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→Ten factors for examination in therapeutics
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Previously explained ''karana'' etc. ten entities are elaborately discussed in relation to specific features of therapeutics diseases ten entities are to be examined such as physician acts like a doer (''karana''),drugs act like instrument (''karan''), imbalance of ''dhatu'' (''karyayoni''), balance of ''dhatu'' (''karya''), attainment of health and happiness (''karyaphala''), life-span (''anubandha''), land as well as patient (''desha''), year and phase of disease (''kala''), initiation of therapy (''pravritti'') and excellence of physician etc. and proper management (''upaya'').[84]
Previously explained ''karana'' etc. ten entities are elaborately discussed in relation to specific features of therapeutics diseases ten entities are to be examined such as physician acts like a doer (''karana''),drugs act like instrument (''karan''), imbalance of [[dhatu]] (''karyayoni''), balance of [[dhatu]] (''karya''), attainment of health and happiness (''karyaphala''), life-span (''anubandha''), land as well as patient (''desha''), year and phase of disease (''kala''), initiation of therapy (''pravritti'') and excellence of physician etc. and proper management (''upaya'').[84]
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Earlier, physician has been mentioned as doer (''karana''). ''Bhishak'' is the one who should be able to win over the diseases and expert in applying the ideas of the aphorisms and knows the pros and cons of life (science) properly from all aspects. He should know how to bring about balance between ''dhatus'' (''dhatu samya''), must be learned, trained in scriptures and qualified enough for the same and has received practical training and expertise in duties. He should be introspective, desirous of maintaining balance of all ''dhatus'', considering the consequence of treatment in appropriate patients, with proper qualities of management, with due considerations of one’s own capabilities and limitations.
Earlier, physician has been mentioned as doer (''karana''). ''Bhishak'' is the one who should be able to win over the diseases and expert in applying the ideas of the aphorisms and knows the pros and cons of life (science) properly from all aspects. He should know how to bring about balance between [[dhatu]] ([[dhatu]] samya), must be learned, trained in scriptures and qualified enough for the same and has received practical training and expertise in duties. He should be introspective, desirous of maintaining balance of all [[dhatu]], considering the consequence of treatment in appropriate patients, with proper qualities of management, with due considerations of one’s own capabilities and limitations.
The physician endowed with the following qualities is capable of bringing forth the equilibrium of ''dhatus'': clear scientific knowledge , practical knowledge, alert, purity, skill, and possession of all required equipment, with proper sense perceptions (all sense and motor organs), acquaintance with human constitution and the knowledge of the course of action. [86]
The physician endowed with the following qualities is capable of bringing forth the equilibrium of [[dhatu]]: clear scientific knowledge , practical knowledge, alert, purity, skill, and possession of all required equipment, with proper sense perceptions (all sense and motor organs), acquaintance with human constitution and the knowledge of the course of action. [86]
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The medicament has been mentioned here as instrument (''karana'') which serves as equipment for the physician making effort for effective balance of ''dhatus'' particularly different from the entities ending with procedure (original source, inclination, place, time and procedure). In view of agents applied medicament or therapy is advocated as of two types – spiritual (''daivavyapashraya'') and rational (''yuktivyapashayam'').
The medicament has been mentioned here as instrument (''karana'') which serves as equipment for the physician making effort for effective balance of [[dhatu]] particularly different from the entities ending with procedure (original source, inclination, place, time and procedure). In view of agents applied medicament or therapy is advocated as of two types – spiritual (''daivavyapashraya'') and rational (''yuktivyapashayam'').
In spiritual therapy, incantation, roots, gems, auspicious rites, expiation, fasting, blessings, bowing, visit to temples(sacred places) etc. are employed.
In spiritual therapy, incantation, roots, gems, auspicious rites, expiation, fasting, blessings, bowing, visit to temples(sacred places) etc. are employed.
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==== Assessment of disequilibrium of ''dhatu'' ====
==== Assessment of disequilibrium of [[dhatu]]====
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The original source is disequilibrium of ''dhatus'' known by the emergence of signs of the disorder. Examination regarding this and the material cause of the disorder consists of the observation of the characters of their diminution or aggravation and also of those denoting curability, incurability, mildness and severity of the disorder.[88]
The original source is disequilibrium of [[dhatu]] known by the emergence of signs of the disorder. Examination regarding this and the material cause of the disorder consists of the observation of the characters of their diminution or aggravation and also of those denoting curability, incurability, mildness and severity of the disorder.[88]
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==== Assessment of equilibrium of ''dhatu'' ====
==== Assessment of equilibrium of [[dhatu]] ====
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Action (''karya'') is to bring about equilibrium of ''dhatus'' and its feature is absence of disease. Its examination is based on following criteria: alleviation of the disorder, normalcy of voice and complexion, nourishment of body, increase in strength, desire for food, relish at meal time, proper and timely digestion of the ingested food, timely sleep, non-appearance of abnormal dreams, easy awakening, easy elimination of urine, feces and semen, overall normalcy of mind, intellect and sense organs and associated with no other unhealthy features.[89]
Action (''karya'') is to bring about equilibrium of [[dhatu]] and its feature is absence of disease. Its examination is based on following criteria: alleviation of the disorder, normalcy of voice and complexion, nourishment of body, increase in strength, desire for food, relish at meal time, proper and timely digestion of the ingested food, timely sleep, non-appearance of abnormal dreams, easy awakening, easy elimination of urine, feces and semen, overall normalcy of mind, intellect and sense organs and associated with no other unhealthy features.[89]
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The place of living and patients’ body constitutes the field of action (''karya desha'').
The place of living and patients’ body constitutes the field of action (''karya desha'').
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Assessment of place of living is done with a view considering the patient and medicine. Regarding patient the things to be considered are – in which area patient is born, grown or diseased; in that particular area, the people mostly have such diet, such lifestyle, such behavior and conduct, such strength, such mind setup, this particular things are naturally accustomed, these are the wrong habits/ or the domination of ''dosha'', liking, area associated disorders, these are the wholesome entities and unwholesome entities for the people. The knowledge regarding place of living examination about drugs will be described in [[Kalpa Sthana]] section. [92-93]
Assessment of place of living is done with a view considering the patient and medicine. Regarding patient the things to be considered are – in which area patient is born, grown or diseased; in that particular area, the people mostly have such diet, such lifestyle, such behavior and conduct, such strength, such mind setup, this particular things are naturally accustomed, these are the wrong habits/ or the domination of [[dosha]], liking, area associated disorders, these are the wholesome entities and unwholesome entities for the people. The knowledge regarding place of living examination about drugs will be described in [[Kalpa Sthana]] section. [92-93]
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Patient is the substratum of the act (''karyadesha''). Examination of the patient is conducted for the knowledge of life span or the degree of strength and morbidity. The variations in dosage and potency of prescribed drugs is according to the degree of morbidity and the degree of strength of patient, because if potent drug is administered suddenly by a physician having not been examined properly, it may kill the weak patient; the weak patients are not able to bear intensely potent drugs which are predominant in ''agni'' and ''vayu'' or cauterization, application of alkali and surgical operation. They may cause instantaneous death due to unbearable and over intense impulse of the drug. Keeping this fact in mind, the physician should treat the weak patient with drug which is not harmful, mild, delicate, and progressively strong in order, without complication and not creating any emergent condition, particularly ladies, because they have unstable, soft, bare and timid heart, they are mostly delicate, weak and dependent on others. On the other hand, the drugs having low potency and applied by one who has not been examined properly in strong patients having severe disorder becomes ineffective. Hence the patient should be examined in respect of constitution (''prakriti''), morbidty (''vikriti''), constitution of ''dhatu'' (''sara''), compactness (''samhanana''), measurement (''pramana''), suitability (''satmya''), psyche (''sattva''), power of intake and digestion of food (''aharashakti''), power of exercise (''vyayamashakti'') and age (''vaya'') for the knowledge of the degree of strength.[94]
Patient is the substratum of the act (''karyadesha''). Examination of the patient is conducted for the knowledge of life span or the degree of strength and morbidity. The variations in dosage and potency of prescribed drugs is according to the degree of morbidity and the degree of strength of patient, because if potent drug is administered suddenly by a physician having not been examined properly, it may kill the weak patient; the weak patients are not able to bear intensely potent drugs which are predominant in [[agni]] and [[vayu]] or cauterization, application of alkali and surgical operation. They may cause instantaneous death due to unbearable and over intense impulse of the drug. Keeping this fact in mind, the physician should treat the weak patient with drug which is not harmful, mild, delicate, and progressively strong in order, without complication and not creating any emergent condition, particularly ladies, because they have unstable, soft, bare and timid heart, they are mostly delicate, weak and dependent on others. On the other hand, the drugs having low potency and applied by one who has not been examined properly in strong patients having severe disorder becomes ineffective. Hence the patient should be examined in respect of constitution ([[prakriti]]), morbidty (''vikriti''), constitution of [[dhatu]] (''sara''), compactness (''samhanana''), measurement (''pramana''), suitability (''satmya''), psyche (''sattva''), power of intake and digestion of food (''aharashakti''), power of exercise (''vyayamashakti'') and age (''vaya'') for the knowledge of the degree of strength.[94]
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Explanation regarding factors ''prakriti'' etc. are explained henceforth– the constitution (''prakriti'') associated with fetus (''garbha'') is determined by constitution of sperm and ovum, the time (of conception) and status of health of uterus, diet and lifestyle of mother (during pregnancy) and interaction of ''mahabhutas''. Body humors (''dosha''), one or more than one which predominates in these factors gets attached to the fetus which is called physical or ''doshika'' constitution (''dosha prakriti'') of human beings which is emerged from the initial stage of fetus. Hence some persons are constitutionally having predominance of ''kapha''(''shleshma'') some ''pittala'', some ''vatala'' some having, combined ''dosha'' and some with balanced ''dhatus''. Their characters are described here. [95]
Explanation regarding factors [[prakriti]] etc. are explained henceforth– the constitution ([[prakriti]]) associated with fetus ([[garbha]]) is determined by constitution of sperm and ovum, the time (of conception) and status of health of uterus, diet and lifestyle of mother (during pregnancy) and interaction of [[mahabhuta]]. Body humors ([[dosha]]), one or more than one which predominates in these factors gets attached to the fetus which is called physical or ''doshika'' constitution ([[dosha]] [[prakriti]]) of human beings which is emerged from the initial stage of fetus. Hence some persons are constitutionally having predominance of [[kapha]](''shleshma'') some [[pitta]]la, some [[vata]]la some having, combined [[dosha]] and some with balanced [[dhatu]]. Their characters are described here. [95]
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''Shleshma'' is unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), sweet (''madhura''), essence (''sara''), dense (''sandra''), slow acting (''manda''), stable (''stimita''), heavy (''guru''), cold (''sheeta''), slimy (''vijjala'') and clear (''acchah''). Because of its unctuousness the person with predominance of ''kapha'' has unctuous organs; due to smoothness smooth organs; due to softness he has pleasing, delicate and fair organs; due to sweetness person has abundant semen, libido and more progeny; due to nature of essence excellent person has compact and stable body; due to density, all organs are well developed and perfect; due to slowness, dull/ slow in activities, diet and speech; due to stability delayed initiation, irritation and slow in change of attitude /(disorders are slowly progressive); due to heaviness movements are supported with essence and stability; due to coldness little hunger, thirst, heat and perspiration, due to sliminess well united and strong joint ligaments, due to clarity clear eyes, face with clear and unctuous complexion and affectionate voice. Because of presence of these qualities the ''kapha'' dominated personality(''shleshmala'') persons are strong, wealthy, learned, brave, calm and long lived.[96]
''Shleshma'' is unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), sweet (''madhura''), essence (''sara''), dense (''sandra''), slow acting (''manda''), stable (''stimita''), heavy (''guru''), cold (''sheeta''), slimy (''vijjala'') and clear (''acchah''). Because of its unctuousness the person with predominance of [[kapha]] has unctuous organs; due to smoothness smooth organs; due to softness he has pleasing, delicate and fair organs; due to sweetness person has abundant semen, libido and more progeny; due to nature of essence excellent person has compact and stable body; due to density, all organs are well developed and perfect; due to slowness, dull/ slow in activities, diet and speech; due to stability delayed initiation, irritation and slow in change of attitude /(disorders are slowly progressive); due to heaviness movements are supported with essence and stability; due to coldness little hunger, thirst, heat and perspiration, due to sliminess well united and strong joint ligaments, due to clarity clear eyes, face with clear and unctuous complexion and affectionate voice. Because of presence of these qualities the [[kapha]] dominated personality(''shleshmala'') persons are strong, wealthy, learned, brave, calm and long lived.[96]
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[[Pitta]] is hot (''ushna''), sharply/acutely acting (''tikshna''), liquid (''drava''), of fleshy smell (''visram''), sour (''amla'') and pungent (''katu''). Due to hotness, the persons having predominance of [[pitta]] are intolerant to heat, vulnerable to disorders due to heat delicate and beautiful body, plenty of moles, freckles, black-moles and pimples, excessive hunger and thirst, early appearance of wrinkles, graying and falling of hairs, mostly soft, scanty and brown beard/mustaches, hairs; due to sharpness/acuteness, sharply acting and valor, intense digestive power, intake of plenty of food and drink, lack of endurance, frequently eating; due to liquidity, lax and soft joints and muscles, excess perspiration, urination and defecation; due to fleshy smell foul smell in axilla, mouth, head and body; due to pungency and sourness there is less semen, libido and few progeny; because of presence of these qualities persons having predominance of [[pitta]] are moderate in strength, lifespan, knowledge, understanding, wealth and means.[97]
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===== Characteristics of ''vata prakriti'' =====
===== Characteristics of [[vata]] [[prakriti]] =====
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[[Vata]] is rough (''ruksha''), light (''laghu''), mobile (''chala''), abundant (''bahu''), swift (''shighra''), cold (''sheeta''), coarse (''parusha'') and non-slimy (''vishada'').
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Due to roughness the persons with predominance of ''vata'' have rough, underdeveloped and short stature, constant rough, weak, low, adhered and hoarse voice, wakeful; due to lightness, light and fickle movements, activities, diet and speech; due to mobility, unstable joints, eye brows, jaw, lips, tongue, head, shoulder, hands and feet; due to abundance, talkativeness and visually abundance of tendons and venous network; due to swiftness hasty initiation, quick irritation and disorder, quick in fear attachment and disenchantment, quick in acquisition but with a poor memory (retention); due to coldness intolerance to cold, continuously infliction with cold, shivering and stiffness; due to coarseness, coarse hairs, beard-mustaches, hairs, nails, teeth, face, hands and feet, due to non-sliminess cracked body parts and constant sound in joints during movement. Because of presence of these qualities the persons having predominance of ''vata'' have mostly low degree of strength, life-span, progeny, means and wealth. [98]
Due to roughness the persons with predominance of [[vata]] have rough, underdeveloped and short stature, constant rough, weak, low, adhered and hoarse voice, wakeful; due to lightness, light and fickle movements, activities, diet and speech; due to mobility, unstable joints, eye brows, jaw, lips, tongue, head, shoulder, hands and feet; due to abundance, talkativeness and visually abundance of tendons and venous network; due to swiftness hasty initiation, quick irritation and disorder, quick in fear attachment and disenchantment, quick in acquisition but with a poor memory (retention); due to coldness intolerance to cold, continuously infliction with cold, shivering and stiffness; due to coarseness, coarse hairs, beard-mustaches, hairs, nails, teeth, face, hands and feet, due to non-sliminess cracked body parts and constant sound in joints during movement. Because of presence of these qualities the persons having predominance of [[vata]] have mostly low degree of strength, life-span, progeny, means and wealth. [98]
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And due to combination of ''doshas'', characters are found accordingly.[99]
And due to combination of [[dosha]], characters are found accordingly.[99]
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In persons having equilibrium of all ''dhatus'', the characters of all of the three are found. Thus one should examine the constitution.[100]
In persons having equilibrium of all [[dhatu]], the characters of all of the three are found. Thus one should examine the constitution.[100]
==== Assessment of ''vikriti'' (disorder) ====
==== Assessment of ''vikriti'' (disorder) ====
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Patient examination should be done with respect of ''vikriti'' as well. ''Vikriti'' is ''vikara'' (disorder or pathological manifestation). The disorder should be examined in terms of the strength of the cause (''hetu''), ''dosha''(vitiating factors), ''dushya''(vitiated factors), constitution (''prakriti''), place (''desha''), time (''kala'') and the symptoms. The severity of the disease cannot be known without knowing the strength of the cause etc. factors. The disease having common ''dushya'', constitution, place and time along with strong cause and severity of symptoms is more, then such diseases are severe. The contrary is mild. The moderate disease has similarity in one of the ''dosha'', ''dushya'' etc. and as such moderate strength of cause and severity of symptoms.[101]
Patient examination should be done with respect of ''vikriti'' as well. ''Vikriti'' is ''vikara'' (disorder or pathological manifestation). The disorder should be examined in terms of the strength of the cause ([[hetu]]), [[dosha]](vitiating factors), ''dushya''(vitiated factors), constitution ([[prakriti]]), place (''desha''), time (''kala'') and the symptoms. The severity of the disease cannot be known without knowing the strength of the cause etc. factors. The disease having common ''dushya'', constitution, place and time along with strong cause and severity of symptoms is more, then such diseases are severe. The contrary is mild. The moderate disease has similarity in one of the [[dosha]], ''dushya'' etc. and as such moderate strength of cause and severity of symptoms.[101]
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===== Characteristics of ''rakta sara'' (best quality of blood tissue) =====
===== Characteristics of [[rakta dhatu]] sara (best quality of blood tissue) =====
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