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{{#seo:

{{#seo:

|title=Yasyashyavanimitta

|title=Yasyashyavanimittiyam Indriyam Adhyaya

|titlemode=append

|titlemode=append

|keywords=Arishta, Vikara, Bala, Marana, Jivita, change in eye color, grave diseases, death

|keywords=Arishta, Vikara, Bala, Marana, Jivita, change in eye color, grave diseases, death

<big>'''Abstract'''</big>

<big>'''Abstract'''</big>

<div style="text-align:justify;">

<div style="text-align:justify;">

This chapter, ([[Yasyashyavanimitta]]), includes various signs and symptoms related to imminent death that start with changes in color of eyes and identified in a patient as well as in healthy individuals. It has been emphasized that physician should have knowledge of all [[Arishta]] [[Lakshana]] (near death signs) described in this chapter. Clinically only few of them manifest at a stage in an individual and hence the person must be examined properly. Certain features related with imminent death are described which when associated with any disease indicate grave prognosis. Complications which indicate the incurability of a disease are scientific and are seen till date. Description of eight grave diseases and symptoms of approaching death are other two important topics which add value to this chapter. These signs are important in palliative care. Therefore, knowledge of such predictive signs and symptoms is an integral part of medical science.  

This chapter, ([[Yasyashyavanimittiyam Indriyam Adhyaya]]), includes various signs and symptoms related to imminent death that start with changes in color of eyes and identified in a patient as well as in healthy individuals. It has been emphasized that physician should have knowledge of all [[Arishta]] [[Lakshana]] (near death signs) described in this chapter. Clinically only few of them manifest at a stage in an individual and hence the person must be examined properly. Certain features related with imminent death are described which when associated with any disease indicate grave prognosis. Complications which indicate the incurability of a disease are scientific and are seen till date. Description of eight grave diseases and symptoms of approaching death are other two important topics which add value to this chapter. These signs are important in palliative care. Therefore, knowledge of such predictive signs and symptoms is an integral part of medical science.  

'''Keywords:''' [[Arishta]], Vikara, Bala, Marana, Jivita,'' change in eye color, grave diseases, death.

'''Keywords:''' [[Arishta]], Vikara, Bala, Marana, Jivita,'' change in eye color, grave diseases, death.

</div>

</div>

{{Infobox

{{Infobox

|title = Yasyashyavanimitta

|title = Yasyashyavanimittiyam Indriyam Adhyaya

|label1 = Section/Chapter

|label1 = Section/Chapter

|data1 = [[Indriya Sthana]] Chapter 9

|data1 = [[Indriya Sthana]] Chapter 9

|label3= Succeeding Chapter

|label3= Succeeding Chapter

|data3 = [[Sadyomaraneeya]]

|data3 = [[Sadyomaraneeyam Indriyam Adhyaya]]

|label5 = Other Sections

|label5 = Other Sections

|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

== Introduction ==

== Introduction ==

<div style="text-align:justify;">

<div style="text-align:justify;">

[[Yasyashyavanimitta]] refers to color changes in eyes. In the first four chapters of [[Indriya Sthana]], conditions related to ''Indriya'' or five sense organs have been described. In those chapters, derangements in functional aspects of ''indriyas'' have been given importance and Atreya told to examine them by the help of ''Anumana Pramana''. In this chapter certain anatomical changes or changes which can be examined by ''Pratyaksha Pramana''(direct observation) are mentioned which are equally important indicators of life span.  

[[Yasyashyavanimittiyam Indriyam Adhyaya]] refers to color changes in eyes. In the first four chapters of [[Indriya Sthana]], conditions related to ''Indriya'' or five sense organs have been described. In those chapters, derangement in functional aspects of ''indriyas'' have been given importance and Atreya told to examine them by the help of ''Anumana Pramana''. In this chapter certain anatomical changes or changes which can be examined by ''Pratyaksha Pramana''(direct observation) are mentioned which are equally important indicators of life span.  

Nowadays, importance is given to the identification of approaching death. Educational and training programs are organized to educate family members/relatives/attendants so that patient care is not neglected near death and this specialized field is commonly known as Palliative care. The World Health Organization (WHO) defines palliative care as 'an approach that improves the quality of life of individuals and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual'.<ref> Available from: http://www.who.int/hiv/topics/palliative/PalliativeCare/en/ </ref>

Nowadays, importance is given to the identification of approaching death. Educational and training programs are organized to educate family members/relatives/attendants so that patient care is not neglected near death and this specialized field is commonly known as Palliative care. The World Health Organization (WHO) defines palliative care as 'an approach that improves the quality of life of individuals and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psycho-social and spiritual'.<ref> Available from: http://www.who.int/hiv/topics/palliative/PalliativeCare/en/ </ref>

The aging of the population, with the numerous chronic debilitating and malignant conditions associated with growing older, has focused attention on palliative care. The terminal state is an integral process and a time to reconcile differences so that patient and family may accept death with a minimum of physical, spiritual, and psychosocial anguish.<ref> Rousseau P., Hospice and palliative care, Dis Mon. 1995 Dec;41(12):779-842. </ref> Hospice care is a specialized philosophy and system of care for the terminally ill patient that accepts death in an affirmative way and provides palliative care and emotional support to dying patients and their families.<ref> Plumb JD, Ogle KS., Hospice care, Prim Care. 1992 Dec;19(4):807-20. </ref> Hospice and palliative care philosophy lays emphasis on relieving suffering and improving quality of life at the end of life in order to permit experiences that will have positive meaning. The role of the physician is central in providing this care.<ref> Sethi S. Hospice: an underutilized resource, J Okla State Med Assoc. 2001 Mar;94(3):79-84. </ref> When recovery is uncertain it is better to discuss this rather than giving false hope to the patient and family. This is generally perceived as a strength in the doctor-patient relationship and helps to build trust.<ref> John Ellershaw, Care of the dying patient: the last hours or days of life, BMJ. 2003 January 4; 326(7379): 30–34. </ref> Charak also supports this view and states that those near death should not be treated. Thus it becomes important that physician should be well trained in identifying features of impending death.

The aging of the population, with the numerous chronic debilitating and malignant conditions associated with growing older, has focused attention on palliative care. The terminal state is an integral process and a time to reconcile differences so that patient and family may accept death with a minimum of physical, spiritual, and psycho-social anguish.<ref> Rousseau P., Hospice and palliative care, Dis Mon. 1995 Dec;41(12):779-842. </ref> Hospice care is a specialized philosophy and system of care for the terminally ill patient that accepts death in an affirmative way and provides palliative care and emotional support to dying patients and their families.<ref> Plumb JD, Ogle KS., Hospice care, Prim Care. 1992 Dec;19(4):807-20. </ref> Hospice and palliative care philosophy lays emphasis on relieving suffering and improving quality of life at the end of life in order to permit experiences that will have positive meaning. The role of the physician is central in providing this care.<ref> Sethi S. Hospice: an underutilized resource, J Okla State Med Assoc. 2001 Mar;94(3):79-84. </ref> When recovery is uncertain it is better to discuss this rather than giving false hope to the patient and family. This is generally perceived as a strength in the doctor-patient relationship and helps to build trust.<ref> John Ellershaw, Care of the dying patient: the last hours or days of life, BMJ. 2003 January 4; 326(7379): 30–34. </ref> Charak also supports this view and states that those near death should not be treated. Thus it becomes important that physician should be well trained in identifying features of impending death.

In order to care for dying patients it is essential to “identify dying”. This aim can be attained by applying the knowledge given in this chapter. Presently to predict prognostic value few tools have been designed. Most widely-used prognostic tools is the Palliative Performance Scale (PPS) which has been studied primarily in inpatient settings and in patients with cancer. Few researches are on going to develop tools for prognosis in other diseases also.<ref> Harrold J, Rickerson E, Carroll JT, McGrath J, Morales K, Kapo J, Casarett D., Is the palliative performance scale a useful predictor of mortality in a heterogeneous hospice population?, J Palliat Med. 2005 Jun;8(3):503-9. </ref> Research can be done to develop a scale based on parameters described in Ayurvedic ''Arishta Vigyana'' and this chapter can also contribute a lot in making such kind of tool.

In order to care for dying patients it is essential to “identify dying”. This aim can be attained by applying the knowledge given in this chapter. Presently to predict prognostic value few tools have been designed. Most widely-used prognostic tools is the Palliative Performance Scale (PPS) which has been studied primarily in inpatient settings and in patients with cancer. Few researches are on going to develop tools for prognosis in other diseases also.<ref> Harrold J, Rickerson E, Carroll JT, McGrath J, Morales K, Kapo J, Casarett D., Is the palliative performance scale a useful predictor of mortality in a heterogeneous hospice population?, J Palliat Med. 2005 Jun;8(3):503-9. </ref> Research can be done to develop a scale based on parameters described in Ayurvedic ''Arishta Vigyana'' and this chapter can also contribute a lot in making such kind of tool.

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We shall now expound the chapter "Yasyashyavanimitta" (Signs and Symptoms useful for Palliative Care among Patients approaching Death). Thus said Lord Atreya. [1-2]

We shall now expound the chapter "Yasyashyavanimittiyam Indriyam Adhyaya" (Signs and Symptoms useful for Palliative Care among Patients approaching Death). Thus said Lord Atreya. [1-2]

Note: The chapter deals with sensorial prognosis from the observation of the dark brown color of the eye of a man.  

Note: The chapter deals with sensorial prognosis from the observation of the dark brown color of the eye of a man.