Changes

Thus ends the ninth chapter on small quadruple in Shlokasthana in the treatise composed by Agnivesha and redacted by Charaka.

Thus ends the ninth chapter on small quadruple in Shlokasthana in the treatise composed by Agnivesha and redacted by Charaka.

=== Tattva Vimarsha ===

=== ''Tattva Vimarsha'' ===

* Four components i.e. Physician, Medicine, Caretaker/nursing staff and patient are essential pillars for any healthcare system.[3]

* Four components i.e. Physician, Medicine, Caretaker/nursing staff and patient are essential pillars for any healthcare system.[3]

* Disease is a state of unhappiness due to disequilibrium of body elements. Health is a state of happiness due to equilibrium of these elements. [4]     

* Disease is a state of unhappiness due to disequilibrium of body elements. Health is a state of happiness due to equilibrium of these elements. [4]     

* The management by all four components leading to equilibrium of body elements is called “chikitsa”.[5]

* The management by all four components leading to equilibrium of body elements is called “chikitsa”.[5]

* There are four qualities of an ideal vaidya [learned knowledgeable physician]: Shrute paryavadatatvam [good listener, clear understanding and knowledge of science], bahusha drishtakarmata [maximum practical experience], dakshya [dexterity, alertness and devotion towards duties], and shaucham [purity of body and mind, hygiene]. [6]     

* There are four qualities of an ideal ''vaidya'' (learned knowledgeable physician): ''Shrute paryavadatatvam'' (good listener, clear understanding and knowledge of science), ''bahusha drishtakarmata'' (maximum practical experience), ''dakshya'' ((dexterity, alertness and devotion towards duties), and ''shaucham'' (purity of body and mind, hygiene). [6]     

* The four qualities of ideal medicine include bahuta [easy and abundant in availability], yogyatwam [efficacy with good pharmacological properties], anekavidha kalpana [preparations in various pharmaceutical forms] and sampat [intact properties without getting affected by insects, moisture etc.] [7]

* The four qualities of ideal medicine include ''bahuta'' (easy and abundant in availability), ''yogyatwam'' (efficacy with good pharmacological properties), ''anekavidha kalpana'' (preparations in various pharmaceutical forms) and ''sampat'' (intact properties without getting affected by insects, moisture etc.) [7]

* The four qualities of a nursing staff/caretaker of patients includes upacharadnyata [knowledge of taking care of patient (nursing) as well as preparation, dispensing, administration of medicines and healthy recipes], dakshyam [dexterity, alert to perform duties quickly], bhartari anuraga [affectionate towards patient like he/she is treating his/her brother] and shaucham [purity of body and mind and hygiene]. [8]

* The four qualities of a nursing staff/caretaker of patients includes ''upacharadnyata'' (knowledge of taking care of patient (nursing) as well as preparation, dispensing, administration of medicines and healthy recipes), ''dakshyam'' (dexterity, alert to perform duties quickly), ''bhartari anuraga'' (affectionate towards patient like he/she is treating his/her brother) and ''shaucham'' (purity of body and mind and hygiene). [8]

* The four qualities of a patient include smriti [good memory to remember treatment guidelines], nirdeshakaritwam [obedience to follow given instructions], abhirutwam [fearlessness or courage to handle complex procedures or face adversities of disease], and dnyapakatwam [ability to provide all information about the disease, giving proper history]. [9]   

* The four qualities of a patient include ''smriti'' (good memory to remember treatment guidelines), ''nirdeshakaritwam'' (obedience to follow given instructions), ''abhirutwam'' (fearlessness or courage to handle complex procedures or face adversities of disease), and ''dnyapakatwam'' (ability to provide all information about the disease, giving proper history). [9]   

* The Ayurvedic physician should know the processing methods in pharmaceutics as the cook knows the recipes. He/she should be brave like a warrior to face adversities in disease management. As like a potter, the physician should think creatively and innovatively to manage disease with advances skills, newer techniques and new formulations. [11-12]

* The Ayurvedic physician should know the processing methods in pharmaceutics as the cook knows the recipes. He/she should be brave like a warrior to face adversities in disease management. As like a potter, the physician should think creatively and innovatively to manage disease with advances skills, newer techniques and new formulations. [11-12]

* The physician without proper knowledge [quack] can destroy a patient’s life. Therefore quacks should be strictly prohibited from clinical practice. [14-17]

* The physician without proper knowledge (quack) can destroy a patient’s life. Therefore quacks should be strictly prohibited from clinical practice. [14-17]

* The pranabhisara vaidya [life saviour physician] should be updating his/her scientific knowledge continuously, possess clear understanding of Ayurvedic principles and practices (including the correct and timely application of drugs and procedures), and continuous practical experience. [18]

* The ''pranabhisara vaidya'' (life saviour physician) should be updating his/her scientific knowledge continuously, possess clear understanding of Ayurvedic principles and practices (including the correct and timely application of drugs and procedures), and continuous practical experience. [18]

* The aptitude for being royal physician includes knowledge of etiology, symptomatology, therapeutics and prevention of diseases. [19]

* The aptitude for being royal physician includes knowledge of etiology, symptomatology, therapeutics and prevention of diseases. [19]

* The physician should always try to remove lacunae and update his knowledge and wisdom to improve clinical practice. [20]

* The physician should always try to remove lacunae and update his knowledge and wisdom to improve clinical practice. [20]

* Continuous learning, rationality or capacity for innovative thinking, specific scientific knowledge, good memory, devotion to perform timely duties and action [clinical practice] are the attributes of a successful vaidya [knowledgeable, learned physician]. [21]

* Continuous learning, rationality or capacity for innovative thinking, specific scientific knowledge, good memory, devotion to perform timely duties and action (clinical practice) are the attributes of a successful ''vaidya'' (knowledgeable, learned physician). [21]

* For attaining the qualification of a vaidya, one of the following quality or skill is sufficient: Vidya [the desire to learn continuously], mati [pure prodigious intellect or wisdom acquired by scientific studies], karma drishti [practical knowledge], abhyasa [repeated practice or clinical experience], siddhi [ability to successfully manage most of diseases], and ashraya [residence with or continual guidance from eminent mentors]. One who possesses all these six qualities gives immense happiness [freedom from disease] to all living beings.[22-23]

* For attaining the qualification of a ''vaidya'', one of the following quality or skill is sufficient: ''Vidya'' (the desire to learn continuously), ''mati'' (pure prodigious intellect or wisdom acquired by scientific studies), ''karma drishti'' (practical knowledge), ''abhyasa'' (repeated practice or clinical experience), ''siddhi'' (ability to successfully manage most of diseases), and ''ashraya'' (residence with or continual guidance from eminent mentors). One who possesses all these six qualities gives immense happiness (freedom from disease) to all living beings.[22-23]

* The behaviour of a physician towards patients should be friendly and compassionate to share the unhappiness of disease. The wise physician should affectionately manage the curable disease and be neutral towards the patients tending towards natural death. One should know the limitation that he/she can’t extend the life of a patient in case of natural death. These are the four attitudes while dealing with the patients.[26]

* The behaviour of a physician towards patients should be friendly and compassionate to share the unhappiness of disease. The wise physician should affectionately manage the curable disease and be neutral towards the patients tending towards natural death. One should know the limitation that he/she cannot extend the life of a patient in case of natural death. These are the four attitudes while dealing with the patients.[26]

=== Vidhi Vimarsha ===

=== Vidhi Vimarsha ===