Changes

===Abstract===  

===Abstract===  

 

[[Purvarupeeya]] has been devoted to predict prognosis of diseases by prodromal symptoms. This chapter suggests that knowledge and examination of prodromal symptoms was important in ancient times and emphasis was given that physician should carefully recognize disease in early stage and predict course of disease. With the help of eight diseases of [[Nidana Sthana]] important principles related to prognosis have been laid down which are also applicable to all other diseases and are valid till now. Various aspects of dreams including physiology, types, interpretation and prognostic importance have also been described. Various dreams along with physical and mental features have been incorporated in prodromal symptoms which signify that dreams should also be analyzed and properly investigated before predicting prognosis of any disease. Even with restricted technological tools, par excellence observation and principles described regarding ''Arishta Lakshana'' are valid till now.

[[Purvarupeeya]] has been devoted to predict prognosis of diseases by prodromal symptoms. This chapter suggests that knowledge and examination of prodromal symptoms was important in ancient times and emphasis was given that physician should carefully recognize disease in early stage and predict course of disease. With the help of eight diseases of [[Nidana Sthana]] important principles related to prognosis have been laid down which are also applicable to all other diseases and are valid till now. Various aspects of dreams including physiology, types, interpretation and prognostic importance have also been described. Various dreams along with physical and mental features have been incorporated in prodromal symptoms which signify that dreams should also be analyzed and properly investigated before predicting prognosis of any disease. Even with restricted technological tools, par excellence observation and principles described regarding ''Arishta Lakshana'' are valid till now.

'''Keywords''': Prodromal symptoms, dream, prognosis, disease, death.

'''Keywords''': Prodromal symptoms, dream, prognosis, disease, death.

 

=== Introduction ===

=== Introduction ===

 

In this chapter prodromal symptoms and dreams related to poor prognosis of diseases- fatality are described. In the first verse, Charaka has emphasized that he will describe both common and special prodromal symptoms. This indicates that while there may be some prodromata which result out of normal pathogenesis, some are unusual and unexpected. In the next verse it has been said that if all prodromal symptoms are manifesting and are severe in nature then such a condition will be fatal. This principle is applicable to all other diseases also. Prodromal symptoms of ''kushta'' and ''prameha'' suggest that complications manifest before cardinal symptoms of the disease appear. If body metabolism in any disease is altered severely during latent phase of disease and complications are appearing before manifestation of full-fledged disease then such condition will be difficult to cure. Example of ''gulma'' suggests that there are certain diseases which are incurable in nature and prodromal symptoms related to such clinical conditions will always be precursors of imminent death. It is commonly seen that any person who is emaciated and have low immunity and strength, when affected by disease, has fatal consequences due to less resistance. This fact is explained with the example of ''shosha''. Another important aspect regarding disease prognosis is that, if a person is continuously partaking causative factors or is in constant exposure to the causative factors, body will be unable to fight disease properly and thus there will be less chances of recovery from the disease. This point is also mentioned while describing prognosis of ''shosha''.

In this chapter prodromal symptoms and dreams related to poor prognosis of diseases- fatality are described. In the first verse, Charaka has emphasized that he will describe both common and special prodromal symptoms. This indicates that while there may be some prodromata which result out of normal pathogenesis, some are unusual and unexpected. In the next verse it has been said that if all prodromal symptoms are manifesting and are severe in nature then such a condition will be fatal. This principle is applicable to all other diseases also. Prodromal symptoms of ''kushta'' and ''prameha'' suggest that complications manifest before cardinal symptoms of the disease appear. If body metabolism in any disease is altered severely during latent phase of disease and complications are appearing before manifestation of full-fledged disease then such condition will be difficult to cure. Example of ''gulma'' suggests that there are certain diseases which are incurable in nature and prodromal symptoms related to such clinical conditions will always be precursors of imminent death. It is commonly seen that any person who is emaciated and have low immunity and strength, when affected by disease, has fatal consequences due to less resistance. This fact is explained with the example of ''shosha''. Another important aspect regarding disease prognosis is that, if a person is continuously partaking causative factors or is in constant exposure to the causative factors, body will be unable to fight disease properly and thus there will be less chances of recovery from the disease. This point is also mentioned while describing prognosis of ''shosha''.

Research studies are needed to prove that dreams can be used as markers of prognosis. Some studies have been conducted in this regard but we cannot make strong conclusion on basis of their results. In a few studies it has been shown that hormone levels affect dreams. One of the studies states that cortisol plays an important role in controlling the state of memory systems during sleep. High levels of cortisol, as are observed late at night and, typically in the context of REM sleep, disrupt normal hippocampal → neocortical communication, thereby interfering with forms of memory consolidation dependent upon this communication. At the same time, the content of dreams is also affected.<ref>Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678. </ref> In neurological and psychological diseases dream disturbances are often seen but few other diseases have also been found to affect dreams. Patients with sleep apnea are reported to have intense nightmares.<ref>J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73. </ref> Abnormal dreams have also been reported in diseases like Relapsing fever,<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165. </ref> Cardiac ischemia<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28. </ref> etc. Certain drugs also affect dreams e.g. Anti malarial drug has shown to alter dream types.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203. </ref> This proves that at times diseases certainly affect dreams but intense research studies are needed to actually establish this fact on scientific grounds.

Research studies are needed to prove that dreams can be used as markers of prognosis. Some studies have been conducted in this regard but we cannot make strong conclusion on basis of their results. In a few studies it has been shown that hormone levels affect dreams. One of the studies states that cortisol plays an important role in controlling the state of memory systems during sleep. High levels of cortisol, as are observed late at night and, typically in the context of REM sleep, disrupt normal hippocampal → neocortical communication, thereby interfering with forms of memory consolidation dependent upon this communication. At the same time, the content of dreams is also affected.<ref>Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678. </ref> In neurological and psychological diseases dream disturbances are often seen but few other diseases have also been found to affect dreams. Patients with sleep apnea are reported to have intense nightmares.<ref>J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73. </ref> Abnormal dreams have also been reported in diseases like Relapsing fever,<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165. </ref> Cardiac ischemia<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28. </ref> etc. Certain drugs also affect dreams e.g. Anti malarial drug has shown to alter dream types.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203. </ref> This proves that at times diseases certainly affect dreams but intense research studies are needed to actually establish this fact on scientific grounds.

 

===Sanskrit text, Transliteration and English Translation===

===Sanskrit text, Transliteration and English Translation===

anyasyApi ca rogasya pUrvarUpANi yaM naram|  

anyasyApi ca rogasya pUrvarUpANi yaM naram|  

vishantyanena kalpena tasyApi maraNaM dhruvam||5||

vishantyanena kalpena tasyApi maraNaM dhruvam||5||

 

For enhancing the knowledge of physicians, we will distinctly explain the general and fatal prodromal symptoms of diseases.

For enhancing the knowledge of physicians, we will distinctly explain the general and fatal prodromal symptoms of diseases.

If all prodromal symptoms of ''jwara'' manifests in severe degree, the person will die. If prodromal symptoms of any other disease also appear in the same way as described above, death of the patient is certain. [3-5]

If all prodromal symptoms of ''jwara'' manifests in severe degree, the person will die. If prodromal symptoms of any other disease also appear in the same way as described above, death of the patient is certain. [3-5]

 

==== Incurable prodromal signs of ''Rajayakshma'' leading to death ====

==== Incurable prodromal signs of ''Rajayakshma'' leading to death ====

   

   

pretaiH saha pibenmadyaM svapne yaH kRuShyate shunA|  

pretaiH saha pibenmadyaM svapne yaH kRuShyate shunA|  

sughoraM jvaramAsAdya jIvitaM sa vimu~jcati||9||  

sughoraM jvaramAsAdya jIvitaM sa vimu~jcati||9||  

 

Now we shall discuss certain severe premonitory symptoms which are associated with certain diseases.

Now we shall discuss certain severe premonitory symptoms which are associated with certain diseases.

The consumption which is associated with continuously decreasing strength, worsening rhinitis and over indulgence in sex in prodromal stage will turn out to be incurable.

The consumption which is associated with continuously decreasing strength, worsening rhinitis and over indulgence in sex in prodromal stage will turn out to be incurable.

A man, who in his dreams, is dragged by dog, camel or a donkey towards south, leaves his life as by consumption.   

A man, who in his dreams, is dragged by dog, camel or a donkey towards south, leaves his life as by consumption.   

A person who in his dreams takes alcohol with demons and who is dragged by a dog leaves his life getting affected with severe fever. [6-9]

A person who in his dreams takes alcohol with demons and who is dragged by a dog leaves his life getting affected with severe fever. [6-9]

 

==== Incurable prodromal signs of ''Raktapitta'' leading to death ====

==== Incurable prodromal signs of ''Raktapitta'' leading to death ====

raktasragraktasarvA~ggo raktavAsA muhurhasan|  

raktasragraktasarvA~ggo raktavAsA muhurhasan|  

yaH svapne hriyate  nAryA sa raktaM prApya sIdati||11||  

yaH svapne hriyate  nAryA sa raktaM prApya sIdati||11||  

 

He who sees clothes as if dyed with red lac, leaves his life if he gets affected with severe bleeding disorders.

He who sees clothes as if dyed with red lac, leaves his life if he gets affected with severe bleeding disorders.

In his dream, the man who sees himself adorned with red garlands, clad in red clothes, anointed with red dye and dragged by a continuously laughing woman will succumb to severe bleeding disorders. [10-11]

In his dream, the man who sees himself adorned with red garlands, clad in red clothes, anointed with red dye and dragged by a continuously laughing woman will succumb to severe bleeding disorders. [10-11]

 

==== Incurable prodromal signs of ''Gulma'' leading to death ====  

==== Incurable prodromal signs of ''Gulma'' leading to death ====  

latA kaNTakinI yasya dAruNA hRudi jAyate|  

latA kaNTakinI yasya dAruNA hRudi jAyate|  

svapne gulmastamantAya krUro vishati mAnavam||13||  

svapne gulmastamantAya krUro vishati mAnavam||13||  

 

A man who experiences severe pain, gurgling sounds in abdomen, intestinal peristalsis, excessive debility, discoloration of nails and other body parts is going to die if he is affected with ''gulma''.

A man who experiences severe pain, gurgling sounds in abdomen, intestinal peristalsis, excessive debility, discoloration of nails and other body parts is going to die if he is affected with ''gulma''.

A person, who in his dreams sees hard and thorny creepers grown on his chest and then gets afflicted by ''gulma'', is surely going to die soon. [12-13]  

A person, who in his dreams sees hard and thorny creepers grown on his chest and then gets afflicted by ''gulma'', is surely going to die soon. [12-13]  

 

==== Incurable prodromal signs of ''Kushtha'' leading to death ====

==== Incurable prodromal signs of ''Kushtha'' leading to death ====

nagnasyAjyAvasiktasya juhvato~agnimanarciSham|  

nagnasyAjyAvasiktasya juhvato~agnimanarciSham|  

padmAnyurasi jAyante svapne kuShThairmariShyataH||15||

padmAnyurasi jAyante svapne kuShThairmariShyataH||15||

 

A person whose body even if touched gently leads to deep cuts and whose injuries never heal will be killed by severe skin diseases.

A person whose body even if touched gently leads to deep cuts and whose injuries never heal will be killed by severe skin diseases.

In his dream, a man who sees himself naked, anointed with ghee, offering the oblations without the fire being lit, who has lotuses grown on his chest, will be taken away by death as afflicted by skin diseases.[14-15]

In his dream, a man who sees himself naked, anointed with ghee, offering the oblations without the fire being lit, who has lotuses grown on his chest, will be taken away by death as afflicted by skin diseases.[14-15]

 

==== Incurable prodromal signs of ''Prameha'' leading to death ====

==== Incurable prodromal signs of ''Prameha'' leading to death ====

   

   

mattaM nRutyantamAvidhya preto harati yaM naram|  

mattaM nRutyantamAvidhya preto harati yaM naram|  

svapne harati taM mRutyurapasmArapuraHsaraH||23||  

svapne harati taM mRutyurapasmArapuraHsaraH||23||  

 

He who is affected with disturbing thoughts, anxiety, stupefaction without any specific cause, restlessness, loss of strength will succumb to death as affected with insanity.

He who is affected with disturbing thoughts, anxiety, stupefaction without any specific cause, restlessness, loss of strength will succumb to death as affected with insanity.

He who sees darkness even when he is awake and hears sounds when there is no real sound, will be killed by epilepsy.

He who sees darkness even when he is awake and hears sounds when there is no real sound, will be killed by epilepsy.

In dream, a person who sees himself dancing with ghosts while in intoxication with his head upside down, will be taken away by death getting affected with epilepsy. [18-23]

In dream, a person who sees himself dancing with ghosts while in intoxication with his head upside down, will be taken away by death getting affected with epilepsy. [18-23]

 

स्तभ्येते प्रतिबुद्धस्य हनू मन्ये तथाऽक्षिणी|  

स्तभ्येते प्रतिबुद्धस्य हनू मन्ये तथाऽक्षिणी|  

यस्य तं बहिरायामो गृहीत्वा हन्त्यसंशयम्||२४||  

यस्य तं बहिरायामो गृहीत्वा हन्त्यसंशयम्||२४||  

shaShkulIrvA~apyapUpAn vA svapne khAdati yo naraH|  

shaShkulIrvA~apyapUpAn vA svapne khAdati yo naraH|  

sa cettAdRuk  chardayati pratibuddho na jIvati||25||

sa cettAdRuk  chardayati pratibuddho na jIvati||25||

 

If individual is found with ''bahirayama'' ( a disease with feature of opisthotonus or bending of body backwards) soon after awaking from sleep along with lock jaw, neck stiffness, stale eyes and paralysis is going to lose life soon.

If individual is found with ''bahirayama'' ( a disease with feature of opisthotonus or bending of body backwards) soon after awaking from sleep along with lock jaw, neck stiffness, stale eyes and paralysis is going to lose life soon.

Such an individual in his dream sees himself taking cakes of sesame seeds and ''apupa'' ( a dietary item) and vomits the same when he is awake.[24-25]

Such an individual in his dream sees himself taking cakes of sesame seeds and ''apupa'' ( a dietary item) and vomits the same when he is awake.[24-25]

 

एतानि पूर्वरूपाणि यः सम्यगवबुध्यते|  

एतानि पूर्वरूपाणि यः सम्यगवबुध्यते|  

स एषामनुबन्धं च फलं च ज्ञातुमर्हति||२६||

स एषामनुबन्धं च फलं च ज्ञातुमर्हति||२६||

ityete dAruNAH svapnA rogI yairyAti pa~jcatAm|  

ityete dAruNAH svapnA rogI yairyAti pa~jcatAm|  

arogaH saMshayaM gatvA kashcideva pramucyate||40||

arogaH saMshayaM gatvA kashcideva pramucyate||40||

 

Certain other dreams which are fierce should also be analyzed as they indicate the approaching death of the diseased and grave sufferings for those who are going to be affected.

Certain other dreams which are fierce should also be analyzed as they indicate the approaching death of the diseased and grave sufferings for those who are going to be affected.

If a healthy man sees such dreams, his life becomes doubtful, rarely does he escape. [27-40]

If a healthy man sees such dreams, his life becomes doubtful, rarely does he escape. [27-40]

 

==== Dreams ====

==== Dreams ====

nAtiprasuptaH puruShaH saphalAnaphalAMstathA|  

nAtiprasuptaH puruShaH saphalAnaphalAMstathA|  

indriyeshena manasA svapnAn pashyatyanekadhA||42||  

indriyeshena manasA svapnAn pashyatyanekadhA||42||  

 

When the channels associated with the mind are saturated by the excessively vitiated ''doshas'', such terrible dreams appear in his sleep. The person who is not in deep sleep (subconscious state), sees various fruitful (meaningful) or fruitless (meaningless) dreams in association with sense organs. [41-42]  

When the channels associated with the mind are saturated by the excessively vitiated ''doshas'', such terrible dreams appear in his sleep. The person who is not in deep sleep (subconscious state), sees various fruitful (meaningful) or fruitless (meaningless) dreams in association with sense organs. [41-42]  

 

दृष्टं श्रुतानुभूतं च प्रार्थितं कल्पितं तथा|  

दृष्टं श्रुतानुभूतं च प्रार्थितं कल्पितं तथा|  

भाविकं दोषजं चैव स्वप्नं सप्तविधं विदुः||४३||  

भाविकं दोषजं चैव स्वप्नं सप्तविधं विदुः||४३||  

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' ===

 

*Important principle regarding disease prognosis states that “if all premonitory symptoms of a disease are fully manifested in severe form then it indicates poor prognosis”. [Verse No.3-5]

*Important principle regarding disease prognosis states that “if all premonitory symptoms of a disease are fully manifested in severe form then it indicates poor prognosis”. [Verse No.3-5]

*If any person is continuously exposed to etiological agents and complications appear earlier than such disease is going to have poor prognosis. It is also emphasized that any person who is severely debilitated will not recover from any disease easily. Interpretation based on dreams should also be considered while predicting course of the disease. One special note from this chapter is that they describe symptoms in combination than in solitary appearance which shows the complexity of disease causing and disease prognostic process leading to fatality. Perhaps this needs a specially designed research to study on relation between dreams and ''arishtas''. [Verse No.6-9]

*If any person is continuously exposed to etiological agents and complications appear earlier than such disease is going to have poor prognosis. It is also emphasized that any person who is severely debilitated will not recover from any disease easily. Interpretation based on dreams should also be considered while predicting course of the disease. One special note from this chapter is that they describe symptoms in combination than in solitary appearance which shows the complexity of disease causing and disease prognostic process leading to fatality. Perhaps this needs a specially designed research to study on relation between dreams and ''arishtas''. [Verse No.6-9]

*As mentioned above dreams more or less depict unconsciousness state. Freud called dreams the "royal road to the unconscious”. They are related to activities which we have seen, listened, wished, thought etc. Based on this fact seven types of dream have been classified here. Five of them are mild as they are more near to events which we encounter in day to day life. Last two have fatal consequences as they are due to disease or ''dosha'' involvement. [Verse No.43]

*As mentioned above dreams more or less depict unconsciousness state. Freud called dreams the "royal road to the unconscious”. They are related to activities which we have seen, listened, wished, thought etc. Based on this fact seven types of dream have been classified here. Five of them are mild as they are more near to events which we encounter in day to day life. Last two have fatal consequences as they are due to disease or ''dosha'' involvement. [Verse No.43]

*It is difficult to predict dream consequences on the basis of time or order in which they were seen. Researches are needed to scientifically prove the validity of such dream prediction. [Verse No.44-46]

*It is difficult to predict dream consequences on the basis of time or order in which they were seen. Researches are needed to scientifically prove the validity of such dream prediction. [Verse No.44-46]

 

=== References ===

=== References ===

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