Changes

If half of the face there is blue, blackish, coppery or tawny color and the color of the remaining half is otherwise. Manifestation of unctuousness in one half of the face and roughness in the other half is inauspicious.

If half of the face there is blue, blackish, coppery or tawny color and the color of the remaining half is otherwise. Manifestation of unctuousness in one half of the face and roughness in the other half is inauspicious.

The appearance of swelling in one-half of the face and emaciation in the other half. Spontaneous appearance of various types of ''tila'' (black mole), ''piplu'' (port wine mark),''vyanga'' (freckles), and ''raji'' (spots like mustard) in the face of the patient.

The appearance of swelling in one-half of the face and emaciation in the other half. Spontaneous appearance of various types of ''tila'' (black mole), ''piplu'' (port wine mark),''vyanga'' (freckles), and ''raji'' (spots like mustard) on the face of the patient.

The appearance of flowers like spots in nails and teeth and sticky and powdery substance over the teeth is an indicator of death. Discoloration of lips, legs, heels, eyes, urine, stool and nails of the patient are indicators of diminished strength.

The appearance of flowers like spots in nails and teeth and sticky and powdery substance over the teeth is an indicator of death. Discoloration of lips, legs, heels, eyes, urine, stool and nails of the patient are indicators of diminished strength.

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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 natural constitution of a person depends upon ''Jati'' (caste), ''Kula'' (race), ''Desha'' (place), ''Kala'' (time and season), ''Vaya'' (age), ''Pratyatmaniyata'' (individual habits and habitat). The different variations seen in persons are based upon their caste, race, palce of living, season, age and individual habits. [5]

*The natural constitution of a person depends upon ''Jati'' (caste), ''Kula'' (race), ''Desha'' (place), ''Kala'' (time and season), ''Vaya'' (age), ''Pratyatmaniyata'' (individual habits and habitat). The different variations seen in persons are based upon their caste, race, place of living, season, age and individual habits. [5]

*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]

=== Assessment of various prognostic factors ===

=== Assessment of various prognostic factors ===

Various assessment scales and tools can be applied for objective assessment of the factors described in the chapter. The following tables depicts probable tools and scales of assessment.<ref name= "Mamidi P.">Mamidi P., Gupta K. Varna Swareeyam of Charaka Indriya Sthana - An Explorative Study, Int. J. Ayu. Alt. Med., 2019; 7(5): 152-175</ref> 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. Furthermore, each of these factor is elaborated in forthcoming chapters of this section ([[Indriya Sthana]]).   

Various assessment scales and tools can be applied for objective assessment of the factors described in the chapter. The following tables depict probable tools and scales of assessment.<ref name= "Mamidi P.">Mamidi P., Gupta K. Varna Swareeyam of Charaka Indriya Sthana - An Explorative Study, Int. J. Ayu. Alt. Med., 2019; 7(5): 152-175</ref> These parameters can be applied for clinical assessment of relevant factors. There is a wide scope for research on implementing these practices to predict prognosis and life span of individual. Furthermore, each of these factors is elaborated in forthcoming chapters of this section ([[Indriya Sthana]]).   

{| class="wikitable"

{| class="wikitable"

| 8 || Interest (bhakti) || The mood, interest and pleasure questionnaire (MIPQ), Strong interest inventory test etc;

| 8 || Interest (bhakti) || The mood, interest and pleasure questionnaire (MIPQ), Strong interest inventory test etc;

|-

|-

| 9 || purity or cleanliness (shaucham) || Hygiene behaviour scale (HBS), Hand washing behaviour scale Terms of planned behaviour model, Yale-Brown obsessive compulsive scale (Y-BOCS), Cleaning and Hygiene scale etc;

| 9 || purity or cleanliness (shaucham) || Hygiene behavior scale (HBS), Hand washing behavior scale Terms of planned behavior model, Yale-Brown obsessive compulsive scale (Y-BOCS), Cleaning and Hygiene scale etc;

|-

|-

| 10 || Modesty (sheelam) || Philadelphia geriatric centre morale scales, The big five personality test (BFPT), The traits personality questionnaire 5 (TPQue5), Rorschach ink blot technique, Minnesota multiphasic personality inventory, Eysenck personality inventory, Maudsley personality questionnaire etc;

| 10 || Modesty (sheelam) || Philadelphia geriatric centre morale scales, The big five personality test (BFPT), The traits personality questionnaire 5 (TPQue5), Rorschach ink blot technique, Minnesota multiphasic personality inventory, Eysenck personality inventory, Maudsley personality questionnaire etc;

|-

|-

| 11 || Behavioral conduct (achara) || Behavior and symptom identification scale (BASIS), Client adjustment rating scale, Social behaviour assessment schedule, Social maladjustment schedule etc;

| 11 || Behavioral conduct (achara) || Behavior and symptom identification scale (BASIS), Client adjustment rating scale, Social behavior assessment schedule, Social maladjustment schedule etc;

|-

|-

| 12 || Memory ([[smruti]]) || Addenbrookes cognitive assessment - Revised (ACE-R), Abbreviated mental test score (AMTS), General practitioner assessment of cognition (GPCOG), Memory impairment screen (MIS), Montreal cognitive assessment (MoCA), PGI memory scale, Test your memory (TYM) etc;

| 12 || Memory ([[smruti]]) || Addenbrookes cognitive assessment - Revised (ACE-R), Abbreviated mental test score (AMTS), General practitioner assessment of cognition (GPCOG), Memory impairment screen (MIS), Montreal cognitive assessment (MoCA), PGI memory scale, Test your memory (TYM) etc;

| |Discoloration of whole body [ Cha.Sa. [[Indriya Sthana]] 1/9]||  Cyanosis; Melasma; Addison’s disease; Post-inflammatory hyper pigmentation; Cutaneous amyloidosis; Acanthosis nigricans; Wilson’s disease; Purpura; Fungal infections in immunocompromised patients; Jaundice; Hepatocellular carcinoma; Pallor; Hypomelanosis or hypopigmentation; Vitiligo;

| |Discoloration of whole body [ Cha.Sa. [[Indriya Sthana]] 1/9]||  Cyanosis; Melasma; Addison’s disease; Post-inflammatory hyper pigmentation; Cutaneous amyloidosis; Acanthosis nigricans; Wilson’s disease; Purpura; Fungal infections in immunocompromised patients; Jaundice; Hepatocellular carcinoma; Pallor; Hypomelanosis or hypopigmentation; Vitiligo;

|-

|-

| |Discoloration of right half of body [Cha.Sa.[[Indriya Sthana]] 1/10]|| Harlequin colour change;

| |Discoloration of right half of body [Cha.Sa.[[Indriya Sthana]] 1/10]|| Harlequin color change;

|-

|-

| |Discoloration of upper half of body [Cha.Sa.[[Indriya Sthana]] 1/10]||  Differential cyanosis; Reverse differential cyanosis; Spinal cord injury (SCI); Paraplegia;

| |Discoloration of upper half of body [Cha.Sa.[[Indriya Sthana]] 1/10]||  Differential cyanosis; Reverse differential cyanosis; Spinal cord injury (SCI); Paraplegia;

| |Unilateral facial  discoloration [Cha.Sa.[[Indriya Sthana]] 1/10]  || Unilateral facial flushing in Harlequin syndrome; Horner’s syndrome; Parry-Romberg syndrome;

| |Unilateral facial  discoloration [Cha.Sa.[[Indriya Sthana]] 1/10]  || Unilateral facial flushing in Harlequin syndrome; Horner’s syndrome; Parry-Romberg syndrome;

|-

|-

| |Unilateral numbness or hyperesthecia in body  [Cha.Sa.[[Indriya Sthana]] 1/10]  ||  Hemiplegia or hemiparesisi; Paraplegia or paraparesis; Diplegia; HSP (Hereditary spastic paraplegia); CMV (cytomegalovirus) polyradiculopathy; SCI; Myelopathies;

| |Unilateral numbness or hyperesthesia in body  [Cha.Sa.[[Indriya Sthana]] 1/10]  ||  Hemiplegia or hemiparesis; Paraplegia or paraparesis; Diplegia; HSP (Hereditary spastic paraplegia); CMV (cytomegalovirus) polyradiculopathy; SCI; Myelopathies;

|-

|-

||Unilateral numbness or hyperesthecia on face [Cha.Sa.[[Indriya Sthana]] 1/10]  || DAN (Diabetic autonomic neuropathy); Anhidrosis & Hyperhidrosis; SCI; Cervical spine pathology; Unilateral facial seborrhoea in Ramsay-Hunt syndrome & Facial paralysis;

||Unilateral numbness or hyperesthecia on face [Cha.Sa.[[Indriya Sthana]] 1/10]  || DAN (Diabetic autonomic neuropathy); Anhidrosis & Hyperhidrosis; SCI; Cervical spine pathology; Unilateral facial seborrhoea in Ramsay-Hunt syndrome & Facial paralysis;

|-

|-

| |Unilateral unctuousness or dryness in body  [Cha.Sa.[[Indriya Sthana]] 1/10]  || Paraplegia; SCI; Myelopathy;

| |Unilateral unctuousness or dryness of body  [Cha.Sa.[[Indriya Sthana]] 1/10]  || Paraplegia; SCI; Myelopathy;

|-

|-

| |Appearance of moles, freckles, pinples on body  [Cha.Sa.[[Indriya Sthana]] 1/11]  || Basal cell carcinoma; Squamous cell carcinoma; Scleroderma; SLE (Systemic lupus erythematosus); Inflammatory & Infectious dermatoses; Sturge-Weber syndrome; Fungal & Viral skin infections; Melanocytic nevi; Hyper pigmentations; Carcinoid syndrome;

| |Appearance of moles, freckles, pimples on body  [Cha.Sa.[[Indriya Sthana]] 1/11]  || Basal cell carcinoma; Squamous cell carcinoma; Scleroderma; SLE (Systemic lupus erythematosus); Inflammatory & Infectious dermatoses; Sturge-Weber syndrome; Fungal & Viral skin infections; Melanocytic nevi; Hyper pigmentations; Carcinoid syndrome;

|-

|-

| |Abnormal discoloration of nails, eyes, face, urine, stools, hands, legs, lips etc.  [Cha.Sa.[[Indriya Sthana]] 1/12]  || Cyanosis; Melanonychia; Acroperniosis; Chemosis; Jaundice; Panda eye; Iris nevi; Horner’s syndrome; Melanoma; Alkaptonuria; Black water fever; Biliary obstruction; Upper and lower gastrointestinal bleeding; Peripheral vascular disease (PVD); Acrocyanosis; Raynaud’s phenomenon; Mottling at end-of-life stages;

| |Abnormal discoloration of nails, eyes, face, urine, stools, hands, legs, lips etc.  [Cha.Sa.[[Indriya Sthana]] 1/12]  || Cyanosis; Melanonychia; Acroperniosis; Chemosis; Jaundice; Panda eye; Iris nevi; Horner’s syndrome; Melanoma; Alkaptonuria; Black water fever; Biliary obstruction; Upper and lower gastrointestinal bleeding; Peripheral vascular disease (PVD); Acrocyanosis; Raynaud’s phenomenon; Mottling at end-of-life stages;

!  Abnormal voice!! Relevant disease or pathology

!  Abnormal voice!! Relevant disease or pathology

|-

|-

| | Hoarseness or raspyness like a sheep [Cha.Sa.[[Indriya Sthana]] 1/14]  || Due to structural changes of vocal cords (Acute or chronic laryngitis, Polyps etc);

| | Hoarseness or raspiness like a sheep [Cha.Sa.[[Indriya Sthana]] 1/14]  || Due to structural changes of vocal cords (Acute or chronic laryngitis, Polyps etc);

|-

|-

| |  Feeble [Cha.Sa.[[Indriya Sthana]] 1/14]  ||  Aphonic palilalia; Hypophonia; Paresis of vocal cords; LMN (lower motor neuron) lesions;

| |  Feeble [Cha.Sa.[[Indriya Sthana]] 1/14]  ||  Aphonic palilalia; Hypophonia; Paresis of vocal cords; LMN (lower motor neuron) lesions;