Issue : 01 DOI : 10.5281/zenodo.8147277
INTERNATIONAL
JOURNAL
OF
DIAGNOSTICS
AND
RESEARCH
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
32
Abstract
Ancient Ayurvedic texts such as the Charaka Samhitha and SushruthaSamhitha, which discuss various
methods of examination such as Prathyaksha (sensual direct perception), Yukti (logic), Anumana (inference),
etc. Under the general heading of Arishtalakshanas (Prognostic features), have greatly helped in making a
diagnosis or speculating on a prognosis. The development of medical technology has completely changed
how diagnoses are made, whether they are made today or in the past. In the past, doctors used their sense of
touch, hearing, and sight to diagnose patients and determine their prognosis (Panchendriyapariksha). These
Tools are replacing skills as a result of technological advancements. Information about "Indriyasthana" was
gathered from historical Ayurvedic texts such as the Sushrutha Samhitha Sutrasthana and the Charaka
Samhita. Google Scholar and Google Search were utilized to search electronic databases for pertinent studies
and reviews published.Every bit of data was combined and contrasted. This unique old wisdom is re-
examined using contemporary insights to emphasize the value of close observation and in-depth analysis.
We will be able to determine the type and severity of disease more accurately when we integrate a
comprehensive physical examination into our daily routine. This information will help determine future
treatment plans. As a result, an effort has been made to comprehend Arishta Lakshana side as with ominous
signs. The goal of this paper is to revive these lost skills and add to the current body of medical knowledge.
Keywords: Arishta, Ayurveda, Prognostic features, ominous signs
Corresponding author: Dr. Santosh Chavhan
Article Info: Published on : 15/04/2024
P
Publisher
ROGANIDAN VIKRUTIVIGYAN PG ASSOCIATION
FOR PATHOLOGY AND RADIODIGNOSIS
DOI
: 1 0 . 5 2 8 1 / z e n e d o . 1 0 9 7 2 6 4 2
Reg. No. : MAHA-703/16(NAG)
Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Analyzing Arishta Lakshanas In Context Of Ominous Symptoms: A
Comprehensive Review
Dr.Santosh Chavhan
1
, Dr.Yash Gupta
2
1
Professor & HOD, Dept. of Rognidan & Vikrutividnyan, D Y Patil Deemed to be University, Nerul, Navi Mumbai.
2
PG Scholar, Dept. of Rognidan & Vikrutividnyan, D Y Patil Deemed to be University, Nerul, Navi Mumbai
Cite this article as: - Dr. Santosh Chavhan (2024) ; Analyzing Arishta Lakshanas In Context Of Ominous Symptoms: A
Comprehensive Review; Inter.J.Dignostics and Research 1(3) 32-40, DOI:10.5281/zenedo.10972642
Introduction:
In the Ancient time, diagnosis relied heavily on
bedside diagnosis and clinical reasoning. The
prognosis is an estimate of the course that an illness
will take once it has started. It explains the potential
outcomes of an illness, such as death, the possibility
of recovery, and recurrence, along with the
probability that these outcomes will materialize.
The ancient medical system known as Ayurveda has
placed greater emphasis on a comprehensive
clinical examination as well as clinical signs and
symptoms. Enhancing Vaidya’s strength and skill
in the absence of technological advancements was
the main goal of clinical training. Thus,
G
A
R
V
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
33
Panchendriya Pariksha, which diagnoses using all
five sense organs, is unique. In order to correctly
diagnosis and prognosis, the Vaidyas needed to
possess deep theoretical understanding, keen
senses, quick thinking, and a great deal of
experience.The father of modern medicine, Osler,
also expressed the same idea, saying that "Medicine
is learned by the bedside and not in the classroom."
Ayurvedic treatises from antiquity, such as the
Charaka Samhita, Bhela Samhita, Kashypa
Samhita, and Harita Samhita, address life
predictors rather than merely causes or symptoms
of death. All of these treatises also explain
premonitory signs of sudden death as well as signs
of impending death. A variety of descriptions
pertaining to The prognosis of diseases and fatal
signs are described by the attributes Swapna
(dream), Swara (voice), Gandha (smell), Prabha
(luster), Chaya (shadow), Pratichaya (reflected
shadow), Rasa (taste), and Sparsha (touch). Some
indications and symptoms that arise prior to or
during a patient's demise are compared to Arishta-
Lakshana.
[1]
These Lakshanas are interpreted using
the previously mentioned methods, including
Pratyaksha (direct perception), Anumana
(inference), Yukti (reasoning/logic), and
Aptopadesha (established doctrine).
[2]
While
Acharya Dalhana divided Arishta Lakshana into
Niyata Arishta (definite) and Aniyata Arishta (in-
definite), Arishta-Lakshana was divided into two
categories by Acharya Vagbhata: Sthaayi (definite)
and Asthaayi (in-definite).
[3]
Strong symptoms that
resemble Arishta but are not Arishta can
occasionally be caused by aggravated Doshas; these
symptoms are known as Arishta bhasa and are
alleviated by pacifying Doshas.
[4]
In an attempt to
understand the Arishta Lakshana with a modern
understanding that focuses on medical and
neurological aspects, not many papers have been
published in the last few years. A significant
amount of evidence has been gathered in an effort
to comprehend how the Arishta lakshanas relate to
contemporary medical entities.
Materials and methodology:
The Knowledge about "Indriyasthana" has been
gathered from historical Ayurvedic texts such as
Sushruta samhitha and Charaka samhita.
Regardless of their appearance or publication year,
electronic databases Google Search and Google
Scholar were used to locate pertinent studies and
reviews published up till December 2023 which
closely matched the circumstances described as
Arishtas. "Arishta Lakshanas," "Indriyasthana,"
"Charaka indriyasthana," "Prognosis,"
"Diagnosis," "Ulcers," and other pertinent terms
were the search terms used. Both full-text, open-
access English papers and abstracts were taken into
consideration.
Observation :
1. Arishta Lakshanas in relation with Vrana
(Ulcer)
[5]
:
According to modern science, an ulcer is an area
where the surface epithelium breaks. A general
examination is performed when evaluating an ulcer
clinically in order to look for signs of heart failure,
discharge, TB, malnourishment, relationship to the
underlying structure, edge and margin, site, size,
shape, surface, surrounding area, solitary or
multiple, in duration at the base and circulation
impairment, enlarged nodes, neurologic deficits,
and so forth.Similarly, Panch endriya pareeksha
(examination based on five sense organs), such The
basis of Ayurveda's emphasis on clinical
examination is Dhalabdha (Sound), Rupa (Color,
Size, Structure, Sides, and Edges), and Gandha
(Smell).
Contemporary view with prognostic signs
related to Gandha (smell):
The smell known as Vranagandha transforms into
Putigandha (putrifaction/foul smell) and
Pankagandha (mud) of Mamsa (decayed meat of
various animals).
When a chronic fungal infection is present,
the ulcer may progress to Marjolin's ulcer, a
severe cutaneous cancer with an unpleasant-
smelling discharge. Infected necrotizing
carcinomatous ulcers release an offensive
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
34
odor associated with putrifaction.
[6]
The Severe carcinomatous lesions with
maggots emit an unpleasant stench skin to
putrifaction. Fun gating wounds develop as
a result of malignant lesions that often
penetrate through the skin to underlying
tissues.
[7]
Contemporary view with prognostic signs
related to Varna (colour):
Vranavarna (color) changes into- Kumkuma (dark
red, reddish brown),Shyama (bluish black to bluish
purple), or Kangushta (yellowish).
Because of its high vascularity, squamous
cell carcinoma turns dark reddish brown,
and the entire ulcer may be covered in
serum or old coagulated blood.
Slough, or a yellowish mass of dead soft
tissues, may cover a carcinomatous ulcer as
a result of a secondary infection caused by
gram-positive organisms.
[8]
Contemporary view with prognostic signs
related to Strava (discharge):
Severe Puyarudhira Strava (bleeding and
pus discharge) from the existing Vrana in
patients who are already severely emaciated,
breathing difficulties, and anorexic
(Pranamamsakshaya): This is related to
Marmasthana (vital structures).
Excessive discharge is caused by an infected
necrotizing carcinomatous ulcer. In some
cases, surgical removal of these ulcers
combined with appropriate antiseptic care
and radiation therapy may help to control
the discharge; however, even with
consistent treatment, the condition may
worsen and eventually be considered
hopeless.
Presence of non-healing ulcer -
appearance of Vrana in a seriously ill
patient who is not improving despite
receiving early treatment. A modern
perspective with poor prognostic indicators
associated with the existence of a non-
healing ulcer.
[9]
Contemporary view with prognostic signs
related to Aakruti (shape and Size) of the ulcer:
Vrana's appearance in patients with disabilities as a
variety of animals. Kennedy Terminal Ulcers may
resemble pears, butterflies, horseshoes, or other
shapes.
[10,11]
2.Arishta Lakshanas related to physical and
mental status:
The following is a summary of acute or long-term
changes to a disabled person body in terms of color,
smell, voice, vision, breathing, and the emergence
of aberrant signs and symptoms. The majority of
these Arishta Lakshanas are more noticeable in
older patients because aging causes general
debility.
Contemporary view with prognostic signs
related to Dehavarna (colour of the body):
Skin becomes Neela/Shyava (blue and bluish
black); lips, nails, and other extremities (Kara and
Pada) of patients in Athura have the same color.the
development of a greenish discoloration on the skin
in patients, known as Hareeta Varna.
[12]
Both central and peripheral cyanosis - Tetralogy of
Fallots- When there is an excessive amount of
blood that is deoxygenated in the arteries, the skin
turns blue. More than half of the hemoglobin is
converted, which greatly reduces oxygen transport,
particularly to the brain, increases the risk of
respiratory distress, and even puts death in the
balance. A pulmonary systemic fistula must be
created as a palliative measure for congenital
cyanotic heart disorders, which may not be
reversible and need immediate medical attention.
The Treatment for atrial septal defect (ASD)
cyanosis must be tailored to the specific cause of
the condition.
[13]
When pulmonary artery pressure is
elevated, cyanosis can happen, just like in
Eisenmenger syndromes that have a poor prognosis.
Patients with Valvular Heart Disease (VHD) have a
high and increasing death rate. In patients with
VHD, comorbidities, advanced age, and end organ
failure are all linked to aworse prognosis.
[14]
Peripheral cyanosis (feet, toes up to knee) is a
clinical indicator of approaching death in patients
with advanced cancer.
[15]
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
35
Contemporary view with prognostic signs
related to Swara (Voice):
Regarding Swara (the voice), the voice changes or
hoarseness (weak, vague, or resembling Shuka's
(the bird's) voice) in a weak, malnourished, and
emaciated patient, the patient may repeat words
pointlessly, interrupt others, stop speaking, or make
any strange noises that are not immediately
identifiable (Bala Mamsa Heena).
Nearly two thirds of laryngeal
malignancies, of which more than 90%
are squamous epithelial carcinomas,
occur in the vocal cords. Vocal cords are
penetrated by laryngeal tumors.
[16]
The
effects of head and neck cancer, non-
laryngeal (oral cavity, oropharynx, hypo-
pharynx, and nasopharyngeal), and
laryngeal cancers on voice and speech
outcomes are expected to differ due to
the different tumor sites. In patients with
laryngeal tumors, the tumor may affect
voice quality, and the treatment for the
tumor may have an effect on speech
quality as well. Additionally, voice
quality can be harmed by radiation to the
lymph nodes.
[17]
The prognosis for stage III/IV laryngeal
squamous cell carcinoma is poor, with a
high risk of both local recurrence and
distant metastases. This risk also applies
to tumor volumes greater than 46 cm.
[18]
One of the primary indicators of a poor
prognosis in papillary thyroid carcinomas
(PTCs) is recurrent laryngeal nerve
(RLN) invasion. Official caregivers’ list
delirium and speech impediment as final
indicators of dementia and impending
death in elderly patients. One of the very
specific physical indicators of death in
patients with advanced cancer is grunting
of the vocal cords.
[19]
Contemporary view with prognostic signs
related to Gandha (Body odor):
- A disabled patient's body odor, whether
pleasant or unpleasant, should be noted.
Smells like urine, feces, or dead bodies
[20]
with present-day perspective with poor
prognostic indicators associated with
Gandha (body odor). Bodily odor is caused
by volatile organic compounds (VOC) The
primary sources of volatile organic
compounds (VOCs) are vaginal secretions,
sweat, skin, urine, and feces. For example,
advanced leukemia: breath emits a pleasant
scent. Renal failure: Urine odor is exhaled.
Rotting smell coming from the affected area.
Advanced cancer of the breast and head and
neck. Odor, especially the smell of a dead
body, has been cited by a number of
caregivers as a warning sign of impending
death. Daily independence gradually
diminishes in dementia end-of-life cases;
incontinence often results from a decline in
cognitive function, creating an unpleasant
stench in the homes of the elderly.
Contemporary view with prognostic signs
related to Sparsana (touch):
Modern perspective exhibiting poor
prognostic indicators associated with
sparsana (touch). Hypothermia, or a
dropping body temperature, is a warning
indication of impending death in dementia
patients. The illness known as sarcopeniais
characterized by a gradual loss of skeletal
muscle mass, strength, and function.
Sarcopenia is a significant risk factor for
adverse health outcomes such as disability,
frailty, loss of independence, morbidity, and
mortality. It has also been associated with a
lower quality of life in the elderly.
Contemporary view with prognostic indicators
associated with Shwas (breathing pattern):
Breathing issues such as Atihraswa or
Atidirgha Uchwasa (too short or too long
breathing pattern of respiration) arise in the
incapacitated patient.
In cancer patients and elderly patients, a
change in breathing pattern is indicative of
impending death. Caregivers in remote areas
reported the highest frequency of symptoms
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
36
that fell into the category of breathing
problems, confirming its status as a leading
indicator of impending death. Breathing
pattern problems have been linked to lower
jaw breathing, while forceful, panting, and
shoulder breathing have occasionally been
linked to dyspnea. Patients with internal
organ failure, dementia, and cancer who are
nearing the end of their lives frequently
experience these symptoms.
In cancer patients, apnea episodes and
Cheyne-Stokes breathing are significant
physical indicators of approaching death.
When a patient experiences Cheyne-Stokes
breathing, they will inhale several times,
then exhale for a prolonged period of time
before breathing normally again.
Contemporary view with prognostic indicators
regarding Netra (eyes):
[21,22]
Any modifications to the morphology of the
eyes, such as aberrant protrusion or
depression of the eyeballs, as well as
functional impairments pertaining to vision
and eye movements.
Exophthalmos, or proptosis, and
enophthalmos are associated with advanced
and metastatic carcinomas related to the
eyes. Cancer of the para-orbital region is
one of the most common causes of
unilateral proptosis.Since they are localized
and have vague symptoms, they are
typically diagnosed later. Treating that kind
of lesion would most likely lead to provide
little hope for disease control and result in a
permanent facial deformity.
Breast cancer is the most common cause of
proptosis and the most common metastatic
cause. Due to an intraorbital lesion, the
patient developed unilateral proptosis, and
the histology of the orbital lesion indicated
metastatic breast cancer.
The emergence of unilateral usually,
proptosis is the first sign of eye metastases.
Bilateral involvement has been documented
in breast cancer metastases.
Pain, blurred vision, and peri-orbitaledoema
are associated with proptosis. Pain from
tumor necrosis that resembles inflammatory
orbitopathy deceives and impedes future
research. It typically takes 4.5 to 6.5 years
from the time of initial diagnosis to the
emergence of orbital metastases, and the
main tumor is usually found before
symptoms of orbital disease manifest. After
orbital metastases are diagnosed, the
average breast cancer survivor time is 22
months, which suggests a poor prognosis.
Contemporary view with prognostic signs
related to Hikka, Atisara and Anaha
[23,24,25]
Concerning Hikka, Atisara, and Anaha
development of clinical symptoms in
patients who are already severely ill, such as
Gambheera Hikka (hiccough), Raktaatisara
or Atisara (blood mixed stools, loose
stools), and Anaha (bloating and distension
of abdomen).
Present-day perspective featuring
unfavorable indicators concerning Hikka,
Atisara, and Anaha persistent and
uncontrollable Hiccups in patients receiving
palliative care.
The significant proportion of patients
receiving palliative care experience
persistent or unmanageable hiccups, which
pose a diagnostic and therapeutic challenge.
In severely ill patients, especially following
an acute myocardial infarction, a persistent
hiccup may impede recovery and even
endanger the patient's life, requiring
aggressive therapeutic measures.
Cardiovascular hiccups can have ischemia
or myocardial infarction as their primary
cause and major risk factor. When patients
are receiving stroke rehabilitation or are in a
palliative care setting, The most typical
reason for hiccups is inferior myocardial
infarction.
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
37
Contemporary view with prognostic signs
related to Shopha (swelling):
Concerning the existence of Shopha
(Swelling) Development of Sopha
(swelling) in the Udara (abdomen), which
later spreads to the Hasta pada (extremities)
and causes numerous ailments in a short
amount of time. In a patient who is already
severely disabled, Shopha is accompanied
by weakness in the lower limbs. Shopha
(generalized) in the abdomen, genital parts,
and extremities in a patient suffering from
Bala Varna Heenata (pallor and
debilitation). This unique symptom usually
appears in the last stages of life and is
characterized by bloody faeces and tarry
stools.
Ascites, a collection of fluid seen in certain
cancer types, Urine-related distension can
happen in the final stages of life.
Modern perspective with unfavorable
prognostic indicators associated with Sopha
(edema) Ascites with limb edema in
addition Most patients who have AL
amyloidosis die within a year due to heart or
kidney problems. While immunotherapy,
radiation therapy, and other anti-tumor
therapies have been tried, none of them have
proven to be completely successful in
treating ascites resulting from
gastrointestinal cancer in these patients.
Severe edema in the lower extremities may
be a sign of end-stage events in many
different types of cancer, malignant ascites
carries a high risk of morbidity. Following a
diagnosis of malignant ascites, the median
survival period is one to four months.
[26]
Lower limb edema is linked to numerous
terminal illnesses, including cancer, end-
stage renal disease, advanced neurological
disease, chronic heart failure, liver disease,
and chronic respiratory disorders. Including
vaginal and upper body edema would give a
more comprehensive picture of the
condition's extent. For instance, scrotal
swelling is a poor prognostic indicator in
patients with renal failure.
Generalized edema, or anasarca: Anasarca
are large edemas that are widely dispersed.
Numerous diseases, including lymphatic
system issues, liver failure, heart failure,
and renal failure, may be the reason. When
the interstitial volume exceeds 2.5–3 liters,
it typically becomes clinically noticeable.
[27]
The underlying cause determines the
prognosis for Anasarca. But by the time
Anasarca shows up, the underlying illness
has usually progressed beyond treatment.
Contemporary view with dire indicators linked
to Indriya Jnanam (sensorial perception):
[28,29,30]
Hallucinations as an imminent death sign,
this is why the temporal lobes are important
in near-death experiences. Aberrant activity
in these lobes may produce strange
impressions and sensations because this area
of the brain is involved in memory and
sensory processing. The theory of fading
brains is the most widely recognized
account of near-death experiences
According to this theory, hallucinations
caused by brain activity as brain cells begin
to die are what cause near-death
experiences. Patients with end-stage
dementia frequently exhibit Behavioral and
Psychological Symptoms of Dementia
(BPSD), which include delusions, anxiety,
irritability, and loud yelling.
27
In relation
with Indriya Jnanam (sensory perception),
Presence of hallucinations in Alzheimer’s
Disease (AD) has been repeatedly
associated with more severe cognitive and
functional decline, earlier
institutionalization, higher burden of
disease, and increased mortality. Research
suggests that visual hallucinations tend to
occur at the advanced stages of AD. A 78
percent increased risk of death was
associated with hallucinations, and a more
than twofold increased risk of death was
seen in those who experienced both auditory
and visual hallucinations. Terminal agitation
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
38
may be linked to biochemical imbalances as
many organs fail. In advanced disease,
confusion and terminal restlessness or
agitation are common. Estimates suggest
that between 25 and 85 percent of dying
individual’s exhibit restless symptoms
before passing away.
It occurs more frequently when a cancer is
nearing its end. Acute, uncontrollably
painful situations are one of the things that
make dying patients agitated. The Reduced
vital reactions, delirium, and loss of
consciousness are indicators and symptoms
of senile dementia's final stages.
Discussion:
Prognosis is defined as "foreseeing and
fortelling, by the side of the sick, the
present, the past, and the future" in
Hippocrates' "On Prognostics," the first
book of modern medicine. Hippocrates' day
saw the realization that one of the best
approaches to heal was through good
communication between the doctor and the
patient. Prognosis has taken longer in
modern medicine to become a fundamental
part of care than diagnosis and treatment
did.
In clinical practice and training, Prognosis
estimation, or the likelihood that a person
will experience a specific result over a
specified period of time, is regarded as less
important than the diagnosis and
management of a disease.
Regrettably, there is currently a trend
toward less opportunities for observational
skills and a greater reliance on technology.
This is particularly true if there is only a
slight increase in life expectancy following
a risky and painful surgery. It is commonly
acknowledged that for certain illnesses,
certain patients will benefit from a specific
surgical technique while others will not. The
most qualified person to give a patient
advice regarding the course and potential
consequences of their illness is the doctor.
Knowing the prognosis can assist the patient
and/or physician in making important end-
of-life decisions, such as whether or not to
try particular therapies. It's interesting to
note that, in the absence of contemporary
technological advancements, the assessment
was conducted using sense organs. For
instance, the Arishta Lakshana was
evaluated using Gandha, or body odor. It is
now known that the human body emits
volatile organic compounds (VOCs), which
are indicative of an individual's metabolic
state. Volatile organic compounds (VOCs)
have the potential to serve as diagnostic
biomarkers for a variety of illnesses,
including genetic disorders, metabolic
diseases, and infectious diseases. Odors are
olfactory cues that can provide information
about a person's physiological or
psychological state. Finding out how the
sense of smell can be utilized to diagnose
physical problems in people is fascinating.
Although VOCs and body odors may have
therapeutic value, there hasn't been much
work done to develop objective or
quantitative diagnostic criteria. As a result,
an effort has been made to compile all of the
historical information and the relevant
modern viewpoints. Clinical findings that
have been reported as Arishta Lakshanas
and in "Charaka indriyasthana" and other
places seem to have the potential to be
clinically applicable and have prognostic
significance in the modern era.
In end-of-life care settings, this modest
attempt may aid in the formal caregivers'
development of observational skills.
Research-wise, it is possible to create and
validate new prognostic indices that are
based on life expectancy as opposed to
mortality risk.
A comprehensive physical examination
should be a regular part of our routine
because it will help us determine the type
and severity of the disease and help
determine how best to treat it in the future.
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
39
Conclusion:
The Fundamental principles of good clinical
practice of medicine are the core clinical skills of
diagnosis, prognosis and treatment. Prognosis is a
skill that is currently underutilized, even though it
is an essential part of general medicine. Prognosis
is a lost art that needs to be found again and put in
its rightful place. It is recommended that we move
from a diagnosis-driven medical model to a more
advantageous prognosis-driven model. Prognosis
prediction is important to help patients and doctors
make the best decisions possible. It is said with
good reason that a surgeon should have the heart of
a lion (brave), the hands of a woman (delicate), and
the eyes of an eagle (vigilance). This paper
provides a glimpse of the in-depth knowledge
mentioned in the classical texts of Ayurveda that
helps a doctor understand the prognosis of the
disease at a time when the country is debating the
competency of Ayurvedic science and Ayurvedic
doctors to adopt technologically advance skills.
References:
1. Doctors to perform surgeries.
https://medicine.yale.edu/news/yale
medicine–magazine/the–lost–art– of–the–
physical–exam
2. Susrutha.Susrutha samhita with Nibandha
sangraha Commentary. Sutrasthanam. India,
Varanasi: Chowkhamba Krishnadas
Academy; 2014. p. 129.
3. Ashtangahridaya V. Sareerasthana. India,
Varanasi: Chowkhambha Krishnadas
Academy; 2006.
4. Vinay Kumar HS, Gopikrishna S.
Understanding of Arishtain Present Era with
SpecialReference to VarnaArishta. IAMJ.
2018;6(1):1.
5. Susrutha. Susrutha Samhita, with Nibandha
sarasangraha Commentary, Sutrasthanam.
India, Varanasi: ChowkhambaKrishnadas
Academy; 2014. p. 130–131
6. https://www.nfnn.com.au/wp
content/uploads/2019/05/Ulcers–of–the–
Lower–Extremity.pdf
7. Bromley S, Freeman MD. The use of Zinc
peroxide in Malignant lesions. JAMA.
1940;115(3):181–186.
8. Gopalakrishnan S, Srinivasan R, Saxena
SK, et al. Myiasis in different types of
carcinoma cases in southern India. Indian J
Med Microbiol. 2008;26(2):189–92.
9. H Shibuya H, Terashi H, Kurata S, et al.
Gas gangrene following sacral pressure
sores. J Dermatol. 1994;21(7):518–523.
10. Joy E Schank. The Kennedy Terminal
Ulcer– Alive and Well. J Am CollClin
Wound Spec. 2018;8(1–3):54–55.
11. Kennedy Terminal Ulcers Information and
Warning signs.
12. Hayk S Arakelyan. Green Man syndrome.
2016.
13. Hirakawa Y, Uemura K. Signs and
Symptoms of Impending Death in End– of–
life Elderly Dementia Sufferers: Point of
View of Formal Caregivers in Rural Areas–
A Qualitative Study. J Rural Med.
2012;7(2):59–64.
14. Agnivesha. CharakaSamhita, with Ayurveda
Deepika Commentary of Chakrapanidatta
and Vidyitini Hindi Commentary of Pt.
KashinathaSastri. 1st Edn. The
Chowkambha Sanskrit Series, India,
Varanasi: PradhamaBhaga; 1969. p. 864–
865.
15. Agnivesha, Charakasamhita, with Ayurveda
Deepika Commentary of Chakrapanidatta
and Vidyitini Hindi Commentary of Pt.
KasinathaSastri. 1st Edn. The Chowkambha
Issue : 03
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 01
Copyright @ : - Dr. Santosh Chavhan Inter. J.Digno. and Research IJDRMSID0016 | ISSN : 2584-2757
40
Sanskrit Series. India, Varanasi:
PradhamaBhaga; 1969. p. 873
16. Keche P, Nitnaware AZ, Mair M, et al. A
Study of Tumours Giving Rise to Unilateral
Proptosis. Indian J Otolaryngol Head Neck
Surg. 2013;65(Suppl 1):6–13.
17. Nambiar KR, Ajith PS, Arjunan A.
Unilateral Proptosis as the initial
manifestation of malignancy. J Egypt
NatlCanc Inst. 2017;29(3):159– 161.
18. Chen W, Lei J, You J, et al. Predictive
factors and prognosis for recurrent laryngeal
nerve invasion in papillary thyroid
carcinoma. Onco Targets Ther.
2017;10:4485–4491.
19. Issa MR, Samuels SE, Bellile E, et al.
Tumor Volumes and Prognosis in Laryngeal
Cancer. Cancers (Basel). 2015;7(4):2236–
2261.
20. Agnivesha, Charakasamhita, with Ayurveda
Deepika Commentary of Chakrapanidatta
and Vidyitini Hindi Commentary of Pt.
KasinathaSastri. 1st Edn. The Chowkambha
Sanskrit Series. India, Varanasi:
PradhamaBhaga; 1969. p. 873
21. Athanasiov PA, Prabhakaran VC, Selva D.
Non‐ traumatic Enophthalmos: a review.
ActaOphthalmol. 2008;86(4):356–364.
22. Nambiar KR, Ajith PS, Arjunan A.
Unilateral Proptosis as the initial
manifestation of malignancy. J Egypt
NatlCanc Inst. 2017;29(3):159– 161.
23. Jeon YS, Kearney AM, Baker PG. Review
Management of hiccups in palliative care
patients. BMJ Support Palliat Care.
2018;8(1):1–6.
24. Launois S, Bizec JL, Whitelaw WA, et al.
Hiccup in adults: an overview. EurResplr J.
1993;8:583–575.
25. Yuan SM. Myocardial Ischemia Presenting
With Hiccups. J Coll Physicians Surg Pak.
2019;29(5):469–473.
26. Esther Rantzen. End of life: The facts–A
booklet for people in the final stages of life
and their careers.
27. Mohamad EL HAJ, Roche J, Jardri R, et al.
Clinical and neurocognitive aspects of
hallucinations in Alzheimer’s disease.
NeurosciBiobehav Rev. 2017; 83:713–720.
28. John M Thomas, Cooney Leo, Terri R
Fried. Prognosis Reconsidered in Light of
Ancient Insights—From Hippocrates to
Modern Medicine. JAMA Intern Med.
2019; 179(6):820–823.
29. Thomas M Gill. The Central Role of
Prognosis in Clinical Decision Making.
JAMA. 2012; 307(2):199–200.
30. www.sciencedaily.com/releases/2009/07/09
0727135521.htm
ISSN : 2584-2757
DOI : 10.5281/zenedo.10972642
Dr. Santosh Chavhan Inter. J.Digno. and Research
This work is licensed under Creative
Commons Attribution 4.0 License
Submission Link : http://www.ijdrindia.com
Benefits of Publishing with us
Fast peer review process
Global archiving of the articles
Unrestricted open online access
Author retains copyright
Unique DOI for all articles
https://ijdrindia.com