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Anthropometric measurements require understanding of anthropometric landmarks some of which can be shown in the figure:
Anthropometric measurements require understanding of anthropometric landmarks some of which can be shown in the figure:
----[i] Dev R.R.K., editor, (1st ed.). Shabdakalpadrum, Kand 3. Delhi: Amar Publications, 2018; 284.
----The advancement in technology led to development of many anthropometric tools. Some of them are as follows:
'''1. Anthropometer:''' Anthropometer measures vertical dimensions of the human body. The instrument consists of three aluminium square profiles and a double-sided measuring system with a reading scale. The long axis of the instrument is mounted with a telescopic round sleeve with a double-sided groove that features a dimension reading index. The sleeve is mounted with a sliding needle, whose tip is applied to the appropriate anthropometric point.
'''2. Spreading Caliper:''' Spreading Caliper is used to measure dimensions of the head and selected body width or depth dimensions in children (e.g. biacromial width, biiliocristal width, bispinal width, bitrochanteric width, transverse width of chest, biepicondylar width of humerus, biepicondylar width of femur).
==== 3. Pelvimeter: Pelvimeter used for measuring the width and depth dimensions of the adult population. ====
==== 4. Modified Thoracometer: The instrument primarily serves for easy determination of the length of the foot. While measuring the foot length, the subject stands with his/her feet slightly apart, with the weight distributed evenly on both legs. The axis of the instrument is parallel to the inner edge of the foot, the bent toes need to be pressed against the floor. ====
==== 5. Small height rod: This instrument is primarily designated to determine selectedvertical dimensions of the lower extremity (e.g. sphyrion height). ====
[vii] Gadgil, Neha & Kulkarni, Akshar. (2019). An observational study to quantify the measure of Anjali Pramana -A pilot study. 1 Neha Dattatraya Gadgil, and.
==== 6. Sliding Caliper: This instrument is designed to determine selected dimensions of the head (e.g. morphological facial height, nasal height and width, the distance between the inner/outer eye corners, lower jaw height, mouth width, hand width, foot width, etc. The rounded ends serve for measurements carried out on live bodies, while the sharp ends are used for determining the dimensions of skeletal material. ====
==== 7. Caliper: This instrument measures skinfold thickness. The instrument has two arms, of which one is calibrated scale. The base of this arm features a circular opening for the index or middle finger. The other (sliding) arm with a slot for measurement of the skinfold thickness has a base with a larger circular opening for the thumb. ====
==== 8. Soft metric tape: This tool is used for measuring girth dimensions. ====
'''Importance of concept'''
'''In determining life span'''
Any deviation from the normal measurements possibly points towards an anatomical or genetical anomaly, which may consequently reduce the life span of the person. According to Ayurveda scholars, a person with tip of the nose raised lives a maximum life span of 70 years [Su. Sa. [[Sutra Sthana]] 35/8]; and a person whose phalanges are short, penis enormously bigger positioned upwards from its normal place, nose higher and gums visible while laughing or talking lives a maximum life span of 25 years only. [Su. Sa. [[Sutra Sthana|Sthana]] 35/9-11] Contrarily, if a man or woman, endowed with standard body and body organ measurements, then he attains long life and prosperity [Su. Sa. [[Sutra Sthana]] 35/16-17]. It is also postulated that if the height of person in standing position is equal to the arm span of that person, than this person is said to possess sama sharira (body with optimum proportion of measurements of body parts). A sama sharira person is endowed with longevity, strength, ojas (the essence of all seven dhatus or tissues, that is vital for life), happiness, power, wealth, and virtues. [Cha. Sa. [[Sutra Sthana|Viman Sthana]] 8/117]
'''In preservation and promotion of health'''
· Pramanataha pariksha is helpful in identification of four (too tall, too dwarf, too fat or too emaciated) among eight of the undesirable constituents. [Cha. Sa. [[Sutra Sthana]] 21/3] A person aspiring good health shall make possible efforts to reach close to the standards measurements. For example, reducing weight for an obese person is possible by suitable diet and exercise. However, increasing height of a dwarf adult or decreasing height in tall person is not possible by medical management.
· Pramanatah pariksha is helpful in determining Basal Metabolic Index (BMI). The normal range for BMI is 19–24·9 kg/ , overweight is 25–29·9 kg/ , and obesity ≥ 30 kg/ .[i]
'''In relation to anthropometry'''
Pramantaha pariksha is like anthropometry (the '''systematic measurement of th'''e physical properties of the human body, primarily dimensional descriptors of body size and shape). Anthropometry, along with physical measurement of human body, also takes into consideration the body weight, body parts, human physical appearance and physical attractiveness.
'''Individualistic approach'''
Anguli pramana of body and body parts of an individual is determined by measuring the utsedha (height), ayama (length), vistara (breadth) by taking his own finger’s (swaanguli) breadth, as unit of measurement. The breadth of one finger is counted as one angula, and so on. The anguli pramana is used for measurement of length, breadth, height, circumference, etc, in contrast to anjali pramana, which is the measurement of volume. One anjali pramana is the maximum volume of a liquid that can be held in the cup formed by joining of the two palms of an individual together. This volume is one anjali for that particular individual (swa-anjali). Measurements of body and body parts depend on sex, race, geographical location, nutrition, exposure to disease, genetics and physical activity. Hence swa-angula and swa-anjali pramana give individualistic information rather than a generalized one. These pramana do not vary according to above mentioned conditions.
'''Application of knowledge of pramanatah pariksha in contemporary practices'''
Surgeons use pramanatah pariksha in determining important landmarks in person’s body. By knowing the distance of key areas on the surgeon’s hand, he can measure critical distances, saving time.
A few key measurements are noted as follows: -
1. The width of the surgeon’s index finger = ≈2 cm
2. The length from the tip of the thumb to the interphalangeal joint = ≈3.5 cm
3. The length from the tip of the thumb to the metacarpophalangeal joint = ≈6.5 cm.[ii]
Each surgeon should check these distances on his or her hand to know exactly what each landmark represents.
One of the examples in which pramanatah pariksha is utilized by clinicians is 3-3-2 rule. Clinicians can utilize the 3-3-2 rule as a predictive tool to identify and prepare for these challenging scenarios in advance to minimize complications. The 3-3-2 rule involves measuring 3 different distances in the patient's neck using the clinician's fingers.
'''3:''' The measurement of 3 fingers between the upper and lower teeth of a patient's open mouth indicates the ease of accessing the airway through the oral opening.
'''3:''' A measurement of 3 fingers from the anterior tip of the mandible to the anterior neck estimates the volume of the submandibular space.
'''2:''' A measurement of 2 fingers between the floor of the mandible and the thyroid notch on the anterior neck determines the location of the larynx relative to the base of the tongue.[iii]
'''In diagnosis and prognosis'''
Pramana is mentioned as one of the ten investigations regarding patients, and it can be used for estimation of strength (physical, psychological, immunological) of patients. [Cha. Sa. [[Sutra Sthana|Vimana Sthana]] 8/94].
'''In management of diseases'''
No two individual are completely alike physically, physiologically, psychologically, or in vital reactions, and thus the dose of drugs varies from person to person. A child or a person with lower body stature requires less dose of a drug as compared to an adult or person with big body stature. The volume of anjali varies in proportion with the size of the individual. Ancient scholars utilized this factor. Example, maximum oral dose of peeluparnyadi oil is mentioned as 1 anjali [Cha. Sa. [[Sutra Sthana|Chikitsa Sthana]] 27/42]. If two persons, one of smaller body stature (hence smaller volume in his 1 anjali) and one of bigger body stature (hence bigger volume in his 1 anjali) consume this oil of volume of their 1 anjali pramana, then automatically the person with smaller volume will consume smaller quantity of oil and person of bigger stature will consume more quantity of oil. Some other drugs whose doses, or the doses of their composition drugs are mentioned in anjali pramana are amalatas (''Cassia'' ''fistula''). [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 8/9], aragvadhadi arishta [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 8/15] and lodhra sura (beverage prepared from ''Symplocos racemosa'') [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 9/9].
'''Current researches'''
1. Anguli pramana as a tool for assessment of health status with reference to body mass index (B.M.I.):
An observational study for correlation between anguli pramana and BMI was carried out on 30 healthy individuals between age group 18-55 years from Himalayiya Ayurvedic Medical College & Hospital, Dehradun. In this study, it was observed that if the health status of an individual was altered, either in terms of increased or decreased figures of BMI, then their swa-anguli pramana deviated from standard values of mentioned swa-anguli pramana. [iv]
2. Scientific study of Charakokta anguli pramana in reference to human height:
In this study, anthropometric measurements by finger were taken and exact site of particular finger in a manner to execute “anguli sthana nishchiti” (demarcation points for measurement by anguli pramana) was determined. The data of aayama (height) and vistaara (arm span) of the 100 volunteers was recorded and statistically analysed. After comparing the anguli pramana obtained at 78 different sites of both hands, it was established that measurement of anguli pramana at the site of medio-lateral proximal interphalangeal joint of middle finger of right and left hand, would be most accurate in estimating anguli pramana. [v]
3. Anguli pramana in ayurveda - a method of measurement in ancient times:
This study directed that anguli pramana measurement should be done at the site of medio-lateral proximal interphalangeal joint of middle finger of right or left hand. [vi]
4. Concept of anguli pramana sharira and importance in Ayurveda:
The author translates the ayurveda terminologies of demarcation points for describing pramanatah pariksha in ayurveda texts into modern anatomical terminologies. [vii] Some of these are:
· Shira (heads circumference) the maximum distance round the head with the tape placed above the eyebrow ridges and positioned over the greatest posterior projection at the back of the head.
· Skandha (shoulder joint)
· Aaratni (from elbow joint to little finger)
· Prabahu (from shoulder joint to elbow joint)
· Prapani (from elbow joint to wrist joint)
· Jangha (from knee joint to ankle joint)[length] [circumference]
· Uru (from hip joint to knee joint) [length] [circumference]
· Janu (knee joint) [circumference]
· Gulpha (ankle joint) [circumference]
· Parshni (Heels) [length] [breadth]
'''Future scope of research:'''
There is a wide scope of research in perspective of pramantah pariksha. Some of these topics are as follows:
· To know the landmarks of finger, the distance of breadth of finger
· Angula and anjali, can other body parts (like arm length, palm’s breadth, etc) too be used as an individualistic approach for anthropometric measurements.
· To find the appropriate anthropometric measurements based on geographic variations.
· To find average anthropometric measurements based on constitution (prakriti) of individuals.
· To find the correlation of health and life span of the persons with standard anthropometric measurements and persons with variation in anthropometric measurements.
----[i] Xavier Pi-Sunyer, F. (2000). Obesity: Criteria and classification. Proceedings of the Nutrition Society, 59(4), 505-509. doi:10.1017/S0029665100000732
[ii] Frey, Jordan & Zide, Barry. (2020). Ten Tips Based on Anatomy and Design to Refine Face and Neck Lift Surgery. Plastic and Reconstructive Surgery - Global Open. Publish Ahead of Print. 1. 10.1097/GOX.0000000000002791.
[iii] Sharma S, Patel R, Hashmi MF, et al. 3-3-2 Rule. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK493235/</nowiki>
[iv]Bahuguna M, Vaidh S. Anguli Pramana as a Tool for Assessment of Health Status w.r.t. BMI. WJPR. 2022 Apr;11(5):2083-2089. doi: 10.20959/wjpr20225-23931. ISSN 2277– 7105.
[v]Muley SK, Surve AA, Bhingare SD. Scientific study of Charakokta Anguli Pramana in reference to human height. Ayu. 2013 Oct;34(4):356-60. doi: 10.4103/0974-8520.127709. PMID: 24696571; PMCID: PMC3968696.
[vi] Dr. Radheshyam Sharma. (2020). Anguli Pramana in Ayurveda - A method of measurement in Ancient time. ''Journal of Ayurveda and Integrated Medical Sciences'', ''5''(01), 122-125. <nowiki>https://doi.org/10.21760/jaims.v5i01.825</nowiki>
[vii] Mishra B. Concept of Anguli Pramana Sharir and Importance in Ayurveda. IJIRMF 2016 July;3(7):279-281. ISSN – 2455-0620