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'''b. Darshan pariksha (Direct observation)'''
'''b. Darshan pariksha (Direct observation)'''
While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..
While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..
'''#Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)
'''#Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]
'''#Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].
'''#Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions.
'''#Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly.
<br/>All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.
=='''c. Sattva pariksha (assessment of quality of excellence of mind)'''
<p style="text-align:justify;">Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]</p>
<p style="text-align:justify;">Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].
<br/>Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.
<br?>Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.</p>
<p style="text-align:justify;">'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-</p>