2,062
edits
Changes
Jump to navigation
Jump to search
Line 2:
Line 2: − + + + + − − <big>'''Abstract'''</big> − − <div style="text-align:justify;"> − The seventh chapter [[Pannarupiyam Indriyam Adhyaya]] deals with the loss of shadow image in eyes, changes in complexion and luster indicative of imminent death. Difference between shadow and luster is also explained in this chapter with characteristic features of shadows pertaining to each of [[pancha mahabhuta]]. The chapter focuses on fatal prognostic features related to complexion and luster. − − Keywords: shadow image, complexion, luster, ''chhaya, varna, prabha''. − Line 26:
Line 21: + + + + + + + + + + + + + + + + + + + − |header3 = − }} − + + + Line 55:
Line 69: − + Line 71:
Line 85: − + Line 86:
Line 100: + Line 111:
Line 126: + Line 149:
Line 165: − + Line 192:
Line 208: − + − + + + − + − + − + − + − + − + − + + + + Line 235:
Line 256: − + − + + Line 261:
Line 283: − + − + + Line 296:
Line 319: − + − + Line 367:
Line 390: − + Line 449:
Line 472: − + − + + − + − + − *''Tejas mahabhuta'' promote luster complexion, strength, energy, power, digestive fire, and vitality. It also alleviates all ''vatika'' diseases and sustains youthful age. (Su.Chi.38/50)+ − *The normal watery rasa converted to reddish color by ''pitta'' is ''rakta'' and its equilibrium brings health. (Su.Su.14/5)+ − + − + − + − + − + − + − + − *''Jatharagni'' is the primary factor for sustenance of life, color, strength, health, enthusiasm, plumpness, complexion, ''ojas, tejas,'' ''agni'' and ''prana''.+ − *To seethings devoid of their real characteristics - e.g., bright things looking dull and lusterless - indicates impending death of the patient.+ − *''Pannarupi'' implies something whose form or aspect has disappeared. ''Pannarupam'' , the word, has been derived from ''apannarupam,'' implies ill-formed or confused in respect of shape.+ − *Any alterations in ''chhaya'' (complexion) and ''prabha'' (luster) denotes the ominous sign for the patient. + − *The process of dying usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body.+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − === Sign of Imminent Death ===+ − + + + + + + + + + + + + + + + + + + + + + + + + + + Line 482:
Line 562: − + − + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +
Pannarupiyam Indriyam Adhyaya (view source)
Revision as of 19:51, 23 September 2021
, 19:51, 23 September 2021→Parapsycholoigical approach
|title=Pannarupiyam Indriyam Adhyaya
|title=Pannarupiyam Indriyam Adhyaya
|titlemode=append
|titlemode=append
|keywords=shadow image, complexion, luster, chhaya, varna, prabha
|keywords=shadow image, complexion, luster, chhaya, varna, prabha, Ayurveda, pupuliary reaction, signs of death, Indian system of medicine, charak samhita.
|description=Indriya Sthana Chapter 7.Fatal signs of changes in Shadows, Complexion, and luster
|description=Indriya Sthana Chapter 7.Fatal signs of changes in Shadows, Complexion, and luster
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}
}}
<big>'''[[Indriya Sthana]] Chapter 7.Fatal signs of changes in shadows, complexion, and luster'''</big>
<big>'''[[Indriya Sthana]] Chapter 7.Fatal signs of changes in shadows, complexion, and luster'''</big>
{{Infobox
{{Infobox
|title = Pannarupiyam Indriyam Adhyaya
|title = Pannarupiyam 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]]
|label6 = Translator and commentator
|data6 = Byadgi P.S, Singh A.
|label7 = Reviewer
|data7 = Babu S.P.
|label8 = Editors
|data8 = Khandel S.K., Babu S.P., Deole Y.S., Basisht G.
|label9 = Year of publication
|data9 = 2020
|label10 = Publisher
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s05.008 10.47468/CSNE.2020.e01.s05.008]
}}
<big>'''Abstract'''</big>
<div style="text-align:justify;">
The seventh chapter [[Pannarupiyam Indriyam Adhyaya]] deals with the loss of shadow image in eyes, changes in complexion and luster indicative of imminent death. Difference between shadow and luster is also explained in this chapter with characteristic features of shadows pertaining to each of [[pancha mahabhuta]]. The chapter focuses on fatal prognostic features related to complexion and luster.
'''Keywords:''' shadow image, complexion, luster, [[chhaya]], [[varna]], [[prabha]], pupuliary reaction, signs of death.
== Introduction ==
== Introduction ==
If there is any distortion in the image of the examiner reflected as a shadow in the pupil of the patient, should be considered as a sign of imminent death of the patient. ''Nimittanurupa vikriti'' (image pertaining to death) will serve as a yard stick to measure the span of life.
If there is any distortion in the image of the examiner reflected as a shadow in the pupil of the patient, should be considered as a sign of imminent death of the patient. ''Nimittanurupa vikriti'' (image pertaining to death) will serve as a yard stick to measure the span of life. The chapter deals with clinical observations of changes in skin complexion, pupillary reactions and their relevant prognosis.
The Sanskrit word "panna" means destruction or deterioration. Hence the chapter deals with the deterioration of complexion due to various disease pathologies leading to bad prognosis and death.
</div>
</div>
==Sanskrit text, Transliteration and English Translation==
==Sanskrit text, Transliteration and English Translation==
Note: The chapter deals with the signs of imminent death as indicated by the distortion of the image reflected in the pupil.
Note: The chapter deals with the signs of imminent death as indicated by the distortion of the image reflected in the pupil.
=== Loss of shadow image in eyes ===
=== Loss of shadow image in eyes or pupillary reaction ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
The condition in which loss of shadow image is observed in the pupil (eyes) of the patient, should be discarded for treatment.[3]
The condition in which loss of shadow image is observed in the pupil (eyes) of the patient, should be discarded for treatment.[3]
=== Features of fatal prognosis as per shadows ===
=== Features of fatal prognosis based on shadows ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
If any sorts of deformity observed in body parts in the shadow of the person in moonlight, sunlight, light of a lamp, water or mirror. He should be considered as dead. [4]
If any sorts of deformity observed in body parts in the shadow of the person in moonlight, sunlight, light of a lamp, water or mirror. He should be considered as dead. [4]
==== Deformities observed in shadow ====
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
Observation of shadow of a patient as broken, torn, hazy, devoid of certain organs, seeing excess organs, not conspicuous, bifurcated, deformed and without head, such other similar abnormal shadows if develops without any apparent cause it is considered as severe morbidity.[5-6]
Observation of shadow of a patient as broken, torn, hazy, devoid of certain organs, seeing excess organs, not conspicuous, bifurcated, deformed and without head, such other similar abnormal shadows if develops without any apparent cause it is considered as severe morbidity.[5-6]
</div>
</div>
==== Assessment parameters of shadow ====
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
<div style="text-align:justify;">
<div style="text-align:justify;">
The term ''sansthana'' means shape which may be symmetrical or asymmetrical.
The term ''sansthana'' means shape which may be symmetrical or asymmetrical.
Measurement is of three kinds namely short, medium, and large The image reflected in water, mirror, etc., corresponding to the measurement and shape of the body of the individual is known as ''praticchhaya'' which is nothing but reflected shadow based on the color and luster of the individual.[8-9]
Measurement is of three kinds namely short, medium, and large The image reflected in water, mirror, etc., corresponding to the measurement and shape of the body of the individual is known as ''praticchhaya'' which is nothing but reflected shadow based on the complexion and luster of the individual.[8-9]
</div>
</div>
=== Features of Shadow of [[Pancha Mahabhuta]] ===
=== Features of Shadow of [[Pancha Mahabhuta]] ===
</div></div>
</div></div>
The following are the distinctive characteristic features of shadows pertaining to each of the five great elements.
The following are the distinctive characteristic features of shadows pertaining to each of the five great elements [table 1].
===Table 1: Shadows of [[Pancha Mahabhuta]]:===
====Table 1: Shadows of [[Pancha Mahabhuta]]====
{| class="wikitable"
{| class="wikitable"
! rowspan="1"| S.No
! rowspan="1"| S.No
! rowspan="1"| Mahabhuta
! rowspan="1"| [[Mahabhuta]]
! rowspan="1"| Distinctive characteristic features of shadows
! rowspan="1"| Distinctive characteristic features of shadows
|-
|-
| 1 || Akash Bhoota || Clear , blue, unctuous and lustrous shadow
| 1 || [[Akasha mahabhuta]] || Clear , blue, unctuous and lustrous shadow
|-
|-
| 2.|| Vayu Bhoota || Dry, brown, and reddish
| 2.|| [[Vayu mahabhuta]] || Dry, brown, and reddish
|-
|-
| 3.|| Agni Bhoota || Bright red, brilliant and pleasing to the eyes
| 3.|| [[Agni mahabhuta]] || Bright red, brilliant and pleasing to the eyes
|-
|-
| 4.|| Jala Bhoota || Clear like cat’s eye, and excessive unctuous
| 4.|| [[Jala mahabhuta]] || Clear like cat’s eye, and excessive unctuous
|-
|-
| 5.|| Prithvi Bhoota || Stable, unctuous, compact, smooth, black and white
| 5.|| [[Prithvi mahabhuta]] || Stable, unctuous, compact, smooth, black and white
|-
|-
|}
|}
The shadow pertaining to ''vayu bhuta'' is of inferior in nature whereas the remaining four are indicative of pleasure and happiness. ''Vayu bhuta'' shadows indicative of great calamities and miseries.[10-13]
The shadow pertaining to [[vayu mahabhuta]] is of inferior in nature whereas the remaining four are indicative of pleasure and happiness. [[Vayu mahabhuta]] shadows indicative of great calamities and miseries.[10-13]
</div>
=== Types of [[prabha]] (luster) ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
<div style="text-align:justify;">
<div style="text-align:justify;">
All varieties of luster are constituted of ''tejas bhuta''. They are classified as seven type’s namely red, yellow, white, brown, green, pale yellowish and black. Of them which are emanative, unctuous, and dense are auspicious and those others which are dry, dirty and thin are inauspicious.[14-15]
All varieties of luster are constituted of [[tejas mahabhuta]]. They are classified as seven type’s namely red, yellow, white, brown, green, pale yellowish and black. Of them which are emanative, unctuous, and dense are auspicious and those others which are dry, dirty and thin are inauspicious.[14-15]
</div>
</div>
=== Difference between ''Chhaya'' (shadow) and ''Prabha''(lustre) ===
=== Difference between [[Chhaya]] (shadow) and [[Prabha]](luster) ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
<div style="text-align:justify;">
<div style="text-align:justify;">
The shadow decreases the complexion of the body whereas the lustre illuminates. The shadow can be observed from nearby whereas lustre illuminates from a distance. There is nothing devoid of lustre or shadow. Certain distinctive features of the shadow and the lustre when mature indicates emergence of inauspicious or auspicious results in relation to human beings. [16-17]
The shadow decreases the complexion of the body whereas the luster illuminates. The shadow can be observed from nearby whereas luster illuminates from a distance. There is nothing devoid of luster or shadow. Certain distinctive features of the shadow and the luster when mature indicates emergence of inauspicious or auspicious results in relation to human beings. [16-17]
</div>
</div>
=== Fatal signs ===
=== Bad prognositc signs in various diseases ===
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
<div style="text-align:justify;">
<div style="text-align:justify;">
Patient who is suffering from ''kamala'', swelling of face, wasting in temples and terrifying appearance with high fever such patient should be discarded for management.
Patient who is suffering from [[kamala]], swelling of face, wasting in temples and terrifying appearance with high fever such patient should be discarded for management.
Patient who faints again and again while being lifted from bed cannot survive for a week.
Patient who faints again and again while being lifted from bed cannot survive for a week.
The patient afflicted with multiple ''doshas'' having movements in upward, downward both directions along with disordered ''grahani''(Duodenum and Small intestine) cannot survive for longer than for a fortnight.[18-20]
The patient afflicted with multiple ''doshas'' having movements in upward, downward both directions along with disordered [[grahani]](Duodenum and Small intestine) cannot survive for longer than for a fortnight.[18-20]
</div>
</div>
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
If patient is suffering from shallow respiration with irregular twitching in the body is said to be severe fatal condition like almost dead.
If patient is suffering from shallow respiration with irregular twitching in the body is said to be severe fatal condition like almost dead.
Person who is suffering from respiratory distress with abundance of ''kapha'' along with diminution of complexion, strength and less intake of food will not survive for longer.[21-26]
Person who is suffering from respiratory distress with abundance of [[kapha]] along with diminution of complexion, strength and less intake of food will not survive for longer.[21-26]
</div>
</div>
<div class="mw-collapsible mw-collapsed">
<div class="mw-collapsible mw-collapsed">
Who is well versed with the observation of above signs and symptoms which indicates imminent death, is entitled to be known as intelligent physician. [32]
Who is well versed with the observation of above signs and symptoms which indicates imminent death, is entitled to be known as intelligent physician. [32]
== Tattva Vimarsha (Fundamental Principles) ==
== [[Tattva Vimarsha]] (Fundamental Principles) ==
*Shadow image in pupils, changes in complexion and luster should be examined to assess prognosis.
*Shadow image in pupils, changes in complexion and luster should be examined to assess prognosis.
*Perception of distorted images of body parts or their absence are ominous signs.
*Perception of distorted images of body parts or their absence are ominous signs.
== Vidhi Vimarsha (Applied Inferences) ==
== [[Vidhi Vimarsha]] (Applied Inferences) ==
<div style="text-align:justify;">
<div style="text-align:justify;">
=== Role of [[Panchamahabhuta]] in complexion and luster ===
The Sanskrit word ''Pannarupi'' implies something whose form or aspect has disappeared. ''Pannarupam'' , the word, has been derived from ''apannarupam,'' implies ill-formed or confused in respect of shape. Any alterations in [[chhaya]] (complexion) and [[prabha]] (luster) denotes the ominous sign for the patient.
Following cross references are important to be re-visited to assess the role of ''pancha-mahabhuta'', especially ''tejas mahabhuta'' in complexion and luster.
=== Role of [[Pancha mahabhuta]] in complexion and luster ===
*Qualities of ''Pancha-mahabhuta'' are:
Following cross references are important to be re-visited to assess the role of [[pancha mahabhuta]], especially [[tejas mahabhuta]] in complexion and luster.
**Qualities of ''Akasha'' are- sound, auditory organ, all orifices and distinctness.
**Qualities of ''Vayu'' are – touch tactile organ, all activities, movements in all body parts and lightness.
*Qualities of [[Pancha mahabhuta]] are:
**Qualities of ''Tejas'' are – vision, visual organ, complexion, heat, splendor, digestion, intolerance, sharpness and valor.
**Qualities of [[Akasha]] are sound, auditory organ, all orifices and distinctness.
**Qualities of ''Apa'' are- taste, gustatory organ, all liquidity, heaviness, coldness, unctuousness and semen and
**Qualities of [[Vayu]] are touch tactile organ, all activities, movements in all body parts and lightness.
**Qualities of ''Parthiva'' (i.e., those that have qualities of the ''prithvi'' element) are- smell, olfactory organ, hardness and heaviness.(Su.Sha.1/19)
**Qualities of [[Tejas]] are vision, visual organ, complexion, heat, splendor, digestion, intolerance, sharpness and valor.
*''Tejas'' element is the causative factor of complexion when at the time of conception, it is predominantly associated with ''apa'' element, it makes the fetus fair- complexioned, predominance in ''parthivi'' elements causes black one. That in ''parthivi'' and ''akasha'' elements gives to black- sky complexion while predominance in ''apa'' and ''akasha'' elements makes fair-sky complexion of fetus. If ''tejas'' does not reach the visual organ, it makes the fetus born blind, the same associated with blood makes red eyed, that associated with ''pitta'' and ''kapha'' makes yellow- eyed and white-eyed respectively, if associated with ''vata'' it causes deformity in eyes.
**Qualities of [[Apa]] are taste, gustatory organ, all liquidity, heaviness, coldness, unctuousness and semen and
**Qualities of [[Prithvi]] (i.e., those that have qualities of the [[prithvi]] element) are- smell, olfactory organ, hardness and heaviness. [Su. Sa. Sharira Sthana 1/19]<ref name= "Sushruta"> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>
==== Role of [[tejas]] and [[agni]] in luster ====
*[[Tejas mahabhuta]] promote luster complexion, strength, energy, power, digestive fire, and vitality. It also alleviates all [[vata]] [[dosha]] dominant diseases and sustains youthful age. [Su. Sa. Chikitsa Sthana 38/50]<ref name="Sushruta"/> The normal [[rasa dhatu]] converted to reddish color by [[pitta]] is [[rakta dhatu]] and its equilibrium brings health. [Su.Sa. Sutra Sthana 14/5]<ref name="Sushruta"/>
[[Tejas]] element is the causative factor of complexion when at the time of conception, it is predominantly associated with [[apa]] element, it makes the fetus fair- complexioned, predominance in [[prithvi]] elements causes black one. That in [[prithvi]] and [[akasha]] elements gives to black- sky complexion while predominance in [[apa]] and [[akasha]] elements makes fair-sky complexion of fetus. If [[tejas]] does not reach the visual organ, it makes the fetus born blind, the same associated with blood makes red eyed, that associated with [[pitta]] and [[kapha]] makes yellow- eyed and white-eyed respectively, if associated with [[vata]] it causes deformity in eyes.
[[Agni]] is the primary factor for sustenance of life, color, strength, health, enthusiasm, plumpness, complexion, [[ojas]], [[tejas]], and [[prana]].
==== Assessment of complexion and shadows and their relation with [[pancha mahabhuta]] ====
The changes in complexion and shadows can be assessed upon various parameters. This can indicate the dominance of specific [[mahabhuta]]. The characteristics are as shown in table 2 below.
{| class="wikitable"
|+ Table 2: [[Mahabhuta]] and their characteristics related to [[chhaya]] (skin complexions)
|-
! Parameter!! [[Akasha mahabhuta]]!! [[Vayu mahabhuta]]!! [[Agni mahabhuta]] !! [[Jala mahabhuta]]!! [[Prithvi mahabhuta]]
|-
| | Color || Neela (blue) || Shyava-aruna (grayish red) || Rakta (red) || Vaidurya(cat’s eye) || Shyama Shweta (Shy colour or white)
|-
| | Luminosity || Saprabha (lustrous) || Hataprabha(Lustreless) || Diptabha (illuminating) || -- || --
|-
| | Brightness || Pure ||-- ||-- || Like pure vaidurya(cat’s eye) || Unctuous
|-
| | Transparency || --|| --|| Vishudhdha (purely transparent) || Shuddha(Transparent) ||--
|-
|| Hydration & Elasticity || Slightly unctuous || Dried ||-- || Good unction || Unctuous
|-
| | Homogeneity ||-- ||-- || Darshanapriya (charming) ||-- || Shlakshna (smooth)
|-
| | Firmness ||-- ||-- ||-- ||-- || Sthira (stable) and ghana(solid)
|-
|}
=== Difference in [[Chhaya]] (complexion) and [[Prabha]] (luster) ===
The following table 3 depicts difference between complexion and luster. This is helpful for assessment of disease pathologies and prognosis.
#Patient who is suffering from ''kamala'', swelling in face, wasting in temples, and terrifying appearance with high fever has grave prognosis.
{| class="wikitable"
|+ Table 3: Difference between [[Chhaya]] and [[Prabha]]
|-
! [[Chhaya]] !! [[Prabha]]
|-
| | Dependent on Varna and Prabha || Illuminates Varna and it is independent
|-
| | Easily detectable when the person in nearer || Illuminates from a distance
|-
| | Five types based on [[mahabhuta]] || Seven types based upon color
|-
| | Originates from any [[mahabhuta]] || Originates from ‘[[tejas]] only
|-
| | Denotes skin complexion || Denotes skin radiance or luminance or AURA
|-
| | Can be measured or differentiated by using various scales like ‘Fitzpatrick skin type scale’, ‘Luschan’s chromatic scale’, C.L.B.T (skin colour, luminance, brightness and transparency) etc; || Can be measured by using ‘Optical method having three parameters like Complexion / diffusion’ (Cd), Complexion / reflection (Cr), Complexion / specular position (Csp), and C.L.B.T etc;
|-
|}
=== Signs of bad prognosis ===
To see things devoid of their real characteristics - e.g., bright things looking dull and lusterless - indicates impending death of the patient. The process of dying usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body.
=== Sign of imminent death ===
#Patient who is suffering from [[kamala]], swelling in face, wasting in temples, and terrifying appearance with high fever has grave prognosis.
#Patient who faints again and again while being lifted from bed may not survive for a week. This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible. The dying person may also experience hallucinations, sometimes seeing or speaking to people that are not there or died in the past. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life to this earth.
#Patient who faints again and again while being lifted from bed may not survive for a week. This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible. The dying person may also experience hallucinations, sometimes seeing or speaking to people that are not there or died in the past. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life to this earth.
#At the end of life, patients often lose interest in eating and drinking because the body is conserving its energy and no longer requires the same level of nourishment. It is important to let each individual decide how much, even if it is little or nothing, that he or she wishes to eat or drink. Family members should not force food or drink, as it will only make their loved one feel uncomfortable or upset. Near the end of life, patients no longer feel hunger pangs and forcing them to eat may actually cause nausea and abdominal pain. Eventually, the patient may become entirely unable to swallow food and fluids. Frequent mouth care will be given to help prevent dry mouth.
#At the end of life, patients often lose interest in eating and drinking because the body is conserving its energy and no longer requires the same level of nourishment. It is important to let each individual decide how much, even if it is little or nothing, that he or she wishes to eat or drink. Family members should not force food or drink, as it will only make their loved one feel uncomfortable or upset. Near the end of life, patients no longer feel hunger pangs and forcing them to eat may actually cause nausea and abdominal pain. Eventually, the patient may become entirely unable to swallow food and fluids. Frequent mouth care will be given to help prevent dry mouth.
#As cardiac output and intravascular volume decrease at the end of life, there will be evidence of diminished peripheral blood perfusion. Tachycardia, hypotension, peripheral cooling, peripheral and central cyanosis, and mottling of the skin (livedo reticularis) are expected. Venous blood may pool along dependent skin surfaces. Urine output falls as perfusion of the kidneys diminishes.
#As cardiac output and intravascular volume decrease at the end of life, there will be evidence of diminished peripheral blood perfusion. Tachycardia, hypotension, peripheral cooling, peripheral and central cyanosis, and mottling of the skin (livedo reticularis) are expected. Venous blood may pool along dependent skin surfaces. Urine output falls as perfusion of the kidneys diminishes.
In parapsychology and many forms of spiritual practice, an aura is a field of subtle, luminous radiation surrounding a person or object (like the halo oraureola in religious art). <ref>Aura (paranormal); From Wikipedia, the free encyclopedia; available at http://en.wikipedia.org/wiki/Aura_(paranormal)</ref>,
=== Poor prognostic features and relevant disease pathologies ===
<ref>How to see and READ the AURA: Part 1; available at http://www.thiaoouba.com/seeau.htm</ref>
The prognostic features described in this chapter can be observed in various disease pathologies as shown in table 4. <ref>Mamidi P. et.al., Pannarupeeyam of Charaka Indriya Sthana- An Explorative Study, Int. J. Ayu. Alt. Med., 2019; 7(6): 223-235</ref> There is a wide scope of research to study the exact clinical correlation of the features and underlying disease pathologies.
{| class="wikitable"
|+ Table 4:Reference verse and probable relevant pathology
|-
! Reference verse !! Relevant disease or pathology
|-
| | Cha.Sa.[[Indriya Sthana]] 7/18 || Hepatic encephalopathy; Cirrhosis of liver; Infective hepatitis; Hepatocellular carcinoma; Hepatoblastoma;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/19 || Central vertigo; Vertebro basilar insufficiency; Cerebrovascular accidents; Carotid artery stenosis;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/20 || Carcinomas with secondary or distal metastases; Various autoimmune, neuromuscular, muscular dystrophies; Bleeding disorders; Malabsorption syndromes; Small intestinal bacterial overgrowth (SIBO)
|-
| | Cha.Sa.[[Indriya Sthana]] 7/21-22|| End stage renal disease (ESRD); Acute kidney injury (AKI); Carcinomas; Malabsorption syndrome; Thyrotoxicosis; Fecal impaction; Intestinal (complete or partial) obstruction; Pelvic neoplasms; End stage liver disease (ESLD); Hypercatabolic syndrome;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/23 || Hypercatabolic syndrome; Thyrotoxicosis; Carcinomas; Cachexia; Sarcopenia;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/24 || Hypovolemic shock; Metabolic acidosis; Diabetic ketoacidosis; Fluid and electrolyte imbalance in hypovolemia; Cerebral hypoperfusion;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/25 || Delirium (increased psychomotor activity subtype or hyperactive); Status epilepticus; Cerebral hypoperfusion;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/26 || Pulmonary edema; Lung cancer; Pulmonary embolism; Pulmonary cachexia; Pulmonary tuberculosis;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/27 || Cerebral hypo perfusion; Cerebral ischemia; Perinaud’s syndrome; Oculogyric crisis; Stenosis or aneurysm or kinking or atherosclerosis or dissection of carotid artery;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/28 || Mumps; Diphtheria; Bilateral parotid tuberculosis; Other neoplastic or infectious diseases of salivary glands;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/29 || Idiopathic facial paresis; Bell’s palsy;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/30 || Acquired cryptorchidism; Testicular atrophy in carcinoma; Buried penis; Penile carcinoma;
|-
| | Cha.Sa.[[Indriya Sthana]] 7/31 || Cancer cachexia; Sarcopenia; Muscular dystrophies or hypertrophies
|-
|}
=== Parapsycholoigical approach ===
In parapsychology and many forms of spiritual practice, an aura is a field of subtle, luminous radiation surrounding a person or object (like the halo or aureola in religious art). <ref>Aura (paranormal); From Wikipedia, the free encyclopedia; available at http://en.wikipedia.org/wiki/Aura_(paranormal)</ref>, <ref>How to see and READ the AURA: Part 1; available at http://www.thiaoouba.com/seeau.htm</ref>
'''Acknowledgement:''' The contributors acknowledge support of Dr. M. Prasad and Dr.G.Kshama for providing tables 2,3 and 4 from their published article referred in this chapter.
</div>
</div>
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
== References ==
== References ==