastra karmas for different therapeutic purposes.

Asthtavidha shastra karma described in sushruta samhita focuses on various forms of

surgical interventions which can be used to cure the disease, the shalya chikitsa not only

utilizes sharp instruments (Shastra karmas) but this branch also suggest uses of blunt

instruments (Yantra karmas) for many medical purposes.

Ayurveda has highly developed branch of stree roga and prasuti tantra under the Ashtang of

koumarbhritya. The female disorders like Granthi, arbuda, stanarogas, kanda and arshas etc.

need assistance of shastra karma, therefore a skilled physician should perform shalya

chikitsa in streeroga only whenever required. From ancient texts, Kaviraj gananath sen has

shown that most modern surgical instruments are only minor modifications of the instruments

used daily by ancient physicians.

Here we are discussing about yantras, shastras and ashtavidha shastra karmas used in

gynecology and obstetrics in various ways.

Yantras[1]

शल्याणानाां आहारणोऩायो यांत्राणण |

तत्र मन:शरीरबाधाकराणण शल्यानन,तेषामाहरणॊऩायो यांत्राणण ।।४॥[6]

Foreign bodies that cause pain to manah and sharir is called shalya and the methods to

remove these are called Yantras.

• यांन्त्त्रशतमेको्तरम,अत्र हस्तमेव प्रधानतमां यांत्राणामवगच्छ।।३॥[7]

Acharyas have classified Yantras into 101 types.

Among all the yantras, Hasta is considered as the Pradhantamyantra because surgical

instruments are in many ways simply extension of human hand.

Hasta (hand)

Ayurvedic classics have described use of Hasta to correct various gynecological conditions

specifically that of Sthanapavrit (displaced) yoni.

e.g.

1. Nisrit yoni (Yoni protruding outside) should be inserted gently pressing with hand.


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2. Samvrita yoni should be dilated with the help of fingers.[2]

3. The procedure of extracting Mudhagarbha[3]

with Hasta, various acts like Utkarshana,

Apkarshana, Sthanapavartan ,Udavartan, Utakartan, Bhedana etc. are to be done only

with one hand taking care not to injure the mother and foetus.[4]

4. Also procedures like manual removal of retained placenta, Acharyas have stated that

labricated hand with trimmed nails should be inserted following umbilical cord and

placenta[5]

is then delivered. Based on Akriti or Shape, Yantras are of 6 main types,

तानन षटप्रकाराणण,तद्यथा[8]-

स्वस्स्तकयांत्राणण, सांदांशयांत्राणण, ताऱयांत्राणण, नाडीयांत्राणण, शऱाकायांत्राणण, उऩयांत्राणण चनेत।।५॥

तत्र चतुर्विंशनत: स्वस्स्तकयांत्राणण,द्वे सांदांशयांत्र,ेद्व ेताऱयांत्र,ेर्वांशनतनााड्य:अष्टार्वांशनत: शऱाका:,

ऩांन्त्चर्वांशनतरुऩयांत्राणण ॥६॥

Yantra name Correlate with Praman Sankhya

Swastika Yantra Cruciform like instrument 18 angula 24

Sadansha Yantra Pincer like instrument 16 angula 2

Tal Yantra Spoon shaped instrument 12 angula 2

Nadi yantra Tubular instrument According to use 20

Shalaka Yantra Rod like instrument Vividhakar 28

Upyantra Accessary instrument Sandhi, koshta,

Dhamani yathayogya

25

Swastika yantra

तत्र स्वस्स्तकयांत्राणण-

अष्टादशान्त्गुऱप्रमाणानन,ससांह्व्याघ्रवकृतरक्ष्वृऺ स््दर्ऩमाजााशृ्रगाऱमृगैवाारुककाकककुरचाषभासशशा

घा्युऱुकचचस्ल्ऱश्येनगृध्रक्रौभृांगराजाज्जसऱकणाावभज्जननस्न्त्दमुखमुखानन,मसुराकृनतसभ:ककऱैवाब

ध्दानन,मूऱेऽन्त्कुशवदावृ् तवारांगाणण, अस्स्थर्वद-ष््शल्योध्दरणाथामुऩशदश्यन्त्ते ॥१०॥[9]

These are 24 in number.

They are named so because of their resemblance to swastika shaped mark; being joined by

Masura (cereal) shaped nail at edges. These are 18 angula long and bear resemblance like the

face of various animals like Sinhamukha (lion), Vyaghramukha (tiger), Vrikmukha (Wolf),

Rikshamukha (bear), etc. and birds like kankamukha (heron), kaakmukha (crow),

Bhashmukha (eagle) etc. At their base, they are bent like circular ring to facilitate grasping.


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Sadansha yantra

सननग्रहोऽननग्रहश्च सांदांशौ षोड्शौन्त्गुऱौ भवत:।

तौ ्वङमाांसससरास्नायुगतशल्योध्दरणाथा-मुऩशदश्येते ॥११॥[10]

Sadansha means to catch or hold. These are 16 angula long.

These are of 2 types

Sanigraha (with catch) e.g. Dressing forceps, Vulsellum, Allies tissue holding forcep,

sponge holding forcep, needle holder, artery forceps, mosquito forceps.

Anigraha (without catch) e.g. plain forceps, toothed forceps, ovum forceps etc.

According to vagbhta – Sanibandhana and Nirnibandhana[11]

One type of Sandanshyantra is 6 angula long and half angula wide.

Taalyantra

They are named so because of their resemblance to palate of fish (scoop like). These are 12

Angula long. They are of two types: Ektaal (having scoop at one end) Dwitaal (having scoop

at both the ends) They are used to remove Shalya from ear canal, nasal cavity, Naadi.[12]

Though their use hasn’t been described as such in Stri Roga & Prasuti Tantra at that time but

in the present era, Uterine Curette and Endometrial Biopsy Curette can be taken under this

category which are used for scraping of endometrium and endometrial sampling respectively.

Nadi yantra

“नाडीयांत्राणण-अप्यनेकप्रकाराणण अनेकप्रयोजनानन एकतोमुखानन, उभयतोमुखाननच|

ताननस्त्रोतोगतशल्योध्दरणारथ्ां,रोगदशानाथाम,श्राचूषणारथ्ां,कक्रयासौकर्ययाारथ्ज्चनेत।ताननस्त्रोतो्दार

ऩररणाहाननयथायोगशदरघ्ाणणच।।१३॥”[13]

Nadiyantra are of 20 types. Hollow from inside.

a) Strotogatashalyauddarnarth- To remove the shalya/foreign bodies from strotas.

b) Rog Darshanarth (to visualise disease) Yonivranekshana Yantra. It is type of Nadiyantra.

It is 16 angula long, hollow in centre has four walls,surrounded with a ring from outside

and resemblnce an unblossomed lotus flower. The base of all four walls are attached with


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small rods, the pressure on which opens or widens the mouth of instrument. Used to

visualize Yoni vrana (ulcers of vagina, cervix)[14]

c) Achushan karma - In treatment procedure of stanvidradhi (breast abscess) repeated

milking should be done in all the stages i.e.in Amavastha, vidhahavastha and

Pakvavastha to prevent suppuration and formation of sinus. Karamns cannula,

menstruation regulation syringe, ventouse suction device, mucous sucker are the devices

used for achushan karma.[15]

d) Chikitsa karma hetu

Garbhashayagrivamukhagatvrana - Dahan and kshar karma hetu.

Naadi vrana prakshalana/Abhyanga yantra - For yonisthitanadivrana abhyanga and

prakshalana of Naadivrana. These are of 6 angula long like Basti yantra – Bag with

nozzle[16]

can be compared with wound syringe, douche bag etc.

Shalaka yantra

These are not hollow from inside. These are 28 in number.

1. Gandupadmukhi shalaka: The upper end of this shalaka is slightly curved.e.g. uterine

sound, bladder sound, hegars dilators, sims anterior vaginal wall retractor, bougies.

2. Sarpaphanamukhi shalaka: Its shape is like serpants hood.it is used to retract the incised

part e.g. London’s bladder retractor, doyens retractor

3. Badishmukhi shalaka: Acharya sushruta has included Badisha under shalaka yantra and

shastra both. These are 2 in number. Used to extract Mudhgarbha.[17]

4. Karpasa kritoshniya: It is of 6 types, cotton is applied on its upper end e.g. sterile cotton

swab used for taking vaginal smear for culture. also used for cleaning of wounds and

applying kshar.

5. Jambavavadana shalaka- Upper part is oblong like seed of jambu. In streeroga its use

has been described in Dahan karma in Sannipataja upadansha.

It is of 3 types – Sthula, Anu, Dirgha.[18]

6. Mutramarga vishodhini shalaka: It is long and broad like Pushpavrinta, used for

Vishodhana of Mutramarga or dilation of urethral passage or in urethral stricture.e.g.

urethral sound or bougie.

7. Garbha shanku shalaka: Both Vagbhatas have included Garbhashanku under

Shalakayantra. It is 8 angula long, curved like a hook and used for extraction of

Mudhagrabha.e.g. ventous.


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8. Angulitranakyantra / Mudrika[19]

: It was used to guard fingers while doing shalya

karma e.g.finger guard or surgical rubber / latex gloves.

9. Badishamukhi yantra: It is also described under shastras for extraction and its upper end

is curved .it is indicated for Aaharana of mudhagarbha. It can be correlated with various

types of hooked instruments.

Shastras[20]

शस्त्रां शह शरररशहांसकसमनत ।

These are taken as sharp edged instruments.

• Number - Palkapya samhita-10, Harita Samhita-12, Sushruta samhita-20, Vagbhata -

26.

Shastra Correlate with Karma

Mandalagra Circular knife Chhedana, lekhana

Karpatra Bone saw Chhedana, lekhana

Vridhipatra Scalpel Chhedana ,bhedana

Nakhashastra Nail parer Chhedana, bhedana

Mudrika Ring knife Chhedana, bhedana

Utpalapatra Lancet Chhedana, bhedana

Ardhadhara Single edged knife Chhedana, bhedana

Kushpatra Bostoury Vistravana

Aatimukha Hawkbill scissors Vistavana

Shararimukha Scissors -

Antarmukha Curved bistoury Vistravana

Shatra Correlate with Karma

Kutharika Chisel Vedhana

Trikurchaka Brush Vistravana

Vrihimukha Trocar Vedhana

Aara Awl Vedhana

Vetasapatra Kind of scalpel Vedhana

Badisha Sharp hook Aaharana

Dantshanku Tooth scalar Aaharana

Eshanai Sharp probe Eshana,vistravana

Suchi Suturing needle Seevan,vedhana

Mandlagra shastra – Its shape is like nail of index finger. Used for extraction of

mudhagarbha.

Karpatra shastra – Its shape is like Karvat leaf,[21]

size according to sushruta 6, vagbhata 10,

Bhoja 12 angula.


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Vridhhi patra shastra – It is 7 angula in pramana. It is used to remove scrotal tumor. There

are two types: 1) Riju (prayatagra)- It is straight, 2) Natagra (Anchitagra)- It is curved

Nakha shastra – Acharya sushruta mention its length to be 8 angula, it has one straight and

one oblique edge.

Mudrika /anguli shastra- In this instrument, a ring of the size of first knuckle of index finger

is fitted with half angula size of blade, the ring is tied with a strong thread. Used for excision,

incision or perforation of obstructed fetal head in mudhagarbha.

Utpalapatra shastra – It has sharp edge like that of utpala leaf. The size of the blade is 3×1

angula. Dalhana[30]

said its length 6 angula.

Ardhadhara shastra – It is 8 angula in length and blade is 2×1 angula.in the management of

mudhagarbha, acharya Harita[29]

says that with Ardhadhara shastra, both arms of fetus

should be cut and extracted.

Aatimukha shastra– Its name is according to aatimukhjalvardhini22

, name of bird. it is 7

angula in pramana.

Antarmukha shastra- Its like half moon shaped, 8 angula in pramana.

Trikurchaka – It is made of 3 kurcha, 8 angula in pramana.

Kutharika – It is like kuthar (Axe), its phal is 7 angula in pramana and the ayam of vrint is ½

angula and it is like Godant.

Vrihimukha – It is 6 angula in which vrunt is 2 and phala is 4 angula.

Aara shastra[22]

- 8 angula in pramana, Til pramana phala, durvankur parinah and vrint like

gopuchha

Vetasapatra shastra - According to bhoja, its size is 4×1 angula.

Badisha shastra – According to Dalhana[30]

its size is 6 angula and that it has sharp upper

end like a thorn. The excision of arbuda is done with mandalgrashastra after holding with a

Badisha.

It is of two types

1) Natyanata (not much curved)

2) Swanata (too much curved)

Dantshanku – It is 6 angula in ayam.

Eshani – Its circumference is according to wound.

Suchi[23]

- Detailed description is available in Samhitas. There are three types of suchi-


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• Vritta suchi – Round body needle, 2 angula long .used for suturing at Alpamansasthana,

soft tissue and in joint area.

• Aayat/tridhara suchi – 3 Angula long, it has three edges. used for suturing at

mansalsthana.

• Dhanurvakra suchi – It can be triangular like tryastraor round like vrita. used in

marmaphalakosha and udara.

Shararimukha shastra – It resembles the long beak of a bird sharari, it is 10 angula long,

Dalhana[30]

has called it as ‘Kartari’. It is used for Raktavisravana (bloodletting or drainage

of pus). Episiotomy scissors, Umbilical cord cutting scissors, Embryotomy scissors are the

examples of shararimukhashastra.

Ashtavidha shastrakarma

All the operative procedure used in gynaecology and obstretics are utilization of ashtavidha

shastrakarmas in various ways.an effort to make out such a list consisting the commonest

surgical procedures of gynaecology and obstretics are ;

Shastrakarmas Stree roga / gynaecology Prasutitantra /obstretics

Chhedana –excision Myomectomy,

hysterectomy,

cystectomy,

polypectomy,

enucleation of breast,

fibroadenoma

Cordcutting,

craniotomy in obstructed

labour

Bhedana –Incision Surgical correlation of

imperforated hymen

surgical correction of vaginal

agenesis laproscopy.

Episiotomy ,

Caesarean section.

Lekhana-scraping Thermal ballooning,

Endometrial biopsy

Curettage, Manual removal

of placenta, Episiotomy

wound if gapping is there

Vedhana-puncturing Laparoscopy

Drainage of haematocolpos

and haematometra.

Amniocentesis,

MTP with the help of

instillation of dye and NS

Eshana-Probing Hysteroscopy,

uterine sounding,

dilatation of OS

Uterine sounding,

Dilatation

Aaharana –Extraction Removal of uterine tumors,

Removal of polyp by

twisting method.

Garbhaaharana, Evacuation,

Manual removal of placenta

Vistravana – Drainage Ovarian drilling ARM (artificial rupture of

membrane)

Seevana- suturing Suturing in all operative

procedures

Suturing in all operative

procedures.


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The above mentioned list is very exemplary and is just a glimpse of the universal approach of

Ayurvedic Shalya Chikitsa. Here, it is important to note that Ashtavidha Shastrakarmas are

not the eight surgical procedures; rather these are the eight basic principles of all the surgical

procedures which can be used for any surgery. These Karmas contain a short but full

description of all the surgeries.

DISCUSSION

Acharya Sushruta lists 101 varieties of blunt instruments and 20 different types of sharp

instruments that should have such a fine edge that they divide the skin's hair. Scalpels,

lancets, saws, scissors, needles, hooks, probes, dilators, sounds, forceps, trocars, catheters,

syringes, candles, rectal & vaginal speculum’s are the main instruments made of iron. Most

modern surgical tools like laproscopy, hysteroscopy are only minor modifications of those

used by the ancient ayurvedic surgeons.

CONCLUSION

We stand on the shoulders of our forebears, as has been said repeatedly and appreciation of

this heritage is perhaps more necessary than ever as innovation succeeds innovation quickly.

Based on the description given in ancient Ayurvedic classics in the context of Yantra Shastras

(surgical instruments), it can be concluded that in Shalya Chikitsa as well as in Stri Roga and

Prasuti Tantra, nearly every instrument used in the present era either for medical

examination or medical / operative procedure was used over ages.

REFERENCES

1. Shastri Dutta Ambika. Sushruta Samhita of Maharshi Sushruta edited with Ayurved

Tattva Sandipika, Sutra Sthana Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14: 7-3.

2. Shukla, Vidyadhar; Tripathi, Ravi Dutt. Charaka Samhita of Agnivesha elaborated by

Charaka and Dridhabala, Chikitsa Sthana Chaukhamba Sanskrit Pratishthan, Delhi, 2006;

30: 43-45.

3. Shastri, Dutta Ambika. Sushruta Samhita of Maharshi Sushruta edited with Ayurved

Tattva Sandipika, Chikitsa Sthana Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14:

15-9.


Tattva Sandipika, Chikitsa Sthana Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14:

15-3.


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5. Mishra, Brahmashankara; Vaishya Rupalalaji. Bhavaprakasha of Sri Bhava Mishra edited

with Vidyotinihindi commentary, Chikitsa Chaukhamba Sanskrit Sansthan, Varanasi,

10(70): 120-122.


Tattva Sandipika, Sharir Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14:

10-21.


Tattva Sandipika, Sutra Sthana Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14: 7-4.


Tattva Sandipika, Sutra Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14: 7-5.


Tattva Sandipika, Sutra Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14: 7-

10.


Tattva Sandipika, Sutra Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14: 7-

11.

11. Tripathi, Dutt Ravi. Astanga Samgraha of Srimad Vriddha Vagbhata, Sutra Sthana,

Chaukhamba Sanskrit Pratishthan Delhi, 2006; 34-6.




Tattva Sandipika, Sutra Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14:

7-13.

14. Tripathi, Dutt Ravi. Astanga Samgraha of Srimad Vriddha Vagbhata Ibid Astanga

Samgraha, Sutra Sthana, Chaukhamba Sanskrit Pratishthan Delhi, 2006; 13: 34-13.


Tattva Sandipika, Chikitsa Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14:

17-47.


Tattva Sandipika, SutraSthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14: 7-15.




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Tattva Sandipika, Chikitsa Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003;

19(14): 49-50.

19. Gupta, Atrideva. Astanga Hridyam of Vagbhatta edited with Vidyotini Hindi

commentary, Sutra Sthana Chaukhamba Prakashan, Varanasi, 2008; 25-32.



15-12.


Chaukhamba Sanskrit Pratishthan Delhi, 2006; 34: 11-12.


Tattva Sandipika, Chikitsa Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003;

15(14): 13-16.


Tattva Sandipika, Sutra Sthana, Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14: 8-4.

24. 28. Shastri, Dutta Ambika. Sushruta Samhita of Maharshi Sushruta edited with Ayurved


15-16.

25. Harita samhita, Asha hindi commentary of Acharya Shastri Ramavalamba on harita

samhita, Pratham sthana chapter, Varanasi; Prachya prakashana, 1985; 1: 30.

26. Acharya Yadavaji Trikamaji., editor. Nibandhsamgraha commentary by Dalhana.

ed.varanasi; chaukhamba orientalia, 1997; 1: 30-41.


Tattva Sandipika, Uttar Sthana Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 14:

22-20, 23-12.


Tattva Sandipika, Sutra Sthana Chaukhamba Sanskrit Sansthan, Varanasi, 2003; 25:

23-24.

29. Shukla, Vidyadhar; Tripathi, Ravi Dutt. Charaka Samhita of Agnivesha elaborated by

Charaka and Dridhabala, Sharir Sthana Chaukhamba Sanskrit Pratishthan, Delhi, edition

2006; 8-34.

30. Kaur Baljot, Chandla Anubha. A Comprehensive Review of Surgical Instruments

(Yantras & Shastras) Used in Stree Roga & Prasuti Tantra in Ayurveda vis-a-vis Modern

Obstetrics & Gynecology. AYUSHDHARA, 2016; 3(6): 977-982.


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31. Dr. Manpreet Kaur, Dr. Krishna Kumar, Dr. Ashokan V.A REVIEW OF SURGICAL

INSTRUMENTS (YANTRAS & SHASTRAS) IN STREE ROGA & PRASUTI

TANTRA IN AYURVEDA VIS-À-VIS MODERN OBSTETRICS & GYNECOLOGY;

ISSN: 2457-0400, 2019; 3(4): 62-67.

32. Shukla kamayani Upadhyay, Upadhyay sudhanshu; Ashtavidha Shastra Karmas (Eight

Surgical Principles) : Application in Gynaecology & Obstetrics; Indian Journal of

Ancient Medicine and Yoga Review article, 2012; 5(3).

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