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==Preamble of Indriya Sthana (Section on Determinants of Remaining Lifespan of Patients)==

Indriya sthana deals with study of specific signs related to Prana (vital life force) perceived by sense organs.

This section of [[Caraka Samhita]] called Indriya Sthana deals with the signs and symptoms useful in determining the remaining lifespan of patients (also called ''arishta lakshana''). In the present era, because of advancements in medical sciences, many ''arishta lakshanas'' are well treatable and cannot be considered as "predictors" of death as they used to even a few centuries back. However, these signs and symptoms could serve as important indicators of prognosis of disease and therefore, would be helpful in the management of patients.

|title = [[Charak Samhita]] Indriya Sthana

 

• Ojus is all pervading, subtlest essence of every micro particle of the body, because it has dominance of Akash mahabhoota (space). This property of akasha is called Apratighata.

|data4 = [[Sutra Sthana]],[[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

• Ojus or Sneha provides and maintains a requisite space, a  non - resistant insulation between  two micro particles, like a dew drop on lotus petal without harming mutual existence. This zero resistant state provides a required space for smooth and effortless movement of dosha, dhatu and mala (all biological substances) and allows them to perform all physiological functions smoothly, called a stage of homeostasis.

 

• Overuse, underuse and misuse of indriya or senses is called Asatmyendriyartha samyoga where inappropriate consumption of this  isolator  insulation of  Ojus or sneha occurs resulting in increase of roukshya or roughness which causes a painful  perception.

 

3. Clinical importance of Indriya

• The first chapter of Sutrasthana  stresses upon the cause of all mental and physical diseases as asatmyendriyarth samyoga (injudicious use of senses), leading to premature deterioration of senses causing shortening of life. (Ch. Su. 1 / 54).

|data7 = [[Varnasvariyam Indriyam Adhyaya]], [[Pushpitakam Indriyam Adhyaya]], [[Parimarshaneeyam Indriyam Adhyaya]], [[Indriyaneekam Indriyam Adhyaya]], [[Purvarupeeyam Indriyam Adhyaya]], [[Katamanisharireeyam Indriyam Adhyaya]], [[Pannarupiyam Indriyam Adhyaya]], [[Avakshiraseeyam Indriyam Adhyaya]], [[Yasyashyavanimittiyam Indriyam Adhyaya]], [[Sadyomaraneeyam Indriyam Adhyaya]], [[Anujyotiyam Indriyam Adhyaya]], [[Gomayachurniyam Indriyam Adhyaya]]

• Sensory organs are exposed to enormous sensations from the external world, voluntarily or involuntarily, all the time. These sensations are of varying degree of traumatic, unpleasant or pleasant in nature.

• Whereas the physical body takes limited amount of food and drinks, the senses encounter enormous stimuli, because indriya buddhi (sensory centres in brain) always remains open and active and acts as extension of brain.  

 

• Constantly sensing such traumatic stimuli, reduces the lifespan of indriya than other organs of body.

==Preamble of Indriya Sthana (Section on assessment of lifespan of patients)==

• With this reason Upnishad prays  loudly for life of indriya “ jeevem sharadh shatam, pasyemah shardah shatam, shrinuyamah ..........”

 

• To accomplish the optimum span of life, for prevention of disease, promotion of health, and repair of sensorium,  with the judicious uses of all senses, the yam, niyam (Do’s and Don’ts) and sadvritta (code and conducts)  are mentioned in detail in Indriyopakramneeya chapter (Ch.su.8).

===Fundamental principles===

• If a person does not take care of indriya, than the life forces deteriorate prematurely, resulting in death, or become inefficient to carry the sensory functions in the middle of the expected lifespan  or  earlier.

• This inefficiency of indriya caused by  injudicious use, manifests several signs and symptoms of imminent or instantaneous death.  

[[Indriya Sthana]] deals with the observation of signs predicting lifespan and signs indicative of reduced duration of remaining life (also called ''arishta lakshana''). The word [[Indriya]] literally means organ, sense, force, vigor.<ref>Sanskrit-English Dictionary available from http://spokensanskrit.org/index.php?mode=3&script=hk&tran_input=Indriya&direct=au retrieved on April 19, 2019</ref>. In the present context, it means ''Prana'' or vital life force.<ref>Commentary by Chakrapani on Cha. Indriya 1/1-2 available on http://niimh.nic.in/ebooks/ecaraka/?mod=adhi retrieved on April 19, 2019</ref>. The seat of ''prana'' in the body is ''Sneha'' or ''Ojus''. ''Indriya'' (sense organs) are said to be the ''linga'' (organs) of ''prana''. An important concept discussed in this section is termed ''Indriyadushti'' (damage to the sensory system). A state of perfect health is ''Anirvedovarta Lakshanam'' (i.e., life without any indication or perception of being alive).[Cha.Sa. [[Sutra Sthana]] 25/40]

• These are categorically described in 12 chapters of indriya sthan, with useful tools for measuring life span, remaining life and  clinical diagnosis of  severity of disease.  

 

===Logical sequencing of chapters===

Life begins with the association of consciousness, or the [[atma]], with the five fundamental elements ([[panchamahabhuta]]) and ends in the dissolution of this association. Since this union (that results in a living being) is by no means permanent and since there is always a possibility of dissolution or death anytime, Ayurvedic texts emphasize on identifying certain signs and symptoms that could forebear, with some level of certainty, imminent death. This section is dedicated to such determinants and is structured in the form of 12 chapters.

• Signs and symptoms of imminent death (Arishtas) described in following 12 chapters are specific for pathologies of sensory organs which can be assessed by sensory deficiencies. These are varna (color), swara (voices/sounds), gandha (smell), rasa (taste), sparsha(touch),along with chhaya (complexion) and prabha (radiance). These are detailed in Varnaswariya, Pushpiitendriya, Parimashneeya, Indriyaneeka, Pannarupiya and Shyavnimitta chapters.

 

• The clinically useful early symptoms which are alarming and serious are mentioned in Purvarupeeya.

• Gomaychurniya, Anujyoti, Avakshirsheeya and Sadyomarneeya  chapters give examples of arishta seen in physical body or Bahyakarana, and pertaining to the Antahkaran (mental, intellectual, emotional, para psychological and para sensorial)  symptoms, with sakun( good / bad consequential happening)), doota( messenger), swapna ( dreams) and miscellaneous  occult sciences. The evidences laid down in these chapters may establish an ayurveda based clinical diagnostic methodology. It is need of the time to re understand this section, to remove the misconception, in certain minds where indriya sthana is unfortunately labelled as arishta sthana, only for pre death symptoms.

* Signs and symptoms (''arishtas'') of imminent death can be perceived by specific changes in sensory system (e.g., ''varna'' (color), ''swara'' (voices/sounds), ''gandha'' (smell), ''rasa'' (taste), ''sparsha''(touch),along with ''chhaya'' (complexion) and ''prabha'' (radiance)) are addressed in chapters [[Varnasvariyam Indriyam Adhyaya]], [[Pushpitakam Indriyam Adhyaya]], [[Parimarshaneeyam Indriyam Adhyaya]], [[Indriyaneekam Indriyam Adhyaya]], [[Pannarupiyam Indriyam Adhyaya]] and [[Yasyashyavanimittiyam Indriyam Adhyaya]].

 

* Clinically useful early warning signs have been mentioned in [[Purvarupeeya]].

 

* [[Gomayachurniyam Indriyam Adhyaya]], [[Anujyotiyam Indriyam Adhyaya]], [[Katamanasharireeyam Indriyam Adhyaya]], [[Avakshiraseeyam Indriyam Adhyaya]] and [[Sadyomaraneeyam Indriyam Adhyaya]] are chapters that give examples of ''arishta'' that could be perceived on the physical level (or, are ''Bahyakarana'') as well as on the mental, intellectual, and emotional levels (or, afflicting the ''Antahkarana'' ), with references to ''shakun''( good / bad consequential happening)), ''doota''( messenger), ''swapna'' ( dreams) and miscellaneous  occult sciences. The evidences laid down in these chapters may establish an [[Ayurveda]]-based clinical diagnostic methodology.  

 

Even though all of the determinants (i.e., signs and symptoms) cannot be explained by rational scientific parameters (as evident by the references above to paranormal and occult sciences), some of these signs and symptoms have been documented and reported as having been experienced by people in various parts of the world. Within the treatise [[Charak Samhita]], physicians are instructed to thoroughly examine the patient for certain  signs that indicate terminal illness and investigate using biomarkers. The treatise then advises physicians to stop any therapeutic treatment being given to such terminal patients and provide them palliative care instead.

In the present era, with advancements in medical sciences, many ''arishta lakshanas'' are well treatable and cannot be considered as "predictors" of death as they used to even a few centuries back. However, these signs and symptoms could serve as important indicators of prognosis of disease and therefore, would be helpful in prompt management to save life of patients.