Gomayachurniyam Indriyam Adhyaya
Indriya Sthana Chapter 12.Auspicious and Inauspicious Characteristics of the messenger
| Section/Chapter | Indriya Sthana Chapter 12 |
|---|---|
| Preceding Chapter | Anujyotiyam Indriyam Adhyaya |
| Succeeding Chapter | None |
| Other Sections | Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana |
| Translator and commentator | Pandya D. |
| Reviewer | Babu S.P. |
| Editors | Khandel S.K. , Babu S.P., Deole Y.S., Basisht G. |
| Year of publication | 2020 |
| Publisher | Charak Samhita Research, Training and Skill Development Centre |
| DOI | 10.47468/CSNE.2020.e01.s05.013 |
Abstract
The concluding chapter is about auspicious and inauspicious features of the informer, or the person who wants to take the physician to the house of the patient. There is a description of his physical appearance, mental status, behavior, time of calling, the circumstances while on the to the patient’s house, condition of patient’s house, surroundings, family members, availability of requirements for a treatment. Along with medical ethics about informing patient, circumstances which indicate good prognosis and poor prognosis are discussed in this chapter. Finally, a nice briefing of all eleven chapters is provided for quick revision of this section.
Keywords: Gomaya Churniya, doota, arishta, asanna mrityu Lakshana, messenger, near death signs, fatal signs, moribund signs.
Introduction
In the earlier chapters, various signs of immediate death are described. In this chapter, good or bad omens as signs for good or bad prognosis in a patient or even healthy person, sometimes observed are mentioned.
The term 'gomaya churna' means "fine powder that resembles cowdung". If the physician sees fine powder resembling cowdung falling from patient’s scalp, it indicates the life span of individual is less than a month. The chapter also covers details about the messenger who comes to the physician with the news about the patient. In ancient days, the communication media was manual messaging system only. The person, called doota (or messenger) was assigned the duty to convey messages from one place to another. It is interesting to know that various signs seen in this messenger, his dressing, behavior, time of messaging, his mental state, and the circumstances also are significantly observed to assess the prognosis of a remote unseen patient. However, due to advancement in communication technology, there ample ways of messaging are available. The remote physician is easily accessible through internet media also. Therefore actual examination of the patient is possible in various ways and the significance of old messaging system through doota is reduced. Still, in order to avail of the advantages of this very personalized process, the literature in this chapter is important. The signs of good and bad prognosis and importance of their explanation to the patient and his relatives before starting the treatment is also described in this chapter.
Sanskrit text, Transliteration and English Translation
गोमयचूर्णीयेन्द्रियोपक्रमः
अथातो गोमयचूर्णीयमिन्द्रियं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
Now we shall expound the chapter "Gomayachurniyam Indriyam" (Auspicious and Inauspicious Characteristics of the messenger). Thus said Lord Atreya. [1-2]
यस्य गोमयचूर्णाभं चूर्णं मूर्धनि जायते|
सस्नेहं भ्रश्यते चैव मासान्तं तस्य जीवितम्||३||
निकषन्निव यः पादौ च्युतांसः परिधावति|
विकृत्या न स लोकेऽस्मिंश्चिरं वसति मानवः||४||
यस्य स्नातानुलिप्तस्य पूर्वं शुष्यत्युरो भृशम्|
आर्द्रेषु सर्वगात्रेषु सोऽर्धमासं न जीवति||५||
यमुद्दिश्यातुरं वैद्यः संवर्तयितुमौषधम् |
यतमानो न शक्नोति दुर्लभं तस्य जीवितम्||६||
विज्ञातं बहुशः सिद्धं विधिवच्चावचारितम्|
न सिध्यत्यौषधं यस्य नास्ति तस्य चिकित्सितम्||७||
आहारमुपयुञ्जानो भिषजा सूपकल्पितम्|
यः फलं तस्य नाप्नोति दुर्लभं तस्य जीवितम्||८||
If a person complains that, an unctuous powder like cow dung powder falls on his scalp, the person may live for one month thereafter. [3]
A person is complaining of his feet rubbing against another like friction for braking, and his shoulder dislocate while running, does not remain alive in this world. [4]
If a person feels that, after taking bath or after applying Lepa (any fragrant liniment or herbal paste), his chest gets dried first, and rest of body remains wet, the person does not live even for a fortnight. [5]
If a physician is keenly providing medicine or therapy to a patient but not getting result for the same, the patient survives hardly. [6]
The drug which is well known, tried in many cases successfully, prepared and administered as per classical procedure, fails to get desired effect in an individual, should be considered beyond treatment. [7]
If a diet prepared and administered as per advice of physician, not giving desired effect, the patient hardly survives. [8]
Attributes of a messenger (doota)
दूताधिकारे वक्ष्यामो लक्षणानि मुमूर्षताम्|
यानि दृष्ट्वा भिषक् प्राज्ञः प्रत्याख्यायादसंयमम्||९||
मुक्तकेशेऽथवा नग्ने रुदत्यप्रयतेऽथवा|
भिषगभ्यागतं दृष्ट्वा दूतं मरणमादिशेत्||१०||
सुप्ते भिषजि ये दूताश्छिन्दत्यपि च भिन्दति|
आगच्छन्ति भिषक् तेषां न भर्तारमनुव्रजेत्||११||
जुह्वत्यग्निं तथा पिण्डान् पितृभ्यो निर्वपत्यपि|
वैद्ये दूता य आयान्ति ते घ्नन्ति प्रजिघांसवः||१२||
कथयत्यप्रशस्तानि चिन्तयत्यथवा पुनः|
वैद्ये दूता मनुष्याणामागच्छन्ति मुमूर्षताम्||१३||
मृतदग्धविनष्टानि भजति व्याहरत्यपि|
अप्रशस्तानि चान्यानि वैद्ये दूता मुमूर्षताम्||१४||
विकारसामान्यगुणे देशे कालेऽथवा भिषक्|
दूतमभ्यागतं दृष्ट्वा नातुरं तमुपाचरेत्||१५||
दीनभीतद्रुतत्रस्तमलिनामसतीं स्त्रियम्|
त्रीन् व्याकृतींश्च षण्डांश्च दूतान् विद्यान्मुमूर्षताम्||१६||
अङ्गव्यसनिनं दूतं लिङ्गिनं व्याधितं तथा|
सम्प्रेक्ष्य चोग्रकर्माणं न वैद्यो गन्तुमर्हति||१७||
आतुरार्थमनुप्राप्तं खरोष्ट्ररथवाहनम्|
दूतं दृष्ट्वा भिषग्विद्यादातुरस्य पराभवम्||१८||
पलालबुसमांसास्थिकेशलोमनखद्विजान्|
मार्जनीं मुसलं शूर्पमुपानच्चर्म विच्युतम् [१] ||१९||
तृणकाष्ठतुषाङ्गारं स्पृशन्तो लोष्टमश्म च|
तत्पूर्वदर्शने दूता व्याहरन्ति मुमूर्षताम्||२०||
यस्मिंश्च दूते ब्रुवति वाक्यमातुरसंश्रयम्|
पश्येन्निमित्तमशुभं तं च नानुव्रजेद्भिषक्||२१||
तथा व्यसनिनं प्रेतं प्रेतालङ्कारमेव वा|
भिन्नं दग्धं विनष्टं वा तद्वादीनि वचांसि वा||२२||
रसो वा कटुकस्तीव्रो गन्धो वा कौणपो महान्|
स्पर्शो वा विपुलः क्रूरो यद्वाऽन्यदशुभं भवेत्||२३||
तत्पूर्वमभितो वाक्यं वाक्यकालेऽथवा पुनः|
दूतानां व्याहृतं श्रुत्वा धीरो मरणमादिशेत्||२४||
इति दूताधिकारोऽयमुक्तः कृत्स्नो मुमूर्षताम्|२५|
Now we explain sign and symptoms of impending death of a person, pertaining to the characteristic features of doota (informer/messanger - who comes to call a physician to treat his patient). If a physician observes following signs in the informer, a physician is advised to gently avoid accepting the patient because the patient seems incurable. [9]
If an informer arrives to a physician with uncombed hair, naked, crying or unclean, then his related patient should be considered dead. [10]
When an informer comes at late night when physician was asleep or in lunch time when he is cutting or spitting something, this untimely arrival of an informer is inauspicious sign for the patient’s life. [11]
An informer arrives when, the physician is engaged in yajna (offering to holy fire with chanting of mantras) or offering pinda (offering for his late ancestors), this untimely call is also inauspicious for the patient’s life. [12]
An informer arrives when, the physician is engaged in discussion about some inauspicious matter which required to think seriously, this untimely call of informer is an inauspicious to patient’s life. [13]
An informer arrives when, the physician is engaged in discussion for any one died or burnt or anything destroyed or lost or any other inauspicious thing, this is an inauspicious consequence too for patient’s life. [14]
An informer explains the same symptoms in his patient, as seen in epidemic in that area, then the physician should avoid to treat such incurable diseases. [15]
If a lady informer who is miserably frightened, hurried, upset, dirty, disreputable and without her chastity, with disfigured body, three in numbers or an informer is eunuch person than, the physician should consider their concerned patient is surely near death. [16]
An informer with disfigured body, ill himself, heavily intoxicated, occupied in cruel activities, physician should avoid to go with him to treat his concerned patient. [17]
An informer comes with vehicle like cart pulled by donkey or by camel, the physician should know that his concerned patient has been defeated in life against death. [18]
When the physician enters a patient’s house, on call of an informer and finds that, informer is still preparing the house for physician visit-by removing dust, husk, flesh, bones, hair, nails, teeth, broom, ponding stick, winnowing basket cinders, loosened bits of leather from shoes, straw, ash of half burnt sticks, loaf of a mud and pebbles of stones -is seriously inauspicious sign for concerned patient’s life [19-20]
While the messenger is narrating about his patient and physician notices the following inauspicious signs in the messenger:
- heavily drunken with ghostly appearance,
- wearing adornments like a ghost such as – broken, half burnt, destroyed things,
- speaking loudly abusive words,
- smelling like a cadaver
- thorny to touch,
- and looking cruel in appearance
Above signs are highly inauspicious for patient’s life, and a wise physician should avoid further proceedings for treatment. [21-24]
Signs indicating imminent death observed on the way to patient’s house
पथ्यातुरकुलानां च वक्ष्याम्यौत्पातिकं पुनः||२५||
अवक्षुतमथोत्क्रुष्टं स्खलनं पतनं तथा|
आक्रोशः सम्प्रहारो वा प्रतिषेधो विगर्हणम्||२६||
वस्त्रोष्णीषोत्तरासङ्गश्छत्रोपानद्युगाश्रयम्|
व्यसनं दर्शनं चापि मृतव्यसनिनां तथा||२७||
चैत्यध्वजपताकानां पूर्णानां पतनानि च|
हतानिष्टप्रवादाश्च दूषणं भस्मपांशुभिः||२८||
पथच्छेदो बिडालेन शुना सर्पेण वा पुनः|
मृगद्विजानां क्रूराणां गिरो दीप्तां दिशं प्रति||२९||
शयनासनयानानामुत्तानानां च दर्शनम्|
इत्येतान्यप्रशस्तानि सर्वाण्याहुर्मनीषिणः||३०||
एतानि पथि वैद्येन पश्यताऽऽतुरवेश्मनि|
शृण्वता च न गन्तव्यं तदागारं विपश्चिता||३१||
इत्यौत्पातिकमाख्यातं पथि वैद्यविगर्हितम्|३२|
Now we shall narrate the signs indicating imminent death seen by physician on the way he proceeds for patient’s house on a call by informer. Followings are inauspicious for life of a patient because in such an emergent conditions the time and mind set of a physician is very important, and these signs are obstructing, time consuming, and concentration diverting factors for a physician.[25]
When physician is going to patients house and sees, someone is sneezing, someone got pushed and fell down, had a trauma, crying miserably, beating someone, or the way has been suddenly obstructed, diverted in a long way or commendation by shouting.[26]
While walking (it was general practice those days) wearing garments torn by thorns, cape falls down, umbrella or shoe need repair, seeing dead person, quarrelling persons, to see the big and respectable trees and flag fell down, filled water container broke down, to have news regarding death of his near and dear, or some other inauspicious matter, dirt of dust or ash covers body, the way crossed by cat, snake, to hear the sound of dangerous animals, vehicle turns upside down in an accident are distracting causes on the way to patient’s house, are certainly inauspicious for the life of patient. [25 -31 1/2]
Signs at the patient’s home
इमामपि च बुध्येत गृहावस्थां मुमूर्षताम्||३२||
प्रवेशे पूर्णकुम्भाग्निमृद्बीजफलसर्पिषाम्|
वृषब्राह्मणरत्नान्नदेवतानां च निर्गतिम्||३३||
अग्निपूर्णानि पात्राणि भिन्नानि विशिखानि च|
भिषङ् मुमूर्षतां वेश्म प्रविशन्नेव पश्यति||३४||
छिन्नभिन्नानि दग्धानि भग्नानि मृदितानि च|
दुर्बलानि च सेवन्ते मुमूर्षोर्वैश्मिका जनाः||३५||
शयनं वसनं यानं गमनं भोजनं रुतम्|
श्रूयतेऽमङ्गलं यस्य नास्ति तस्य चिकित्सितम्||३६||
शयनं वसनं यानमन्यं वाऽपि परिच्छदम्|
प्रेतवद्यस्य कुर्वन्ति सुहृदः प्रेत एव सः||३७||
अन्नं व्यापद्यतेऽत्यर्थं ज्योतिश्चैवोपशाम्यति|
निवाते सेन्धनं यस्य तस्य नास्ति चिकित्सितम्||३८||
आतुरस्य गृहे यस्य भिद्यन्ते वा पतन्ति वा|
अतिमात्रममत्राणि दुर्लभं तस्य जीवितम्||३९||
Now the inauspicious signs observed by a physician while entering the house of a patient - As the physician enters the house and sees the auspicious things are departing from house like- A filled earthen pot of water, a pot containing fire, sand, ghee, seeds, bullocks, brahmins, gems stones, and idols of deities, and fire pots with flames in many directions, Departing these auspicious articles are indicative of departing life of a patient. [32-34]
The things used by people living in the house are split, cracked, burnt, broken or crushed. [35]
The patient whose bed, cloths, vehicle, gait, food and voice bears inauspicious should not be treated. [36]
If arrangement of bed, cloth, vehicle and other apparel which are befitting for a dead body, the patient should be considered as already dead. [37]
If food for a patient get extremely nasty and fire (for prepare new food) is extinguished even it is supplied proper fuel in a wind free place, (in that house) then the patient should not be treated. [38]
If plates or saucers often fall down and get broken in the patient’s house, then he (the patient) hardly survives. [39]
भवन्ति चात्र-
यद्द्वादशभिरध्यायैर्व्यासतः परिकीर्तितम्|
मुमूर्षतां मनुष्याणां लक्षणं जीवितान्तकृत्||४०||
तत् समासेन वक्ष्यामः पर्यायान्तरमाश्रितम्|
पर्यायवचनं ह्यर्थविज्ञानायोपपद्यते||४१||
अत्यर्थं पुनरेवेयं विवक्षा नो विधीयते|
तस्मिन्नेवाधिकरणे यत् पूर्वमभिशब्दितम्||४२||
Thus it is said: Whatever sign and symptoms described in above twelve chapters regarding impending death of person, now we shall sum up in few stanzas as this is a concluding chapter of this section called Indriya Sthana
Of course there is no intension to repeat all as those are already explained but just to have a quick revision and for more clear understanding these are explained here. [40-42].
Summary of all moribund signs
वसतां चरमं कालं शरीरेषु शरीरिणाम्|
अभ्युग्राणां विनाशाय देहेभ्यः प्रविवत्सताम्||४३||
इष्टांस्तितिक्षतां प्राणान् कान्तं वासं जिहासताम्|
तन्त्रयन्त्रेषु भिन्नेषु तमोऽन्त्यं प्रविविक्षताम्||४४||
विनाशायेह रूपाणि यान्यवस्थान्तराणि च|
भवन्ति तानि वक्ष्यामि यथोद्देशं यथागमम्||४५||
प्राणाः समुपतप्यन्ते विज्ञानमुपरुध्यते|
वमन्ति बलमङ्गानि चेष्टा व्युपरमन्ति च||४६||
इन्द्रियाणि विनश्यन्ति खिलीभवति चेतना |
औत्सुक्यं भजते सत्त्वं चेतो भीराविशत्यपि||४७||
स्मृतिस्त्यजति मेधा च ह्रीश्रियौ चापसर्पतः|
उपप्लवन्ते पाप्मान ओजस्तेजश्च नश्यति||४८||
शीलं व्यावर्ततेऽत्यर्थं भक्तिश्च परिवर्तते|
विक्रियन्ते प्रतिच्छायाश्छायाश्च विकृतिं प्रति||४९||
शुक्रं प्रच्यवते स्थानादुन्मार्गं भजतेऽनिलः|
क्षयं मांसानि गच्छन्ति गच्छत्यसृगपि क्षयम्||५०||
ऊष्माणः प्रलयं यान्ति विश्लेषं यान्ति सन्धयः|
गन्धा विकृतिमायान्ति भेदं वर्णस्वरौ तथा||५१||
वैवर्ण्यं भजते कायः कायच्छिद्रं विशुष्यति|
धूमः सञ्जायते मूर्ध्नि दारुणाख्यश्च चूर्णकः||५२||
सततस्पन्दना देशाः शरीरे येऽभिलक्षिताः|
ते स्तम्भानुगताः सर्वे न चलन्ति कथञ्चन||५३||
गुणाः शरीरदेशानां शीतोष्णमृदुदारुणाः|
विपर्यासेन वर्तन्ते स्थानेष्वन्येषु तद्विधाः||५४||
नखेषु जायते पुष्पं पङ्को दन्तेषु जायते|
जटाः पक्ष्मसु जायन्ते सीमन्ताश्चापि मूर्धनि||५५||
भेषजानि न संवृत्तिं प्राप्नुवन्ति यथारुचि|
यानि चाप्युपपद्यन्ते तेषां वीर्यं न सिध्यति||५६||
नानाप्रकृतयः क्रूरा विकारा विविधौषधाः|
क्षिप्रं समभिवर्तन्ते प्रतिहत्य बलौजसी||५७||
शब्दः स्पर्शो रसो रूपं गन्धश्चेष्टा विचिन्तितम् |
उत्पद्यन्तेऽशुभान्येव प्रतिकर्मप्रवृत्तिषु||५८||
दृश्यन्ते दारुणाः स्वप्ना दौरात्म्यमुपजायते|
प्रेष्याः प्रतीपतां यान्ति प्रेताकृतिरुदीर्यते||५९||
प्रकृतिर्हीयतेऽत्यर्थं विकृतिश्चाभिवर्धते|
कृत्स्नमौत्पातिकं घोरमरि(नि)ष्टमुपलक्ष्यते||६०||
इत्येतानि मनुष्याणां भवन्ति विनशिष्यताम्|
लक्षणानि यथोद्देशं यान्युक्तानि यथागमम्||६१||
Now the signs and change in condition, as proposed and accepted by scriptural authority, will be described. This indicate departure of the soul having lived in the body for maximum period prepares to migrate out of the body after relinquishing the beloved prana (vital breath), giving up the beautiful abode and entering into the final darkness when all the systems and organs are disintegrated. [43-45]
These are as follows:
- Infirmity of prana (vital breath); cloudiness of understanding;
- Strength drains from body organs;
- Cessation of movement;
- Sensory abilities gets destroyed; impairment of conscious;
- Curiosity makes mind restless,
- Mind infirmed with fear;
- Distraction of memory, medha (intellect), hri (natural shy), sri (luster of the body);
- Aggravation of symptoms of the disease;
- Destruction of Ojas (Immune System) and Teja (radiance);
- Radical changes in the conduct;
- Changes in likings (and disliking);
- Distortion in reflected image and apparition of an individual
- Ejection of semen (or even feces or urine) from its own place;
- Upward movement of vayu;
- Wasting of muscle tissue and loss of blood;
- Attenuation of ushma(the component responsible for producing heat in body, maintained by proper digestion and metabolism);
- Dislocation or laxity of joints;
- Morbid changes in body odor, hoarseness of voice and alteration in complexion;
- Discoloration of the body;
- Dryness in the body orifices;
- Appearance of excessive smoke in the head;
- Appearance of powder like cow dung in the head;
- Complete cessation of pulsation in the body area which pulsate constantly in normal course;
- Attributes manifestation of opposite property like cold, hot, soft, hard and similar other in various area of the body.
- Pushpa– flower spots appearance in nail (while pressure given to nail and do not disappear even release of pressure) and mud like adherence in teeth.
- Matting of eye lashes and appearance of hair partitions in head.
- Difficulty to obtain results even after taking desired quality medicines.
- Manifestation of various types of disease which destroys body strength and Ojas and needs multiple drugs for the same.
- Manifestation of inauspicious sound, touch, taste, vision, smell, action and thoughts occurs while physician thinking about treatment (of the patient)
- To see cruel dreams.
- Hostile efforts of informer and change in body constitution like a ghost.
- Diminution of normal characteristic features and excessive aggravation of morbid condition
- Manifestation of majority of cruel signs of immediate death. [46-60]
As asked earlier, the signs of immediate death told by authority are described. [61]
Medical ethics for conveying death signs
मरणायेह रूपाणि पश्यताऽपि भिषग्विदा|
अपृष्टेन न वक्तव्यं मरणं प्रत्युपस्थितम्||६२||
पृष्टेनापि न वक्तव्यं तत्र यत्रोपघातकम्|
आतुरस्य भवेद्दुःखमथवाऽन्यस्य कस्यचित्||६३||
अब्रुवन्मरणं तस्य नैनमिच्छेच्चिकित्सितुम्|
यस्य पश्येद्विनाशाय लिङ्गानि कुशलो भिषक्||६४||
In spite of seeing signs of imminent death, the physician should not announce (about the patient) until unless he is specially requested for so. Even on request, it should not be announced if it is likely to result in collapse of the patient or to distress others. [62-63] After seeing such signs of imminent death a wise physician should not demand to treat the patient without announcing about his death. [64]
लिङ्गेभ्यो मरणाख्येभ्यो विपरीतानि पश्यता|
लिङ्गान्यारोग्यमागन्तु वक्तव्यं भिषजा ध्रुवम्||६५||
दूतैरौत्पातिकैर्भावैः पथ्यातुरकुलाश्रयैः|
आतुराचारशीलेष्टद्रव्यसम्पत्तिलक्षणैः||६६||
If physician come across the positive signs (opposite of imminent death signs) of recovery, like the positive signs seen in an informer, or manifestation of some of auspicious signs appears in the way of patient’s home, good feature at the patient’s home, good manners and conducts of the patient and availability of quality drug, the physician certainly announce it positively. [65-66].
Auspicious positive signs of messenger
स्वाचारं हृष्टमव्यङ्गं यशस्यं शुक्लवाससम्|
अमुण्डमजटं दूतं जातिवेशक्रियासमम्||६७||
अनुष्ट्रखरयानस्थमसन्ध्यास्वग्रहेषु च|
अदारुणेषु नक्षत्रेष्वनुग्रेषु ध्रुवेषु च||६८||
विना चतुर्थीं नवमीं विना रिक्तां चतुर्दशीम्|
मध्याह्नमर्धरात्रं च भूकम्पं राहुदर्शनम्||६९||
विना देशमशस्तं चाशस्तौत्पातिकलक्षणम्|
दूतं प्रशस्तमव्यग्रं निर्दिशेदागतं भिषक्||७०||
If an informer comes with following characteristics, should be considered auspicious and it is the sign of good / favorable prognosis:
- The informer who is with good conduct and behavior
- He is reputed, well dressed in white and clean cloths.
- Well shaved or whose hair well combed
- His dress and actions are analogous to his cast.
- Has not come on a vehicle carried by camel or donkey
- He has not come at the time of Sandhya (junction of evening and night time)
- He has not come at the time when cruel planet are situated in some inauspicious place
- Has arrived at a time when the Nakshatra is not appropriate or auspicious.
- Has arrived on other than 4th, 9th and 14th lunar day.
- Has come at the time other than noon or midnight, no earthquake and eclipse.
- Come from auspicious place and no manifestation of any sign of impending death.
- He is not anxious.
Such informers are told of having good prognostic for the patient. [67-70]
Positive signs on the way to patient’s house
दध्यक्षतद्विजातीनां वृषभाणां नृपस्य च||७१||
रत्नानां पूर्णकुम्भानां सितस्य तुरगस्य च|
सुरध्वजपताकानां फलानां यावकस्य च||७२||
कन्यापुंवर्धमानानां बद्धस्यैकपशोस्तस्था|
पृथिव्या उद्धृतायाश्च वह्नेः प्रज्वलितस्य च||७३||
मोदकानां सुमनसां शुक्लानां चन्दनस्य च|
मनोज्ञस्यान्नपानस्य पूर्णस्य शकटस्य च||७४||
नृभिर्धेन्वाः सवत्साया वडवायाः स्त्रियास्तथा|
जीवञ्जीवकसिद्धार्थसारसप्रियवादिनाम्||७५||
हंसानां शतपत्राणां चाषाणां शिखिनां तथा|
मत्स्याजद्विजशङ्खानां प्रियङ्गूनां घृतस्य च||७६||
रुचकादर्शसिद्धार्थरोचनानां च दर्शनम्|
गन्धः सुरभिर्वर्णश्च सुशुक्लो मधुरो रसः||७७||
मृगपक्षिमनुष्याणां प्रशस्ताश्च गिरः शुभाः|
छत्रध्वजपताकानामुत्क्षेपणमभिष्टुतिः||७८||
भेरीमृदङ्गशङ्खानां शब्दाः पुण्याहनिस्वनाः|
वेदाध्ययनशब्दाश्च सुखो वायुः प्रदक्षिणः||७९||
पथि वेश्मप्रवेशे तु विद्यादारोग्यलक्षणम्|८०|
During entering or on the way of patient’s house, the physician come across to the following, good signs which indicate good recovery and prognosis of the patient.
Curd, intact rice, Brahmin, king’s bullocks, gems, water filled pot, white horse, flag and banners of Lord Indra, fruits, barley, boy and girl seated in the elders lap, upturned land, blazing fire, sweets, white colored flower, sandal paste, delicious food articles, and drinks, fully loaded cart with its driver, cows with calves, mare with her calf, woman with her child, birds like mynah, water bird, sparrow, swan bird of paradise, blue jay and the peacock, fish, goat, elephant, ghee, necklace like ornaments, mirror, white mustered, bile of cow, to have good fragrance, white colored, sweet taste, sweets and auspicious voice of animal, birds, and human, unfolding of umbrella, flag and banners, prayer, sound of cattle drums, and conches, auspicious sounds of Vedic hymns recitation, and soothing wind from south direction. [71-80]
Positive signs in patient’s house
मङ्गलाचारसम्पन्नः सातुरो वैश्मिको जनः||८०||
श्रद्दधानोऽनुकूलश्च प्रभूतद्रव्यसङ्ग्रहः|
धनैश्वर्यसुखावाप्तिरिष्टलाभः सुखेन च||८१||
द्रव्याणां तत्र योग्यानां योजना सिद्धिरेव च|
गृहप्रासादशैलानां नागानामृषभस्य च||८२||
हयानां पुरुषाणां च स्वप्ने समधिरोहणम्|
सोमार्काग्निद्विजातीनां गवां नॄणां पयस्विनाम्||८३||
अर्णवानां प्रतरणं वृद्धिः सम्बाधनिःसृतिः|
स्वप्ने देवैः सपितृभिः प्रसन्नैश्चाभिभाषणम्||८४||
दर्शनं शुक्लवस्त्राणां ह्रदस्य विमलस्य च|
मांसमत्स्यविषामेध्यच्छत्रादर्शपरिग्रहः||८५||
स्वप्ने सुमनसां चैव शुक्लानां दर्शनं शुभम्|
अश्वगोरथयानं च यानं पूर्वोत्तरेण च|
रोदनं पतितोत्थानं द्विषतां चावमर्दनम्||८६||
Some more auspicious signs indicative of good prognosis:
Patient and his family member involved in auspicious acts, looks faithful and favorable in nature. Collection of adequate funds and required materials, attainment of wealth, power and happiness, easy access of desirable objects, easy availability of required drug, favorable effect of the drug when administered (in the patient).
Dreams like climbing on house, palace, hill, elephant, bullock, horse and human. Vision of the moon, the sun, fire, Brahmin, cow and man carrying milk, swimming in the ocean / crossing the seas, improvement from bad situation/ end of problems of suffering. See in the dream to have talk with the gods and forefathers in their joyful mood, to see white clothes, to have meat, fish, poison, keeps himself away from amedhya (substances which are not good for mind) and using umbrella and mirror, seeing of white flower, riding on horses, bulls, and chariots and moving towards north east, rising after falling, defeat of enemies. These all are considered as signs of good prognosis. [80-86]
Auspicious signs of health
सत्त्वलक्षणसंयोगो भक्तिर्वैद्यद्विजातिषु|
साध्यत्वं न च निर्वेदस्तदारोग्यस्य लक्षणम्||८७||
आरोग्याद्बलमायुश्च सुखं च लभते महत्|
इष्टांश्चाप्यपरान् भावान् पुरुषः शुभलक्षणः||८८||
Person with good and Noble quality, faith and devotion towards the physician and Brahmin, not having negative feeling regarding his health is the sign of quick recovery from the disease. He attains health, strength, longevity, happiness, and other benefits by these good qualities. [87-88]
Summary
तत्र श्लोकौ-
उक्तं गोमयचूर्णीये मरणारोग्यलक्षणम्|
दूतस्वप्नातुरोत्पातयुक्तिसिद्धिव्यपाश्रयम्||८९||
To sum up:
In these chapters signs of imminent death as indicated by appearance of substance resembling cow dung powder on his head, signs and symptoms of imminent death, quick recovery, informers, dreams, patient situation, and accomplishment are described. [89]
इतीदमुक्तं प्रकृतं यथातथं तदन्ववेक्ष्यं सततं भिषग्विदा|
तथा हि सिद्धिं च यशश्च शाश्वतं स सिद्धकर्मा लभते धनानि च||९०||
Signs and symptoms mentioned here should always be observed and studied well by physician. Then only a physician can attain success, fame, and wealth.[90]
Tattva Vimarsha (Fundamental Principles)
- The state of messenger informing physician about the patient, circumstances on the way to patient’s house, and condition of patient’s house can give important clues about the probable prognosis of patient’s disease. Hence the physician shall observe this keenly.
- Person with good and noble quality, faith and devotion towards the physician, Anirveda (not having negative feeling regarding his health) is the sign of quick recovery from the disease. These are necessary qualities to attain health, strength, longevity, happiness, and other benefits.
Vidhi Vimarsha (Applied Inferences)
Poor prognostic features
The features described in text can be categorized under different groups as shown in table 1. These can be observed on a patient with poor prognosis. The underlying reasons or pathologies behind these pathologies can be studied.
| Factors | Related to visiting physician | Related to messenger |
|---|---|---|
| Dressing | -- | Uncombed hair, improper clothing, looking unclean |
| Activities | Sleeping. Cutting or spitting something, offering food to his ancestors or fire | (When physician see Duta) touching straw, husk, flesh, bones, hair, nails, teeth broom, pounding stick, winnowing basket cinders, loosened bits of leather from a shoe, straw stick, dry lump of earth, or stone, |
| Behavior | Crying, looking miserable, feared, hassled, upset, groggy, | |
| Thinking about | Discouraging matter, dead person or burnt / destroyed thing | |
| Surroundings | (at time of narration about patient – observed by physician) bad omens, ornaments of dead person or dead body | (@ physician house – observed by messenger) is of similar property that of patient suffering |
| Vehicle | Arrived on vehicle pulled by camel or donkey | |
| Observed by Physician(by five sensory organs) | Broken / destroyed / burnt thing, hear some sound denoting destruction, having pungent or very strong taste, touching harsh feeling substance, having some inauspicious sensation | |
| Miscellaneous | Messenger is of trans gender, three in number, diseased, addicted, having cruel occupation |
Observations during medical examination and visit to patient
In ancient times, when the hospital management sector was not well developed, the messanger used to call the physician to see patients at home. During the visit to patient, some observations were noted which indicate poor prognosis of patient. The observations need to be studied to check their applicability in present era. These are summarized and grouped in table 2 below.
| Location | Situation observed by physician |
|---|---|
| While entering in patient’s house | filled clay pot, fire, seeds, fruit, ghee, bullock, a Brahmin, precious stone, idle food especially prepared for the Gods |
| Inside the house | full of fire, with extinguished flame |
| Status of things being used by other member of the family | split, cracked, brunt, broken or crushed |
| Status of patient and its surroundings | bed, cloths, vehicle, gait, food and voice bears inauspicious, arrangement of bed, cloth, vehicle and other apparel which are befitting a dead body |
| Status of patient’s food | Gets extremely nasty and fire (to prepare new food) is extinguished even with proper fuel and wind free area |
| Status of crockery | often fall down and get broken |
Contemporary views
The prognostic features described in the text can be observed in various disease conditions in contemporary clinical practice. The probable relevant conditions are summarized in the table 3 and 4.[1]
| Factor [Reference verse] | Contemporary understanding or concept or relevant disease |
|---|---|
| Response to treatment [Cha.Sa.Indriya Sthana 12/6-8] | Not responding to aggressive treatment and progressive deterioration of health indicates end of life stages; Cachexia (cancer induced); |
| Social prevalnce of disese [Cha.Sa.Indriya Sthana 12/15] | Endemic or epidemic diseases; Contagious, infectious diseases; |
| Signs of good prognosis [Cha.Sa.Indriya Sthana 12/87-88] | Positive psychology; Health psychology; Psychoneuroimmunology; |
| Importance of knowledge of prognosis [Cha.Sa.Indriya Sthana 12/90] | Benefits of prognostication of life expectancy; Proper identification of red flag signs & symptoms; |
The prognositc features can be observed in various diseases or pathologies as described below in table 4.
| Prognositc feature | Probable relevant disease or pathology |
|---|---|
| Signs of skin lesions [Cha.Sa.Indriya Sthana 12/3] | Seborrheic dermatitis (SD) & Malassezia infections (dandruff) in immunocompromised patients; |
| Signs of abnormal gait [Cha.Sa.Indriya Sthana 12/4] | Parkinson’s disease (PD); |
| Signs of abnormal body temperature [Cha.Sa.Indriya Sthana 12/5] | Localized hyperthermia or hypermetabolism or hypervascularization or hyperperfucions due to an underlying inflammation or neoplastic conditions; |
| Decline in vital function [Cha.Sa.Indriya Sthana 12/46] | Death rattle; Dyspnea; Agitation or restlessness seen in Delirium; |
| Decline in cognition [Cha.Sa.Indriya Sthana 12/46] | Cognitive decline or impairment seen in Dementia, Delirium and other neurodegenerative diseases; |
| Decline in motor function [Cha.Sa.Indriya Sthana 12/46] | Functional decline; Frailty; Slowed psychomotor functions; Fatigue; |
| Decline in psychomotor function [Cha.Sa.Indriya Sthana 12/46] | Hypoactive subtype of delirium; Reduced psychomotor activity; Lethargy; |
| Decline in sensory function [Cha.Sa.Indriya Sthana 12/47] | Sensory impairment; Cognitive impairment; |
| Decline in consciousness level [Cha.Sa.Indriya Sthana 12/46] | Clouding or disturbance or of consciousness seen in delirium; |
| Decline in orientation [Cha.Sa.Indriya Sthana 12/47] | Restlessness or agitation or anxiety seen in delirium; Dying process; End of life processes; Fear of death; Depression; Terminal drop; |
| Decline in memory and cognition [Cha.Sa.Indriya Sthana 12/48] | Memory and cognitive impairments seen in Dementias; |
| Change in behavior pattern [Cha.Sa.Indriya Sthana 12/48] | Disinhibition; Behavioural and personality changes seen in FTD (frontotemporal dementia); Neurodegenerative diseases; |
| Decline in immunity [Cha.Sa.Indriya Sthana 12/48] | Immunosenescence; Immunocompromised states; Hypometabolism or hypoperfusion; |
| Change in behavior and personality [Cha.Sa.Indriya Sthana 12/49] | Personality changes in FTD; BPSD (behavioural and psychological symptoms of dementia); Anhedonia; Depression; |
| Change in complexion and lustre [Cha.Sa.Indriya Sthana 12/49] | Pathological changes seen in reflections and shadows; Abnormalities of complexion; |
| Improper ejaculation [Cha.Sa.Indriya Sthana 12/50] | Incontinence; Dribbling ejaculation in spinal cord injury or pathology; Hypotonia or Atonia; |
| Signs of critical medical emergency [Cha.Sa.Indriya Sthana 12/50] | Acute painful emergency conditions; Acute abdomen; Cerebrovascualr accidents; Cardiovascular pathologies; |
| Depletion of body tissues [Cha.Sa.Indriya Sthana 12/50] | Sarcopenia; Cachexia; Anaemia; Malnutrition; |
| Decrease in body temperature [Cha.Sa.Indriya Sthana 12/51] | Hypothermia; Cold clammy skin in hypovolemic or hemorrhagic shock; |
| Laxity of joints [Cha.Sa.Indriya Sthana 12/51] | Generalized joint hyperlaxity; Multidirectional instability of joints (MDI); |
| Abnormal olfaction [Cha.Sa.Indriya Sthana 12/51] | VOC (volatile organic compounds) specific to particular diseases; |
| Abnormal complexion [Cha.Sa.Indriya Sthana 12/51] | Deterioration of complexion; Cyanosis; Pallor; Hyper or hypo pigmentation; |
| Abnormal voice [Cha.Sa.Indriya Sthana 12/51] | Dysphonia; Aphonia; Hypophonia; |
| Abnormal discoloration or pigmentation of skin [Cha.Sa.Indriya Sthana 12/52] | Changes in skin colour is one of the signs and symptoms of impending death in end-of-life senile dementia; |
| Abnormal dryness of mucosa [Cha.Sa.Indriya Sthana 12/52] | Dehydration; Hypovolemia; |
| Abnormal hot flushing and heat sensation [Cha.Sa.Indriya Sthana 12/52] | Dyspnoea or breathlessness seen in life threatening conditions; |
| Abnormal dryness of scalp [Cha.Sa.Indriya Sthana 12/52] | Malassezia infection (dandruff) in immunocompromised patients; |
| Abnormal pulsation [Cha.Sa.Indriya Sthana 12/53] | Diminished or absent peripheral pulses; Takayasu’s arteritis; Atherosclerosis; Thrombosis |
| Abnormal alternate hot and cold sensation [Cha.Sa.Indriya Sthana 12/54] | Hypothermia; Hyperthermia; |
| Abnormal alternated rough and unctuous touch [Cha.Sa.Indriya Sthana 12/54] | Stony hardness in carcinoma; Flaccidity in lower motor neuron diseases; Malacia; Neuromuscular conditions; |
| Abnormal discoloration of nails [Cha.Sa.Indriya Sthana 12/55] | Leukonychia; Melanonychia; Splinter haemorrhages; |
| Abnormal discoloration of teeth [Cha.Sa.Indriya Sthana 12/55] | Periodontitis; |
| Abnormal eye lashes [Cha.Sa.Indriya Sthana 12/55] | Blepharitis; Malassezia infections in immunocompromised patients; |
| Abnormal scalp hair lines [Cha.Sa.Indriya Sthana 12/55] | Excessive sebum production in Seborrheic dermatitis (SD) associated with AIDS; |
| Non response to medicines [Cha.Sa.Indriya Sthana 12/56] | Terminal illness which doesn’t responds to aggressive treatment and requires palliative or hospice care; |
| Abnormal depletion of ojas [Cha.Sa.Indriya Sthana 12/57] | Functional decline; Immunosenescence; |
| Abnormal sensorium [Cha.Sa.Indriya Sthana 12/58] | Sensory impairment; Agnosias; Hallucinations; Abnormal psychomotor activity seen in delirium; various neurodegenerative conditions; |
| Abnormal dreams [Cha.Sa.Indriya Sthana 12/59] | Nightmares found in ICU (intensive care urnit) patients; |
Acknowledgement: The contributors acknowledge support of Dr. M. Prasad and Dr.G.Kshama for providing table 3 and 4 from their published article referred in this chapter.
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References
- ↑ Gupta K. et.al., Gomaya Choorneeyam of Charaka Indriya Sthana - An Explorative Study, Int. J. Ayu. Alt. Med., 2019; 7(6): 288-306