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|title=Pratyaksha pramana

|title=Pratyaksha pramana

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|description='Pratyaksha' means direct perception and 'pramana' means the tools for acquiring knowledge. Pratyaksha pramana is the most important method to acquire medical knowledge by direct perception

|description='Pratyaksha' means direct perception and 'pramana' means the tools for acquiring knowledge. Pratyaksha pramana is the most important method to acquire medical knowledge by direct perception

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The word ‘pratyaksha pramana’ means first hand evidence. Pramana denotes sensory perception. Here the individual gains knowledge through the medium of sense organs. It is considered as the most primary and important tool for diagnosis, prognosis, inference, conclusion and treatment of the diseases according to [[Ayurveda]]. It is the means of acquiring knowledge through the medium of sense organs and self-experiences. The direct clinical examination of patient (pratyaksha pariksha) is vital for diagnosis of disease. It also involves the examination and assessment of complications ([[upadrava]]), and prognosis or impending death ([[arishta]]). The pacifying factors ([[upashaya]]) and aggravating factors ([[anupashaya]]) are observed by direct examination. Thus it forms the basis for anumana pramana. [Cha.Sa.[[Sutra Sthana]] 11/21]

<p style="text-align:justify;">The word ‘pratyaksha pramana’ means first hand evidence. Pramana denotes sensory perception. Here the individual gains knowledge through the medium of sense organs. It is considered as the most primary and important tool for diagnosis, prognosis, inference, conclusion and treatment of the diseases according to [[Ayurveda]]. It is the means of acquiring knowledge through the medium of sense organs and self-experiences. The direct clinical examination of patient (pratyaksha pariksha) is vital for diagnosis of disease. It also involves the examination and assessment of complications ([[upadrava]]), and prognosis or impending death ([[arishta]]). The pacifying factors ([[upashaya]]) and aggravating factors ([[anupashaya]]) are observed by direct examination. Thus it forms the basis for anumana pramana. [Cha.Sa.[[Sutra Sthana]] 11/21] </p>

{{Infobox

{{Infobox

|label2 = Authors

|label2 = Authors

|data2 = Bojani M. K. ¹, Joglekar A. A.²  

|data2 = Bhojani M. K. ¹, Joglekar A. A.²  

|label3 = Reviewers

|label3 = Reviewer

|data3 = Basisht G.³,  

|data3 = [[Gopal Basisht|Basisht G.]]³,  

|label4 = Editors  

|label4 = Editors  

|data4 = Deole Y.S.³ Basisht G.³

|data4 = [[Yogesh Deole|Deole Y.S.]]⁴ [[Gopal Basisht|Basisht G.]]³

|label5 = Affiliations

|label5 = Affiliations

|data5 = ¹ Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi

|data5 = ¹ Department of Sharira Kriya, All India Institute of Ayurveda, New Delhi

²Department of Samhita Siddhant, All India Institute of Ayurveda, New Delhi

²Department of Samhita Siddhant, All India Institute of Ayurveda, New Delhi

³ [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar,India

³ Rheumatologist, Orlando, Florida, U.S.A.

 

⁴ Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India

|label6 = Correspondence emails

|label6 = Correspondence emails

|data6 = carakasamhita@gmail.com

|data6 = meera.samhita@aiia.gov.in,

carakasamhita@gmail.com

|label7 = Date of first publication:

|label7 = Publisher

|data7 = January 20, 2022

|data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India

|label8 = DOI

|label8 = Date of first publication:

|data8 = under process

 

|label9 = DOI

|data9 = 10.47468/CSNE.2022.e01.s09.081

}}

}}

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

==Classification of knowledge obtained through pratyaksha==

==Classification of knowledge obtained through pratyaksha==

The knowledge obtained through pratyaksha can be full-fledged knowledge of an object with all its attributes (savikalpa) or Primary or non-determinate or non-conceptual perception (nirvikalpa). Savikalpa pratyaksha can again be divided as Direct (laukika) or Indirect (alaukika).<ref>Pratyaksha Pramana: Knowledge Perception Through Sense Organs [Internet]. Easy Ayurveda. 2017 [cited 2021 Nov 30]. Available from: https://www.easyayurveda.com/2017/04/20/pratyaksha-pramana/</ref>

The knowledge obtained through pratyaksha can be full-fledged knowledge of an object with all its attributes (savikalpa) or Primary or non-determinate or non-conceptual perception (nirvikalpa). Savikalpa pratyaksha can again be divided as Direct (laukika) or Indirect (alaukika).<ref name= easy> Pratyaksha Pramana: Knowledge Perception Through Sense Organs [Internet]. Easy Ayurveda. 2017 [cited 2021 Nov 30]. Available from: https://www.easyayurveda.com/2017/04/20/pratyaksha-pramana </ref>

 

As the [[indriya]] play a key role in obtaining the knowledge in case of pratyaksha pramana acharya Chakrapani has rightfully described the six types of indriya-arthasannikarsha (Conjugation or relation of sense organs and object of knowledge) given as below  [Chakrapani on Cha.Sa.[[Sutra Sthana]] 11/20]

As the [[indriya]] play a key role in obtaining the knowledge in case of pratyaksha pramana acharya Chakrapani has rightfully described the six types of indriya-arthasannikarsha (Conjugation or relation of sense organs and object of knowledge) given as below  [Chakrapani on Cha.Sa.[[Sutra Sthana]] 11/20]

#Samvaya - The relation between sound (shabda) and ear (karna) can be understood with this sannikarsha. This type of conjugation is used to comprehend the relationship between [[akasha mahabhuta]] and shabda [[guna]]. The logic behind the sensation of sound is explained by this type of sannikarsha.

#Samvaya - The relation between sound (shabda) and ear (karna) can be understood with this sannikarsha. This type of conjugation is used to comprehend the relationship between [[akasha mahabhuta]] and shabda [[guna]]. The logic behind the sensation of sound is explained by this type of sannikarsha.

#Samveta Samvaya- Here the quality of the sound (shabda[[guna]]) is understood as well. The knowledge about the quality of shabda or shabdatwa can be understood by this type of sannikarsha.  For example, the kshamatwa , karkashatwa of voice is denoted by this type of sannikarsha.

#Samveta Samvaya- Here the quality of the sound (shabda[[guna]]) is understood as well. The knowledge about the quality of shabda or shabdatwa can be understood by this type of sannikarsha.  For example, the kshamatwa , karkashatwa of voice is denoted by this type of sannikarsha.

#Visheshya Visheshana Abhaava- The knowledge of unknown object is made with the help of this sannikarsha. For instance, the void or free space denotes the absence of solid object at that place. For instance, the presence of normalcy in body tissues (dhatusamya) or arogyalakshana denotes the absence of disease ([[roga]]).

#Visheshya Visheshana Abhaava- The knowledge of unknown object is made with the help of this sannikarsha. For instance, the void or free space denotes the absence of solid object at that place. For instance, the presence of normalcy in body tissues (dhatu samya) or arogyalakshana denotes the absence of disease ([[roga]]).

==Process of obtaining knowledge==  

==Process of obtaining knowledge==  

'''3) Visual inspection (darshana or chakshushya pratyaksha)'''

'''3) Visual inspection (darshana or chakshushya pratyaksha)'''

Through the medium of visual perception (chakshu indriya) or netra, the complexion (varna), shape, location, appearance, form (sansthana), size or measurements (pramana), altered complexion (chhaya), normalcy (prakriti), abnormal characteristics (vikruti), good nourished built (upachaya), malnourished built (apachaya) can be assessed. The advent of investigation techniques like endoscopy, proctoscopy, fundoscopy, colonoscopy, X-ray techniques ultrasonography, microscopy, electron microscopy, CT (computer tomography) scans and MRI (magnetic resonance imaging) have made the visual inspection (darshana pariksha) more precise.

Through the medium of visual perception (chakshu indriya) or netra, the complexion (varna), shape, location, appearance, form (sansthana), size or measurements (pramana), altered complexion (chhaya), normalcy ([[prakriti]]), abnormal characteristics ([[vikriti]]), good nourished built (upachaya), malnourished built (apachaya) can be assessed. The advent of investigation techniques like endoscopy, proctoscopy, fundoscopy, colonoscopy, X-ray techniques ultrasonography, microscopy, electron microscopy, CT (computer tomography) scans and MRI (magnetic resonance imaging) have made the visual inspection (darshana pariksha) more precise.

   

   

Visual inspection is done to assess the abnormalities like pallor, cyanosis, oedema, petechial hemorrhage, skin lesions, deformities etc.

Visual inspection is done to assess the abnormalities like pallor, cyanosis, oedema, petechial hemorrhage, skin lesions, deformities etc.

'''4) Gustation (rasanapariksha)'''

'''4) Gustation (rasanapariksha)'''

This examination is applicable for the purpose of organoleptic and taste threshold studies.  In clinical practice, this can’t be done by physician himself. It is done indirectly either by interrogation or by inspection/inference. It is not subjected to direct perception by the examiner but can be ascertained by inference (anumana pramana). Following phenomena can be observed by means of this method-

This examination is applicable for the purpose of organoleptic and taste threshold studies.  In clinical practice, this can’t be done by physician himself. It is done indirectly either by interrogation or by inspection/inference. It is not subjected to direct perception by the examiner but can be ascertained by inference ([[anumana pramana]]). Following phenomena can be observed by means of this method-

#Yuka sansparshena shareeravairasya: Repulsion of parasites or organisms like lice from the patient’s body indicates the impairment of body physiology resulting in the attraction or repulsion of the insects from the body.  

#Yuka sansparshena shareeravairasya: Repulsion of parasites or organisms like lice from the patient’s body indicates the impairment of body physiology resulting in the attraction or repulsion of the insects from the body.  

#Makshikopasarpanena shariramadhurya: Attraction of flies towards patient indicates excessive sweetness (atimadhurya) in the body

#Makshikopasarpanena shariramadhurya: Attraction of flies towards patient indicates excessive sweetness (atimadhurya) in the body

#Lohitapitta sandeha: The differentiation between the vitiated and pure blood is done by this technique. It is also indicated in the differential diagnosis of conditions like bleeding disorders (raktapitta). To determine the nature of the blood, whether pure or vitiated, it should be fed to dog or crows. Acceptance or consumption of blood indicates purity, while rejection refers to impurity.  

#Lohitapitta sandeha: The differentiation between the vitiated and pure blood is done by this technique. It is also indicated in the differential diagnosis of conditions like bleeding disorders ([[raktapitta]]). To determine the nature of the blood, whether pure or vitiated, it should be fed to dog or crows. Acceptance or consumption of blood indicates purity, while rejection refers to impurity.  

#Aruchi, aasyavairasya: The impairment of taste of the patient can be assessed by the method of interrogation.  

#Aruchi, aasyavairasya: The impairment of taste of the patient can be assessed by the method of interrogation.  

#Mutre pippilikaabhisarpana: As indicated in diabetes with obstinate urinary disorders ([[prameha]]), this refers to the excessive sweetness in urine ([[mutra]]) and body.

#Mutre pippilikaabhisarpana: As indicated in diabetes with obstinate urinary disorders ([[prameha]]), this refers to the excessive sweetness in urine ([[mutra]]) and body.

===As a tool for teaching and learning methodology===

===As a tool for teaching and learning methodology===

Pratyakshapramana, being direct perception and experiential type of knowledge, has wide application for both learning and teaching of various concepts of [[Ayurveda]]. One who is able to attain both practical and theoretical knowledge becomes successful physician. [Su.Sa.Sharira Sthana 5/48]<ref name=Susruta/> Thus, a surgeon should dissect the human cadaver to know anatomical aspects of every organ in the body before performing surgeries.  Mere theoretical knowledge cannot  be successful in treatment of the patient and can tend to cause potential harm to the health of patient. [Su.Sa.Sutra Sthana 3/48]<ref name=Susruta/> The importance of practical knowledge of the physician is highlighted. Extensive practical experience (drishtakarma), proficiency in performing different types of procedures (kriyavana) are important qualities of a physician (Vaidya). [Cha.Sa. [[Sutra Sthana]] 9/4-6] The education system explained in [[Ayurveda]] is largely based on the direct observational knowledge obtained through the medium of pratyakshapramana. Thus, teaching of [[Ayurveda]] and its principles should be based on the practical application of the concepts. The effect of treatment on the patients, the conditions like [[dosha]]-avastha, vyadhi- avastha should be observed by the students of [[Ayurveda]] themselves to acquire complete knowledge of [[Ayurveda]]. This method can be correlated with the psychomotor domain of the bloom’s taxonomy.<ref>???</ref>

Pratyakshapramana, being direct perception and experiential type of knowledge, has wide application for both learning and teaching of various concepts of [[Ayurveda]]. One who is able to attain both practical and theoretical knowledge becomes successful physician. [Su.Sa.Sharira Sthana 5/48]<ref name=Susruta/> Thus, a surgeon should dissect the human cadaver to know anatomical aspects of every organ in the body before performing surgeries.  Mere theoretical knowledge cannot  be successful in treatment of the patient and can tend to cause potential harm to the health of patient. [Su.Sa.Sutra Sthana 3/48]<ref name=Susruta/> The importance of practical knowledge of the physician is highlighted. Extensive practical experience (drishtakarma), proficiency in performing different types of procedures (kriyavana) are important qualities of a physician (Vaidya). [Cha.Sa. [[Sutra Sthana]] 9/4-6] The education system explained in [[Ayurveda]] is largely based on the direct observational knowledge obtained through the medium of pratyakshapramana. Thus, teaching of [[Ayurveda]] and its principles should be based on the practical application of the concepts. The effect of treatment on the patients, the conditions like [[dosha]]-avastha, vyadhi- avastha should be observed by the students of [[Ayurveda]] themselves to acquire complete knowledge of [[Ayurveda]]. This method can be correlated with the psychomotor domain of the bloom’s taxonomy.<ref name= Bhalerao> Bhalerao S, Ranade A, Vaidya ADB. Bloom’s taxonomy reiterates Pramana. Journal of Ayurveda and Integrative Medicine. 2017 Jan 1;8(1):56–7.</ref>

===As research tool===

===As research tool===

==Contemporary approach==

==Contemporary approach==

It is believed that the physicians that are well versed with the art of physical examination are more likely to make correct diagnosis. Thus, the direct observation made by the examining physician plays key role in diagnosis and treatment. With the advent of advancement in the field of diagnostic technologies, patient management has been revolutionised. The invention of various radiological and imaging techniques like X-ray, MRI, CT Scan, Angiography, USG and Doppler, endoscopy, laparoscopy techniques has changed the face of modern medicine. These all help to assess and witness the internal human pathology that otherwise can escape the physical examination. These are the examples of extended application of pratyakshapramana as they help to visualize the body mechanism. The development pertaining to interactive learning and teaching techniques is also an application of pratyakshapramana. The practical or hands on sessions in different workshops are examples of the same.  

It is believed that the physicians that are well versed with the art of physical examination are more likely to make correct diagnosis. Thus, the direct observation made by the examining physician plays key role in diagnosis and treatment. With the advent of advancement in the field of diagnostic technologies, patient management has been revolutionized. The invention of various radiological and imaging techniques like X-ray, MRI, CT Scan, Angiography, USG and Doppler, endoscopy, laparoscopy techniques has changed the face of modern medicine. These all help to assess and witness the internal human pathology that otherwise can escape the physical examination. These are the examples of extended application of pratyaksha pramana as they help to visualize the body mechanism. The development pertaining to interactive learning and teaching techniques is also an application of pratyaksha pramana. The practical or hands on sessions in different workshops are examples of the same.  

 

The scope of direct observation is very limited for an individual, as there are infinite and unknown phenomena that cannot be assessed by pratyaksha alone.[Cha.Sa.[[Sutra Sthana]] 11/7] There are hindrances to acquirement of knowledge through the medium of pratyaksha as mentioned earlier. Thus, many times it is necessary to combine the knowledge from all sources like authoritative statements (aaptopadesha), analogy (upamana), inference (anumana), logical reasoning (yukti) to acquire correct knowledge regarding any phenomena. One who might have practical experience regarding different treatment procedures and surgical interventions, but lacks theoretical and fundamental knowledge cannot succeed in endeavours and does not gain validation from peers and authority. [Su. Sa. Sutra Sthana 3/49]<ref name=Susruta/> Thus, the knowledge of pratyaksha should be combined with the theoretical study to obtain precision and proficiency in treatment.

==Limitations of pratyaksha pramana==

 

==Related chapters==

[[Tistraishaniya Adhyaya]], [[Trividha Roga Vishesha Vijnaniya Vimana]], [[Rogabhishagjitiya Vimana]], [[Pramana]]

The scope of direct observation is very limited for an individual, as there are infinite and unknown phenomena that cannot be assessed by pratyaksha alone.[Cha.Sa.[[Sutra Sthana]] 11/7] There are hindrances to acquirement of knowledge through the medium of pratyaksha as mentioned earlier. Thus, many times it is necessary to combine the knowledge from all sources like authoritative statements (aaptopadesha), analogy (upamana), inference (anumana), logical reasoning (yukti) to acquire correct knowledge regarding any phenomena. One who might have practical experience regarding different treatment procedures and surgical interventions, but lacks theoretical and fundamental knowledge cannot succeed in endeavors and does not gain validation from peers and authority. [Su. Sa. Sutra Sthana 3/49]<ref name=Susruta/> Thus, the knowledge of pratyaksha should be combined with the theoretical study to obtain precision and proficiency in treatment.

#Dilip Kumar G in his editorial note for the Journal of Natural & Ayurvedic Medicine has discussed the basic concept of pratyaksha along with the exceptions for direct observations.<ref>G Dilip Kumar. Concept of Direct Perception in Ayurveda. JONAM [Internet]. 2018 [cited 2021 Nov 30];2(8). Available from: https://medwinpublishers.com/JONAM/JONAM16000159.pdf</ref>  

#Dilip Kumar G in his editorial note for the Journal of Natural & Ayurvedic Medicine has discussed the basic concept of pratyaksha along with the exceptions for direct observations.<ref>G Dilip Kumar. Concept of Direct Perception in Ayurveda. JONAM [Internet]. 2018 [cited 2021 Nov 30];2(8). Available from: https://medwinpublishers.com/JONAM/JONAM16000159.pdf</ref>  

#Prashant Kumar Jhas explained the concept of pratyakshapramana in purview of Indian philosophy and epithetical basis of the same.<ref>Jha DPK. Concept of Pratyaksha Pramana: A Brief Review Of Indian Philosophy. 2019;25:5.</ref>  

#Prashant Kumar Jhas explained the concept of pratyakshapramana in purview of Indian philosophy and epithetical basis of the same.<ref>Jha DPK. Concept of Pratyaksha Pramana: A Brief Review Of Indian Philosophy. 2019;25:5.</ref>  

#Brooks in his article, “Epistemology and Embodiment: Diagnosis and the Senses in Classical Ayurvedic Medicine” explained the application of epistemology and philosophy for the purpose of diagnosis of different diseases according to [[Ayurveda]].<ref>Brooks LA. Epistemology and Embodiment: Diagnosis and the Senses in Classical Ayurvedic Medicine. Asian Review of World Histories. 2018 Jan 30;6(1):98–135.</ref>  

#Brooks in his article, “Epistemology and Embodiment: Diagnosis and the Senses in Classical Ayurvedic Medicine” explained the application of epistemology and philosophy for the purpose of diagnosis of different diseases according to [[Ayurveda]].<ref>Brooks LA. Epistemology and Embodiment: Diagnosis and the Senses in Classical Ayurvedic Medicine. Asian Review of World Histories. 2018 Jan 30;6(1):98–135.</ref>  

#R. Bhat explained the concept of pratyaksha to understand the disease pathology according to contemporary science by explanation of various terms related to the concept.<ref>Pratyaksha Pramana: Knowledge Perception Through Sense Organs [Internet]. Easy Ayurveda. 2017 [cited 2021 Nov 30]. Available from: https://www.easyayurveda.com/2017/04/20/pratyaksha-pramana/</ref>  

#R. Bhat explained the concept of pratyaksha to understand the disease pathology according to contemporary science by explanation of various terms related to the concept.<ref name= easy/>

#Bhalerao S. discussed that observational and instrumentation skills can be correlated as extension of knowledge of pratyaksha and form the psychomotor domain of blooms taxonomy.<ref>Bhalerao S, Ranade A, Vaidya ADB. Bloom’s taxonomy reiterates Pramana. Journal of Ayurveda and Integrative Medicine. 2017 Jan 1;8(1):56–7.</ref>  

#Bhalerao S. discussed that observational and instrumentation skills can be correlated as extension of knowledge of pratyaksha and form the psychomotor domain of blooms taxonomy.<ref name= Bhalerao/>

#Aparna S. et al. has explained the consideration of pratyakshabadhakara bhava as method to rectify the knowledge obtained through pratyaksha.<ref>Aparna Shanbhag et al.  Pratyaksha Badhakara Bhava - The Intention behind invention. J Ayurveda Integr Med Sci 2020;4:134-137</ref>  

#Aparna S. et al. has explained the consideration of pratyaksha badhakara bhava as method to rectify the knowledge obtained through pratyaksha.<ref>Aparna Shanbhag et al.  Pratyaksha Badhakara Bhava - The Intention behind invention. J Ayurveda Integr Med Sci 2020;4:134-137</ref>  

#Ankita A. has explored the role of different pramana as research tools considering the pratyakshapramana as tool for data collection and observation.<ref>Ankita A A REVIEW ON ROLE OF PRAMANAS IN AYURVEDIC RESEARCH METHODOLO-GY. IAMJ. 2021 Feb 21;9(2):423–9.</ref>  

#Ankita A. has explored the role of different pramana as research tools considering the pratyaksha pramana as tool for data collection and observation.<ref>Ankita A. A Review on role of pramana in Ayurvedic research methodology. IAMJ. 2021 Feb 21;9(2):423–9.</ref>  

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