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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.  

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,'' Duta, [[Arishta]], Asanna Mrityu [[Lakshana]],'' messenger, near death signs, fatal signs.

'''Keywords''': Gomaya Churniya, [[doota]], [[arishta]], asanna mrityu [[Lakshana]], messenger, near death signs, fatal signs, moribund signs.

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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.  

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.

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.

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== Sanskrit text, Transliteration and English Translation ==

== Sanskrit text, Transliteration and English Translation ==

If a diet prepared and administered as per advice of physician, not giving desired effect, the patient hardly survives. [8]

If a diet prepared and administered as per advice of physician, not giving desired effect, the patient hardly survives. [8]

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=== Attributes of a messenger ===

=== Attributes of a messenger ([[doota]]) ===

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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]

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 to 31 1/2]

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]

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=== Signs at the patient’s home ===

=== Signs at the patient’s home ===

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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]

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:

These are as follows:

#Infirmity of ''prana'' (vital breath); cloudiness of understanding;

#Infirmity of [[prana]] (vital breath); cloudiness of understanding;

#Strength drains from body organs;

#Strength drains from body organs;

#Cessation of movement;

#Cessation of movement;

#Curiosity makes mind restless,  

#Curiosity makes mind restless,  

#Mind infirmed with fear;

#Mind infirmed with fear;

#Distraction of memory, ''medha'' (intellect), ''hri'' (natural shy), ''sri'' (luster of the body);

#Distraction of memory, [[medha]] (intellect), ''hri'' (natural shy), ''sri'' (luster of the body);

#Aggravation of symptoms of the disease;

#Aggravation of symptoms of the disease;

#Destruction of ''Ojas'' (Immune System) and ''Teja'' (radiance);

#Destruction of [[Ojas]] (Immune System) and [[Teja]] (radiance);

#Radical changes in the conduct;

#Radical changes in the conduct;

#Changes in likings (and disliking);

#Changes in likings (and disliking);

#Distortion in reflected image and apparition of an individual

#Distortion in reflected image and apparition of an individual

#Ejection  of semen (or even feces or urine) from its own place;

#Ejection  of semen (or even feces or urine) from its own place;

#Upward movement of ''vayu'';

#Upward movement of [[vayu]];

#Wasting of muscle tissue and loss of blood;

#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);

#Attenuation of [[ushma]](the component responsible for producing heat in body, maintained by proper digestion and metabolism);

#Dislocation of joints;

#Dislocation or laxity of joints;

#Morbid changes in body odor, hoarseness of voice and alteration in complexion;

#Morbid changes in body odor, hoarseness of voice and alteration in complexion;

#Discoloration of the body;

#Discoloration of the body;

== Vidhi Vimarsha (Applied Inferences) ==

== Vidhi Vimarsha (Applied Inferences) ==

===Table 1: Conditions denoting poor prognosis:===

=== 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.

 

{| class="wikitable"

{| class="wikitable"

! rowspan="1"| Factors

! rowspan="1"| Factors

! rowspan="1"| Related to Physician  

! rowspan="1"| Related to Physician  

|}

|}

===Table 2: Bad omens observed inside the patient’s house denoting poor prognosis===

=== 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.   

{| class="wikitable"

{| class="wikitable"

! rowspan="1"| Location

! rowspan="1"| Location

! rowspan="1"| Situation observed by physician   

! rowspan="1"| Situation observed by physician   

| Status of things being used by other member of the family || split, cracked, brunt, broken or crushed  

| 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<br>• arrangement of bed, cloth, vehicle and other apparel which are befitting a dead body

| 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 patient’s food || Gets extremely nasty and fire (to prepare new food) is extinguished even with proper fuel and wind free area   

|}

|}

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