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Trividha Roga Vishesha Vijnaniya Vimana (view source)

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|title=Trividha Roga Vishesha Vijnaniya Vimana

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|titlemode=append

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|keywords=Aptopadesha, Pratyaksha, Anumana, Diagnosis, Authoritative instructions, Direct observations, inference, examination methods and tools

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|description=Vimana Sthana Chapter 4. Three-fold clinical examination for comprehensive diagnosis of diseases

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}}

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<big>'''Vimana Sthana Chapter 4. Three-fold clinical examination for comprehensive diagnosis of diseases '''</big>

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===Sanskrit Text, Transliteration and English Translation===

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अथातस्त्रिविधरोगविशेषविज्ञानीयं विमानं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

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athātastrividharōgaviśēṣavijñānīyaṁ vimānaṁ vyākhyāsyāmaḥ||1||

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iti ha smAha bhagavAnAtreyaH||2||

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</div></div>

We shall now expound the chapter on the “Three-fold Examination Method and its tools”, for a complete diagnosis of a disease. Thus said Lord Atreya. [1-2]

==== Three methods for knowledge of disease ====

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त्रिविधं खलु रोगविशेषविज्ञानं भवति; तद्यथा आप्तोपदेशः, प्रत्यक्षम्, अनुमानं चेति||३||

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trividhaṁ khalu rōgaviśēṣavijñānaṁ bhavati; tadyathā āptōpadēśaḥ, pratyakṣam, anumānaṁ cēti||3||

trividhaM khalu rogavisheShavij~jAnaM bhavati; tadyathA AptopadeshaH, pratyakSham, anumAnaMceti||3||

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</div></div>

Specific features of diseases can be determined in three ways – by means of ''aptopadesha'' (authoritative instruction), ''pratyaksha'' (direct observation), and ''anumana'' (inference). [3]

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तत्राप्तोपदेशो नामाप्तवचनम्| आप्ता ह्यवितर्कस्मृतिविभागविदो निष्प्रीत्युपतापदर्शिनश्च| तेषामेवङ्गुणयोगाद्यद्वचनं तत् प्रमाणम्| अप्रमाणं पुनर्मत्तोन्मत्तमूर्खरक्तदुष्टादुष्टवचनमिति ; प्रत्यक्षं तु खलु तद्यत् स्वयमिन्द्रियैर्मनसा चोपलभ्यते| अनुमानं खलु तर्को युक्त्यपेक्षः||४||

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tatrāptōpadēśō nāmāptavacanam| āptā hyavitarkasmr̥tivibhāgavidō niṣprītyupatāpadarśinaśca| tēṣāmēvaṅguṇayōgādyadvacanaṁ tat pramāṇam| apramāṇaṁ punarmattōnmattamūrkharaktaduṣṭāduṣṭavacanamiti ; pratyakṣaṁ tu khalu tadyat svayamindriyairmanasā cōpalabhyatē| anumānaṁ khalu tarkō yuktyapēkṣaḥ||4||

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pratyakShaM tu khalu tadyatsvayamindriyairmanasA copalabhyate|

anumAnaM khalu tarko yuktyapekShaH||4||

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</div></div>

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Authoritative instructions are the teachings of ''apta'' (persons who are the most reliable). ''Apta'' are free from doubts, their memory is unimpaired, they know things in their entirety by determinate experience. They see things without any attachment or affection (''nishpriti'' and ''nirupatapa''). Because of these qualities, what they say is authentic. On the other hand, statements- true or false- made by intoxicated, mad, illiterate people and people with attachments are not to be considered as authoritative.

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''Anumana'' or inference is the indirect knowledge based on [[Apamarga Tanduliya Adhyaya#'''Yukti Pramana and Yuktivyapashraya Chikitsa(Rational therapeutics)'''|''Yukti'' i.e. reasoning, logic and experiments]]. [4]

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त्रिविधेन खल्वनेन ज्ञानसमुदायेन पूर्वं परीक्ष्य रोगं सर्वथा सर्वमथोत्तरकालमध्यवसानमदोषं भवति, न हि ज्ञानावयवेन कृत्स्ने ज्ञेये ज्ञानमुत्पद्यते| त्रिविधे त्वस्मिन् ज्ञानसमुदये पूर्वमाप्तोपदेशाज्ज्ञानं, ततः प्रत्यक्षानुमानाभ्यां परीक्षोपपद्यते| किं ह्यनुपदिष्टं पूर्वं यत्तत् प्रत्यक्षानुमानाभ्यां परीक्षमाणो विद्यात्| तस्माद्द्विविधा परीक्षा ज्ञानवतां प्रत्यक्षम्, अनुमानं च;त्रिविधा वा सहोपदेशेन||५||

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trividhēna khalvanēna jñānasamudāyēna pūrvaṁ parīkṣya rōgaṁ sarvathā sarvamathōttarakālamadhyavasānamadōṣaṁ bhavati, na hi jñānāvayavēna kr̥tsnē jñēyē jñānamutpadyatē| trividhē tvasmin jñānasamudayē pūrvamāptōpadēśājjñānaṁ, tataḥ pratyakṣānumānābhyāṁ parīkṣōpapadyatē| kiṁ hyanupadiṣṭaṁ pūrvaṁ yattat pratyakṣānumānābhyāṁ parīkṣamāṇō vidyāt| tasmāddvividhā parīkṣā jñānavatāṁ pratyakṣam, anumānaṁ ca; trividhā vā sahōpadēśēna||5||

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kiM hyanupadiShTaM pUrvaM yattat pratyakShAnumAnAbhyAM parIkShamANo vidyAt|

tasmAddvividhA parIkShA j~jAnavatAM pratyakSham, anumAnaM ca; trividhA vA sahopadeshena||5||

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</div></div>

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First of all, one should examine the various aspects of diseases by employing all the three ''pramanas'' (i.e., the three methods of examination). Observations made on the nature of the disease thereafter are infallible. One cannot acquire authoritative knowledge about anything in all its aspects simply by examining it through a part of these “sources of knowledge”. Of all the sources of knowledge one should acquire knowledge in the beginning through authoritative instructions and, thereafter proceed to examine a thing through ''pratyaksha'' (direct observations), and ''anumana'' (inference). What is to be examined by “direct observations” and inference unless something can be studied prima facie. Hence, all the three methods of examination are always to be used in the sequence viz. ''aptopadesha, pratyaksha'' and ''anumana''. In other words, it could be said that if a physician possesses the textual knowledge (''aptopadesha'') then, for him, there are only two methods of examinations. [5]

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==== Criteria of knowledge of disease ====

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तत्रेदमुपदिशन्ति बुद्धिमन्तः- रोगमेकैकमेवम्प्रकोपणमेवंयोनिमेवमुत्थानमेवमात्मानमेवमधिष्ठानमेवंवेदनमेवं संस्थानमेवंशब्द

स्पर्शरूपरसगन्धमेवमुपद्रवमेवंवृद्धिस्थानक्षयसमन्वितमेवमुदर्क मेवन्नामानमेवंयोगं विद्यात्; तस्मिन्नियं प्रतीकारार्था प्रवृत्तिरथवा निवृत्तिरित्युपदेशाज्ज्ञायते||६||

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tatrēdamupadiśanti buddhimantaḥ- rōgamēkaikamēvamprakōpaṇamēvaṁyōnimēvamutthānamēvamātmānamēvamadhiṣṭhānamēvaṁvēdanamēvaṁ saṁsthānamēvaṁśabdasparśarūparasagandhamēvamupadravamēvaṁvr̥ddhisthānakṣayasamanvitamēvamudarka mēvannāmānamēvaṁyōgaṁ vidyāt; tasminniyaṁ pratīkārārthā pravr̥ttirathavā nivr̥ttirityupadēśājjñāyatē||6||

tatredamupadishanti buddhimantaH-rogamekaikamevamprakopaNamevaMyonimevamutthAnamevamAtmAnamevamadhiShThAnamevaMvedanamevaMsaMsthAnamevaMshabdasparsharUparasagandham<br>evamupadravamevaMvRuddhisthAnakShayasamanvitamevamudarkamevannAmAnamevaMyogaM vidyAt; tasminniyaM pratIkArArthA pravRuttirathavA nivRuttirityupadeshAjj~jAyate||6||

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</div></div>

Using the ''aptopadesha'' method of examination, one acquires knowledge as described here using the following terms that wise men, or ''apta'', use to understand a disease:

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==== Knowledge by direct perception ====

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प्रत्यक्षतस्तु खलु रोगतत्त्वं बुभुत्सुः सर्वैरिन्द्रियैः सर्वानिन्द्रियार्थानातुरशरीरगतान् परीक्षेत, अन्यत्र रसज्ञानात्; तद्यथा- अन्त्रकूजनं, सन्धिस्फुटनमङ्गुलीपर्वणां च, स्वरविशेषांश्च, ये चान्येऽपि केचिच्छरीरोपगताः शब्दाः स्युस्ताञ्छ्रोत्रेण परीक्षेत; वर्णसंस्थानप्रमाणच्छायाः शरीरप्रकृतिविकारौ, चक्षुर्वैषयिकाणि यानि चान्यान्यनुक्तानि तानि चक्षुषा परीक्षेत; रसं तु खल्वातुरशरीरगतमिन्द्रियवैषयिकमप्यनुमानादवगच्छेत्, न ह्यस्य प्रत्यक्षेण ग्रहणमुपपद्यते, तस्मादातुरपरिप्रश्नेनैवातुरमुखरसं विद्यात्, यूकापसर्पणेन त्वस्य शरीरवैरस्यं, मक्षिकोपसर्पणेन शरीरमाधुर्यं, लोहितपित्तसन्देहे तु किं धारिलोहितं लोहितपित्तं वेति श्वकाकभक्षणाद्धारिलोहितमभक्षणाल्लोहितपित्तमित्यनुमातव्यम्, एवमन्यानप्यातुरशरीरगतान् रसाननुमिमीत; गन्धांस्तु खलु सर्वशरीरगतानातुरस्य प्रकृतिवैकारिकान् घ्राणेन परीक्षेत; स्पर्शं च पाणिना प्रकृतिविकृतियुक्तम्| इति प्रत्यक्षतोऽनुमानादुपदेशतश्च परीक्षणमुक्तम्||७||

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pratyakṣatastu khalu rōgatattvaṁ bubhutsuḥ sarvairindriyaiḥ sarvānindriyārthānāturaśarīragatān parīkṣēta, anyatra rasajñānāt; tadyathā- antrakūjanaṁ, sandhisphuṭanamaṅgulīparvaṇāṁ ca, svaraviśēṣāṁśca, yē cānyē'pi kēciccharīrōpagatāḥ śabdāḥ syustāñchrōtrēṇa parīkṣēta; varṇasaṁsthānapramāṇacchāyāḥ , śarīraprakr̥tivikārau, cakṣurvaiṣayikāṇi yāni cānyānyanuktāni tāni cakṣuṣā parīkṣēta; rasaṁ tu khalvāturaśarīragatamindriyavaiṣayikamapyanumānādavagacchēt, na hyasya pratyakṣēṇa grahaṇamupapadyatē, tasmādāturaparipraśnēnaivāturamukharasaṁ vidyāt, yūkāpasarpaṇēna tvasya śarīravairasyaṁ, makṣikōpasarpaṇēna śarīramādhuryaṁ, lōhitapittasandēhē tu kiṁ dhārilōhitaṁ lōhitapittaṁ vēti śvakākabhakṣaṇāddhārilōhitamabhakṣaṇāllōhitapittamityanumātavyam, ēvamanyānapyāturaśarīragatān rasānanumimīta; gandhāṁstu khalu sarvaśarīragatānāturasya prakr̥tivaikārikān ghrāṇēna parīkṣēta; sparśaṁ ca pāṇinā prakr̥tivikr̥tiyuktam| iti pratyakṣatō'numānādupadēśataśca parīkṣaṇamuktam||7||

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pratyakShatastu khalu rogatattvaM bubhutsuH sarvairindriyaiH sarvAnindriyArthAnAturasharIragatAnparIkSheta, anyatra rasaj~jAnAt; tadyathA- antrakUjanaM, sandhisphuTanama~ggulIparvaNAM ca,svaravisheShAMshca, ye cAnye~api keciccharIropagatAH shabdAH syustA~jchrotreNa parIkSheta;varNasaMsthAnapramANacchAyAH , sharIraprakRutivikArau, cakShurvaiShayikANi yAnicAnyAnyanuktAni tAni cakShuShA parIkSheta; rasaM tukhalvAturasharIragatamindriyavaiShayikamapyanumAnAdavagacchet, na hyasya pratyakSheNagrahaNamupapadyate, tasmAdAturapariprashnenaivAturamukharasaM vidyAt, yUkApasarpaNena tvasyasharIravairasyaM, makShikopasarpaNena sharIramAdhuryaM, lohitapittasandehe tu kiM dhArilohitaMlohitapittaM veti shvakAkabhakShaNAddhArilohitamabhakShaNAllohitapittamityanumAtavyam,evamanyAnapyAturasharIragatAn rasAnanumimIta; gandhAMstu khalu sarvasharIragatAnAturasyaprakRutivaikArikAn ghrANena parIkSheta; sparshaM ca pANinA prakRutivikRutiyuktam|

iti pratyakShato~anumAnAdupadeshatashca parIkShaNamuktam||7||

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</div></div>

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A physician who wants to examine the patient and diagnose the disease through ''pratyaksha'' (direct observations) method of examination should examine with his own senses (all senses except the one relating to the gustatory organ, i.e., taste), in the body of the patient.

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===== Knowledge by inference =====

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इमे तु खल्वन्येऽप्येवमेव भूयोऽनुमानज्ञेया भवन्ति भावाः| तद्यथा- अग्निं जरणशक्त्या परीक्षेत, बलं व्यायामशक्त्या, श्रोत्रादीनि शब्दाद्यर्थग्रहणेन, मनोऽर्थाव्यभिचरणेन, विज्ञानं व्यवसायेन, रजःसङ्गेन, मोहमविज्ञानेन, क्रोधमभिद्रोहेण, शोकं दैन्येन, हर्षमामोदेन, प्रीतिं तोषेण, भयं विषादेन, धैर्यमविषादेन, वीर्यमुत्थानेन, अवस्थानमविभ्रमेण, श्रद्धामभिप्रायेण, मेधां ग्रहणेन, सञ्ज्ञां नामग्रहणेन, स्मृतिं स्मरणेन, ह्रियमपत्रपणेन, शीलमनुशीलनेन, द्वेषं प्रतिषेधेन, उपधिमनुबन्धेन , धृतिमलौल्येन, वश्यतां विधेयतया, वयोभक्तिसात्म्यव्याधिसमुत्थानानि कालदेशोपशयवेदनाविशेषेण, गूढलिङ्गं व्याधिमुपशयानुपशयाभ्यां, दोषप्रमाणविशेषमपचारविशेषेण, आयुषः क्षयमरिष्टैः, उपस्थितश्रेयस्त्वं कल्याणाभिनिवेशेन, अमलं सत्त्वमविकारेण, ग्रहण्यास्तु मृदुदारुणत्वं स्वप्नदर्शनमभिप्रायं द्विष्टेष्टसुखदुःखानि चातुरपरिप्रश्नेनैव विद्यादिति||८||

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imē tu khalvanyē'pyēvamēva bhūyō'numānajñēyā bhavanti bhāvāḥ tadyathā agniṁ jaraṇaśaktyā parīkṣēta balaṁ vyāyāmaśaktyā, śrōtrādīni śabdādyarthagrahaṇēna, manō'rthāvyabhicaraṇēna, vijñānaṁ vyavasāyēna, rajaḥsaṅgēna, mōhamavijñānēna, krōdhamabhidrōhēṇa, śōkaṁ dainyēna, harṣamāmōdēna, prītiṁ tōṣēṇa, bhayaṁ viṣādēna, dhairyamaviṣādēna, vīryamutthānēna

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ime tu khalvanye~apyevameva bhUyo~anumAnaj~jeyA bhavanti bhAvAH|

tadyathA- agniM jaraNashaktyA parIkSheta, balaM vyAyAmashaktyA, shrotrAdInishabdAdyarthagrahaNena, mano~arthAvyabhicaraNena, vij~jAnaM vyavasAyena, rajaHsa~ggena,mohamavij~jAnena, krodhamabhidroheNa, shokaM dainyena, harShamAmodena, prItiM toSheNa, bhayaMviShAdena, dhairyamaviShAdena, vIryamutthAnena , avasthAnamavibhrameNa,shraddhAmabhiprAyeNa, medhAM grahaNena, sa~jj~jAM nAmagrahaNena, smRutiM smaraNena,hriyamapatrapaNena, shIlamanushIlanena, dveShaM pratiShedhena, upadhimanubandhena [3] ,dhRutimalaulyena, vashyatAM vidheyatayA, vayobhaktisAtmyavyAdhisamutthAnAnikAladeshopashayavedanAvisheSheNa, gUDhali~ggaM vyAdhimupashayAnupashayAbhyAM,doShapramANavisheShamapacAravisheSheNa, AyuShaH kShayamariShTaiH, upasthitashreyastvaMkalyANAbhiniveshena, amalaM sattvamavikAreNa, grahaNyAstu mRududAruNatvaMsvapnadarshanamabhiprAyaM dviShTeShTasukhaduHkhAni [4] cAturapariprashnenaiva vidyAditi||8||

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</div></div>

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Charak observed that the objects known by direct perceptions are very limited, whereas the range of inference is fairly vast in areas that are not known by our means of perception, i.e., sense organs. Here, reasoning and logic already stated in scriptures need to be used. The following subjects could be understood through ''anumana'' (inference):

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</div>

==== Importance of three fold examination ====

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भवन्ति चात्र- आप्ततश्चोपदेशेन प्रत्यक्षकरणेन च|

अनुमानेन च व्याधीन् सम्यग्विद्याद्विचक्षणः||९||

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bhavanti cātra-

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Aptatashcopadeshena pratyakShakaraNena ca|

anumAnena ca vyAdhIn samyagvidyAdvicakShaNaH||9||

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</div></div>

To sum up this chapter, it can be said that the wise should properly understand a disease by means of three methods, i.e., the words documented by the wise, direct observation and inference. [9]

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सर्वथा सर्वमालोच्य यथासम्भवमर्थवित्| अथाध्यवस्येत्तत्त्वे च कार्ये च तदनन्तरम्||१०||

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sarvathā sarvamālōcya yathāsambhavamarthavit|

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sarvathA sarvamAlocya yathAsambhavamarthavit|

athAdhyavasyettattve ca kArye ca tadanantaram||10||

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</div></div>

As far as possible, all factors should be discussed in their entirety. After examining the disease by ''aptopadesha'', the physician should obtain knowledge regarding the nature of disease and the therapies required therefore. [10]

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कार्यतत्त्वविशेषज्ञः प्रतिपत्तौ न मुह्यति|

अमूढः फलमाप्नोति यदमोहनिमित्तजम्||११||

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kāryatattvaviśēṣajñaḥ pratipattau na muhyati|

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kAryatattvavisheShaj~jaH pratipattau na muhyati|

amUDhaH phalamApnoti yadamohanimittajam||11||

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</div></div>

One who is well versed in the specific nature of the disease as well as the therapies required therefore seldom fails to act properly. It is only he who acts properly that reaps the results of proper action (i.e. achieves success). [11]

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ज्ञानबुद्धिप्रदीपेन यो नाविशति तत्त्ववित् |

आतुरस्यान्तरात्मानं न स रोगांश्चिकित्सति||१२||

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jnānabuddhipradīpēna yō nāviśati tattvavit |

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j~jAnabuddhipradIpena yo nAvishati tattvavit |

AturasyAntarAtmAnaM na sa rogAMshcikitsati||12||

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</div></div>

When a physician who, even if well versed in knowledge of the disease and its treatment does not try to enter into the heart of the patient by virtue of the light of his knowledge, he will not be able to treat the disease. [12]

==== Summary ====

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तत्र श्लोकौ-

सर्वरोगविशेषाणां त्रिविधं ज्ञानसङ्ग्रहम्|

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ये यथा चानुमानेन ज्ञेयास्तांश्चाप्युदारधीः| भावांस्त्रिरोगविज्ञाने विमाने मुनिरुक्तवान्||१४||

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tatra ślokau-

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ye yathA cAnumAnena j~jeyAstAMshcApyudAradhIH|

bhAvAMstrirogavij~jAne vimAne muniruktavAn||14||

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</div></div>

To sum up again,

Three methods for the determination of all types of diseases are - factors understood by the instructions of ''apta'' (sages), by direct observation and inference, along with the methods prescribed in respective chapters for specific subject.[13-14]

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इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते विमानस्थाने

त्रिविधरोगविशेषविज्ञानीयं विमानं नाम चतुर्थोऽध्यायः||४||

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ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē vimānasthānē trividharōgaviśēṣavijñānīyaṁ vimānaṁ nāma caturthō'dhyāyaḥ||4||

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</div></div>

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Thus ends the fourth chapter of [[Vimana Sthana]] on “The determination of the three factors for understanding the specific characteristics of diseases” of Agnivesha’s work as redacted by Charak.

Agnivesha

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