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===Introduction ===

==Introduction ==

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Charak has placed [[Indriya Sthana]] (section about near death signs) before [[Chikitsa Sthana]] (section about the treatment of diseases) possibly, to guide physician when not to treat a patient. In this chapter of [[Indriya Sthana]], [[Varnasvariyamindriyam Adhyaya]], Charak mentions near death signs and symptoms that can be directly observed by visual and other faculties. This chapter also describes ''prakriti'', the natural disposition of an individual, and ''vikriti'', or abnormalities , since such knowledge helps in discerning any sign of ''vikriti'' in a "healthy" individual. Three types of morbid conditions are observed namely, ''lakshana nimitta'', caused by bodily marks, ''lakshya nimitta'', caused by etiological factors which disturb the health, and ''nimitta anuroopa vikriti'', a break down for no apparent reason resembling etiological factors. The chapter describes various near death signs with changes in color, the complexion of body parts and voice.

Charak has placed [[Indriya Sthana]] (section about near death signs) before [[Chikitsa Sthana]] (section about the treatment of diseases) possibly, to guide physician when not to treat a patient. In this chapter of [[Indriya Sthana]], [[Varnasvariyamindriyam Adhyaya]], Charak mentions near death signs and symptoms that can be directly observed by visual and other faculties. This chapter also describes ''prakriti'', the natural disposition of an individual, and ''vikriti'', or abnormalities , since such knowledge helps in discerning any sign of ''vikriti'' in a "healthy" individual. Three types of morbid conditions are observed namely, ''lakshana nimitta'', caused by bodily marks, ''lakshya nimitta'', caused by etiological factors which disturb the health, and ''nimitta anuroopa vikriti'', a break down for no apparent reason resembling etiological factors. The chapter describes various near death signs with changes in color, the complexion of body parts and voice.

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

==Sanskrit text, Transliteration and English Translation==

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Lord Athreya says, "Now we shall expound the normal and abnormal color, complexion and voice in a person which especially relies on two ''indriyas'' –visual and auditory faculty".[1-2]

Now we shall expound the chapter "Varnasvariyam indriyam" (Fatal signs in complexion and voice). Thus said Lord Atreya.[1-2] 

Note: This chapter deals with normal and abnormal color, complexion and voice in a person which especially relies on two "indriya" –visual and auditory faculty.

==== Factors for assessment of residual span of life ====

=== Factors for assessment of residual span of life ===

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Some of the signs and symptoms are not apparent in a patient but can be observed in the surrounding of the patient. These are evaluated by logic based on scriptural instructions and inference. The factors not observed in patients are often circumstantial like an informer who comes with news of patient and the good/bad omens seen by the physician. Those which can be seen in patients are examined by observing their constitution and morbid conditions. But all these factors should be assessed wisely in the quest for the life of the patient. [4]

Some of the signs and symptoms are not apparent in a patient but can be observed in the surrounding of the patient. These are evaluated by logic based on scriptural instructions and inference. The factors not observed in patients are often circumstantial like an informer who comes with news of patient and the good/bad omens seen by the physician. Those which can be seen in patients are examined by observing their constitution and morbid conditions. But all these factors should be assessed wisely in the quest for the life of the patient. [4]

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==== Factors responsible for natural constitution ====  

=== Factors responsible for natural constitution ===  

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==== Types of pathological abnormalities ====

=== Types of pathological abnormalities ===

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==== Normal complexion ====

=== Normal complexion ===

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There are four types of natural complexion – black, dark (blue or brown), dark-fair (blue or brown), fair white, There may some more complexions with combinations of such colors.[8]

There are four types of natural complexion – black, dark (blue or brown), dark-fair (blue or brown), fair white, There may some more complexions with combinations of such colors.[8]

==== Abnormal complexion ====

=== Abnormal complexion ===

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Sudden appearance of any one of the abnormal colors in nails, eyes, face, urine, stool, hands, legs and lips together with diminished strength, complexion and senses indicate imminent death. Such other abnormal complexions too that appear suddenly for the first time without any apparent cause in the patient with constant deterioration of health are the signs of death. [12-13]

Sudden appearance of any one of the abnormal colors in nails, eyes, face, urine, stool, hands, legs and lips together with diminished strength, complexion and senses indicate imminent death. Such other abnormal complexions too that appear suddenly for the first time without any apparent cause in the patient with constant deterioration of health are the signs of death. [12-13]

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==== Normal and abnormal voice ====

=== Normal and abnormal voice ===

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If the abnormal and inauspicious voices occur suddenly, or rhythm, tone, pitch, resonance and frequency of voice changes on sudden onset, it is inauspicious (there is a grave indication of imminent death).[15]  

If the abnormal and inauspicious voices occur suddenly, or rhythm, tone, pitch, resonance and frequency of voice changes on sudden onset, it is inauspicious (there is a grave indication of imminent death).[15]  

==== Various fatal signs in complexion ====

=== Various fatal signs in complexion ===

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==== Summary ====

=== Summary ===

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Thus the fatal signs related with complexion and voice are described. One who knows the details of these facts will not be confused in knowing lifespan of patient.

Thus the fatal signs related with complexion and voice are described. One who knows the details of these facts will not be confused in knowing lifespan of patient.

=== ''Tattva Vimarsha'' / Fundamental Principles===  

== Tattva Vimarsha (Fundamental Principles) ==  

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*The prognosis of disease leading to death can be predicted by keen observation of complexion, color of body parts and voice. [3]

*The prognosis of disease leading to death can be predicted by keen observation of complexion, color of body parts and voice. [3]

*The complexion is a tool to assess malaise, cheerfulness, dryness and unctuousness in body i.e. the circulatory and metabolic state of body. [9]

*The complexion is a tool to assess malaise, cheerfulness, dryness and unctuousness in body i.e. the circulatory and metabolic state of body. [9]

=== ''Vidhi Vimarsha'' / Applied Inferences===

== Vidhi Vimarsha (Applied Inferences) ==

*'''Sudden change in following factors indicate near death signs:'''  

*'''Sudden change in following factors indicate near death signs:'''