9,091
edits
Changes
Jump to navigation
Jump to search
Line 919:
Line 919: − 1. “Taste” of the mouth of a patient: By interrogation + − 2. Impairment of “taste” of an individual: could be inferred by the behavior of parasites like lice (if instead of getting drawn to a person, they get repelled by it), or if someone attracts flies or ants (implying “sweet taste” emanated by the patient)+ − 3. Bleeding from the body: doubts about the nature of blood can be resolved by giving it to dog & crow. Its intake indicates its purity and rejection indicates that the blood is vitiated by pitta dosha and the patient is suffering from raktapitta.+ − 4. Similarly other tastes can be inferred. + + − 4. Gandha pariksha:+ + + − 5. Sparshana pariksha (palpation) − The physician has to touch the patient by his hand and do examination of normal and abnormal touches. − Care should be taken, however, to ensure that the physician’s hand should not be too warm or cold. Also, palpation should be performed very gently. The examination done by this method helps in assessing rise of body temperature, palpation of pulse, any tenderness, guarding, rigidity, swelling, lump or growth, lymphadenopathy, palpation of organs to reveal organomegally, size of organ palpable, surface, borders, consistency, bruits etc. − + + + + + + − 1. Inferring the effect from cause (future knowledge): For example, by observing the seed one can have knowledge of the fruit it will bear. − 2. Inferring the cause from effect (past knowledge): For example, by looking at pregnancy one can have the past knowledge of sexual intercourse. − 3. General inference (present knowledge): For example, by seeing smoke one can have knowledge of fire. − Clinical Application − Since there are many things that cannot be perceived using sensory organs alone, anumana or the power to deduce or infer is an important and effective tool that a physician may employ. Charaka has enumerated the following factors to be observed by inference. − 1. Agni (digestive fire) –from the power of digestion − 2. Bala (strength)-from capacity for exercise. − 3. Condition of senses- from their capacity to perceive the respective objects − 4. Existence of mind- from the perception of specific objects even in the presence of all other senses along with their respective objects. − 5. Knowledge of things from proper reaction to it. − 6. Rajoguna from attachment to women − 7. Moha-from lack of understanding − 8. Anger –from revengeful disposition − 9. Grief - by Sorrowful disposition − 10. Joy -by happiness − 11. Pleasure – from satisfaction (reflected by the appearance of face & eyes) − 12. Fear – from apprehension − 13. Courage–from strength of mind even when one is in dangerous situation − 14. Energy of an individual –from initiative in such actions which are normally difficult to perform. − 15. Stability of mind from the avoidance of any mistake. − 16. Desire from request. − 17. Intelligence from power of comprehension of scriptures etc. − 18. Recognition from recollection of the name − 19. Memory from power of remembrance. − 20. Modesty from bashfulness − 21. Liking from habitual intake − 22. Disliking from no inclination for something − 23. Deception from subsequent manifestations –individual pertaining to be well wisher but actually having evil intentions − 24. Courage from firmness − 25. Obedience from compliance with orders − 26. Age, liking, adaptation, disease, cause of disease from stage of life, habitat, conduciveness, symptoms, pain respectively. − 27. Disease in latent phase can be diagnosed by therapies which would alleviate or aggravate the symptoms of disease. − 28. Vitiation of doshas from the quantity of provocating factors − 29. Approaching death from prognostic signs − 30. Prosperity from initiation of useful work − 31. Sattavika mind from absence of impairment − 32. Similarly, condition of grahani (intestines), dreams, desires, likes- dislikes, happiness- unhappiness etc can be known by interrogation of the patient. − + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − Example: + +
→Rasapariksha (gustation-by inference)
“Tastes” of various factors in the body be ascertained by inference and not by direct observation:
“Tastes” of various factors in the body be ascertained by inference and not by direct observation:
# “Taste” of the mouth of a patient: By interrogation
# Impairment of “taste” of an individual: could be inferred by the behavior of parasites like lice (if instead of getting drawn to a person, they get repelled by it), or if someone attracts flies or ants (implying “sweet taste” emanated by the patient)
# Bleeding from the body: doubts about the nature of blood can be resolved by giving it to dog & crow. Its intake indicates its purity and rejection indicates that the blood is vitiated by pitta dosha and the patient is suffering from raktapitta.
# Similarly other tastes can be inferred.
Nowadays various laboratory tests are available to diagnose this, such as blood glucose etc.
Nowadays various laboratory tests are available to diagnose this, such as blood glucose etc.
===== Gandha pariksha =====
The physician should be able to smell normal and abnormal smells of the entire body of patient by olfactory sense organ.
The physician should be able to smell normal and abnormal smells of the entire body of patient by olfactory sense organ.
Various types of odour are recognizable from the breath. The odour of alcohol, and odour of diabetic ketoacidosis have been described as ‘sweet and sickly’. The odour in condition of uraemia is ‘ammonical or fishy,’ and hepatic failure is ‘mousy’. Halitosis is common in patients with poor dental hygiene and associated with chronic gingivitis. In suppurative conditions of lungs, breath may have putrid odour.
Various types of odour are recognizable from the breath. The odour of alcohol, and odour of diabetic ketoacidosis have been described as ‘sweet and sickly’. The odour in condition of uraemia is ‘ammonical or fishy,’ and hepatic failure is ‘mousy’. Halitosis is common in patients with poor dental hygiene and associated with chronic gingivitis. In suppurative conditions of lungs, breath may have putrid odour.
Anumana (estimation, or analysis)
===== Sparshana pariksha (palpation) =====
The physician has to touch the patient by his hand and do examination of normal and abnormal touches. Care should be taken, however, to ensure that the physician’s hand should not be too warm or cold. Also, palpation should be performed very gently. The examination done by this method helps in assessing rise of body temperature, palpation of pulse, any tenderness, guarding, rigidity, swelling, lump or growth, lymphadenopathy, palpation of organs to reveal organomegally, size of organ palpable, surface, borders, consistency, bruits etc.
==== Anumana (estimation, or analysis) ====
The scope of perception has limitations and there are many ailments that cannot be perceived using sensory organs. Such imperceptible ailments can be diagnosed using agama (texts), anumana (inference) & yukti (reasoning). [Ch. Su 11/7]
The scope of perception has limitations and there are many ailments that cannot be perceived using sensory organs. Such imperceptible ailments can be diagnosed using agama (texts), anumana (inference) & yukti (reasoning). [Ch. Su 11/7]
Anumana depends on prior knowledge acquired through pratyaksha (direct observation) and yukti (logical reasoning) and is applicable when the patient is aware of ailments suffered in the past (medical history) that can aid in drawing inferences about his current afflictions. It can also be defined as new information or inference drawn on the basis of applying one’s intelligence on information drawn through pratyaksha. It can be of three types-
Anumana depends on prior knowledge acquired through pratyaksha (direct observation) and yukti (logical reasoning) and is applicable when the patient is aware of ailments suffered in the past (medical history) that can aid in drawing inferences about his current afflictions. It can also be defined as new information or inference drawn on the basis of applying one’s intelligence on information drawn through pratyaksha. It can be of three types-
YUKTI [Ch Su 11/25]
# Inferring the effect from cause (future knowledge): For example, by observing the seed one can have knowledge of the fruit it will bear.
# Inferring the cause from effect (past knowledge): For example, by looking at pregnancy one can have the past knowledge of sexual intercourse.
# General inference (present knowledge): For example, by seeing smoke one can have knowledge of fire.
==== Clinical Application ====
Since there are many things that cannot be perceived using sensory organs alone, anumana or the power to deduce or infer is an important and effective tool that a physician may employ. Charaka has enumerated the following factors to be observed by inference:
# Agni (digestive fire) –from the power of digestion
# Bala (strength)-from capacity for exercise.
# Condition of senses- from their capacity to perceive the respective objects
# Existence of mind- from the perception of specific objects even in the presence of all other senses along with their respective objects.
# Knowledge of things from proper reaction to it.
# Rajoguna from attachment to women
# Moha-from lack of understanding
# Anger –from revengeful disposition
# Grief - by Sorrowful disposition
# Joy -by happiness
# Pleasure – from satisfaction (reflected by the appearance of face & eyes)
# Fear – from apprehension
# Courage–from strength of mind even when one is in dangerous situation
# Energy of an individual –from initiative in such actions which are normally difficult to perform.
# Stability of mind from the avoidance of any mistake.
# Desire from request.
# Intelligence from power of comprehension of scriptures etc.
# Recognition from recollection of the name
# Memory from power of remembrance.
# Modesty from bashfulness
# Liking from habitual intake
# Disliking from no inclination for something
# Deception from subsequent manifestations –individual pertaining to be well wisher but actually having evil intentions
# Courage from firmness
# Obedience from compliance with orders
# Age, liking, adaptation, disease, cause of disease from stage of life, habitat, conduciveness, symptoms, pain respectively.
# Disease in latent phase can be diagnosed by therapies which would alleviate or aggravate the symptoms of disease.
# Vitiation of doshas from the quantity of provocating factors
# Approaching death from prognostic signs
# Prosperity from initiation of useful work
# Sattavika mind from absence of impairment
#Similarly, condition of grahani (intestines), dreams, desires, likes- dislikes, happiness- unhappiness etc can be known by interrogation of the patient.
==== YUKTI [Ch Su 11/25] ====
Yukti, or reasoning, is the fourth pariksha. The intellect perceives things as an outcome of a combination of various factors by employing yukti. Trivarga or dharma, artha and kama can be achieved by yukti.
Yukti, or reasoning, is the fourth pariksha. The intellect perceives things as an outcome of a combination of various factors by employing yukti. Trivarga or dharma, artha and kama can be achieved by yukti.
Example:
1. Harvest–due to combination of water, tilling operation, seeds & season.
1. Harvest–due to combination of water, tilling operation, seeds & season.
2. By combining of panchamahabhuta and chetana, garbha is formed (or conceived).
2. By combining of panchamahabhuta and chetana, garbha is formed (or conceived).