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===Derivation of pramana===   

==Derivation of pramana==   

The word ‘praman’ is derived from Sanskrit verb ‘ma’ with prefix ‘pra’ where ‘ma’ dhatu means ‘to measure’<ref>Dev R.R.K., editor, (1st ed.). Shabdakalpadrum, Kand 3. Delhi: Amar Publications, 2018; 284.</ref>

The word ‘praman’ is derived from Sanskrit verb ‘ma’ with prefix ‘pra’ where ‘ma’ dhatu means ‘to measure’<ref>Dev R.R.K., editor, (1st ed.). Shabdakalpadrum, Kand 3. Delhi: Amar Publications, 2018; 284.</ref>

===Derivation of  pariksha===  

==Derivation of  pariksha==  

The word ‘pariksha’ is derived by combining two words. ‘Pari’ means ‘around’ and ‘Iksh’ menas ‘to see’.<ref>Dev R.R.K., editor, (1st ed.). Shabdakalpadrum, Kand 3. Delhi: Amar Publications, 2018; 67.</ref> Thus pariksha means to look around or to do research. Hence ‘pramanatah pariksha’ means research or examination by measurements.

The word ‘pariksha’ is derived by combining two words. ‘Pari’ means ‘around’ and ‘Iksh’ menas ‘to see’.<ref>Dev R.R.K., editor, (1st ed.). Shabdakalpadrum, Kand 3. Delhi: Amar Publications, 2018; 67.</ref> Thus pariksha means to look around or to do research. Hence ‘pramanatah pariksha’ means research or examination by measurements.

===Synonyms===  

==Synonyms==  

'''Praman and pariksha''<ref>Gangadhar Commentary on Charak Samhita Sutrasthana, Taistraishaniya Adhyaya, 11/17, reprinted 2020, Chaukhamba Sanskrit Sansthan, Varanasi, page no 70.</ref>

'''Praman and pariksha''<ref>Gangadhar Commentary on Charak Samhita Sutrasthana, Taistraishaniya Adhyaya, 11/17, reprinted 2020, Chaukhamba Sanskrit Sansthan, Varanasi, page no 70.</ref>

Pramana are described under the heading of vaada-marga. (methods of discussion). [Charak Samhita [[Vimana Sthana]] 8/ 27]. The vaada-marga are different tools or methods to establish the related facts and phenomena.

Pramana are described under the heading of vaada-marga. (methods of discussion). [Charak Samhita [[Vimana Sthana]] 8/ 27]. The vaada-marga are different tools or methods to establish the related facts and phenomena.

===Pramana in the context of ten fold assessment of patient (dashavidha pariksha):===

==Pramana in the context of ten fold assessment of patient (dashavidha pariksha):==

The word pramana is applied to denote assessment or measurement.

The word pramana is applied to denote assessment or measurement.

These constitute an examination of a person to assess normal or abnormal body constitution called ‘pramanatah pariksha’. [Cha. Sa. [[Vimana Sthana]] 8/ 94]

These constitute an examination of a person to assess normal or abnormal body constitution called ‘pramanatah pariksha’. [Cha. Sa. [[Vimana Sthana]] 8/ 94]

===Types===

==Types==

1.     Anguli pramana (measurements by fingers)

1.     Anguli pramana (measurements by fingers)

2.     Anjali Pramana (measurements by cup hallow formed by joining palms together)

2.     Anjali Pramana (measurements by cup hallow formed by joining palms together)

===Assessment criteria===

==Assessment criteria==

====1.     Anguli pramana====

===1.     Anguli pramana===

The anguli pramana of body, body parts or organs mentioned by Ayurveda scholars are as follows:

The anguli pramana of body, body parts or organs mentioned by Ayurveda scholars are as follows:

Ø  Dimensional analysis of the oldest engineered caves at the Barabar and Nagarjuni hills (dated to the Mauryan Period) has revealed that the basic length measure of one angula of that period was 1.763 cm.<ref>Balasubramanian, R. (10 September 2009). "New Insights on metrology during Maurya period". ''Current Science''. '''97'''</ref> Although recent studies suggest that the breadth of finger can be approximated as 3⁄4^th of an inch or 1⁄16^th of a foot.<ref>Noah Webster; John Walker (1830). ''American dictionary of the English language''. digit: Converse. p. 247.</ref><ref>Ronald Edward Zupko (1985). ''A dictionary of weights and measures for the British Isles: the Middle Ages to the twentieth century''. American Philosophical Society. pp. 109–10. ISBN 978-0-87169-168-2</ref>

Ø  Dimensional analysis of the oldest engineered caves at the Barabar and Nagarjuni hills (dated to the Mauryan Period) has revealed that the basic length measure of one angula of that period was 1.763 cm.<ref>Balasubramanian, R. (10 September 2009). "New Insights on metrology during Maurya period". ''Current Science''. '''97'''</ref> Although recent studies suggest that the breadth of finger can be approximated as 3⁄4^th of an inch or 1⁄16^th of a foot.<ref>Noah Webster; John Walker (1830). ''American dictionary of the English language''. digit: Converse. p. 247.</ref><ref>Ronald Edward Zupko (1985). ''A dictionary of weights and measures for the British Isles: the Middle Ages to the twentieth century''. American Philosophical Society. pp. 109–10. ISBN 978-0-87169-168-2</ref>

====2.     Anjali pramana====

===2.     Anjali pramana===

Ayurveda scholars described the volume of certain body components in anjali pramana. The quantities mentioned are their maximum normal quantity.  A study conducted in India found that the measure of one anjali for a woman is approximately 100 ml & for a man is approximately 135 ml.<ref>Gadgil, Neha & Kulkarni, Akshar. (2019). An observational study to quantify the measure of Anjali Pramana -A pilot study. 1 Neha Dattatraya Gadgil, and.</ref>

Ayurveda scholars described the volume of certain body components in anjali pramana. The quantities mentioned are their maximum normal quantity.  A study conducted in India found that the measure of one anjali for a woman is approximately 100 ml & for a man is approximately 135 ml.<ref>Gadgil, Neha & Kulkarni, Akshar. (2019). An observational study to quantify the measure of Anjali Pramana -A pilot study. 1 Neha Dattatraya Gadgil, and.</ref>

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===Application of pramana in diagnosis of various diseases:===

==Application of pramana in diagnosis of various diseases:==

The equilibrium of dosha, dhatu (body tissues) and mala (metabolic waste of body) is responsible for keeping a person healthy. Any derangement in pramana leads to disorders. Example depletion of rasa dhatu (plasma) causes precordial pain, palpitation, sense of emptiness and thirst, whereas increase in pramana of rasa dhatu may result in nausea and salivation.

The equilibrium of dosha, dhatu (body tissues) and mala (metabolic waste of body) is responsible for keeping a person healthy. Any derangement in pramana leads to disorders. Example depletion of rasa dhatu (plasma) causes precordial pain, palpitation, sense of emptiness and thirst, whereas increase in pramana of rasa dhatu may result in nausea and salivation.

It’s difficult to understand how the ancient Ayurveda scholars estimated the volume of body fluids. Ayurveda scholars had an understanding of qualities of substances based on their panchabhautika composition (the five universal elements or panchamahabhuta). The proportion or volume of a substance in most cases has a direct relationship with its qualities. For example, proportion of water present in a substance decides moisture content or dryness in it. In the absence of advanced medical techniques, how the volume of body fluids was measured in ancient times is a topic for research. Most probably the Ayurveda scholars estimated the qualities of fluid in body and thereafter assessed its volume inside the body.

It’s difficult to understand how the ancient Ayurveda scholars estimated the volume of body fluids. Ayurveda scholars had an understanding of qualities of substances based on their panchabhautika composition (the five universal elements or panchamahabhuta). The proportion or volume of a substance in most cases has a direct relationship with its qualities. For example, proportion of water present in a substance decides moisture content or dryness in it. In the absence of advanced medical techniques, how the volume of body fluids was measured in ancient times is a topic for research. Most probably the Ayurveda scholars estimated the qualities of fluid in body and thereafter assessed its volume inside the body.

===Contemporary views:===  

==Contemporary views:==  

Anthropometric measurements require understanding of anthropometric landmarks some of which can be shown in the figure:

Anthropometric measurements require understanding of anthropometric landmarks some of which can be shown in the figure:

'''8.  Soft metric tape:'''This tool is used for measuring girth dimensions.

'''8.  Soft metric tape:'''This tool is used for measuring girth dimensions.

===Importance of concept===

==Importance of concept==

====In determining life span====

===In determining life span===

Any deviation from the normal measurements possibly points towards an anatomical or genetical anomaly, which may consequently reduce the life span of the person. According to Ayurveda scholars, a person with tip of the nose raised lives a maximum life span of 70 years [Su. Sa. [[Sutra Sthana]] 35/8]; and a person whose phalanges are short, penis enormously bigger positioned upwards from its normal place, nose higher and gums visible while laughing or talking lives a maximum life span of 25 years only. [Su. Sa.  [[Sutra Sthana|Sthana]] 35/9-11] Contrarily, if a man or woman, endowed with standard body and body organ measurements, then he attains long life and prosperity [Su. Sa. [[Sutra Sthana]] 35/16-17]. It is also postulated that if the height of person in standing position is equal to the arm span of that person, than this person is said to possess sama sharira (body with optimum proportion of measurements of body parts). A sama sharira person is endowed with longevity, strength, ojas (the essence of all seven dhatus or tissues, that is vital for life), happiness, power, wealth, and virtues. [Cha. Sa. [[Sutra Sthana|Viman Sthana]] 8/117]

Any deviation from the normal measurements possibly points towards an anatomical or genetical anomaly, which may consequently reduce the life span of the person. According to Ayurveda scholars, a person with tip of the nose raised lives a maximum life span of 70 years [Su. Sa. [[Sutra Sthana]] 35/8]; and a person whose phalanges are short, penis enormously bigger positioned upwards from its normal place, nose higher and gums visible while laughing or talking lives a maximum life span of 25 years only. [Su. Sa.  [[Sutra Sthana|Sthana]] 35/9-11] Contrarily, if a man or woman, endowed with standard body and body organ measurements, then he attains long life and prosperity [Su. Sa. [[Sutra Sthana]] 35/16-17]. It is also postulated that if the height of person in standing position is equal to the arm span of that person, than this person is said to possess sama sharira (body with optimum proportion of measurements of body parts). A sama sharira person is endowed with longevity, strength, ojas (the essence of all seven dhatus or tissues, that is vital for life), happiness, power, wealth, and virtues. [Cha. Sa. [[Sutra Sthana|Viman Sthana]] 8/117]

====In preservation and promotion of health====

===In preservation and promotion of health===

*Pramanataha pariksha is helpful in identification of four (too tall, too dwarf, too fat or too emaciated) among eight of the undesirable constituents. [Cha. Sa. [[Sutra Sthana]] 21/3] A person aspiring good health shall make possible efforts to reach close to the standards measurements. For example, reducing weight for an obese person is possible by suitable diet and exercise. However, increasing height of a dwarf adult or decreasing height in tall person is not possible by medical management.  

*Pramanataha pariksha is helpful in identification of four (too tall, too dwarf, too fat or too emaciated) among eight of the undesirable constituents. [Cha. Sa. [[Sutra Sthana]] 21/3] A person aspiring good health shall make possible efforts to reach close to the standards measurements. For example, reducing weight for an obese person is possible by suitable diet and exercise. However, increasing height of a dwarf adult or decreasing height in tall person is not possible by medical management.  

*Pramanatah pariksha is helpful in determining Basal Metabolic Index (BMI). The normal range for BMI is 19–24·9 kg/, overweight is 25–29·9 kg/ , and obesity ≥ 30 kg/ <ref>Xavier Pi-Sunyer, F. (2000). Obesity: Criteria and classification. Proceedings of the Nutrition Society, 59(4), 505-509. doi:10.1017/S0029665100000732</ref>

*Pramanatah pariksha is helpful in determining Basal Metabolic Index (BMI). The normal range for BMI is 19–24·9 kg/, overweight is 25–29·9 kg/ , and obesity ≥ 30 kg/ <ref>Xavier Pi-Sunyer, F. (2000). Obesity: Criteria and classification. Proceedings of the Nutrition Society, 59(4), 505-509. doi:10.1017/S0029665100000732</ref>

====In relation to anthropometry====

===In relation to anthropometry===

Pramantaha pariksha is like anthropometry (the '''systematic measurement of th'''e physical properties of the human body, primarily dimensional descriptors of body size and shape). Anthropometry, along with physical measurement of human body, also takes into consideration the body weight, body parts, human physical appearance and physical attractiveness.   

Pramantaha pariksha is like anthropometry (the '''systematic measurement of th'''e physical properties of the human body, primarily dimensional descriptors of body size and shape). Anthropometry, along with physical measurement of human body, also takes into consideration the body weight, body parts, human physical appearance and physical attractiveness.   

====Individualistic approach====

===Individualistic approach===

Anguli pramana of body and body parts of an individual is determined by measuring the utsedha (height), ayama (length), vistara (breadth) by taking his own finger’s (swaanguli) breadth, as unit of measurement. The breadth of one finger is counted as one angula, and so on. The anguli pramana is used for measurement of length, breadth, height, circumference, etc, in contrast to anjali pramana, which is the measurement of volume. One anjali pramana is the maximum volume of a liquid that can be held in the cup formed by joining of the two palms of an individual together. This volume is one anjali for that particular individual (swa-anjali). Measurements of body and body parts depend on sex, race, geographical location, nutrition, exposure to disease, genetics and physical activity. Hence swa-angula and swa-anjali pramana give individualistic information rather than a generalized one. These pramana do not vary according to above mentioned conditions.

Anguli pramana of body and body parts of an individual is determined by measuring the utsedha (height), ayama (length), vistara (breadth) by taking his own finger’s (swaanguli) breadth, as unit of measurement. The breadth of one finger is counted as one angula, and so on. The anguli pramana is used for measurement of length, breadth, height, circumference, etc, in contrast to anjali pramana, which is the measurement of volume. One anjali pramana is the maximum volume of a liquid that can be held in the cup formed by joining of the two palms of an individual together. This volume is one anjali for that particular individual (swa-anjali). Measurements of body and body parts depend on sex, race, geographical location, nutrition, exposure to disease, genetics and physical activity. Hence swa-angula and swa-anjali pramana give individualistic information rather than a generalized one. These pramana do not vary according to above mentioned conditions.

===Application of knowledge of pramanatah pariksha in contemporary practices===

==Application of knowledge of pramanatah pariksha in contemporary practices==

Surgeons use pramanatah pariksha in determining important landmarks in person’s body. By knowing the distance of key areas on the surgeon’s hand, he can measure critical distances, saving time.

Surgeons use pramanatah pariksha in determining important landmarks in person’s body. By knowing the distance of key areas on the surgeon’s hand, he can measure critical distances, saving time.

'''2:''' A measurement of 2 fingers between the floor of the mandible and the thyroid notch on the anterior neck determines the location of the larynx relative to the base of the tongue.<ref>Sharma S, Patel R, Hashmi MF, et al. 3-3-2 Rule. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK493235/</nowiki></ref>

'''2:''' A measurement of 2 fingers between the floor of the mandible and the thyroid notch on the anterior neck determines the location of the larynx relative to the base of the tongue.<ref>Sharma S, Patel R, Hashmi MF, et al. 3-3-2 Rule. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: <nowiki>https://www.ncbi.nlm.nih.gov/books/NBK493235/</nowiki></ref>

====In diagnosis and prognosis====

===In diagnosis and prognosis===

Pramana is mentioned as one of the ten investigations regarding patients, and it can be used for estimation of strength (physical, psychological, immunological) of patients. [Cha. Sa. [[Sutra Sthana|Vimana Sthana]] 8/94].

Pramana is mentioned as one of the ten investigations regarding patients, and it can be used for estimation of strength (physical, psychological, immunological) of patients. [Cha. Sa. [[Sutra Sthana|Vimana Sthana]] 8/94].

====In management of diseases====

===In management of diseases===

No two individual are completely alike physically, physiologically, psychologically, or in vital reactions, and thus the dose of drugs varies from person to person. A child or a person with lower body stature requires less dose of a drug as compared to an adult or person with big body stature. The volume of anjali varies in proportion with the size of the individual. Ancient scholars utilized this factor. Example, maximum oral dose of peeluparnyadi oil is mentioned as 1 anjali [Cha. Sa. [[Sutra Sthana|Chikitsa Sthana]] 27/42].  If two persons, one of smaller body stature (hence smaller volume in his 1 anjali) and one of bigger body stature (hence bigger volume in his 1 anjali) consume this oil of volume of their 1 anjali pramana, then automatically the person with smaller volume will consume smaller quantity of oil and person of bigger stature will consume more quantity of oil. Some other drugs whose doses, or the doses of their composition drugs are mentioned in anjali pramana are amalatas (''Cassia'' ''fistula''). [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 8/9], aragvadhadi arishta [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 8/15] and lodhra sura (beverage prepared from ''Symplocos racemosa'') [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 9/9].

No two individual are completely alike physically, physiologically, psychologically, or in vital reactions, and thus the dose of drugs varies from person to person. A child or a person with lower body stature requires less dose of a drug as compared to an adult or person with big body stature. The volume of anjali varies in proportion with the size of the individual. Ancient scholars utilized this factor. Example, maximum oral dose of peeluparnyadi oil is mentioned as 1 anjali [Cha. Sa. [[Sutra Sthana|Chikitsa Sthana]] 27/42].  If two persons, one of smaller body stature (hence smaller volume in his 1 anjali) and one of bigger body stature (hence bigger volume in his 1 anjali) consume this oil of volume of their 1 anjali pramana, then automatically the person with smaller volume will consume smaller quantity of oil and person of bigger stature will consume more quantity of oil. Some other drugs whose doses, or the doses of their composition drugs are mentioned in anjali pramana are amalatas (''Cassia'' ''fistula''). [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 8/9], aragvadhadi arishta [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 8/15] and lodhra sura (beverage prepared from ''Symplocos racemosa'') [Cha. Sa. [[Sutra Sthana|Kalpa Sthana]] 9/9].

===Current researches===

==Current researches==

1.     Anguli pramana as a tool for assessment of health status with reference to body mass index (B.M.I.):

1.     Anguli pramana as a tool for assessment of health status with reference to body mass index (B.M.I.):

*    Parshni (Heels) [length] [breadth]

*    Parshni (Heels) [length] [breadth]

===Future scope of research:===

==Future scope of research:==

There is a wide scope of research in perspective of pramantah pariksha. Some of these topics are as follows:

There is a wide scope of research in perspective of pramantah pariksha. Some of these topics are as follows: