Among the Ayurvedic compendia that survive in manuscript, few are as complete and practical as the Prayogasāra, a treatise on applied therapeutics whose pediatric focus earned it the subtitle Bālatantra. Compiled by the physician Kalyāṇa, the text runs to thirty-two folios covering the full arc of family medicine — from fertility and pregnancy to the diseases of newborns and children.
The opening verses set the tone. After saluting Gaṇeśa, Kalyāṇa explains that he has drawn together what is scattered across treatises like the Suśruta and distilled it into a single manual of practices. The text is organized not by theory but by use: what to prescribe, when to prescribe it, and for whom.
Diseases of Infancy and Childhood
The manuscript devotes sustained attention to conditions unique to children. It describes talukantaka (swelling of the palate), kukunaka (infantile eye discharge), kundigudapaka (painful rectal inflammation), and the skin conditions ahīpūtanā and jagallikā — the latter a painless, mung-bean-sized nodule the text links to kapha and vāta. Teething is treated as a root cause of fevers and body pains, and the author repeatedly warns against strong purgatives and emetics in the very young.
What is stated in one place, having considered that, is compiled by me in this Bālatantra.
Dosage for Small Bodies
Pediatric dosing is a recurring concern. The text gives age-based increments using honey, milk, sugar, and ghee as vehicles, and employs the small units guñjā and māṣaka for pellets and electuaries. Formulations such as caturbhadra — built around ativiṣā and bilva — appear again and again for fever, diarrhea, cough, and vomiting in infants, always adjusted to the child's strength.
The Wet Nurse and the Quality of Milk
A remarkable chapter addresses the selection of a wet nurse (dhātrī). She should be of medium build, dark-complexioned, robust, pure-minded, and free from afflictions; her milk must be continuous and free from froth. The manuscript warns that milk that is cold, curdled, or impure causes disease in the child, and it prescribes a series of decoctions — of amṛtā and saptaparṇa, or pāṭhā and mustā — to purify vitiated milk when the nurse's diet has gone wrong.
Read together, these chapters present a coherent system: pediatric care in the Bālatantra begins before conception and continues through weaning, with the physician, the mother, and the nurse all held accountable for the child's health.