Changes

|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 = Basisht G.³,  

|label4 = Editors  

|label4 = Editors  

|data4 = Deole Y.S.³ Basisht G.³

|data4 = Deole Y.S.⁴ 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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==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==  

*Gurgling sound in intestines (antrakujana) or examination of intestinal peristalsis

*Gurgling sound in intestines (antrakujana) or examination of intestinal peristalsis

*Crepitus in joints ,cracking or popping sounds in joints (sandhisphutanaanguliparvana)

*Crepitus in joints, cracking or popping sounds in joints (sandhisphutanaanguliparvana)

*Assessment of voice of the patient (swaravishesha)<ref>Mehta DD, Hillman RE. Voice assessment: Updates on perceptual, acoustic, aerodynamic, and endoscopic imaging methods. Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):211–5.</ref>  

*Assessment of voice of the patient (swaravishesha)<ref>Mehta DD, Hillman RE. Voice assessment: Updates on perceptual, acoustic, aerodynamic, and endoscopic imaging methods. Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):211–5.</ref>  

*Other specific sounds like hiccups, breath, cough, burping (shariropagatashabda)

*Other specific sounds like hiccups, breath, cough, burping (shariropagatashabda)

The physician palpates patients for examination. Here the tactile perception (or sparshanendriya) is medium to gain knowledge about normal or abnormal characters of the body. The heat/hotness (aushnya), coldness (shaitya), softness (mardava), hardness (kathinya), smoothness (shlakshna), roughness (kharata) can be perceived.  Thus the temperature, skin texture, dryness, roughness of the skin, different organs, hair and lesions on the body can be assessed with the help of this pratyaksha. For instance, coldness of body (gatra-shaitya) indicates depletion of [[pitta dosha]] (kshaya); hotness (aushnya) indicates fever ([[jwara]]). Soft skin (twak mardava) is the characteristic of [[pitta]] and [[kapha]] dominant [[prakriti]]. Hardness (kathinya) is mentioned in ascites (udara), splenomegaly (pleeha), prostatic enlargement (asthila). Smoothness (shlakshnata) is characteristic of [[kapha]] [[prakriti]], while roughness (kharata) of skin, hairs etc. is seen in [[vata]] [[prakriti]] individuals. It is comparable with the palpation of the body to understand the body temperature, pulse diagnosis, tenderness, rigidity, lump or growth, lymphadenopathy, organomegaly, size of palpable organs, its borders, surface etc.  

The physician palpates patients for examination. Here the tactile perception (or sparshanendriya) is medium to gain knowledge about normal or abnormal characters of the body. The heat/hotness (aushnya), coldness (shaitya), softness (mardava), hardness (kathinya), smoothness (shlakshna), roughness (kharata) can be perceived.  Thus the temperature, skin texture, dryness, roughness of the skin, different organs, hair and lesions on the body can be assessed with the help of this pratyaksha. For instance, coldness of body (gatra-shaitya) indicates depletion of [[pitta dosha]] (kshaya); hotness (aushnya) indicates fever ([[jwara]]). Soft skin (twak mardava) is the characteristic of [[pitta]] and [[kapha]] dominant [[prakriti]]. Hardness (kathinya) is mentioned in ascites (udara), splenomegaly (pleeha), prostatic enlargement (asthila). Smoothness (shlakshnata) is characteristic of [[kapha]] [[prakriti]], while roughness (kharata) of skin, hairs etc. is seen in [[vata]] [[prakriti]] individuals. It is comparable with the palpation of the body to understand the body temperature, pulse diagnosis, tenderness, rigidity, lump or growth, lymphadenopathy, organomegaly, size of palpable organs, its borders, surface etc.  

'''3) Visual inspection (darshana or chakshyshya 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 (darshanapariksha) 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 (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.

   

   

Visual inspection is done to assess the abnormalities like pallor, cyanosis, oedema, petechial haemorrhage, 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)'''

#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.

'''5) Olfactory perception (ghrana pratyaksha or gandhapariksha)'''

'''5) Olfactory perception (ghrana pratyaksha or gandha pariksha)'''

In this method, olfactory perception helps to examine the smell of body fluids or body odour. The olfactory perception is used to determine the abnormality. For instance, the blood ([[rakta]]) and menstrual blood ([[artava]]) have specific smell of blood (vistragandha), [[oja]] has smell of parched or fried grain (lajagandha), reproductive fluids ([[shukra]]) has smell similar to honey (madhu gandha). The discharges from wound (vranastrava) are of 14 types having smells like purulent, foul smell, unpleasant smell.

In this method, olfactory perception helps to examine the smell of body fluids or body odour. The olfactory perception is used to determine the abnormality. For instance, the blood ([[rakta]]) and menstrual blood ([[artava]]) have specific smell of blood (vistra gandha), [[oja]] has smell of parched or fried grain (laja gandha), reproductive fluids ([[shukra]]) has smell similar to honey (madhu gandha). The discharges from wound (vrana strava) are of 14 types having smells like purulent, foul smell, unpleasant smell.

   

   

Halitosis or bad breath is the common feature of dental problems, diabetes etc. Urine and faeces have their typical ammoniac smell and deviation from same may indicate abnormality. Similarly foul-smelling discharge from wounds, sinuses, vagina etc. indicates underlying pathology.<ref>halitosis - Google Search [Internet]. [cited 2021 Nov 28]. Available from:  

Halitosis or bad breath is the common feature of dental problems, diabetes etc. Urine and feces have their typical ammoniac smell and deviation from same may indicate abnormality. Similarly foul-smelling discharge from wounds, sinuses, vagina etc. indicates underlying pathology.<ref>halitosis - Google Search [Internet]. [cited 2021 Nov 28]. Available from:  

https://www.google.com/search?q=halitosis&rlz=1C1SQJL_enIN876IN876&oq=halitosis&aqs=chrome..69i57j0i433i512j0i512l8.2365j0j15&sourceid=chrome&ie=UTF-8

https://www.google.com/search?q=halitosis&rlz=1C1SQJL_enIN876IN876&oq=halitosis&aqs=chrome..69i57j0i433i512j0i512l8.2365j0j15&sourceid=chrome&ie=UTF-8

</ref> The putrefaction indicates the release of foul smell from the body is feature of cell death.

</ref> The putrefaction indicates the release of foul smell from the body is feature of cell death.

===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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