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* [[Gomaychurniya]], [[Anujyoti]], [[Kathamanasharireeya]], [[Avakshirsheeya]] and [[Sadyomarneeya]] 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.  

* [[Gomaychurniya]], [[Anujyoti]], [[Kathamanasharireeya]], [[Avakshirsheeya]] and [[Sadyomarneeya]] 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.  

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

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.

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 ([[Charaka 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.

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 ([[Charaka 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.

Palliative care to the terminally ill/dying patients is provided today in all communities across the world. It is a specialized field of healthcare that encompasses educational and training programs organized to educate family members/relatives/attendants to ensure patient care is not neglected especially in terminal cases. 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'.  

Palliative care to the terminally ill/dying patients is provided today in all communities across the world. It is a specialized field of healthcare that encompasses educational and training programs organized to educate family members/relatives/attendants to ensure patient care is not neglected especially in terminal cases. 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'.  

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. 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. 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. 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 strength in the doctor-patient relationship and helps to build trust. Charaka 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.

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 time to reconcile differences so that patient and family may accept death with a minimum of physical, spiritual, and psychosocial anguish. 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. 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. 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 strength in the doctor-patient relationship and helps to build trust. Charaka 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 these chapters. Presently to predict prognostic value, few tools have been designed. Most widely-used prognostic tool is the Palliative Performance Scale (PPS) which has been studied primarily in inpatient settings and in patients with cancer. Few researches are ongoing to develop tools for prognosis in other diseases also.  Research can be done to develop a scale based on parameters described in Ayurvedic Arishta Vigyana and these chapters 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 these chapters. Presently to predict prognostic value, few tools have been designed. Most widely-used prognostic tool is the Palliative Performance Scale (PPS) which has been studied primarily in inpatient settings and in patients with cancer. Few researches are ongoing to develop tools for prognosis in other diseases also.  Research can be done to develop a scale based on parameters described in Ayurvedic Arishta Vigyana and these chapters can also contribute a lot in making such kind of tool.

Before going into the details of these chapters, an overview of concepts laid down in previous chapters of Charaka Samhita, regarding the importance of sense organs (Indriya),in  constitution and dissolution of life will be helpful to understand this process.

Before going into the details of these chapters, an overview of concepts laid down in previous chapters of Charaka Samhita, regarding the importance of sense organs (Indriya),in  constitution and dissolution of life will be helpful to understand this process.