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===Introduction/ ''Vishayanupravesha'' ===

== Introduction ==

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While describing the qualities of an ideal ''bhishaja'' (physician) it has been stated that he should be friendly, and compassionate to the patients, should have devotion and love for treating the curable diseases and should not treat the untreatable ones [Cha. Su. 9/26].  During the Samhita period, many diseases were incurable because of lack of treatments available at that time. Now, large number of diseases can be controlled and gives longer productive life to patients by providing emergency and intensive  care treatments. That is why during that time it was important to determine the prognosis in terms of curability or incurability of diseases. Physicians did not treat incurable patients especially terminally ill patients. A set of symptoms and signs of terminally ill patients was identified called ''Arishta lakshanas''. With the rising high cost of healthcare especially the end of life care, knowledge and recognition of these signs and symptoms have become more relevant during the current times.  

While describing the qualities of an ideal ''bhishaja'' (physician) it has been stated that he should be friendly, and compassionate to the patients, should have devotion and love for treating the curable diseases and should not treat the untreatable ones [Cha. Su. 9/26].  During the Samhita period, many diseases were incurable because of lack of treatments available at that time. Now, large number of diseases can be controlled and gives longer productive life to patients by providing emergency and intensive  care treatments. That is why during that time it was important to determine the prognosis in terms of curability or incurability of diseases. Physicians did not treat incurable patients especially terminally ill patients. A set of symptoms and signs of terminally ill patients was identified called ''Arishta lakshanas''. With the rising high cost of healthcare especially the end of life care, knowledge and recognition of these signs and symptoms have become more relevant during the current times.  

After describing fatal signs regarding complexion and voice, diagnosed by visual and auditory senses respectively, the present chapter describes signs to be examined by gustatory and olfactory senses.

After describing fatal signs regarding complexion and voice, diagnosed by visual and auditory senses respectively, the present chapter describes signs to be examined by gustatory and olfactory senses.

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===Sanskrit text, Transliteration and English Translation===

==Sanskrit text, Transliteration and English Translation==

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Now We shall expound the chapter "Pushpitakamindriyam"(Fatal signs of Tactile and Olfactory perception). Thus said Lord Atreya.[1-2]   

Now We shall expound the chapter "Pushpitakam indriyam"(Fatal signs of Tactile and Olfactory perception). Thus said Lord Atreya.[1-2]   

Note: The chapter deals with features of odor and taste indicating impending death.

Note: The chapter deals with features of odor and taste indicating impending death.

====Definition of Arishta (fatal signs) ====

===Definition of Arishta (fatal signs) ===

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Similarly as a flower predicts the future growth of a fruit, appearance of various types of ''arishta lakshanas'' denote the impending death. [3]

Similarly as a flower predicts the future growth of a fruit, appearance of various types of ''arishta lakshanas'' denote the impending death. [3]

==== Importance of ''Arishta'' (fatal signs) ====

=== Importance of ''Arishta'' (fatal signs) ===

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To expound the knowledge about various premonitory symptoms preceding death as indicative of its imminence, we now illustrate the various kinds of such presentations in persons.[7]

To expound the knowledge about various premonitory symptoms preceding death as indicative of its imminence, we now illustrate the various kinds of such presentations in persons.[7]

==== Fatal signs related to body odor ====

=== Fatal signs related to body odor ===

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We shall further discuss the premonitory symptoms based on various odors in order to facilitate the physician’s knowledge by which he can predict death. The individual whose body emits pleasant or unpleasant smell continuously without any appreciable cause cannot survive for more than a year. This is all about premonitory symptoms based on the smell emitted by the body of the individual.[8-16]

We shall further discuss the premonitory symptoms based on various odors in order to facilitate the physician’s knowledge by which he can predict death. The individual whose body emits pleasant or unpleasant smell continuously without any appreciable cause cannot survive for more than a year. This is all about premonitory symptoms based on the smell emitted by the body of the individual.[8-16]

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==== Fatal signs related to sense of taste ====

=== Fatal signs related to sense of taste ===

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==== Summary ====

=== Summary ===

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Symptoms of impending death of ''pushpita'' persons relating to the general variations in the taste and smell of individuals has been described here. Such symptoms lead to the death of the person. [23]

Symptoms of impending death of ''pushpita'' persons relating to the general variations in the taste and smell of individuals has been described here. Such symptoms lead to the death of the person. [23]

=== Tattva Vimarsha(Fundamental Principles) ===

== Tattva Vimarsha(Fundamental Principles) ==

*Death doesn’t occur without showing ''Arishta'' (fatal signs). One shall always be free from ''Prajnaparadha'' (intellectual errors) to identify and diagnose these signs correctly. [5-6]

*Death doesn’t occur without showing ''Arishta'' (fatal signs). One shall always be free from ''Prajnaparadha'' (intellectual errors) to identify and diagnose these signs correctly. [5-6]

*''Arishta'' related to ''Gandha - Pitta'' is primarily responsible factor for all odors as it has ''visra gandha''. When ''pitta'' reaches the ''twak'' or skin and exerts its ''visra gandha'' by ''bhrajaka pitta'', it’s  odor is of sweat and sebum ???. In this way we can derive the cause and effect. All these verses describe how the various smells (both good as well as bad odors) emitted by the body of an individual without any appreciable causes denote the impending death of the person within a year.  

*''Arishta'' related to ''Gandha - Pitta'' is primarily responsible factor for all odors as it has ''visra gandha''. When ''pitta'' reaches the ''twak'' or skin and exerts its ''visra gandha'' by ''bhrajaka pitta'', it’s  odor is of sweat and sebum ???. In this way we can derive the cause and effect. All these verses describe how the various smells (both good as well as bad odors) emitted by the body of an individual without any appreciable causes denote the impending death of the person within a year.  

=== Vidhi Vimarsha (Applied Inferences) ===

== Vidhi Vimarsha (Applied Inferences) ==

*''Arishta'' related to various odors (''Gandha''):  These smells coming from the body of individuals represent manifestations of major metabolic disorder which is altering the normal smell of the body. For example, fruity odor in diabetes (ketoacidosis), odor of Ammonia in renal ? hepatic failure and fecal smell in high intestinal obstruction etc. [Verse 8-16]

*''Arishta'' related to various odors (''Gandha''):  These smells coming from the body of individuals represent manifestations of major metabolic disorder which is altering the normal smell of the body. For example, fruity odor in diabetes (ketoacidosis), odor of Ammonia in renal ? hepatic failure and fecal smell in high intestinal obstruction etc. [Verse 8-16]