Pushpitakam Indriyam Adhyaya

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Indriya Sthana Chapter 2.Fatal signs of Tactile and Olfactory perception

Pushpitakam Indriyam Adhyaya
Section/Chapter Indriya Sthana Chapter 2
Preceding Chapter Varnasvariyam Indriyam Adhyaya
Succeeding Chapter Parimarshaneeyam Indriyam Adhyaya
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana
Translator and commentator Khandel S.K., Rai S.
Reviewer Babu S.
Editors Khandel S.K., Babu S.P., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s05.003

Abstract

This chapter sums up the variations in the sense of taste of the body and smell of the individual which indicate imminent death of the person (Arishta Lakshana). Variations in the smell of body and the altered taste sense of a person may reveal the disease processes in that patient.

Keywords: fatal signs, pushpita, body odour, sense of taste.

Introduction

While describing the qualities of an ideal bhishaja (physician) it has been stated that he should be friendly, and compassionate to the patients, should have devotion and love for treating the curable diseases and should not treat the untreatable ones. [Cha.Sa.Sutra Sthana9/26] During the Samhita period, many diseases were incurable because of lack of treatments available at that time. Now, large number of diseases can be controlled and gives longer productive life to patients by providing emergency and intensive care treatments. That is why during that time it was important to determine the prognosis in terms of curability or incurability of diseases. Physicians did not treat incurable patients especially terminally ill patients. A set of symptoms and signs of terminally ill patients was identified called Arishta lakshanas. With the rising high cost of healthcare especially the end of life care, knowledge and recognition of these signs and symptoms have become more relevant during the current times.

After describing fatal signs regarding complexion and voice, diagnosed by visual and auditory senses respectively, the present chapter describes signs to be examined by gustatory and olfactory senses.

Sanskrit text, Transliteration and English Translation

अथातः पुष्पितकमिन्द्रियं व्याख्यास्यामह||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ puṣpitakamindriyaṁ vyākhyāsyāmaha||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH puShpitakamindriyaM vyAkhyAsyAmaha||1||

iti ha smAha bhagavAnAtreyaH||2||

Now We shall expound the chapter "Pushpitakam Indriyam"(Fatal signs of Tactile and Olfactory perception). Thus said Lord Atreya.[1-2]

Note: The chapter deals with features of odor and taste indicating impending death.

Definition of Arishta (fatal signs)

पुष्पं यथा पूर्वरूपं फलस्येह भविष्यतः|
तथा लिङ्गमरिष्टाख्यं पूर्वरूपं मरिष्यतः||३||

puṣpaṁ yathā pūrvarūpaṁ phalasyēha bhaviṣyataḥ|
tathā liṅgamariṣṭākhyaṁ pūrvarūpaṁ mariṣyataḥ||3||

puShpaM yathA pUrvarUpaM phalasyeha bhaviShyataH|
tathA li~ggamariShTAkhyaM pUrvarUpaM mariShyataH||3||

Similarly as a flower predicts the future growth of a fruit, appearance of various types of arishta lakshanas denote the impending death. [3]

Importance of Arishta (fatal signs)

अप्येवं तु भवेत् पुष्पं फलेनाननुबन्धि यत्|
फलं चापि भवेत् किञ्चिद्यस्य पुष्पं न पूर्वजम् ||४||

न त्वरिष्टस्य जातस्य नाशोऽस्ति मरणादृते|
मरणं चापि तन्नास्ति यन्नारिष्टपुरःसरम्||५||

apyēvaṁ tu bhavēt puṣpaṁ phalēnānanubandhi yat|
phalaṁ cāpi bhavēt kiñcidyasya puṣpaṁ na pūrvajam ||4||

na tvariṣṭasya jātasya nāśō'sti maraṇādr̥tē|
maraṇaṁ cāpi tannāsti yannāriṣṭapuraḥsaram||5||

apyevaM tu bhavet puShpaM phalenAnanubandhi yat|
phalaM cApi bhavet ki~jcidyasya puShpaM na pUrvajam [1] ||4||

na tvariShTasya jAtasya nAsho~asti maraNAdRute|
maraNaM cApi tannAsti yannAriShTapuraHsaram||5||

The flower may sometimes be devoid of fruits and sometimes even the fruits may be produced without being preceded by flowers. But once an arishta manifests, it doesn’t depart without ensuing in death. Conversely, death can not occur without earlier manifestation of arishta. [4-5]

मिथ्यादृष्टमरिष्टाभमनरिष्टमजानता|
अरिष्टं वाऽप्यसम्बुद्धमेतत् प्रज्ञापराधजम्||६||

mithyādr̥ṣṭamariṣṭābhamanariṣṭamajānatā|
ariṣṭaṁ vā'pyasambuddhamētat prajñāparādhajam||6||

mithyAdRuShTamariShTAbhamanariShTamajAnatA|
ariShTaM vA~apyasambuddhametat praj~jAparAdhajam||6||

An ignorant person may sometimes wrongly perceive symptoms presenting in an individual as arishta lakshana and sometimes he may even not recognize the arishta lakshana presenting in an individual, all this is the result of intellectual errors.[6]

सम्बोधनार्थं तु लिङ्गैर्मरणपूर्वजैः|
पुष्पितानुपदेक्ष्यामो नरान् बहुविधैर्बहून् ||७||

jñānasambōdhanārthaṁ tu liṅgairmaraṇapūrvajaiḥ|
puṣpitānupadēkṣyāmō narān bahuvidhairbahūn ||7||

j~jAnasambodhanArthaM tu li~ggairmaraNapUrvajaiH|
puShpitAnupadekShyAmo narAn bahuvidhairbahUn [1] ||7||

To expound the knowledge about various premonitory symptoms preceding death as indicative of its imminence, we now illustrate the various kinds of such presentations in persons.[7]

Fatal signs related to body odor

नानापुष्पोपमो गन्धो यस्य भाति दिवानिशम्|
पुष्पितस्य वनस्येव नानाद्रुमलतावतः||८||

तमाहुः पुष्पितं धीरा नरं मरणलक्षणैः|
स ना संवत्सराद्देहं जहातीति विनिश्चयः||९||

एवमेकैकशः पुष्पैर्यस्य गन्धः समो भवेत्|
इष्टैर्वा यदि वाऽनिष्टैः स च पुष्पित उच्यते||१०||

समासेनाशुभान् गन्धानेकत्वेनाथवा पुनः|
आजिघ्रेद्यस्य गात्रेषु तं विद्यात् पुष्पितं भिषक्||११||

आप्लुतानाप्लुते काये यस्य गन्धाः शुभाशुभाः|
व्यत्यासेनानिमित्ताः स्युः स च पुष्पित उच्यते||१२||

तद्यथा- चन्दनं कुष्ठं तगरागुरुणी मधु|
माल्यं मूत्रपुरीषे च मृतानि कुणपानि च||१३||

ये चान्ये विविधात्मानो गन्धा विविधयोनयः|
तेऽप्यनेनानुमानेन विज्ञेया विकृतिं गताः||१४||

इदं चाप्यतिदेशार्थं लक्षणं गन्धसंश्रयम्|
वक्ष्यामो यदभिज्ञाय भिषङ्मरणमादिशेत्||१५||

वियोनिर्विदुरो गन्धो यस्य गात्रेषु जायते|
इष्टो वा यदि वाऽनिष्टो न स जीवति तां समाम्||१६||

एतावद्गन्धविज्ञानं,...|१७|

nānāpuṣpōpamō gandhō yasya bhāti divāniśam|
puṣpitasya vanasyēva nānādrumalatāvataḥ||8||

tamāhuḥ puṣpitaṁ dhīrā naraṁ maraṇalakṣaṇaiḥ|
sa nā saṁvatsarāddēhaṁ jahātīti viniścayaḥ||9||

ēvamēkaikaśaḥ puṣpairyasya gandhaḥ samō bhavēt|
iṣṭairvā yadi vā'niṣṭaiḥ sa ca puṣpita ucyatē||10||

samāsēnāśubhān gandhānēkatvēnāthavā punaḥ|
ājighrēdyasya gātrēṣu taṁ vidyāt puṣpitaṁ bhiṣak||11||

āplutānāplutē kāyē yasya gandhāḥ śubhāśubhāḥ|
vyatyāsēnānimittāḥ syuḥ sa ca puṣpita ucyatē||12||

tadyathā- candanaṁ kuṣṭhaṁ tagarāguruṇī madhu|
mālyaṁ mūtrapurīṣē ca mr̥tāni kuṇapāni ca||13||

yē cānyē vividhātmānō gandhā vividhayōnayaḥ|
tē'pyanēnānumānēna vijñēyā vikr̥tiṁ gatāḥ||14||

idaṁ cāpyatidēśārthaṁ lakṣaṇaṁ gandhasaṁśrayam|
vakṣyāmō yadabhijñāya bhiṣaṅmaraṇamādiśēt||15||

viyōnirvidurō gandhō yasya gātrēṣu jāyatē|
iṣṭō vā yadi vā'niṣṭō na sa jīvati tāṁ samām||16||

ētāvadgandhavijñānaṁ,...|17|

nAnApuShpopamo gandho yasya bhAti [1] divAnisham|
puShpitasya vanasyeva nAnAdrumalatAvataH||8||

tamAhuH puShpitaM dhIrA naraM maraNalakShaNaiH|
sa nA [2] saMvatsarAddehaM jahAtIti vinishcayaH||9||

evamekaikashaH puShpairyasya gandhaH samo bhavet|
iShTairvA yadi vA~aniShTaiH sa ca puShpita ucyate||10||

samAsenAshubhAn gandhAnekatvenAthavA punaH|
Ajighredyasya gAtreShu taM vidyAt puShpitaM bhiShak||11||

AplutAnAplute kAye yasya gandhAH shubhAshubhAH|
vyatyAsenAnimittAH syuH sa ca puShpita ucyate||12||

tadyathA- candanaM kuShThaM tagarAguruNI madhu|
mAlyaM mUtrapurIShe ca mRutAni [3] kuNapAni ca||13||

ye cAnye vividhAtmAno gandhA vividhayonayaH|
te~apyanenAnumAnena vij~jeyA vikRutiM gatAH||14||

idaM cApyatideshArthaM lakShaNaM gandhasaMshrayam|
vakShyAmo yadabhij~jAya bhiSha~gmaraNamAdishet||15||

viyonirviduro [4] gandho yasya gAtreShu jAyate|
iShTo vA yadi vA~aniShTo na sa jIvati tAM samAm||16||

etAvadgandhavij~jAnaM,...|17|

One who emits the fragrance of several flowers or that of wood from various kinds of creepers and bushes - all blooming with flowers, from his body day and night is called pushpita, and is indicative of forth coming death. Such a person is sure to die within a year.

A person who emits various repulsive odors collectively and simultaneously is also called pushpita. A person who stinks when his body is covered with perfumed liniment or ointment and gives off a fragrant smell without any such liniment application and without any appreciable cause is also called pushpita. The smell of Chandana (Santalum album Linn.), Kushtha (Saussurea lappa G. B. Clarke), Tagara (Valeriana wallichi DC.), Aguru (Aquilaria agallocha Roxb.), honey, garland, urine, feces, dead body and any other such smell emitted by person is considered premonitory symptom by inference.

We shall further discuss the premonitory symptoms based on various odors in order to facilitate the physician’s knowledge by which he can predict death. The individual whose body emits pleasant or unpleasant smell continuously without any appreciable cause cannot survive for more than a year. This is all about premonitory symptoms based on the smell emitted by the body of the individual.[8-16]

Fatal signs related to sense of taste

...रसज्ञानमतः परम्|
आतुराणां शरीरेषु वक्ष्यते विधिपूर्वकम्||१७||

यो रसः प्रकृतिस्थानां नराणां देहसम्भवः|
स एषां चरमे काले विकारं भजते द्वयम्||१८||

कश्चिदेवास्यवैरस्यमत्यर्थमुपपद्यते|
स्वादुत्वमपरश्चापि विपुलं भजते रसः||१९||

तमनेनानुमानेन विद्याद्विकृतिमागतम्|
मनुष्यो हि मनुष्यस्य कथं रसमवाप्नुयात्||२०||

मक्षिकाश्चैव यूकाश्च दंशाश्च मशकैः सह|
विरसादपसर्पन्ति जन्तोः कायान्मुमूर्षतः||२१||

अत्यर्थरसिकं कायं कालपक्वस्य मक्षिकाः|
अपि स्नातानुलिप्तस्य भृशमायान्ति सर्वशः||२२||

...rasajñānamataḥ param|
āturāṇāṁ śarīrēṣu vakṣyatē vidhipūrvakam||17||

yō rasaḥ prakr̥tisthānāṁ narāṇāṁ dēhasambhavaḥ|
sa ēṣāṁ caramē kālē vikāraṁ bhajatē dvayam||18||

kaścidēvāsyavairasyamatyarthamupapadyatē|
svādutvamaparaścāpi vipulaṁ bhajatē rasaḥ||19||

tamanēnānumānēna vidyādvikr̥timāgatam|
manuṣyō hi manuṣyasya kathaṁ rasamavāpnuyāt||20||

makṣikāścaiva yūkāśca daṁśāśca maśakaiḥ saha|
virasādapasarpanti jantōḥ kāyānmumūrṣataḥ||21||

atyartharasikaṁ kāyaṁ kālapakvasya makṣikāḥ|
api snātānuliptasya bhr̥śamāyānti sarvaśaḥ||22||

..rasaj~jAnamataH param|
AturANAM sharIreShu vakShyate vidhipUrvakam||17||

yo rasaH prakRutisthAnAM narANAM dehasambhavaH|
sa eShAM carame kAle vikAraM bhajate dvayam||18||

kashcidevAsyavairasyamatyarthamupapadyate|
svAdutvamaparashcApi vipulaM bhajate rasaH||19||

tamanenAnumAnena vidyAdvikRutimAgatam|
manuShyo hi manuShyasya kathaM rasamavApnuyAt||20||

makShikAshcaiva yUkAshca daMshAshca mashakaiH saha|
virasAdapasarpanti jantoH kAyAnmumUrShataH||21||

atyartharasikaM kAyaM kAlapakvasya makShikAH|
api snAtAnuliptasya bhRushamAyAnti sarvashaH||22||

We shall now describe the various tastes expressed by the patient, which indicate imminent death of the person. The normal taste by human beings undergoes two types of modifications in case of impending death i.e. either the person develops excessive distaste or his body develops excessive sweetness. These modifications of taste can only be inferred as a person cannot have direct perception of taste of a person’s body.

Flies, lice, wasps and mosquitoes start departing from the body of a moribund person in case of excessive distaste, while flies repeatedly surround the body in case of excessive sweet taste of a moribund person, even after the person has taken bath and applied unguent all over his body. [17-22]

Summary

तत्र श्लोकः-
सामान्येन मयोक्तानि लिङ्गानि रसगन्धयोः|
पुष्पितस्य नरस्यैतत्फलं मरणमादिशेत्||२३||

tatra ślōkaḥ-
sāmānyēna mayōktāni liṅgāni rasagandhayōḥ|
puṣpitasya narasyaitatphalaṁ maraṇamādiśēt||23||

tatra shlokaH-
sAmAnyena mayoktAni li~ggAni rasagandhayoH|
puShpitasya narasyaitatphalaM maraNamAdishet||23||

Symptoms of impending death of pushpita persons relating to the general variations in the taste and smell of individuals has been described here. Such symptoms lead to the death of the person. [23]

Tattva Vimarsha(Fundamental Principles)

  • Death doesn’t occur without showing Arishta (fatal signs). One shall always be free from Prajnaparadha (intellectual errors) to identify and diagnose these signs correctly. [5-6]
  • Arishta related to Gandha - Pitta is primarily responsible factor for all odors as it has visra gandha. When pitta reaches the twak or skin and exerts its visra gandha by bhrajaka pitta, it’s odor is of sweat and sebum ???. In this way we can derive the cause and effect. All these verses describe how the various smells (both good as well as bad odors) emitted by the body of an individual without any appreciable causes denote the impending death of the person within a year.

Vidhi Vimarsha (Applied Inferences)

Prognostic signs related to odor (gandha)

These smells coming from the body of individuals represent manifestations of major metabolic disorder which is altering the normal smell of the body. For example, fruity odor in diabetes (ketoacidosis), odor of Ammonia in renal or hepatic failure and fecal smell in high intestinal obstruction etc. [Verse 8-16]

Prognostic signs related to taste (rasa)

The odor and other parameters can be examined by direct perception (pratyaksha pramana), but taste (rasa) is always examined by inference (anumana pramana) because of lack of laboratory investigations. For example, If flies and ants are attracted towards the body – then it is inferred that the taste of the body has become sweet and if the lice, mosquitoes etc. started leaving the patient’s body, it is inferred that the patient’s body has developed excessive distaste. This information can be helpful in certain rural areas of the world. [Verse 17-22]

Assessment of factors related to odor

The odor or smell of individual can indicate specific underlying morbidity. The probable abnormal conditions are summarized in table 1 and 2. [1] These parameters can be applied for clinical assessment of relevant factor. There is a wide scope for research on implementing these practices to predict prognosis and life span of individual.

Table 1: Specific body odor and probable relevant morbidity
Odour Disease
Acetone / Rotten apple Diabetes / Diabetic ketoacidosis
Sweetish Rice water stools of Cholera
Sweetish / Putrid Diphtheria
Sweetish / Pungent Small pox lesions
Baked-bread Typhoid
Caramelized sugar Maple syrup urine disease
Sweet Leukaemia
Table 2: Specific unpleasant body odor and probable relevant morbidity
Odour Disease
Offensive Cancerous wounds / Infectious diseases / Gynaecological tumours / Necrotic cavity on penis in Squamous cell carcinoma
Unpleasant Fungating wounds in advanced cancers / Vagabond’s disease / Infected eczema / Pemphigus / Herpes labialis / Deep pressure sores on buttocks / Infected leg ulcers
Cheesy / Fishy Vaginal & cervical bacterial infections
Severe malodor Advanced breast, head and neck cancers
Foul Scarlet fever / Pneumonia / Tuberculosis
Stale beer Ulcerated lymph nodes
Butcher’s shop Yellow fever
Musty Phenylketonuria
Cheesy / Acrid / Sweaty feet Isovaleric academia (IVA)
Yeast / Malt / Hop-like Methionine malabsorption syndrome
Cabbage like Hypermethioninemia
Foul / Rotten fish like Trimethylaminuria
Cabbage / Rancid butter Tyrosinaemia
Rotten egg Cystinuria
Urine Uraemia / Kidney failure
Faecal Ileus / Intestinal obstruction
Putrid Scurvy
Rotting Ozena
Musty / Skunk / Characteristic Schizophrenia
Sweaty Acromegaly
Malodor Liver diseases
Obnoxious Gangrenous feet

Acknowledgement: The contributors acknowledge support of Dr. M. Prasad and Dr.G.Kshama for providing tables from their published article referred in this chapter.

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References

  1. Gupta K., Mamidi P., Pushpitakam of Charaka Indriya Sthana - An Explorative Study, Int. J. Ayu. Alt. Med., 2019; 7(5): 176-182