Changes

==== ''Prakriti'' examination ====

==== ''Prakriti'' examination ====

The prakriti or basic constitution is very important to be investigated to know overall health status of a person. The place of birth, place of living, place of work is important for identifying the ethnic habits, suitability, and external causes of a disease. Accordingly, the do’s and don’ts in terms of diet and lifestyle are prescribed, that is the integral part of Ayurvedic prescription. Currently, concept of prakriti is being investigated further in personalized medicine to know the genotype and phenotype of an individual and predicting certaing disorders in view of prevention.  

The ''prakriti'' or basic constitution is very important to be investigated to know overall health status of a person. The place of birth, place of living, place of work is important for identifying the ethnic habits, suitability, and external causes of a disease. Accordingly, the do’s and don’ts in terms of diet and lifestyle are prescribed, that is the integral part of Ayurvedic prescription. Currently, concept of ''prakriti'' is being investigated further in personalized medicine to know the genotype and phenotype of an individual and predicting certain disorders in view of prevention.  

Sara examination:

 

To evaluate immunity or bodie’s resistance to disease, sara or ‘or the best qualities of tissues needs to be examined. The constitutional essence helps to understand the immunity of the person. More the sarata of dhatu, more is the immunological strength of the person. Analogue of ant helps to understand the significance of essence of dhatus. Ant although small and lean in size is able to lift more than its weight due to asthisarata present in it. In Vividhashitpeeteeyadhyaya of sutrasthana (chapter 28), special importance is given to mamsa (muscle), shonita (blood) and asthi dhatu (bone) in Vyadhikshamatva (immunity) which needs to be researched more.

==== ''Sara'' examination ====

Satmya (suitability):

 

The effect of a drug depends upon its interaction with the body tissues. If it is not suitable to the body tissues, then adverse reaction may occur or drug may not be effective. Drug resistance also needs to be considered under the heading of satmya because it is observed that to a person who has developed resistance to certain antibiotics does not offer response to such medicament thus not attaining successful result in the person. Nowadays culture study is used to understand the usefulness of antibiotics in the patient. Therefore the suitability of the patient must be considered before preacribing a medicine.   

To evaluate immunity or bodie’s resistance to disease, ''sara'' or ‘or the best qualities of tissues needs to be examined. The constitutional essence helps to understand the immunity of the person. More the ''sarata'' of ''dhatu'', more is the immunological strength of the person. Analogue of ant helps to understand the significance of essence of ''dhatus''. And although small and lean in size is able to lift more than its weight due to ''asthisarata'' present in it. In [[Vividhashitpitiya Adhyaya]] of [[Sutra Sthana]] (chapter 28), special importance is given to ''mamsa'' (muscle), ''shonita'' (blood) and ''asthi dhatu'' (bone) in ''Vyadhikshamatva'' (immunity) which needs to be researched more.

The ideal time for purification procedures:

 

==== ''Satmya'' (suitability) ====

The effect of a drug depends upon its interaction with the body tissues. If it is not suitable to the body tissues, then adverse reaction may occur or drug may not be effective. Drug resistance also needs to be considered under the heading of ''satmya'' because it is observed that to a person who has developed resistance to certain antibiotics does not offer response to such medicament thus not attaining successful result in the person. Nowadays culture study is used to understand the usefulness of antibiotics in the patient. Therefore the suitability of the patient must be considered before prescribing a medicine.   

 

==== The ideal time for purification procedures ====

 

If in emergency shodhan has to be done in unsuitable weather, then the surroundings of the patient should be made such that it resembles the sadharan kala, for example, if it is very cold then room should be adjusted with warmness and if it is very hot as in grishma, then the temperature in the room should be reduced.  Also a physician must use yukti and accordingly use or make the necessary dravyas sheeta or ushna by appropriate samyoga (combination), samskara (processing) and pramana (dose).

If in emergency shodhan has to be done in unsuitable weather, then the surroundings of the patient should be made such that it resembles the sadharan kala, for example, if it is very cold then room should be adjusted with warmness and if it is very hot as in grishma, then the temperature in the room should be reduced.  Also a physician must use yukti and accordingly use or make the necessary dravyas sheeta or ushna by appropriate samyoga (combination), samskara (processing) and pramana (dose).

Examination of stage of disease:

 

==== Examination of stage of disease ====

Aturavastha or the phase of disease in patient also matters in treatment as seen in context of jwara wherein in kashaya (decoction) should not be administered for seven days or till amapachana does not take place. This interprets that the body of patient shall be able to metabolize the drugs. In case of jwara, the doshas are too vititated with the poor status of agni, therefore the body is unable to metabolize even the drugs also. Therefore langhana (fasting) is the first treatment in jwara. In nutshell, the medicines shall be prescribed considering the phase of disease and status of the patient.  

Aturavastha or the phase of disease in patient also matters in treatment as seen in context of jwara wherein in kashaya (decoction) should not be administered for seven days or till amapachana does not take place. This interprets that the body of patient shall be able to metabolize the drugs. In case of jwara, the doshas are too vititated with the poor status of agni, therefore the body is unable to metabolize even the drugs also. Therefore langhana (fasting) is the first treatment in jwara. In nutshell, the medicines shall be prescribed considering the phase of disease and status of the patient.  

Nowadays, various softwares and decision support systems are available to help physicians regarding the diagnosis. Various subjective assessment scales to examine sara and questionnaires to assess prakriti are available to know the status of patient.  

Nowadays, various softwares and decision support systems are available to help physicians regarding the diagnosis. Various subjective assessment scales to examine sara and questionnaires to assess prakriti are available to know the status of patient.  

Examination of psyche of patient:

 

==== Examination of psyche of patient ====

 

Mana/satva (mind) is said to be tantraka (technical operator) as the one who is preraka (inspirer) or dharaka (owner). Mana is the initiator of all activity but it can carry out its action in conjunction with atma only. If mana is weak it is unable to tolerate the symptoms of disease and he/she exaggerates those. If the doctor makes the mistake of considering the inferior mental strength of patient with severe disease depending on presentation of symptoms and gives strong medicine then he may end up with complication. Symptoms of severely diseased and mildly diseased are mentioned in 7th chapter of Vimansthan.

Mana/satva (mind) is said to be tantraka (technical operator) as the one who is preraka (inspirer) or dharaka (owner). Mana is the initiator of all activity but it can carry out its action in conjunction with atma only. If mana is weak it is unable to tolerate the symptoms of disease and he/she exaggerates those. If the doctor makes the mistake of considering the inferior mental strength of patient with severe disease depending on presentation of symptoms and gives strong medicine then he may end up with complication. Symptoms of severely diseased and mildly diseased are mentioned in 7th chapter of Vimansthan.

The mental status examination has a special importance in today’s medical practice. The physician has to modulate interaction with the patient, dose of medicine, potency of medicine considering the psychology of the patient. The physician who communicates better with the patient helps to heal disease naturally.  

The mental status examination has a special importance in today’s medical practice. The physician has to modulate interaction with the patient, dose of medicine, potency of medicine considering the psychology of the patient. The physician who communicates better with the patient helps to heal disease naturally.  

Assessment of ahara shakti (intake capacity):

 

Aharashakti is not only the quantity of food intake, but also its digestive capacity. Quantity of food taken and digestive capacity of the person is to be considered. The assessment of agni is based upon the food intake capacity of the person. The proporation of body tissue depends upon intake of food and its assimilation inside body. This direcly affects the health status. Hence, ahara shakti is important to be assessd.  

==== Assessment of ahara shakti (intake capacity) ====

 

Aharashakti is not only the quantity of food intake, but also its digestive capacity. Quantity of food taken and digestive capacity of the person is to be considered. The assessment of agni is based upon the food intake capacity of the person. The proporation of body tissue depends upon intake of food and its assimilation inside body. This direcly affects the health status. Hence, ahara shakti is important to be assessed.  

 

Further, if the patient is not responding to oral administration of drugs, then the parenteral or any other route of drug administration is to be chosen.  

Further, if the patient is not responding to oral administration of drugs, then the parenteral or any other route of drug administration is to be chosen.  

Assessment of vyayama shakti (exercise endurance capacity):

 

==== Assessment of vyayama shakti (exercise endurance capacity) ====

 

Vyayamashakti is described as bharvahanshakti i.e. capacity to work. People doing strenuous work or exercise have more forebearance and are strong. The capacity to exercise is directly related with the cardio-vascular, pulmonary, muscular and mental status of the patient, and hence it is linked with healthy lifespan. Nowadays, various stress tests are done for evaluation of these functions and are useful to determine the prognosis of disease to give guidance for necessary intervention.   

Vyayamashakti is described as bharvahanshakti i.e. capacity to work. People doing strenuous work or exercise have more forebearance and are strong. The capacity to exercise is directly related with the cardio-vascular, pulmonary, muscular and mental status of the patient, and hence it is linked with healthy lifespan. Nowadays, various stress tests are done for evaluation of these functions and are useful to determine the prognosis of disease to give guidance for necessary intervention.   

Glossary:  

Glossary:  

16. vacanaśaktim- वचनशक्ति- Person having good vocabulary and also has various interpretation.  

16. vacanaśaktim- वचनशक्ति- Person having good vocabulary and also has various interpretation.  

17. bhūyō'dhyavasāya- भूयोऽध्यवसाय-dhruda nischaya- who has gain complete knowledge and confidence on the subject.

17. bhūyō'dhyavasāya- भूयोऽध्यवसाय-dhruda nischaya- who has gain complete knowledge and confidence on the subject.

18. Sanharsha- संहर्षात् -happiness of wining the competition

18. Sanharsha- संहर्षात् -happiness of wining the competition

19. jñāna-ज्ञान- Shastrārtha jñāna - meaning of the science  

19. jñāna-ज्ञान- Shastrārtha jñāna - meaning of the science  

28. Āviklipta-अaaaasविक्लिप्तैः- Single drug use

28. Āviklipta-अaaaasविक्लिप्तैः- Single drug use

1. Charak Samhita by Agnivesha Edited By Yadavji Trikamji Acharya-Munshiram Manoharlal Publishers Pvt. Ltd. 4th Edition.

1. Charak Samhita by Agnivesha Edited By Yadavji Trikamji Acharya-Munshiram Manoharlal Publishers Pvt. Ltd. 4th Edition.