Changes

==== ''Poorvarupa'' (premonitory signs) ====

==== ''Poorvarupa'' (premonitory signs) ====

The earliest manifested symptoms (that are typically of less intensity) in any disease are termed as poorvarupa or prodromal symptoms of that disease. With time, some of these prodromal symptoms (poorvarupas) become more intense and become the primary symptoms (rupa / lakshana) of that disease. If all these prodromal symptoms become the main symptoms, then it indicates poor prognosis of the disease (i.e., the disease could be considered incurable or hardly curable). So, it is important that diseases do not show all the symptoms in their early stage, or a few of them should appear first with less intensity.  

The earliest manifested symptoms (that are typically of less intensity) in any disease are termed as ''poorvarupa'' or prodromal symptoms of that disease. With time, some of these prodromal symptoms (''poorvarupas'') become more intense and become the primary symptoms (''rupa'' / ''lakshana'') of that disease. If all these prodromal symptoms become the main symptoms, then it indicates poor prognosis of the disease (i.e., the disease could be considered incurable or hardly curable). So, it is important that diseases do not show all the symptoms in their early stage, or a few of them should appear first with less intensity.  

There are two types of Poorvarupa,

 

1. Incomplete manifestation of the symptoms before the appearance of the disease.             

There are two types of ''Poorvarupa'':

2. Poorvarupa caused due to doshadushyasammurchana (interaction of vitiated dosha and dushya) that are different from the previous ones. e.g. feeling of hatred towards children or horripilations seen in jwara. These types of poorvarupas are not seen when the jwara is manifested completely. But if they are seen then the prognosis of the disease is asadhyata (incurable). These signs are symptomatic of the diseases to be seen in the near future and do not indicate dosha predominance in that disease.  

#Incomplete manifestation of the symptoms before the appearance of the disease.             

In some acute diseases, the disease is presented directly with signs and symptoms. In these cases, the unmanifested form of the actual symptoms (rupa) described in the text should be treated as the poorvarupa of a disease. [10]

#''Poorvarupa'' caused due to ''doshadushyasammurchana'' (interaction of vitiated ''dosha'' and ''dushya'') that are different from the previous ones. e.g. feeling of hatred towards children or horripilation seen in ''jwara''. These types of ''poorvarupas'' are not seen when the ''jwara'' is manifested completely. But if they are seen then the prognosis of the disease is ''asadhyata'' (incurable). These signs are symptomatic of the diseases to be seen in the near future and do not indicate ''dosha'' predominance in that disease.  

Vagbhata opines that poorvarupa are signs and symptoms that appear earlier to the actual disease, not specifically assignable to the doshas as they are mild (not clearly recognizable) and few in number. (A. H. Ni. 1/) [11]. This is also substantiated in the Ashtanga Sangraha (A S Ni 1/8) [13]

 

Gangadhara, commentator of Charakasamhita, describes two types of Poorvarupa:

In some acute diseases, the disease is presented directly with signs and symptoms. In these cases, the unmanifested form of the actual symptoms (''rupa'') described in the text should be treated as the ''poorvarupa'' of a disease. [10]

1. Samanya Poorvarupa (general premonitory features): These are the general symptoms of disease which appear before the manifestation of the disease but do not indicate affliction of doshas.

 

2. Vishesha Poorvarupa (specific premonitory features): These are the general symptoms of disease which manifest before the manifestation of the disease and indicate involvement of doshas. [12]

Vagbhata opines that ''poorvarupa'' are signs and symptoms that appear earlier to the actual disease, not specifically assignable to the ''doshas'' as they are mild (not clearly recognizable) and few in number. (A. H. Ni. 1/) [11]. This is also substantiated in the Ashtanga Sangraha (A S Ni 1/8) [13]

Rupa (clinical signs and symptoms):

 

Rupa indicates the specific characteristics of the disease as it progresses, such as the dominance of doshas, various stages viz., ama (immature), pakva (mature), etc. They however, do not include such other factors of diagnosis of the diseases like nidana, upashaya and samprapti. [14]. Rupa includes the following signs and symptoms:

Gangadhara, commentator of [[Charaka Samhita]], describes two types of ''Poorvarupa'':

1. Invariable symptoms of the diseases like hyperpyrexia.

#'''''Samanya Poorvarupa''''' (general premonitory features): These are the general symptoms of disease which appear before the manifestation of the disease but do not indicate affliction of ''doshas''.

2. Symptoms caused by the vitiation of doshas like irregularity in onset and relief of attacks which is characteristic feature of fever caused by the vitiation of vata dosha.

#'''''Vishesha Poorvarupa''''' (specific premonitory features): These are the general symptoms of disease which manifest before the manifestation of the disease and indicate involvement of ''doshas''. [12]

3. Symptoms indicative of specific stages of the diseases like those observed during ama (immature), pakva (mature), and jeerna (chronic) stage.

 

4. Symptoms arise due to the complication of the diseases indicating their incurability.

==== ''Rupa'' (clinical signs and symptoms) ====

5. Premonitary symptoms of the diseases.

 

In present context, different synonyms of rupa have the same meaning but at other places these terms may have different meanings, as follows:

''Rupa'' indicates the specific characteristics of the disease as it progresses, such as the dominance of ''doshas'', various stages viz., ''ama'' (immature), ''pakva'' (mature), etc. They however, do not include such other factors of diagnosis of the diseases like ''nidana, upashaya'' and ''samprapti''. [14].  

 

''Rupa'' includes the following signs and symptoms:

#Invariable symptoms of the diseases like hyperpyrexia.

#Symptoms caused by the vitiation of ''doshas'' like irregularity in onset and relief of attacks which is characteristic feature of fever caused by the vitiation of ''vata dosha''.

#Symptoms indicative of specific stages of the diseases like those observed during ''ama'' (immature), ''pakva'' (mature), and ''jeerna'' (chronic) stage.

#Symptoms arise due to the complication of the diseases indicating their incurability.

#Premonitary symptoms of the diseases.

 

In present context, different synonyms of ''rupa'' have the same meaning but at other places these terms may have different meanings, as follows:

 

Linga: The pratyatma lakshanas (cardinal symptoms) of the disease are also known as linga. For example, copious amounts and high frequency of urine and turbidity of urine is linga of diabetes.  

Linga: The pratyatma lakshanas (cardinal symptoms) of the disease are also known as linga. For example, copious amounts and high frequency of urine and turbidity of urine is linga of diabetes.  

Akruti: Akruti means the shape, posture or appearance of the face and body of the patient in the state of illness or health. This is also indicative of the dosha associated with the disease. E.g. the appearance of the knee-joint looks like the head of jackal in Kroshtukashirsha.  

Akruti: Akruti means the shape, posture or appearance of the face and body of the patient in the state of illness or health. This is also indicative of the dosha associated with the disease. E.g. the appearance of the knee-joint looks like the head of jackal in Kroshtukashirsha.