Abstract

*Dr. Prajakta D. Matkar, Dr. Varsha S. Mali-Irale, Dr. Suyog C. Jawake

ABSTRACT

Ayurveda places primary emphasis on the prevention of disease and embraces a holistic philosophy in addressing diverse states of ill-health. Among the pillars of clinical practice, prognosis occupies a position of central importance, since a reliable estimate of the residual course of disease equips the patient to make informed end-of-life choices and assists the clinician in selecting the most rational line of management. The ancient seers of Ayurveda devoted an entire division of the canonical literature, the Indriyasthana, to this very purpose, in preference to naming it the Arishta Sthana. The word Indriya is here understood in the sense of Prana, so that the section becomes, in essence, a science of the remaining span of life. The Arishta Lakshanas are those clinical signs that herald approaching death, standing in relation to it as the blossom stands to the fruit that is to follow. Classical doctrine holds that death is not encountered in the absence of such indicators, and that once they have unequivocally manifested, demise becomes inevitable. The diagnostic methods set out in the Indriyasthana are inexpensive, uncomplicated and remarkably precise instruments for gauging life expectancy. In the vocabulary of contemporary medicine, the same cluster of features is recognised under the heading of the deathbed phenomenon, and bears close kinship to the prognostic indicators employed within modern palliative care.