Critical review of shirashula (headache) differential diagnosis.

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Journal name: World Journal of Pharmaceutical Research
Original article title: A critical review on differential diagnosis of shirashula (headache) from charak samhita
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Author:

Dr. Nisar Ali Khan and Dr. Pratibha Kondibarao Waghmare


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: A critical review on differential diagnosis of shirashula (headache) from charak samhita

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr202312-28976

Copyright (license): WJPR: All rights reserved


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Summary of article contents:

Introduction

Headaches, referred to in Ayurveda as "Shirashula," are common ailments prompting individuals to seek medical attention. They encompass various aches and discomforts localized in the head and can manifest either as a standalone condition or as a symptom of underlying diseases. The differential diagnosis, which involves systematically ruling out conditions that share similar symptoms, is crucial for identifying the most likely cause of a patient’s headache. Given the prevalence of headaches and the limitations of modern pharmacological treatments, an understanding of the Ayurvedic perspective on this condition is essential for effective management.

Differential Diagnosis in Ayurveda

Differential diagnosis in Ayurveda, particularly related to Shirashula, relies on a comprehensive approach termed "Nidanpanchak," which comprises five essential components: Nidan (causative factor), Purvarupa (premonitory symptoms), Rupa (manifested symptoms), Upashay (relieving factors), and Samprapti (pathophysiology). This systematic method allows Ayurvedic practitioners to accurately categorize various disease presentations related to headaches. Charak Samhita serves as a vital resource, outlining the symptoms and applicable classifications for effective diagnosis, thereby enhancing the practitioner's understanding of headache pathology.

Causes of Shirashula

The study reveals that Shirashula can be caused by multiple factors, predominantly involving vitiated Vayu (air element). This includes various types of Vayu such as Prana, Udana, Vyana, Samana, and Apana, each contributing differently to headache symptoms. For instance, the suppression of natural urges, excessive speaking, and dietary inconsistencies can aggravate these Vayu types, leading to headache. Additionally, factors like improper sleep, dietary mismanagement (Santarpanottha), and blood vitiation play significant roles in the onset of headaches, emphasizing the multifaceted nature of this ailment.

Systemic Implications of Shirashula

Headaches in Ayurveda are not merely isolated issues but can also indicate systemic diseases or conditions affecting overall health. Charaka has categorized Shirashula as both a symptom of specific head diseases and manifestations of systemic disorders, underscoring the significance of identifying potential systemic causes in conjunction with localized symptoms. A thorough understanding of related systemic implications can assist practitioners in devising comprehensive treatment plans tailored to individual patient needs.

Conclusion

The intricate nature of Shirashula requires a nuanced approach to diagnosis and treatment. The Ayurvedic framework emphasizes identifying underlying causes and understanding the interconnectivity of bodily systems to facilitate effective management strategies. Given the prevalence and impact of headaches on quality of life, further research, including observational studies, would be beneficial to analyze the most common causes of headaches based on Ayurvedic principles. This approach promises to enhance the efficacy of treatment options available to those suffering from headaches, providing a holistic pathway towards wellness.

FAQ section (important questions/answers):

What is Shirashula and how is it understood in Ayurveda?

Shirashula refers to headaches and discomforts located in the head. In Ayurveda, it may stem from underlying diseases or stand alone as a condition, necessitating a differential diagnosis to identify probable causes.

What are the key principles for diagnosis in Ayurveda?

In Ayurveda, the key principle is to first diagnose the disease accurately, and then select appropriate therapies. This process utilizes understanding from the five elements of diagnosis known as Nidanpanchak.

How does differential diagnosis work according to Charak Samhita?

Differential diagnosis involves listing all potential conditions that may cause the patient's symptoms. It is crucial for guiding treatment, ruling out serious conditions, and narrowing down to the most likely diagnosis.

What factors contribute to Shirashula according to Charak Samhita?

Shirashula can result from vitiated Vayu, impure blood, improper dietary habits, and effects of purification therapies, among others, necessitating consideration of various health conditions.

Why is understanding the symptoms important in Ayurveda?

Understanding symptoms is crucial as they help diagnose diseases accurately. Symptoms inform treatment decisions and understanding patterns can lead to identifying specific ailments according to Ayurvedic principles.

What are the implications of vitiated Vayu in headache conditions?

Vitiated Vayu can lead to different types of headaches like splitting or aching pain. It can arise from various factors including suppressed urges and improper purification processes, affecting overall health.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Critical review of shirashula (headache) differential diagnosis.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Disease:
Diseases encompass a broad range of health conditions that can affect bodily systems. In Ayurveda, diseases can be categorized by their symptoms, causes, and underlying doshic imbalances. Recognizing and classifying diseases correctly leads to more effective diagnosis and treatment, particularly in managing headaches.

2) Vitiation (Vitiated):
Vitiated refers to the state of being compromised or disturbed, particularly regarding doshas in Ayurveda. When Vata, Pitta, or Kapha are vitiated, symptoms such as Shirashula can arise. Recognizing vitiation helps practitioners identify root causes of headaches and tailor treatments accordingly.

3) Vayu:
Vayu, or air, is one of the three doshas in Ayurveda, responsible for movement and bodily functions. Its vitiation can lead to headaches, as it governs several physiological processes, including sensory and motor functions. Understanding Vayu is vital in diagnosing and treating conditions like Shirashula.

4) Shiroroga (Siroroga, Shiras-roga):
Shiroroga refers to a category of disorders related to the head, including various types of headaches. It encompasses symptoms and conditions affecting the head and is critical for Ayurvedic practitioners to consider when diagnosing and treating headaches like Shirashula, as they must distinguish these symptoms from systemic diseases.

5) Purification:
Purification in Ayurveda (Shodhana) involves detoxifying the body to restore balance to doshas. It may contribute to relieving Shirashula by eliminating accumulated toxins. Proper purification techniques are essential for practitioners to consider in treatment protocols for patients seeking relief from headaches and other symptoms.

6) Rupa:
Rupa refers to the manifestations or symptoms of a disease. In Ayurveda, understanding Rupa is critical for diagnosis and treatment. Symptoms associated with Shirashula can inform practitioners about the underlying conditions, aiding in developing a differential diagnosis to target effective treatments for headaches.

7) Vata:
Vata is one of the three doshas in Ayurveda, associated with movement and communication in the body. Its imbalance can manifest as various ailments, including headaches. Recognizing Vata-related symptoms is essential for Ayurvedic practitioners to address issues like Shirashula, requiring interventions to restore balance.

8) Pitta:
Pitta is the dosha representing transformation and metabolism in the body. Imbalances or vitiation in Pitta can lead to conditions such as excess heat in the body, contributing to headaches and other symptoms. Understanding Pitta's role is crucial for diagnosing and treating Shirashula effectively.

9) Basti:
Basti refers to an Ayurvedic treatment where medicated oils or herbal preparations are administered through the rectum. It is a detoxifying and rejuvenating procedure that can help alleviate symptoms of Shirashula when the headache is caused by an imbalance requiring detoxification from Vata and Kapha.

10) Apana:
Apana is a subtype of Vata dosha in Ayurveda, associated with downward movements, such as excretion and menstruation. When Apana is vitiated, it can lead to discomfort in the lower body, which may manifest as referred pain, including headaches. Understanding this interaction is vital for diagnosing conditions like Shirashula.

11) Ayurveda (Ayus-veda):
Ayurveda is a holistic healing system from India emphasizing balance among body, mind, and spirit. It provides foundational knowledge for understanding diseases, ailments like Shirashula, and healing methodologies through lifestyle, diet, and herbal remedies based on the principles of doshas, dhatus, and srotas.

12) Samhita:
Samhita refers to ancient texts in Ayurveda, such as Charaka Samhita, that document medical knowledge, diagnosis, and treatment methodologies. It serves as a key reference for practitioners in understanding conditions like Shirashula and the principles governing differential diagnosis and treatment options.

13) Kapha:
Kapha is one of the three doshas in Ayurveda, associated with structure and stability. An imbalance in Kapha can lead to various disorders, including headaches. Recognizing the symptoms and root causes related to Kapha helps practitioners provide effective treatments for conditions such as Shirashula.

14) Udana:
Udana is a subtype of Vata dosha associated with upward movements in the body, including speech and respiration. If Udana is vitiated, it can lead to symptoms like headaches. Understanding Udana's role in physiological functions aids practitioners in pinpointing the causes of Shirashula.

15) Sira (Shira):
Shira refers to the head in Sanskrit. In the context of Shirashula, it emphasizes the location of the headache and its importance in the treatment and diagnosis of various head disorders. Proper understanding of Shira is essential for Ayurvedic practitioners addressing head-related ailments.

16) Prana (Pran):
Prana denotes the life force or vital energy in Ayurveda, essential for sustaining life and health. Its vitiation can lead to various disorders, including headaches. Recognizing the impact of Prana on overall well-being helps practitioners in diagnosing and managing conditions like Shirashula effectively.

17) Blood:
Blood plays a vital role in nourishing the body and transporting nutrients. Vitiated blood can contribute to headaches and other disorders in Ayurveda. Understanding blood's condition and its interactions with doshas is crucial for diagnosing and treating conditions like Shirashula.

18) Medicine:
Medicine encompasses the substances and practices used to treat diseases. In Ayurveda, this includes herbal formulations, dietary recommendations, and lifestyle modifications. Understanding different medicinal approaches is vital for effectively treating conditions such as Shirashula and restoring balance in the patient’s body.

19) Nigraha:
Nigraha translates to control or restraint in Ayurveda, referring to methods to suppress pathological urges or reactions. It is relevant in managing conditions like Shirashula when addressing the symptoms caused by excess dosha activity, aiding in restoring equilibrium.

20) Shosha (Sosa):
Shosha refers to a state of wasting or depletion of tissues in the body. In Ayurveda, understanding Shosha is crucial as it can manifest in various forms, including headaches. Addressing the underlying causes of Shosha is vital for effective treatment in conditions like Shirashula.

21) Dosha (Dosa):
Dosha refers to the three principles (Vata, Pitta, Kapha) that govern bodily functions and influences health. Imbalances in doshas lead to diseases and head-related symptoms like Shirashula. Understanding doshic interactions is essential for practitioners aiming to restore wellness through Ayurvedic treatment.

22) Gulma:
Gulma refers to abdominal masses or swellings in Ayurveda, which can arise from metabolic disturbances. Its significance in the context of headaches lies in recognizing abdominal health's holistic influence on the head, aiding in proper diagnoses and treatment of Shirashula.

23) Arishtalakshana (Aristalaksana, Arishta-lakshana):
Arishta-lakshana denotes signs that indicate approaching death, often used in Ayurvedic texts. Recognizing these signs is essential for practitioners to assess the severity of conditions like Shirashula and determine appropriate interventions or palliative care measures.

24) Shalakyatantra (Salakyatantra, Shalakya-tantra, Shalakyatamtra):
Shalakyatantra is a specialized branch of Ayurveda focusing on head, neck, and ear-nose-throat disorders. Its relevance lies in diagnosing and treating conditions like Shirashula, emphasizing localized knowledge and techniques critical in managing symptoms effectively.

25) Maharashtra (Maharastra, Maha-rashtra):
Maharashtra is a state in India, known for its rich cultural heritage and traditional medicine practices, including Ayurveda. The practice of Ayurveda in this region plays a significant role in preserving ancient knowledge and providing treatment options for conditions like Shirashula.

26) Lakshana (Laksana):
Lakshana refers to the signs or characteristics of a disease in Ayurveda. Understanding Lakshana is crucial for effective diagnoses, particularly in conditions like Shirashula, where recognizing specific symptoms can help distinguish it from other health issues.

27) Arishta (Arista):
Arishta is a term used to describe critical or potentially fatal conditions in Ayurveda. Recognizing Arishta in the context of Shirashula is significant, as it prompts practitioners to reevaluate treatment modalities vigorously to prevent severe health consequences.

28) Shankha (Sankha, Samkha, Shamkha):
Shankha refers to a conch shell in Ayurveda but is also a term used for certain types of head pain. Understanding Shankha is vital for Ayurvedic practitioners to differentiate headache types, particularly when diagnosing nuanced conditions like Shirashula.

29) Samana (Shamana):
Samana is a subtype of Vata dosha responsible for the digestion and assimilation of food and energies in the body. An imbalance in Samana can affect overall health, resulting in symptoms such as Shirashula. Recognizing these disturbances is vital for effective treatment.

30) Madhya:
Madhya refers to the middle or balance in Ayurvedic philosophy. Maintaining Madhya among the doshas is essential for optimal health. Understanding this principle informs practitioners in diagnosing and treating conditions like Shirashula, where imbalance may lead to symptoms.

31) Niruha:
Niruha refers to a therapeutic enema used in Ayurveda for detoxification and restoring balance. Understanding Niruha's application is crucial for managing conditions like Shirashula, as it helps eliminate toxins that may exacerbate headache symptoms.

32) Vyadhin (Vyadhi):
Vyadhi translates to disease in Sanskrit, encompassing various health conditions in Ayurveda. Understanding Vyadhi is essential for Ayurvedic practitioners to diagnose and develop effective treatments for conditions such as Shirashula, based on differential diagnosis and clinical assessments.

33) Vyana:
Vyana is a subtype of Vata that circulates energy and blood throughout the body. Its vitiation can lead to various disorders, including headaches. Recognizing Vyana's role enables practitioners to develop targeted interventions for managing Shirashula effectively.

34) Arshas (Arsa, Arsha, Arsas):
Arsha refers to hemorrhoids in Ayurveda, a condition that can cause discomfort and may be related to or exacerbate headaches. Understanding the connection between Arsha and Shirashula helps practitioners provide comprehensive care encompassing related symptoms.

35) Study (Studying):
Study refers to the academic or clinical research conducted to understand health conditions. In the context of Shirashula, studies help illuminate underlying causes and treatment efficacy, providing valuable data for practitioners to refine their Ayurvedic approaches to headache management.

36) Alpa:
Alpa means 'less' in Sanskrit, often referring to insufficient qualities of doshas or elements. Recognizing Alpa in the context of symptoms like Shirashula is integral to understanding its causative factors and tailoring treatment protocols appropriately in Ayurveda.

37) Sign:
Sign in Ayurveda refers to observable indicators of disease, necessary for diagnosis. Recognizing signs associated with conditions like Shirashula aids practitioners in assessing the severity and determining proper interventions for headache management.

38) Niruhabasti (Niruha-basti):
Niruha-basti is a form of enema therapy in Ayurveda, aimed at detoxifying the body. Understanding its role in treating Shirashula emphasizes the importance of addressing underlying imbalances through elimination therapies to restore health effectively.

39) Suryavarta (Surya-avarta):
Suryavarta refers to a specific type of headache characterized by pulsating or throbbing pain often linked with Pitta imbalances. Recognizing Suryavarta in diagnoses allows practitioners to apply appropriate Ayurvedic treatments for symptoms of Shirashula.

40) Madatyaya (Mada-atyaya):
Madatyaya is a term indicating conditions arising from intoxication or excessive consumption of alcohol. Understanding Madatyaya is pivotal for Ayurvedic practitioners as it can lead to headaches like Shirashula, thus informing preventive and treatment approaches.

41) Knowledge:
The Knowledge refers to comprehensive understanding within the Ayurvedic framework regarding health, disease, and treatments. It is foundational for practitioners to provide interventions for conditions such as Shirashula effectively. Continuous learning enhances the ability to treat complex conditions.

42) Udavarta:
Udavarta refers to an upward motion of Vata that can cause discomfort and is relevant in diagnosing certain types of headaches. Understanding Udavarta's implications is important for Ayurvedic practitioners treating Shirashula to develop effective management strategies.

43) Atiyoga:
Atiyoga denotes excessive use or application of a therapeutic method in Ayurveda. Recognizing Atiyoga is crucial in cases like Shirashula, where treatments may become counterproductive, leading to further complications requiring careful evaluation.

44) Vedana:
Vedana refers to pain or discomfort experienced in the body. Understanding Vedana in its various forms is crucial for diagnosing and treating conditions like Shirashula in Ayurveda, helping practitioners tailor their interventions according to patient needs.

45) Antara (Amtara):
Antara refers to the inner or deeper aspects of a condition in Ayurveda. Understanding Antara in the context of Shirashula assists practitioners in examining underlying causes that may not be immediately evident, enabling comprehensive treatment planning.

46) Dushta (Dusta):
Dushta refers to the condition of being tainted, impaired, or corrupted. In Ayurveda, recognizing Dushta is essential in diagnosing persistent or severe cases, such as chronic headache conditions like Shirashula, guiding treatment toward addressing underlying issues.

47) Chardi:
Chardi refers to vomiting in Ayurveda, an important symptom that can indicate various underlying disorders. Understanding its correlation with headaches helps practitioners evaluate and address complications related to symptoms of Shirashula effectively.

48) Pandu (Pamdu, Pamde):
Pandu refers to a pale or anemic condition in Ayurveda, indicating improper functioning of blood and digestion. Recognizing Pandu's role is vital, as it can lead to headaches and understanding this connection aids effective diagnosis and treatment in conditions like Shirashula.

49) Ayoga (Ayas-ga):
Ayoga signifies non-use or lack of therapy application in Ayurvedic practice. Recognizing Ayoga's implications helps practitioners identify cases where treatment has been insufficient or neglected, particularly in managing conditions like Shirashula.

50) Linga (Limga):
Linga refers to the characteristics or indicators of a disease in Ayurveda, closely related to Rupa. Understanding Linga is essential for practitioners in recognizing symptoms of conditions like Shirashula for accurate diagnoses and effective treatments.

51) Water:
Water is a fundamental element representing nourishment and hydration in Ayurveda. It is essential for bodily functions and health, and understanding its importance helps practitioners recognize conditions, such as dehydration, that could lead to headaches like Shirashula.

52) Pana:
Pana refers to the act of drinking or ingestion in Ayurveda. Its significance lies in understanding dietary habits and their impact on health, particularly in relation to symptoms like Shirashula, where hydration and nourishment are critical.

53) Kasa (Kasha):
Kasa refers to cough in Ayurveda, which can be a symptom of various health conditions. Understanding the relationship between Kasa and Shirashula assists practitioners in conducting differential diagnoses for effective treatment approaches.

54) Life:
Life denotes the state of being alive and encompasses physical, mental, and spiritual health. In Ayurveda, preserving life and health integrity is paramount; thus, understanding conditions like Shirashula has significant implications for overall quality of life.

55) Science (Scientific):
Science in Ayurveda reflects the systematic understanding of health, disease, and treatment principles through observation and study. Embracing scientific approaches enriches practitioners' effectiveness in diagnosing and managing conditions like Shirashula.

56) Seat (Seated):
Seat refers to the location of pathology or discomfort within the body. Identifying the seat of pain, particularly in head-related disorders like Shirashula, is essential for practitioners to formulate effective treatment modalities.

57) Vishamashana (Visamasana, Vishamasana):
Vishamashana refers to irregular or improper eating habits in Ayurveda, which can lead to health disturbances. Recognizing Vishamashana's role is essential for managing conditions like Shirashula, as dietary imbalances significantly contribute to headache onset.

58) Pratishyaya (Pratisyaya):
Pratishyaya translates to the condition of being obstructed or constrained, particularly regarding respiratory health. Recognizing Pratishyaya is essential in diagnosing headaches like Shirashula that might arise from nasal or throat obstructions causing referred pain.

59) Apanavayu (Apana-vayu):
Apana-vayu is the subtype of Vata responsible for downward movement in the body related to excretory functions. An imbalance in Apana-vayu can lead to various symptoms, including headaches, which is relevant in managing Shirashula effectively.

60) Apanavata (Apana-vata):
Apana-vata refers specifically to the energetic aspect of Vata responsible for elimination processes. Understanding its role is vital in recognizing how disturbances can contribute to headaches, guiding effective interventions in Ayurvedic practice.

61) Apatarpana:
Apatarpana denotes a condition of tissue depletion or malnourishment in Ayurveda. Recognizing Apatarpana is crucial for diagnosing headaches due to nutrient deficiencies or imbalances, informing treatment approaches and dietary recommendations for conditions like Shirashula.

62) Vatapitta (Vata-pitta):
Vata-pitta denotes the combination of the two doshas, indicating a specific imbalance that can contribute to health issues, including headaches. Understanding doshic interactions is essential for practitioners in formulating precise treatments for conditions like Shirashula.

63) Discussion:
Discussion refers to the analytical review of findings or concepts in Ayurveda regarding health or diseases. Engaging in thoughtful discussion around conditions like Shirashula is vital for enhancing understanding and refining treatment modalities among practitioners.

64) Substance:
Substance in Ayurveda pertains to tangible materials used in treatments, such as herbal formulations. Understanding the nature and application of substances is crucial in managing various health conditions, including Shirashula, ensuring therapeutic efficacy and patient safety.

65) Samprapti:
Samprapti refers to the process of disease development and progression in Ayurveda. Understanding Samprapti provides insights into how conditions like Shirashula evolve, enabling practitioners to craft effective treatment strategies that address all stages of a disease.

66) Purvarupa (Purva-rupa):
Purvarupa denotes the premonitory signs or symptoms preceding a disease. Recognizing Purvarupa is essential in Ayurveda to provide early intervention for conditions like Shirashula, helping practitioners prevent the condition from developing further.

67) Uttamanga (Uttama-anga, Uttamamga):
Uttamanga refers to the head as the 'superior limb' of the body in Ayurveda, emphasizing its importance in health and disease. Recognizing its significance helps practitioners understand the implications of conditions like Shirashula, where treatments target head-related ailments.

68) Kshavathu (Ksavathu):
Kshavathu refers to a sneeze in Ayurveda, a bodily function related to the expulsion of irritants. Recognizing its vital role in Vata's functioning provides insights into headaches like Shirashula that may arise from suppressed sneeze urges. Understanding Kshavathu can help practitioners in effective diagnosis.

69) Splitting:
Splitting refers to a sensation of acute pain, often associated with certain types of headaches. Understanding this symptom is crucial for Ayurveda practitioners diagnosing conditions like Shirashula, as it informs treatment choices that address specific pain modalities.

70) Bleeding:
Bleeding in Ayurveda can indicate serious health issues, often relating to vitiated blood or trauma. Recognizing bleeding's connection to symptoms like Shirashula is essential for practitioners to address underlying conditions and provide appropriate interventions for effective management.

71) Channel:
Channel signifies pathways in the body through which energies and substances flow. Understanding the concept of channels is crucial in Ayurveda for diagnosing and treating conditions like Shirashula, where imbalances can lead to pain or discomfort.

72) Indriya (Imdriya):
Indriya refers to the sensory organs or faculties in Ayurveda. They play a crucial role in perception and can be affected by conditions like Shirashula, where disturbances may impact sensory experiences. Understanding Indriya helps practitioners approach headache management holistically.

73) Visarpa:
Visarpa denotes a type of skin condition characterized by eruptions, often inflammatory or painful. Recognizing the connection between such skin conditions and headaches is essential for practitioners in addressing broader health issues that may manifest as Shirashula.

74) Savisha (Savisa):
Savisha refers to substances or toxins that can induce harm in the body. Understanding Savisha's implications is crucial for practitioners in the context of Shirashula, as exposure can lead to symptoms like headaches that necessitate detoxification and treatment.

75) Quality:
Quality in Ayurveda refers to the characteristics of substances or health states, influencing overall balance. Recognizing how quality impacts doshic interactions helps practitioners design effective treatment strategies for conditions such as Shirashula.

[Note: The above list is limited to 75. Total glossary definitions available: 104]

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Discover the significance of concepts within the article: ‘Critical review of shirashula (headache) differential diagnosis.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Arishtalakshana, Differential diagnosis, Vitiated blood, Quality of life, Charak Samhita, Acharya Charaka, Ayurvedic treatment protocol, Rupa (Symptoms), Vitiated Vayu, Ajeerna, Ayurveda perspective, Nidanpanchak, Modern therapeutics, Urdhvajatrugat Vikara, Observation Study, Marmas (vital points).

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Signs of death.

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