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<p style="text-align:justify;">[[Pramana]]tah means measurement or proportion and pariksha means examination. The term [[pramana]]tah pariksha indicates examination by measurements or proportion. These are means to quantitatively express the proportions of the human body  parts.  In ancient era, the measurements were done by angula (fingers) and anjali (the cup shaped hallow formed by the joining of two palms together). These measurements are referred as anguli pramana and anjali pramana respectively. These measurements are individual specific. Though evolution of technology led to invention of accurate and precise measuring devices, still the ancient means of measurements via anguli and anjali maintain their clinical importance, being an easy, inexpensive, and scientifically justifiable mode of measurement. The anjali pramana is used for measuring the volume of fluid constituents, whereas anguli pramana is used for measuring the dimensions (length, breadth, height, circumference, distance between two points, etc). [[Pramana]] pariksha is one of the ten-fold clinical examinations of patient. [Cha.Sa.[[Vimana Sthana]] 8/94] Having well developed and proportionate body parts is one sign of good health. [Su.Sa.Sutra Sthana 15/40] Underdeveloped or overdeveloped body parts can lead to disease. The present chapter deals with concept and practices of [[pramana]] pariksha. The contemporary science also gives importance to anthropometric measurements and evaluation of body composition. It is assessed on the basis of the nutritional status of an individual. This chapter describes [[pramana]]tah pariksha, its application and importance in healthcare practices. <p style="text-align:justify;">{{Infobox

<p style='text-align:justify;'>Pramanatah means measurement or proportion and pariksha means examination. The term pramanatah pariksha indicates examination by measurements or proportion. These are means to quantitatively express the proportions of the human body  parts.  In ancient era, the measurements were done by angula (fingers) and anjali (the cup shaped hallow formed by the joining of two palms together). These measurements are referred as anguli pramana and anjali pramana respectively. These measurements are individual specific. Though evolution of technology led to invention of accurate and precise measuring devices, still the ancient means of measurements via anguli and anjali maintain their clinical importance, being an easy, inexpensive, and scientifically justifiable mode of measurement. The anjali pramana is used for measuring the volume of fluid constituents, whereas anguli pramana is used for measuring the dimensions (length, breadth, height, circumference, distance between two points, etc). Pramana pariksha is one of the ten-fold clinical examinations of patient. [Cha.Sa.Vimana Sthana 8/94] Having well developed and proportionate body parts is one sign of good health. [Su.Sa.Sutra Sthana 15/40] Underdeveloped or overdeveloped body parts can lead to disease. The present chapter deals with concept and practices of pramana pariksha. The contemporary science also gives importance to anthropometric measurements and evaluation of body composition. It is assessed on the basis of the nutritional status of an individual. This chapter describes pramanatah pariksha, its application and importance in healthcare practices. <p style="text-align:justify;">{{Infobox

|title =  Contributors

|title =  Contributors

|label1 = Section/Chapter/topic

|label1 = Section/Chapter/topic

|data1 = Concepts & Contemporary Practices/[[Pramanatah pariksha]]   

|data1 = Concepts & Contemporary Practices/[[Pramanatah Pariksha]]   

|label2 = Authors

|label2 = Authors

|data2 = Bhojani M. K. ¹, Joglekar Aishwarya ¹  

|data2 = Bhojani M. K. ¹, Rahul Anand ¹  

|label3 = Editor  

|label3 = Editor  

|data3 = Deole Y.S.³

|data3 = [[Yogesh Deole|Deole Y.S.]]³

|label4 = Affiliations

|label4 = Affiliations

|data4 = ¹ Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India

|data4 = ¹ Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India

|data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India

|data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India

|label7 = Date of publication:

|label7 = Date of publication:

|data7 =October 12, 2023

|data7 = October 12, 2023

|label8 = DOI

|label8 = DOI

|data8 = In process

|data8 = {{DoiWithLink}}

}}

}}

==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 ‘[[pramana]]’ 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 ‘[[pramana]]tah 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>

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

1. Examination or assessment tools (pariksha)

1. Examination or assessment tools (pariksha)

5. Curiosity or zeal to acquire knowledge (jignyasa)

5. Curiosity or zeal to acquire knowledge (jignyasa)

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.

For example, anguli pramana (measurement based on the thickness of fingers) is used to denote measurements of body parts. [Cha. Sa. [[Vimana Sthana]] 8/ 117]

For example, anguli pramana (measurement based on the thickness of fingers) is used to denote measurements of body parts. [Cha. Sa. [[Vimana Sthana]] 8/ 117]

Anjali pramana (measurement based on the capacity of palms placed together) is used to denote the quantity of body fluids. [Cha. Sa. [[Sharira Sthana]] 7/15]

Anjali pramana (measurement based on the capacity of palms placed together) is used to denote the quantity of body fluids. [Cha. Sa. [[Sharira Sthana]] 7/15]

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 ‘[[pramana]]tah pariksha’. [Cha. Sa. [[Vimana Sthana]] 8/ 94]

==Types==

==Types==

<nowiki>***</nowiki>Female pelvis is as broad as chest of male.

<nowiki>***</nowiki>Female pelvis is as broad as chest of male.

Ø  Certain differences are observed in the measurements of a human body via anguli pramana. The measurements described by the two Ayurveda scholars are the approximations of body parts of an ideal person. But criteria of idealness vary from person to person. For a person who is native of plains, a long height may be an ideal height. While for a person who is native of hilly areas, shorter height may be the ideal height. This difference in opinion may be the reason of variation in anguli pramana of Charak and Sushrut.

Ø  Certain differences are observed in the measurements of a human body via anguli pramana. The measurements described by the two [[Ayurveda]] scholars are the approximations of body parts of an ideal person. But criteria of idealness vary from person to person. For a person who is native of plains, a long height may be an ideal height. While for a person who is native of hilly areas, shorter height may be the ideal height. This difference in opinion may be the reason of variation in anguli pramana of Charak and Sushrut.

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. [[index.php?title=Special:BookSources/9780871691682|ISBN 978-0-87169-168-2]]</ref>

===2.     Anjali pramana===

===2.     Anjali pramana===

|'''Volume'''

|'''Volume'''

|-

|-

|'''Udaka''' (aqueous element) a substance which is found  

|'''[[Udakavaha Srotas|Udaka]]''' (aqueous element) a substance which is found  

in association with various  body parts/components of body.  

in association with various  body parts/components of body.  

|10

|10

|-

|-

|'''Rasa''' which is the first product of the ingested food after it is metabolised.

|'''[[Rasa dhatu|Rasa]]''' which is the first product of the ingested food after it is metabolised.

|9

|9

|-

|-

|'''Rakta (blood)'''

|'''[[Rakta dhatu|Rakta]] (blood)'''

|8

|8

|-

|-

|'''Purisha (faeces)'''

|'''[[Purisha]] (faeces)'''

|7

|7

|-

|-

|'''Kapha'''

|'''[[Kapha dosha|Kapha]]'''

|6

|6

|-

|-

|'''Pitta'''

|'''[[Pitta]]'''

|5

|5

|-

|-

|'''Mutra (urine)      '''

|'''[[Mutra]] (urine)      '''

|4

|4

|-

|-

|'''Vasa''' (muscle fat)

|'''[[Vasa]]''' (muscle fat)

|3

|3

|-

|-

|'''Medas''' (fat)

|'''[[Meda dhatu|Medas]]''' (fat)

|2

|2

|-

|-

|'''Majja''' (bone marrow)

|'''[[Majja]]''' (bone marrow)

|1

|1

|-

|-

|1/2

|1/2

|-

|-

|'''Shukra''' (semen)

|'''[[Shukra dhatu|Shukra]]''' (semen)

|1/2

|1/2

|-

|-

|'''Shleshmika oja''' (a type of oja)

|'''Shleshmika [[Ojas|oja]]''' (a type of [[Ojas|oja]])

|1/2

|1/2

|}

|}

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

==Application of Pramana in diagnosis of various [[disease]]s==

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 [[Pancha mahabhuta|panchabhautika]] composition (the five universal elements or [[Pancha mahabhuta|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 1'''

[[File:Image.png|thumb|554x554px|'''Figure 1: Anthropometric Landmarks''']]

The advancement in technology led to development of many anthropometric tools. Some of them are as follows:  

The advancement in technology led to development of many anthropometric tools. Some of them are as follows:  

'''1.  Anthropometer:''' Anthropometer measures vertical dimensions of the human body. The instrument consists of three aluminium square profiles and a double-sided measuring system with a reading scale. The long axis of the instrument is mounted with a telescopic round sleeve with a double-sided groove that features a dimension reading index. The sleeve is mounted with a sliding needle, whose tip is applied to the appropriate anthropometric point.

'''1.  Anthropometer:''' Anthropometer measures vertical dimensions of the human body. The instrument consists of three aluminium square profiles and a double-sided measuring system with a reading scale. The long axis of the instrument is mounted with a telescopic round sleeve with a double-sided groove that features a dimension reading index. The sleeve is mounted with a sliding needle, whose tip is applied to the appropriate anthropometric point.[[File:Image.png|thumb|646x646px|'''Figure 1: Anthropometric Landmarks''']]'''2.  Spreading Caliper:''' Spreading Caliper is used to measure dimensions of the head and selected body width or depth dimensions in children (e.g. biacromial width, biiliocristal width, bispinal width, bitrochanteric width, transverse width of chest, biepicondylar width of humerus, biepicondylar width of femur).  

 

'''2.  Spreading Caliper:''' Spreading Caliper is used to measure dimensions of the head and selected body width or depth dimensions in children (e.g. biacromial width, biiliocristal width, bispinal width, bitrochanteric width, transverse width of chest, biepicondylar width of humerus, biepicondylar width of femur).  

'''3.  Pelvimeter:'''  Pelvimeter used for measuring the width and depth dimensions of the adult population.

'''3.  Pelvimeter:'''  Pelvimeter used for measuring the width and depth dimensions of the adult population.

===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.  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 [[dhatu]]s 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 [https://pubmed.ncbi.nlm.nih.gov/15674762/ 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 [https://pubmed.ncbi.nlm.nih.gov/10865763/#:~:text=Anthropometry%20is%20a%20simple%20reliable,and%20skinfold%20thickness%20(SF). 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.   

===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===

'''4.    Concept of anguli pramana sharira and importance in Ayurveda:'''

'''4.    Concept of anguli pramana sharira and importance in Ayurveda:'''

The author translates the ayurveda terminologies of demarcation points for describing pramanatah pariksha in ayurveda texts into modern anatomical terminologies.<ref>Mishra B. Concept of Anguli Pramana Sharir and Importance in Ayurveda. IJIRMF 2016 July;3(7):279-281. ISSN – 2455-0620</ref> Some of these are:

The author translates the [[ayurveda]] terminologies of demarcation points for describing pramanatah pariksha in ayurveda texts into modern anatomical terminologies.<ref>Mishra B. Concept of Anguli Pramana Sharir and Importance in Ayurveda. IJIRMF 2016 July;3(7):279-281. ISSN – 2455-0620</ref> Some of these are:

*    Shira (heads circumference) the maximum distance round the head with the tape placed above the eyebrow ridges and positioned over the greatest posterior     projection at the back of the head.

*   Shira (heads circumference) the maximum distance round the head with the tape placed above the eyebrow ridges and positioned over the greatest posterior       projection at the back of the head.

*    Skandha (shoulder joint)

*   Skandha (shoulder joint)

*    Aaratni (from elbow joint to little finger)

*   Aaratni (from elbow joint to little finger)

*    Prabahu (from shoulder joint to elbow joint)

*   Prabahu (from shoulder joint to elbow joint)

*    Prapani (from elbow joint to wrist joint)

*   Prapani (from elbow joint to wrist joint)

*   Jangha (from knee joint to ankle joint)[length] [circumference]

*   Jangha (from knee joint to ankle joint)[length] [circumference]

*    Uru (from hip joint to knee joint) [length] [circumference]

*   Uru (from hip joint to knee joint) [length] [circumference]

*    Janu (knee joint) [circumference]

*   Janu (knee joint) [circumference]

*   Gulpha (ankle joint) [circumference]

*   Gulpha (ankle joint) [circumference]

*    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:

*     To know the landmarks of finger, the distance of breadth of finger

*To know the landmarks of finger, the distance of breadth of finger

 

 

*     Angula and anjali, can other body parts (like arm length, palm’s breadth, etc) too be used as an individualistic approach for anthropometric measurements.

*To find average anthropometric measurements based on constitution (prakriti) of individuals.

*     To find the appropriate anthropometric measurements based on geographic variations.

*To find the correlation of health and life span of the persons with standard anthropometric measurements and persons with variation in anthropometric measurements.