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==Preamble of Indriya Sthana (Section on Determinants of Remaining Lifespan of Patients)==

==Preamble of Indriya Sthana (Section on Assessment of fatal signs and lifespan of patients)==

<div style="text-align:justify;">This section of [[Charak Samhita]] called [[Indriya Sthana]] deals with the signs and symptoms useful in determining the remaining lifespan of patients (also called ''arishta lakshana''). In the present era, because of advancements in medical sciences, many ''arishta lakshanas'' are well treatable and cannot be considered as "predictors" of death as they used to even a few centuries back. However, these signs and symptoms could serve as important indicators of prognosis of disease and therefore, would be helpful in the management of patients.  

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[[Indriya Sthana]] deals with the observation of predictors of life and fatal signs useful in determining the residual lifespan of patients (also called ''arishta lakshana''). The word ''Indriya'' literally means organ, sense, force, vigor.<ref>Sanskrit-English Dictionary available from [http://spokensanskrit.org/index.php?mode=3&script=hk&tran_input=Indriya&direct=au] retrieved on April 19, 2019</ref>. In the present context, it means ''Prana'' or vital life force.<ref>Commentary by Chakrapani on Cha.Indriya 1/1-2 available on [http://niimh.nic.in/ebooks/ecaraka/?mod=adhi] retrieved on April 19, 2019</ref>. The seat of ''prana'' in the body is ''Sneha'' or ''Ojus''. ''Indriya'' (sense organs) are said to be the ''linga'' (organs) of ''prana''. An important concept discussed in this section is termed ''Indriyadushti'' (damage to the sensory system). A state of perfect health is ''Anirvedovarta Lakshanam'' (i.e., life without any indication or perception of being alive).(Cha.Su.25/40)

Life begins with the association of consciousness, or the ''atma'', with the five fundamental elements (earth, air, fire, ether, and water, or the ''panchamahabhuta'') and ends in the dissolution of this association. Since this union (that results in a living being) is by no means permanent and since there is always a possibility of dissolution or death anytime, Ayurvedic texts emphasized on identifying certain signs and symptoms that could forebear, with some level of certainty, imminent death. This section is dedicated to such determinants and is structured in the form of 12 chapters:

Life begins with the association of consciousness, or the ''atma'', with the five fundamental elements (earth, air, fire, ether, and water, or the ''panchamahabhuta'') and ends in the dissolution of this association. Since this union (that results in a living being) is by no means permanent and since there is always a possibility of dissolution or death anytime, Ayurvedic texts emphasized on identifying certain signs and symptoms that could forebear, with some level of certainty, imminent death. This section is dedicated to such determinants and is structured in the form of 12 chapters.

* Signs and symptoms (''arishtas'') of imminent death specific to pathologies afflicting sense organs that can be perceived by sensory deficiencies (e.g.,  ''varna'' (color), ''swara'' (voices/sounds), ''gandha'' (smell), ''rasa'' (taste), ''sparsha''(touch),along with ''chhaya'' (complexion) and ''prabha'' (radiance)) are addressed in chapters [[Varnasvariyamindriyam Adhyaya]], [[Pushpitakamindriyam Adhyaya]], [[Parimarshaneeyamindriyam Adhyaya]], [[Indriyaneeka]], [[Pannarupiya]] and [[Yasyashyavanimitta]].

* Signs and symptoms (''arishtas'') of imminent death specific to pathologies afflicting sense organs that can be perceived by sensory deficiencies (e.g.,  ''varna'' (color), ''swara'' (voices/sounds), ''gandha'' (smell), ''rasa'' (taste), ''sparsha''(touch),along with ''chhaya'' (complexion) and ''prabha'' (radiance)) are addressed in chapters [[Varnasvariyamindriyam Adhyaya]], [[Pushpitakamindriyam Adhyaya]], [[Parimarshaneeyamindriyam Adhyaya]], [[Indriyaneeka]], [[Pannarupiya]] and [[Yasyashyavanimitta]].

* Clinically useful early warning signs have been mentioned in [[Purvarupeeya]].

* Clinically useful early warning signs have been mentioned in [[Purvarupeeya]].

* [[Gomayachurniya]], [[Anujyoti]], [[Kathamanasharireeya]], [[Avakshiraseeya]] and [[Sadyomaraneeya]] are chapters that give examples of ''arishta'' that could be perceived on the physical level (or, are ''Bahyakarana'') as well as on the mental, intellectual, and emotional levels (or, afflicting the ''Antahkarana'' ),  with references to ''sakun''( good / bad consequential happening)), ''doota''( messenger), ''swapna'' ( dreams) and miscellaneous  occult sciences. The evidences laid down in these chapters may establish an Ayurveda-based clinical diagnostic methodology.  

* [[Gomayachurniya]], [[Anujyoti]], [[Kathamanasharireeya]], [[Avakshiraseeya]] and [[Sadyomaraneeya]] are chapters that give examples of ''arishta'' that could be perceived on the physical level (or, are ''Bahyakarana'') as well as on the mental, intellectual, and emotional levels (or, afflicting the ''Antahkarana'' ),  with references to ''shakun''( good / bad consequential happening)), ''doota''( messenger), ''swapna'' ( dreams) and miscellaneous  occult sciences. The evidences laid down in these chapters may establish an Ayurveda-based clinical diagnostic methodology.  

It is important to note here that [[Indriya Sthana]] deals with the predictors of life, and not just determinants/symptoms of death. There are, therefore, not titled ''Arishta Sthana'' but [[Indriya Sthana]] for a reason. ''Indra'' means ''prana'' (life). The seat of ''prana'' in the body is ''Sneha'' or ''Ojus''. ''Indriya'' (sense organs) are said to be the ''linga'' (organs) of ''prana''. An important concept discussed in the [[Indriya Sthana]] is termed ''Indriyadushti'' (damage to the sensory system). A state of perfect health is ''Anirvedovarta Lakshanam'' (i.e., life without any indication or perception of being alive).  

Even though all of the determinants (i.e., signs and symptoms) cannot be explained by rational scientific parameters (as evident by the references above to paranormal and occult sciences), some of these signs and symptoms have been documented and reported as having been experienced by people in various parts of the world. Within the treatise [[Charak Samhita]], physicians are instructed to thoroughly examine the patient for certain  signs that indicate terminal illness and investigate using biomarkers. The treatise then advises physicians to stop any therapeutic treatment being given to such terminal patients and provide them palliative care instead.

In the present era, with advancements in medical sciences, many ''arishta lakshanas'' are well treatable and cannot be considered as "predictors" of death as they used to even a few centuries back. However, these signs and symptoms could serve as important indicators of prognosis of disease and therefore, would be helpful in prompt management to save life of patients.

Even though all of the determinants (i.e., signs and symptoms) cannot be explained by rational scientific parameters (as evident by the references above to paranormal and occult sciences), some of these signs and symptoms have been documented and reported as having been experienced by people in various parts of the world. Within the treatise ([[Charak Samhita]]), physicians have been instructed to thoroughly examine the patient for certain telltale signs that indicate terminal illness and investigate using biomarkers. The treatise then advises physicians to stop any therapeutic treatment being given to such terminal patients and provide them palliative care instead.</div>

The following research works have been carried out on study of [[Indriya Sthana]] as observed in the directory of researches <ref> Available from https://researches-in-ayurveda.co.in/</ref>

#Sharma V.K.Charakokta Indriya Sthana Ka Pratisanskara Swarupatmaka Vishleshna.Ph. D.Thesis.Rajasthan Ayurved University,Jodhpur.2011

#Anurag Vats.A Critical Study Of Indriya Sthana From Charak Samita . Samhita . Bharti Vidyapeeth’s University, College of Ayurved, Pune, Maharashtra.2006.

 

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