Changes

=== ''Vidhi Vimarsha'' ===

=== ''Vidhi Vimarsha'' ===

• Sudden change in following factors indicate near death signs:  

*Sudden change in following factors indicate near death signs:  

Complexion, voice, smell, taste, touch, eyes, ears, nose, tongue, skin, psyche, desire, cleanliness, conduct, behavior, memory, shape, nature, morbidity, strength, malaise, intellect, exhilaration, dryness, unctuousness, drowsiness, initiation, heaviness, lightness, qualities, diet, regimens, digestion of food, manifestation of disease, disappearance of disease, characters of disease, premonitory signs of the disease, symptoms, complications, administration of proper medicine, and effect of medicine on disease, luster, shadow, dream, state of informer about the patient. Bad omens perceived by the physician on his way to patient’s house, changed conditions of the patient’s residence, signs and symptoms indicating the residual span of life may be evident in these factors. Hence physician should pay careful attention to each one of them and interpretation should be made based on his observations, knowledge and scriptural advice.

Complexion, voice, smell, taste, touch, eyes, ears, nose, tongue, skin, psyche, desire, cleanliness, conduct, behavior, memory, shape, nature, morbidity, strength, malaise, intellect, exhilaration, dryness, unctuousness, drowsiness, initiation, heaviness, lightness, qualities, diet, regimens, digestion of food, manifestation of disease, disappearance of disease, characters of disease, premonitory signs of the disease, symptoms, complications, administration of proper medicine, and effect of medicine on disease, luster, shadow, dream, state of informer about the patient. Bad omens perceived by the physician on his way to patient’s house, changed conditions of the patient’s residence, signs and symptoms indicating the residual span of life may be evident in these factors. Hence physician should pay careful attention to each one of them and interpretation should be made based on his observations, knowledge and scriptural advice.

• The examination of complexion does not just mean the color only. It also includes objects of visual perception like coarseness, glossiness etc. Abnormal swara (voice) include fluctuations in the normal quality of sounds produced (hoarseness of voice, dysphonia), absence of the normal physiological sounds like absence of peristalsis in peritonitis, presence of abnormal sounds like crepitus in joints & crepitations, rhonchi etc. in lungs. Abnormalities in touch include tactile perception of abnormal hardness, softness, warmth etc.

*The examination of complexion does not just mean the color only. It also includes objects of visual perception like coarseness, glossiness etc. Abnormal ''swara'' (voice) include fluctuations in the normal quality of sounds produced (hoarseness of voice, dysphonia), absence of the normal physiological sounds like absence of peristalsis in peritonitis, presence of abnormal sounds like crepitus in joints & crepitations, rhonchi etc. in lungs. Abnormalities in touch include tactile perception of abnormal hardness, softness, warmth etc.

• The morbid conditions are of three types. Such as those indicated by bodily marks, those caused by etiological factors and those resemble etiological factors.

*The morbid conditions are of three types. Such as those indicated by bodily marks, those caused by etiological factors and those resemble etiological factors.

• Lakshana nimitta include visible end stage manifestations.

*''Lakshana nimitta'' include visible end stage manifestations.

• The abnormal colour produced can be considered as ojokshaya lakshana [depletion of quality of tissue]. In Raktarshas [bleeding piles], when there is excessive bleeding, it may lead to poor complexion, strength, enthusiasm and depleted Ojas. If proper measure is not taken the condition may become fatal. The unnatural colors formed can be compared with the cyanotic conditions, discoloration seen in the fatal hepatic and renal pathologies etc. Appearance of white spots, white nails and loss of pigmentation can be seen in chronic liver failure.

*The abnormal color produced can be considered as ''ojokshaya lakshana'' (depletion of quality of tissue). In ''Raktarshas'' (bleeding piles), when there is excessive bleeding, it may lead to poor complexion, strength, enthusiasm and depleted ''Ojas''. If proper measure is not taken the condition may become fatal. The unnatural colors formed can be compared with the cyanotic conditions, discoloration seen in the fatal hepatic and renal pathologies etc. Appearance of white spots, white nails and loss of pigmentation can be seen in chronic liver failure.

• In chronic kidney disease, the conjunctival deposition of calcium leads to redness and gritty feeling in the eye called uremic red eye. Also deposition of calcium as a band in the lamina proprea of cornea leads to band keratopathy.

*In chronic kidney disease, the conjunctival deposition of calcium leads to redness and gritty feeling in the eye called uremic red eye. Also deposition of calcium as a band in the lamina proprea of cornea leads to band keratopathy.

• In chronic hepatic failure, erythematous patches may appear over many parts of the body, especially over the chest wall and supraclavicular regions.

*In chronic hepatic failure, erythematous patches may appear over many parts of the body, especially over the chest wall and supraclavicular regions.

• Appearance of abnormal complexion in the entire or half of the body of the individual without any significant reason is due to abnormal peripheral circulation. Oxygenation can affect the complexion. Serious vascular insufficiencies will also result in impaired skin complexion. In deep vein thrombosis DVT alteration in pigmentation is well appreciated.

*Appearance of abnormal complexion in the entire or half of the body of the individual without any significant reason is due to abnormal peripheral circulation. Oxygenation can affect the complexion. Serious vascular insufficiencies will also result in impaired skin complexion. In deep vein thrombosis DVT alteration in pigmentation is well appreciated.

• When both the lips become bluish like ripe fruits of jambu, this is a clear indication of death. As per modern science this condition is similar to central cyanosis. It is directly due to Vata Pratilomata (reverse direction of Vata) in different organs. The main Srotas involved are Rasavaha srotas and Raktavaha Srotas.

*When both the lips become bluish like ripe fruits of ''jambu'', this is a clear indication of death. As per modern science this condition is similar to central cyanosis. It is directly due to ''Vata Pratilomata'' (reverse direction of ''Vata'') in different organs. The main ''Srotas'' involved are ''Rasavaha srotas'' and ''Raktavaha Srotas.''

Abnormal voices:

*Abnormal voices:

• In sannipatha jwara  - swarasada [low pitched voice] is a lakshana.

**In sannipatha jwara  - swarasada [low pitched voice] is a lakshana.

• In kshathaja kasa  - paravatha ivaakoojan (cooing sound like that of a pigeon comes out of  the throat)

**In kshathaja kasa  - paravatha ivaakoojan (cooing sound like that of a pigeon comes out of  the throat)

• In  Apatantraka –kapota iva koojan ( make sound like a pigeon).

**In  Apatantraka –kapota iva koojan ( make sound like a pigeon).

• In Tetanus  -sudden death occurs due to laryngeal spasm .

**In Tetanus  -sudden death occurs due to laryngeal spasm .

• Dysphonia—Disturbance of phonation due to disturbance in vocal cords. Strained, harsh, low pitched voice, nasal voice.

**Dysphonia—Disturbance of phonation due to disturbance in vocal cords. Strained, harsh, low pitched voice, nasal voice.

• In laryngeal tumors like supra glottic cancer  and glottis cancer hoarseness of voice is a late symptom.

**In laryngeal tumors like supra glottic cancer  and glottis cancer hoarseness of voice is a late symptom.

In fact the abnormal changes in color and voice of the patient reflect serious changes in the physiology. Deep seated pathologies of cardio vascular system, Respiratory system, endocrine system often presents with color changes. Central and peripheral cyanosis represents certain death causing conditions. Similarly lesions in the central nervous system can lead to changes in the voice. Dysarthria, Dysphasia and Dysphonia shows underlining pathologies which may become fatal. In short this chapter highlights the events related with major systems in the body which can cause death.

In fact the abnormal changes in color and voice of the patient reflect serious changes in the physiology. Deep seated pathologies of cardio vascular system, Respiratory system, endocrine system often presents with color changes. Central and peripheral cyanosis represents certain death causing conditions. Similarly lesions in the central nervous system can lead to changes in the voice. Dysarthria, Dysphasia and Dysphonia shows underlining pathologies which may become fatal. In short this chapter highlights the events related with major systems in the body which can cause death.