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Line 326: − + − + − *''Arishta'' related to various odors (''Gandha''): These smells coming from the body of individuals represent manifestations of major metabolic disorder which is altering the normal smell of the body. For example, fruity odor in diabetes (ketoacidosis), odor of Ammonia in renal ? hepatic failure and fecal smell in high intestinal obstruction etc. [Verse 8-16]+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − *''Arishta'' related to taste of the body (''Rasa'')and their examination: ''Gandha'' and other parameters can be examined by ''pratyaksha pramana'', but ''rasa'' is always examined by ''anumana pramana'' or by inference because of lack of laboratory investigations. For example, If flies and ants are attracted towards the body – then it is inferred that the taste of the body has become sweet and if the lice, mosquitoes etc. started leaving the patient’s body, it is inferred that the patient’s body has developed excessive distaste. This information can be helpful in certain rural areas of the world. [Verse 17-22]+ +
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{{#seo:
{{#seo:
|title=Pushpitakam Indriyam Adhyaya
|title=Pushpitakam Indriyam Adhyaya
|keywords=fatal signs, pushpita, body odour, sense of taste, Ayurveda, Indian system of medicine, charak samhita.
|keywords=fatal signs, pushpita, body odour, sense of taste, Ayurveda, Indian system of medicine, charak samhita.
|description=Indriya Sthana Chapter 2.Fatal signs of Tactile and Olfactory perception
|description=Indriya Sthana Chapter 2.Fatal signs of Tactile and Olfactory perception
|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|image_alt=charak samhita
|type=article
|type=article
}}
}}
'''<big>[[Indriya Sthana]] Chapter 2.Fatal signs of Tactile and Olfactory perception</big>'''
'''<big>[[Indriya Sthana]] Chapter 2.Fatal signs of Tactile and Olfactory perception</big>'''
{{Infobox
{{Infobox
|label7 = Reviewer
|label7 = Reviewer
|data7 = Babu S.
|data7 = Babu S.
|label8 = Editor
|label8 = Editors
|data8 = Khandel S.K., Babu S.P.
|data8 = Khandel S.K., Babu S.P., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
|label9 = Date of publication
|label9 = Year of publication
|data9 = December 17, 2018
|data9 = 2020
|label10 = DOI
|label10 = Publisher
|data10 =
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|header3 =
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s05.003 10.47468/CSNE.2020.e01.s05.003]
}}
}}
<big>'''Abstract'''</big>
<big>'''Abstract'''</big>
<div style="text-align:justify;">
<p style="text-align:justify;">This chapter sums up the variations in the sense of taste of the body and smell of the individual which indicate imminent death of the person ([[Arishta]] [[Lakshana]]). Variations in the smell of body and the altered taste sense of a person may reveal the disease processes in that patient. </p>
This chapter sums up the variations in the sense of taste of the body and smell of the individual which indicate imminent death of the person ([[Arishta]] [[Lakshana]]). Variations in the smell of body and the altered taste sense of a person may reveal the disease processes in that patient.
'''Keywords''': fatal signs, ''pushpita'', body odour, sense of taste.
'''Keywords''': fatal signs, ''pushpita'', body odour, sense of taste.
== Introduction ==
== Introduction ==
<div style="text-align:justify;">
<div style="text-align:justify;">
While describing the qualities of an ideal ''bhishaja'' (physician) it has been stated that he should be friendly, and compassionate to the patients, should have devotion and love for treating the curable diseases and should not treat the untreatable ones. [Cha.Sa.[[Sutra Sthana]]9/26] During the Samhita period, many diseases were incurable because of lack of treatments available at that time. Now, large number of diseases can be controlled and gives longer productive life to patients by providing emergency and intensive care treatments. That is why during that time it was important to determine the prognosis in terms of curability or incurability of diseases. Physicians did not treat incurable patients especially terminally ill patients. A set of symptoms and signs of terminally ill patients was identified called ''Arishta lakshanas''. With the rising high cost of healthcare especially the end of life care, knowledge and recognition of these signs and symptoms have become more relevant during the current times.
While describing the qualities of an ideal ''bhishaja'' (physician) it has been stated that he should be friendly, and compassionate to the patients, should have devotion and love for treating the curable diseases and should not treat the untreatable ones. [Cha.Sa.[[Sutra Sthana]]9/26] During the Samhita period, many diseases were incurable because of lack of treatments available at that time. Now, large number of diseases can be controlled and gives longer productive life to patients by providing emergency and intensive care treatments. That is why during that time it was important to determine the prognosis in terms of curability or incurability of diseases. Physicians did not treat incurable patients especially terminally ill patients. A set of symptoms and signs of terminally ill patients was identified called ''[[Arishta]] lakshanas''. With the rising high cost of healthcare especially the end of life care, knowledge and recognition of these signs and symptoms have become more relevant during the current times.
After describing fatal signs regarding complexion and voice, diagnosed by visual and auditory senses respectively, the present chapter describes signs to be examined by gustatory and olfactory senses.
After describing fatal signs regarding complexion and voice, diagnosed by visual and auditory senses respectively, the present chapter describes signs to be examined by gustatory and olfactory senses.
== Tattva Vimarsha(Fundamental Principles) ==
== Tattva Vimarsha(Fundamental Principles) ==
*Death doesn’t occur without showing ''Arishta'' (fatal signs). One shall always be free from ''Prajnaparadha'' (intellectual errors) to identify and diagnose these signs correctly. [5-6]
*Death doesn’t occur without showing ''Arishta'' (fatal signs). One shall always be free from ''[[Prajnaparadha]]'' (intellectual errors) to identify and diagnose these signs correctly. [5-6]
*''Arishta'' related to ''Gandha - Pitta'' is primarily responsible factor for all odors as it has ''visra gandha''. When ''pitta'' reaches the ''twak'' or skin and exerts its ''visra gandha'' by ''bhrajaka pitta'', it’s odor is of sweat and sebum ???. In this way we can derive the cause and effect. All these verses describe how the various smells (both good as well as bad odors) emitted by the body of an individual without any appreciable causes denote the impending death of the person within a year.
*''Arishta'' related to ''Gandha - [[Pitta]]'' is primarily responsible factor for all odors as it has ''visra gandha''. When ''[[pitta]]'' reaches the ''twak'' or skin and exerts its ''visra gandha'' by ''bhrajaka pitta'', it’s odor is of sweat and sebum ???. In this way we can derive the cause and effect. All these verses describe how the various smells (both good as well as bad odors) emitted by the body of an individual without any appreciable causes denote the impending death of the person within a year.
== Vidhi Vimarsha (Applied Inferences) ==
== Vidhi Vimarsha (Applied Inferences) ==
=== Prognostic signs related to odor (gandha) ===
These smells coming from the body of individuals represent manifestations of major metabolic disorder which is altering the normal smell of the body. For example, fruity odor in diabetes (ketoacidosis), odor of Ammonia in renal or hepatic failure and fecal smell in high intestinal obstruction etc. [Verse 8-16]
=== Prognostic signs related to taste (rasa) ===
The odor and other parameters can be examined by direct perception (pratyaksha pramana), but taste (rasa) is always examined by inference (anumana pramana) because of lack of laboratory investigations. For example, If flies and ants are attracted towards the body – then it is inferred that the taste of the body has become sweet and if the lice, mosquitoes etc. started leaving the patient’s body, it is inferred that the patient’s body has developed excessive distaste. This information can be helpful in certain rural areas of the world. [Verse 17-22]
=== Assessment of factors related to odor ===
The odor or smell of individual can indicate specific underlying morbidity. The probable abnormal conditions are summarized in table 1 and 2. <ref name= "Mamidi P.1">Gupta K., Mamidi P., Pushpitakam of Charaka Indriya Sthana - An Explorative Study, Int. J. Ayu. Alt. Med., 2019; 7(5): 176-182</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.
{| class="wikitable"
|+ Table 1: Specific body odor and probable relevant morbidity
|-
! Odour!! Disease
|-
| | Acetone / Rotten apple || Diabetes / Diabetic ketoacidosis
|-
| | Sweetish || Rice water stools of Cholera
|-
| | Sweetish / Putrid || Diphtheria
|-
| | Sweetish / Pungent || Small pox lesions
|-
| | Baked-bread || Typhoid
|-
| | Caramelized sugar || Maple syrup urine disease
|-
| | Sweet || Leukaemia
|-
|}
{| class="wikitable"
|+ Table 2: Specific unpleasant body odor and probable relevant morbidity
|-
! Odour !! Disease
|-
| | Offensive || Cancerous wounds / Infectious diseases / Gynaecological tumours / Necrotic cavity on penis in Squamous cell carcinoma
|-
| | Unpleasant || Fungating wounds in advanced cancers / Vagabond’s disease / Infected eczema / Pemphigus / Herpes labialis / Deep pressure sores on buttocks / Infected leg ulcers
|-
| | Cheesy / Fishy || Vaginal & cervical bacterial infections
|-
| | Severe malodor || Advanced breast, head and neck cancers
|-
| | Foul || Scarlet fever / Pneumonia / Tuberculosis
|-
| | Stale beer || Ulcerated lymph nodes
|-
| | Butcher’s shop || Yellow fever
|-
| | Musty || Phenylketonuria
|-
| | Cheesy / Acrid / Sweaty feet || Isovaleric academia (IVA)
|-
| | Yeast / Malt / Hop-like || Methionine malabsorption syndrome
|-
| | Cabbage like || Hypermethioninemia
|-
| | Foul / Rotten fish like || Trimethylaminuria
|-
| | Cabbage / Rancid butter || Tyrosinaemia
|-
| | Rotten egg || Cystinuria
|-
| | Urine || Uraemia / Kidney failure
|-
| | Faecal || Ileus / Intestinal obstruction
|-
| | Putrid || Scurvy
|-
| | Rotting || Ozena
|-
| | Musty / Skunk / Characteristic || Schizophrenia
|-
| | Sweaty || Acromegaly
|-
| | Malodor || Liver diseases
|-
| | Obnoxious || Gangrenous feet
|-
|}
'''Acknowledgement:''' The contributors acknowledge support of Dr. M. Prasad and Dr.G.Kshama for providing tables from their published article referred in this chapter.
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==References==
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