C) Chaksusaja (Visual perception) - The perception of the Darshan(vision) through the Darsanendriva, eye, the organ of vision. It includes inspection. Assessing the patient’s overall appearance, built, complexion, posture, GALS (gait, arms, legs, spine), nutrition, obesity, oedema, pallor, cyanosis, nails, eyes, lips, tongue, teeth, gums, buccal mucous membrane, tonsils, tremors, scars, body hairs, skin lesion. It also helps in the assessment of the signs of the disease and subsequent diagnosis. The presence of the swan neck deformity in rheumatoid arthritis. Mask face, pill rolling tremor in Parkinson, Monkey face in marasmus, moon face in Kwashiorkor.
D) Sparsanaja (Tactile sensation) The perception of the touch by the Sparsendriya, skin which is the organ of tactile sensation. It includes palpation, percussion. Temperature, oedema, texture of skin i.e., soft, hard, smooth, rough, Nadi-pareeksha (pulse diagnosis), lymph node enlargement, tumour, masses, tenderness, rigidity, organomegaly.
E) Srotaja (Auditory perception) - This is the Shabda(hearing) perception which is done by the auditory organ which is the ear. It includes auscultation. Assessing the patient’s speech, breath sounds, crepitus, bowel sounds, bruits.[9]
Ashtavidha Pareeksha is also based on above Pratyaksha Pareeksha, Nadi and Sparsh Pareeksha can be done by Sparshendriya, Sabda Pareeksha by Sroteindriya, Mala, Mutra, Jivha, Drik, Aakriti Pareeksha by Chakshuindriya.
Abhyantara Laukika (internal) - Perception accomplished through the inner sense Mana/psyche is termed as the Manasa Pratyaksa or the Atma Pratyaksa. The perception of the emotions and feelings like the pleasure, displeasure, attachment and detachment etc.
Anumana (Inference): Inferring knowledge of unknown from the known facts is called as Anumana. It is the indirect knowledge or logical conclusion based on reasoning. The knowledge perceived after perception of Pratyaksha & Aptopdesha is called Anumana.
The source of Anumiti is called Anumana. Anumana Pramana is of two types – a) Swarthanumana is the cause of assumption of logical inference in one’s own mind. b) Pararthanumana is used to impart information to others.
It is demonstrative inference which refers to demonstrating the self-inferred knowledge to others with the help of Panchavayavivakya (5 components of reasoning). Panchavayavivakya contains Pratigya (Proposition), Hetu (Reason or Cause), Udaharana (Example), Upanaya (Justification), Nigamana (Conclusion).[10] Logical reasoning is applied to deduce disease and underlying cause of it, based on observed symptoms. Some of the examples of the application of Anumana in diagnostics are
Pathological manifestation Inference
Ruja (Pain) Vata Dusti (Vitiation of Vata)
Daha (Burning) Pitta Dusti (Vitiation of Pitta)
Sopha (Swelling) Kapha Dusti (Vitiation of Kapha)
Prabha Haani (loss of lustre) Pitta Ksaya (Diminution of Pitta)
Prakritianyathabhava (Alteration in the innate nature) by Arista Lakshana (Imminent death), Viparita Gunnecha (Desire for substances having opposite qualities) by Dosha Chaya (Accumulation of Doshas), digestive fire by the patient's power of digestion, strength by his capacity for exercise, sense-organs like ear etc. by their amity of perception, mind by the power of concentration, understanding by the purposeful nature of the action, passion by the strength of attachment, infatuation by the lack of understanding, anger from actions of violence, grief by hopelessness, joy by happiness, pleasure from the sense of satisfaction, fear by depression, memory by the power of recollection, disease with latent symptoms by testing with therapeutic or provocative medication, the degree of morbidity by the intensity of provocative factors, the imminence of death by the severity of the fatal prognostic signs, the expectation of recovery from whole-some inclinations, the clarity of mind from the absence of disorder, the hard or soft-bowelled condition, the dreams seen, the cravings, the likes and dislikes, pleasure and pain by interrogating the patient.[11]
Yukti (Logical Reasoning and experimental knowledge): The knowledge which sees the things produced by combination of multiple causative factors is Yukti. It is true irrespective of times and helps in achieving the three objects (Dharma, Artha and Kama).[12] Yukti involves the integration of reasoning, experience, and creativity to address complex situations.
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