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REVIEW ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 2  |  Page : 81-93

Pushpeeyam Adhyaya of Bhela Indriya Sthana: An explorative study


Department of Kaya Chikitsa, R. B. Ayurvedic Medical College and Hospital, Agra, Uttar Pradesh, India

Date of Submission26-May-2021
Date of Decision26-Aug-2021
Date of Acceptance13-Sep-2021
Date of Web Publication15-Mar-2022

Correspondence Address:
Dr. Kshama Gupta
Department of Kaya Chikitsa, R. B. Ayurvedic Medical College and Hospital, Agra, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jihs.jihs_14_21

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  Abstract 


Bhela samhita is an ancient Indian textbook of medicine composed by Maharshi Bhela. Indriya sthana is one among the eight sections of Bhela samhita, and it consists of 12 chapters deals with prognostic aspects. Pushpeeyam adhyaya is the 11th chapter of Bhela indriya sthana which consists of 20 verses. Previous works have explored the prognostic potential of various chapters of Bhela indriya sthana. No studies have been conducted on “Pushpeeyam adhyaya” till date. The present study aims to explore the contents of “Pushpeeyam adhyaya” with the help of contemporary medical literature and principles of Freud's interpretation of dreams. Various databases have been searched to identify suitable studies (published in English language) by using appropriate key words. Various conditions such as visual perceptual distortions (erythropsia, photopsia, hyperchromatopsia, achromatopsia, metamorphopsia, etc.), Charles Bonnet syndrome, Anton-Babinski syndrome, retinal and vitreous detachments, end-of-life dreams and visions, hypnagogic visual hallucinations with sleep bruxism, temporal lobe epilepsy, occipital lobe seizures, pilomotor seizures, and psychiatric or neuropsychiatric conditions are documented in “Pushpeeyam adhyaya.” Various dreams such as bad, inauspicious, neutral, wish fulfilling, nightmares, day dreams, lucid dreams, bizarre or absurd dreams and dreams having animal figures, and colors along with their consequences (either death or survival) are documented in “Pushypeeyam adhyaya.” Analysis of dreams with the help of “Freud's interpretation of dreams” principles has revealed that the dreams documented in “Pushpeeyam adhyaya” seems to be rationale. Prognostic estimation based on odors emitted by patients (pushpeeyam) and analyzing dreams (swapna vignaana) of patients are having paramount importance (due to their cost-effectiveness, noninvasiveness, and feasibility) in resource-poor settings. Various hypotheses generated by the present work may pave the way for future research studies.

Keywords: Analysis of dreams, Charaka indriya sthana, Charaka samhita, end-of-life dreams and visions, visual perceptual distortions, volatile organic compounds


How to cite this article:
Gupta K, Mamidi P. Pushpeeyam Adhyaya of Bhela Indriya Sthana: An explorative study. J Integr Health Sci 2021;9:81-93

How to cite this URL:
Gupta K, Mamidi P. Pushpeeyam Adhyaya of Bhela Indriya Sthana: An explorative study. J Integr Health Sci [serial online] 2021 [cited 2022 May 24];9:81-93. Available from: https://www.jihs.in/text.asp?2021/9/2/81/339643




  Introduction Top


“Acharya punarvasu Atreya” had six disciples and “Maharshi Bhela” was one among them. The time period of “Maharshi Bhela” may be considered as 1000–2000 BC. Bhela samhita or compendium is a Sanskrit text on Ayurveda (traditional Indian system of medicine) composed by “Maharshi Bhela.” Maharshi Bhela is one of the principal contributors to Ayurveda and his composed text “Bhela samhita” consists of so many unique concepts. Bhela samhita has been dealt within eight sections and 120 chapters. Indriya sthana is one among those eight sections of “Bhela samhita,” and it deals with prognostic aspects similar to the indriya sthanas” of other ancient Ayurvedic classical texts.[1],[2]

Eleventh chapter of “Bhela indriya sthana” is named as “Pushpeeyam” and it contains 20 verses. The word “Pushpa” denotes a flower; the word “Pushpeeyam” (in the context of indriya sthana) denotes a person who emits pathological body odor or a person who emits body odors which are having prognostic significance or body odor of a person indicating impending death.[3],[4] The second chapter of “Charaka indriya sthana” is named as “Pushpitakam indriyam.”[5] The contents of “Pushpitakam indriyam” of “Charaka indriya sthana,[5] and “Pushpeeyam” of “Bhela indriya sthana” are entirely different. Previous works have explored the hidden concepts and prognostic potential of various chapters of “Charaka indriya sthana” and “Bhela indriya sthana.”[6],[7],[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21],[22],[23],[24],[25] Studies on “Pushpeeyam” chapter of “Bhela indriya sthana” are lacking till date. The aim of the present review is to explore and find out the prognostic importance of 20 verses of “Pushpeeyam” chapter with the help of contemporary medical literature.


  Literature Search Top


A literature search was carried out to identify relevant published (in English language only) and full text articles (without keeping any restrictions of study design). Several online databases were searched to obtain the relevant articles pertaining to contemporary medical literature. Relevant keywords have been used for search. Articles published till May 2021 were included irrespective of their date of appearance and their year of publication. Ayurvedic literature published on Charaka and Bhela indriya sthana has been identified by searching various online databases and search engines. Ayurvedic literature (relevant published books and samhitas) has also been collected from institutional library from where the present study has been carried out.


  Discussion Top


Pushpeeyam” chapter of Bhela indriya sthana consists of 20 verses. Each verse has been explored in the following sections with special reference to their meaning, prognostic importance and their similarity with contemporary medical conditions or diseases [Table 1] and [Table 2].
Table 1: Verses of “Pushpeeyam adhyaya” with their relevant clinical conditions

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Table 2: Analysis of dreams documented in “Pushpeeyam adhyaya

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Shirasyange rakta varnam--sa pushpita ihochyate” (Verse 1)

The person (sa) who perceives (pashyati) his or her own body parts (anga) and/or head (shiras) in red color (rakta varnam) or as gas (anilam) or as a small water jar (ghatika) or perceiving everything in a single color (eka varnam), such a person can be called as “Pushpita” (denotes an impending death). The present verse represents “visual perceptual abnormalities” (visual illusions and hallucinations) caused by various fatal, underlying neurological or ophthalmological or psychiatric or general medical conditions. Visual perceptual abnormalities can be seen in neurological conditions such as delirium, Alzheimer's disease, Picks disease, human immunodeficiency virus, Huntington's chorea, multi-infarct states,  Lewy body dementia More Details, Parkinson's disease, migraine,  Alice in Wonderland syndrome More Details, posterior cerebral infarctions, peduncular hallucinosis, occipital lobe epilepsies (OLEs), parietal lobe seizures, multiple sclerosis, and lateral medullary syndrome (LMS); in psychiatric conditions such as major depression (especially in the elderly), mania, schizophrenia, personality disorders (especially Borderline personality disorder-BPD), panic attacks, substance abuse, posttraumatic stress disorder (PTSD), and Wernicke Korsakoff syndrome with encephalopathy; in ophthalmological conditions such as Charles Bonnet syndrome (CBS) and central visual pathway lesions.[26]

Erythropsia (red vision or red-tinged vision) (rakta varnam pashyati) is a pathological symptom and it can be seen in hemorrhage into the vitreous humor (due to the spontaneous rupture of a diseased vessel of the ciliary body, retina, or choroid). The prognosis in such cases is always poor (pushpita).[27] Erythropsia (rakta varnam pashyati) can also be seen in intraretinal hemorrhages at sub foveal macula.[28] Pseudophakic patients particularly will experience a striking red shift in their vision (rakta varnam pashyati).[29] Visual hallucination is classified into eight categories: tessellopsia (repeated geometry and overlapping patterns); hyperchromatopsia (bright and vivid colors) (rakta varnam pashyati?); prosopometamorphopsia (facial distortions, mutilated, and misshapen heads) (shirasya anilam va ghatikaam va pashyati?); dendropsia (branching forms); perseveration (persistence of details in another scene); illusory visual spread; polyopia (many equal forms); macropsia or micropsia.[30] Verse 1 represents various visual perceptural distortions such as erythropsia (rakta varnam pashyati), prosometamorphopsia (shirasya anilam va ghatikaam va pashyati?), metamorphopsia (distorted vision or size or object distortions)[8] (shirasya anilam va ghatikaam va pashyati), and achromatopsia (partial or total loss of color vision)[8] (eka varnam pashyati) due to various underlying neurological, ophthalmological and psychiatric pathologies [Table 1].

“Ashtaapadam va sukrutam – pushpita prochyate nara” (Verse 2)

While having visual loss (drushti pariheena), if a person (sa) perceives (prapashyati) a spider or eight-legged creature (ashtaapadam) (unpleasant object?) and a beautiful (sukrutam) earthen jar (jagateem) (pleasant object?), such a person can be called as “pushpita” (will die soon). How can a person see or perceive (prapashyati) the objects while having visual loss (drushti pariheena)? Verse 2 denotes visual hallucinations (prapashyati) in the presence of visual loss (drushti pariheena). Visual impairment with visual hallucinations can be seen in syndromes such as  Anton-Babinski syndrome More Details (ABS) and CBS. ABS or Anton's syndrome is characterized by the denial of loss of vision (visual anosognosia) (prapashyati) in the presence of obvious visual loss (drushti pariheena) and cortical blindness (drushti pariheena).[31],[32] CBS is characterized by severe visual impairment (drushti pariheena), visual hallucinations (prapashyati), intact insight, in the absence of brain disease or psychotic disorder, and sensory impairment.[32],[33] Complex visual hallucinations (prapashyati) in CBS patients are made up of images of people, faces, animals, vehicles, trees, flowers, and miniature images. Some CBS patients have described their visual hallucinations as frightening, terrifying, and startling (ashtaapadam prapashyati?).[34] Some CBS patients find the hallucinations as unpleasant or disturbing (ashtaapadam prapashyati), whereas some other patients CBS have described their hallucinations as fairly pleasant or very pleasant (sukrutam prapashyati). Fear-inducing hallucinations (ashtaapadam prapashyati) in CBS patients were associated with negative outcomes (pushpita). For most patients with CBS, symptoms continue for many years with negative consequences (pushpita).[35] According to a case series, “a CBS patient whose eyesight was deteriorated (drushti pariheena) saw faces, odd shapes, animals including a spider (ashtaapadam prapashyati), which he tried to kill and he realized these were hallucinations.” Some CBS patients may respond to their hallucinations such as trying to kill the spider (ashtaapadam). CBS patients can voluntarily change unpleasant visions (prapashyati) (such as tiny creatures crawling on his food-ashtaapadam?), for landscapes with green grass and blue sky (sukrutam jagateem) that evoked a peaceful sensation [Table 1].[36]

“Suptashcha samvrute gehe – sa pushpita ihochyate” (Verse 3)

A person who is asleep (suptashcha) in a closed room or house (samvrute gehe) but still able to see the sky (aakaashameva pashyati) and also chews the cud with his teeth (romanthayati dantaishcha), such a person is known as “pushpita.” How a person can able to see the sky in a closed room? Verse 3 denotes hypnagogic visual hallucinations (suptashcha samvrute gehe aakaashameva pashyati) along with sleep bruxism (romanthayati dantaishcha). Hypnagogic hallucinations (occurs at sleep onset) represent vivid dreamlike experiences of visual imagery (constant or changing colored forms) (suptashcha aakaashameva pashyati) and some patients may describe out-of-body experiences at sleep onset.[37] Bruxism can be defined as a repetitive jaw muscle activity characterized by clenching or grinding of the teeth and/or by thrusting or bracing of the mandible (romanthayati dantaishcha). Bruxism can occur both during sleep time (sleep bruxism-SB) (suptashcha romanthayati dantaishcha) and during wakefulness (awake bruxism-AB).[38] Faciomandibular myoclonus (romanthayati dantaishcha?) is characterized by frequent nocturnal (suptashcha) myoclonic jerks of the masseter and orbicularis oris muscles.[39] Various medical, dental, psychological, and neurological risk factors (pushpita?) have been correlated with bruxism (romanthayati dantaishcha). Hypnagogic hallucinations (suptashcha aakaashameva pashyati) were also more frequently reported in the sleep bruxism (romanthayati dantaishcha) patients and both of these conditions were positivity associated. Parasomnias, such as hypnagogic hallucinations (suptashcha aakaashameva pashyati), were found significantly associated with tooth grinding (romanthayati dantaishcha) during sleep (suptashcha).[40] According to a case report, “A 29-year-old woman reported bruxism (romanthayati dantaishcha), vivid dreams/visual hallucinations (which occurs 1–2 h after falling asleep) (suptashcha aakaashameva pashyati), and motor manifestations such as chewing, grinding teeth (romanthayati dantaishcha), and lip-smacking” [Table 1].[41]

“Deepyamaanamivaakaasham pruthveem--pushpita sa ihochyate” (Verse 4)

The person (sa) who perceives (vetti) the sky (aakaasham), earth (pruthvi), and forests (vanaani) as if they are illuminated and/or aflame (deepyamaana) and also having goose bumps (piloerection) (romasamhrushta), such a person can be called as “pushpita” (or will die soon). Perceiving the objects as if they are illuminated or aflame denotes either “Photopsia” or “Hyperchromatopsia.” Photopsia is characterized by the presence of perceived flashes of light (deepyamaanamiva vetti) in visual field and in hyperchromatopsia colors appears as bright, highly saturated, and luminescent (deepyamaanamiva vetti) due to which objects (aakaasham, pruthvi, and vanaani) have a glittering appearance (deepyamaanamiva).[8] The most common 16 causes for photopsia (deepyamaanamiva vetti) are posterior vitreous detachment (PVD), retinal tear, neovascular age-related macular degeneration (AMD), rhegmatogenous retinal detachment, migraine, hypoglycemia, vertebrobasilar insufficiency, non-AMD choroidal neovascularisation, retinitis pigmentosa, severe cough, central serous chorioretinopathy, intraocular lens reflections, blue field entoptic phenomenon, CBS, digitalis, and metastatic adenocarcinoma to the brain. The photopsias associated with PVD and retinal detachment are characterized by lightning or flash morphology (deepyamaanamiva vetti).[42]

Hyperchromatopsia patients perceive the objects as, “shapes appearing in vivid colors (deepyamaanamiva vetti) with wiggle,” “fireworks exploding in vivid colors (deepyamaanamiva vetti),” and “angular pattern in brilliant colors (deepyamaanamiva vetti).” In hyperchromatopsia, the colors are so hyperintense (deepyamaanamiva vetti) that the patients close their eyes in an attempt to shutout the light and some other patients describes “phosphenes as though a light as powerful as the sun (deepyamaanamiva vetti) had projected the colors” or “perceiving shocking colors” or “perceiving fire” (deepyamaanamiva vetti). Color and brightness contrast was exaggerated (deepyamaanamiva vetti) in hyperchromatopsia giving objects a glittering appearance. Hyperchromatopsia is due to the result of pathologically increased activity at ventral extrastriate region of the brain (V4) (pushpita?).[30]

The word “romasamhrushta” in verse 4 denotes piloerection or goose bumps. Piloerection (romasamhrushta) can be seen in autonomic seizures and in temporal lobe epilepsy (TLE). Piloerection (romasamhrushta) can occur due to a wide variety of structural causes (pushpita?) such as mesial temporal sclerosis, tumours, trauma, cavernomas, cryptogenic epilepsies, and limbic encephalitis.[43] Simple visual auras (such as static, flashing, or moving lights in different colors and shapes) (deepyamaanamiva) are due to the activation of the primary visual cortex and visual association areas. Complex visual auras occur due to the activation of the temporo-occipital junction or basal temporal cortex. Patients with parieto-occipital lobe epilepsy experience visual illusions or hallucinations (deepyamaanamiva vetti?). Piloerection (romasamhrushta) is most common in TLE.[44] Visual hallucinations (elementary and complex) and visual illusions (deepyamaanamiva vetti) can be seen in OLEs and TLE. Hallucinatory and illusional visual seizures involve epileptic discharge in the temporo-parieto-occipital junction. Autonomic disturbances (such as piloerection) (romasamhrushta) of any type are among the most frequent ictal symptoms of TLE. A feeling of “shivering cold” is sometimes associated with piloerection (romasamhrushta).[45]Deepyamaanamiva vetti” and “Romasamhrushta” together in the verse 4 denotes various pathological conditions such as hyperchromatopsia, photopsia, TLE, and OLEs [Table 1];

“Anulipto yathaa dehee--pushpita sa ihochyate” (Verse 5)

A person (sa) who emits bad or unpleasant odor (smells like dead body) (kunapam yathaa) even after application of fragrant substances (anulipto yathaa dehee) and also surrounded by flies (sevante makshikaashchaiva) is called as “pushpita.” Odors such as purisha (faeces), mutra (urine), mruta (carcass), and kunapa (corpse) are considered as “ashubha” or “anishta” (inauspicious). Individual body odor can be altered by various factors (extrinsic and intrinsic). Plenty of volatile organic compounds (VOCs) are emitted from the human body every day. Disease-specific VOCs can be used as diagnostic olfactory biomarkers of infectious, metabolic, genetic, and other diseases. Infections and endogenous metabolic disorders can alter the odor finger prints of an individual by changing the ratio of VOCs. Numerous states of disease are associated with a characteristic odor (pushpita). By observing the attractiveness (sevante makshikaashchaiva) or repulsiveness to insects, physician can indirectly assess the condition or changes of blood chemistry in a particular individual. Pregnancy, greater body mass, suffering with malaria, elevated body temperatures with humidity, and some dietary factors makes an individual more attractive to mosquitoes (sevante makshikaashchaiva). Host location by mosquitoes is guided by host-derived physical (heat, moisture and visual cues) and chemical cues (VOCs). Human skin odors are known to attract (sevante makshikaashchaiva) or repulse insects. Different odors or compounds such as carbon dioxide, carboxylic acid, ammonia, and sweat compounds contribute to attraction of the insects (sevante makshikaashchaiva). Chemical signals (can be detected indirectly by sevante makshikaashchaiva) provide information about a person's genetic compatibility, infection status, and alterations in endocrine and immune systems.[5] Verse 5 denotes pathological body odors (or disease specific VOCs) produced by a patient, who might be suffering with a fatal underlying condition [Table 1].

“Avignaata naram naaree--yam bruyaat na sa jeevati” (Verse 6)

Person (sa) who dreams (swapna) as that he (naram) has been taken away by an unknown woman (avignaata naareee) towards south direction (dakshina disha), that person will not survive (or die soon) (na sa jeevati). Scientific study of dreams is called “Oneirology.” Ancient Ayurvedic scholars have analysed or interpreted dreams (swapna) as a tool to understand the psyche of an individual, to diagnose a disease or to assess its prognosis, and to calculate remaining life expectancy. Dream content reflects experiences during waking time, current concerns, and symptoms of waking life. External sensory stimuli and internal organic states are the source of dreams. Dreams are classified in to seven types [drishta (seen), shruta (heard), anubhuta (experienced), prarthita (desires or wishes), kalpita (imaginary), bhavika (feelings), and doshaja (internal organic states)]. It has been recognised that dreams reflects the presence of illness (na sa jeevati?). Dreams about death and dying (dakshinaam dishaameheeti) are common among people with serious organic disease (na sa jeevati). Dreams of death (dakshinaam dishaameheeti) in men (naram) are positively associated with worse clinical outcomes (na sa jeevati). Dreams “warn” patients whose illness is seen as threatening to the body (na sa jeevati). The owner of south direction (dakshina disha) is “Lord Yama” (God of death) and going towards that direction (dakshinaam dishaameheeti) indicates an impending death (na sa jeevati).[9] End-of-life dreams and visions (ELDVs) (swapna) are commonly (50%–60%) experienced by many people near the time of death (hours or days or weeks or months before death) (na sa jeevati). The most prevalent ELDVs reported are those, in which the dying patients describe seeing deceased people (friends, relatives, or others), living people (friends and relatives), unknown people (avignaata naaree) or forms, making preparations or going on a journey (dakshinaam dishaameheeti), and a dead snake.[46]

“Prakeerna kesho vikara--na sa jeevati taadrusha” (Verse 7)

Person (sa) who dreams (swapne) as that he/she is handless (vikara), having dishevelled hair (prakeerna kesha) and going or reaching (pratipadyeta) towards south direction (dakshina disha) that person will not survive (na sa jeevati). Seeing tangled and unkempt hair (prakeerna kesha) in dreams (swapne) denote, “life will be a veritable burden (na sa jeevati?), business will fall off, and the marriage will be troublesome.” Seeing ugly and malformed hands (vikara?) in dreams (swapne) point to disappointments and poverty (na sa jeevati?) and also seeing a detached hand (vikara), indicates a solitary life. Dreaming as ones hands are tied denotes that he/she will be involved in difficulties.[47] Going towards south direction or reaching to south denotes an impending death.[9] Seeing prakeerna kesha, vikara, dakshina disha pratipadyate, etc., in dreams represents inauspiciousness and such dreams are positively associated with fatal outcomes (death).

“Kushairiva nirudhaanga – na sa jeevati taadrusha” (Verse 8)

Person (sa) who dreams (swapna) as, “Kusha (Desmostachya bipinnata) (halfa grass) is sprouting or germinating (nirudha) from his/her body parts (angam aatmaanam) or kept on his body and also sees (eekshate) sky (kham) as it is clouded with smoke (sa dhumam),” such a person will not survive (na sa jeevati). Many people believe that dreams (swapna) tell us about what might happen in future such as impending dangers (na sa jeevati), hardships, and failure or success in real life. Dreams (swapna) are considered as a source of knowledge of the future. The ability of plants (kusha) to convey specific information is based on religious beliefs about the plants. Diseases (na sa jeevati?), ancestor worship, and propitiation of household deities are believed to be forewarned in dreams (swapna) through some specific events involving plants (kusha), animals, or other objects. Dreaming (swapna) of plants (kusha) which convey bad consequences (na sa jeevati) is considered a bad omen. Appearance of some plants is considered good, while some are considered as evil or bad in dreams (na sa jeevati).[48] Kusha (Desmostachya bipinnata) (halfa grass or big cord grass or salt reed grass) constitute one of the vital ingredients in various rituals and vedic sacrifices (yagnas). It is culturally important grass and widely used in various religious sacrifices and rituals in India.[49] Roots of kusha are having medicinal properties and used in Ayurveda (the Indian traditional system of medicine) to treat various diseases. The floor mat (asana) to perform vedic rituals is made out of this sacred plant (kusha). A ring made of kusha grass is worn in ring finger during the ritual.[50] When a person dies, a handful of kusha grass (kurcha) is brought and sprinkled on the ground where the dead body lay in the house.[51] Dead body would be placed on the sacred kusha grass, and the grass is believed to have a purifying effect on the participants of death ritual.[52] Thus seeing kusha grass in dreams may be the symbolic representation of impending death (as kusha grass and death rituals are associated). To dream of the clear sky signifies distinguished honours and travel with cultured companions. Otherwise (unclear or cloudy or smoky sky) (kham sa dhumam), it portends blasted expectations (na sa jeevati?), and trouble with women.[47] Perceiving kusha grass and smoky or clouded sky in dreams are inauspicious and indicate impending death.

“Ya swapne vrukshamaaruhya – sa pumaan na cha jeevati” (Verse 9 and 10)

Person (sa pumaan) who gets dreams (swapna) such as “climbing (aaruhya) a tree (vruksham) or a building (praasaadam) supported by single pillar (eka sthunam),” “feeling uncomfortable or restless or agitated or threatened (traayate) inside a house (gruhe),” “having loosened (vikacha?), or dishevelled hair (prakeerna kesha) or hair fall (vikacha kesha),” “enter in to fire (agnimaaruhya) with crying (roditi),” and “dancing (nrutyati) in a muddy lake or mud (panke),” such a person (who had these dreams) will not survive (na cha jeevati). People with “vata prakruti” (a specific type of temperament predominant of air and space) experience dreams of flying or rising high in the sky, climbing trees (vruksham aaruhya) or mountains. Those of “pitta prakruti” (a specific type of temperament predominant of fire) have dreams of fire (agnimaaruhya), lightening, and bright flames. Those of “kapha prakruti” (a specific type of temperament predominant of water and earth) will usually dream of lotuses, ponds (panka), clouds, and aquatic birds.[53]

Climbing a tree or mansion and seeing objects such as fire and mud etc. may denote internal pathological aggravation of dosha's (morbid matter) vata, pitta, and kapha, respectively (na cha jeevati?) or such type of dreams are getting originated from internal organic stimuli. To see self as climbing the side of a house (praasaadam adhirohati) in a dream foretells that one has to make or have made extraordinary ventures against to gain something (or it may denote fighting with a chronic and fatal disease?) (na cha jeevati).[47]Praasaadam ekasthuna” denotes a house or a mansion supported by a single pillar and the person dreaming of climbing such a house indicates that there are higher chances of collapse of that house or higher chances of falling or difficulty or despair or challenging task (similar to that of body's protective systems are fighting hardly with a fatal disease) (na cha jeevati?). To dream of crying (roditi), is a forerunner of distressing influences (na cha jeevati?) affecting for evil business engagements and domestic affairs. A man (sa pumaan) to dream (swapne) that he is thinning his hair (vikacha kesha), foreshadows that he will become poor and suffer illness through mental worry (na cha jeevati). For a woman (sa pumaan) to dream (swapne) that her hair is falling out, and baldness is apparent (vikacha kesha) indicates misfortunes (na cha jeevati?). To dream (swapne) of hair fall (vikacha kesha) is a sign of trouble and disappointment (na cha jeevati?).[47]

A dream converts the mild sensations perceived in sleep (swapne) into intense sensations (such as one imagines that one is walking through fire and feels hot-”agnimaaruhya,” if that part of the body becomes only quite slightly warm).[54] Mud (panka) in dreams may represent “accumulation of morbid matter” or “dosha's,” Dancing (nrutyati) in dreams denote disinhibition or mood lability or restlessness or hyperactivity or mania or insanity or seizures (na cha jeevati?). Dancing (nrutyati) in dreams (swapne) counteract or reduces or neutralizes the idea of impending death (na cha jeevati) (dream mechanisms try to counteract anxiety provoking ideas such as disease or death with positive emotions such as dancing and singing).[9] Prakeerna kesha (dishevelled hair) in dreams will also foretell adversity or mishap or danger as explained in “Verse 7.”

Misfortunes (traayate, roditi, vikacha and prakeerna kesha etc) in dreams (swapne) refer to any mishap, adversity, harm, danger, or threat (traayate) that happens to a character (sa pumaan). Nightmares were significantly containing themes of physical aggression, being chased (vrukshamaaruhya or praasaadam adhirohati or traayate gruhe), evil forces, and accidents and interpersonal conflicts. Fear (traayate gruhe) was the most frequently reported emotion in nightmares and bad dreams (swapne). Bad dreams are significantly more emotionally intense (traayate or roditi), more bizarre (nrutyati panke), and more likely to contain misfortunes (na cha jeevati).[55] The nightmare involves a specific danger such as being chased (vrukshamaaruhya or praasaadam adhirohati or traayate gruhe), teased, scolded (roditi), beaten (roditi), strangled, or murdered (roditi). Vocalization (roditi?), movement (aaruhya or adhirohati or nrutyati), and autonomic symptoms can occur in nightmares.[56] Nightmares are highly dysphoric dreams (swapna) involving intense negative emotions (roditi and traayate). Nightmares are more common in psychiatric populations such as PTSD, BPD, Schizophrenia, mood disorders, and sleep disorders. Nightmares are associated with increased psychological distress, self-harm, and suicide (na cha jeevati). Nightmares are the early indicators of the onset of psychosis, PTSD, and sleep disorders (na cha jeevati). A stressful event (such as impending death due to a fatal condition) can be a cause of more frequent nightmares.[57] Verse 9 and 10 denote bad dreams or nightmares associated with misfortunes and foretell impending death.

“Swapne praasaadamaaruhya – na sa jeevati maanava” (Verse 11)

Person (sa) who gets dreams (swapna) such as “climbing (aaruhya) a big (mahaantam) gold (kaanchanam) mansion (praasaadam) and engage in activities such as dancing (nrutya), singing (geeta), eating food (anna), and drinking alcohol (paana) in that mansion such a person (who had these dreams) will not survive (na sa jeevati). Although this dream has positive emotions (nrutya geeta anna and paana) and successful events (mahaantam kaanchanam aaruhya) in its content, it is associated with fatal outcome (na sa jeevati). Dreams may serve as the initial indicators (na sa jeevati) of transference, impending crisis, resistance, acting-out, conflict resolution, and decision making. Dream imagery reflects impulses and wishes (nrutya geeta anna and paana?) often and it also conveys a range of emotions (nrutya geeta anna and paana), past experience, defensive operations, recent events, perceptions of self and others, interpersonal or intrapersonal conflicts, problems and attempts at their resolution.[58] Comforting dreams and visions (nrutya geeta anna and paana and mahaantam kaanchanam aaruhya) are most the common pre death dreams (na sa jeevati). The emotional impact is positive (nrutya geeta anna and paana), comforting and life affirming in people near death (na sa jeevati). Dreamer happiness (nrutya geeta anna and paana) in dream content was positively correlated with time since the death (na sa jeevati). Happiness of the dreamer (nrutya geeta anna and paana) increased with time since the death (na sa jeevati).[59] Dreamers commonly noted comfort provided by ELDVs (na sa jeevati) describing solace, peace and reassurance. A variety of feelings and emotions emerged in ELDVs including positive (nrutya geeta anna and paana), negative (mahaantam praasaadam aaruhya?), mixed or contrasting (nrutya geeta paanaanna and mahaantam praasaadam aaruhya). The majority of emotions in ELDVs (na sa jeevati) were traditionally positive (nrutya geeta paanaanna).[60] The positive dreams mentioned in the present verse denote comforting dreams seen in ELDVs.

“Gajenoshthrena va--neeroga sharadaam shatam” (Verse 12)

A healthy person (neeroga) dreaming as “riding an elephant (gaja) or camel (ushthra) and seeing south direction (pashyet dakshinaam disham) or travelling towards south (gacchet dakshinaam disham)” indicates his long life (one hundred years) (jeevet sharadaam shatam) whereas seeing the similar dream by a diseased person (rogi) indicates his death within a week (jeevet saptaaham). The present verse denotes different consequences or outcomes (jeevet sharadaam shatam and jeevet saptaaham) in different individuals (neerogi and rogi) though the content of dream is same. The outcome or consequences (jeevet sharadaam shatam and jeevet saptaaham) mentioned in the description of dream of present verse are dependent upon the health status of dreamer (neerogi and rogi). To dream of riding an elephant (gajena gacchan), denotes that one will possess wealth, honors, and dignity. One lone elephant in dreams signifies that the dreamer will live a small but solid way (jeevet sharadaam shatam?). To see camel (ushthrena gacchan) in dreams indicates beast of burden, unbearable anguish, and failures (jeevet saptaaham?).[47] Draught animal such as a camel (ushthra) in dreams symbolically represents cachexia or tuberculosis (jeevet saptaaham?). The owner of south direction (dakshinaam disham) is “Yama” (God of death), and seeing (pashyati) or going (gacchati) toward Southern direction (dakshinaam disham) indicates impending death (jeevet saptaaham).[9] Elephants (gaja) in dreams indicate that the dreamer will be able to deal with the obstacle facing at the current time (jeevet sharadaam shatam). Dreaming of elephants (gaja) represent power, sovereignty, stability, and stead-fastness (jeevet sharadaam shatam?). Riding an elephant in dreams suggests that the dreamer has a tendency to be the leader of his family. Person traveling toward south (gacchet dakshinaam disham) riding dog or camel (ushthra) or ass will die (jeevet saptaaham) of “Rajayakshma” (cachexia or tuberculosis).[61]

“Yaati yo durdine vaapi – na sa jeevati taadrusha” (Verse 13)

A person (yo) who dreams (swapne) as “going toward Southern direction (dakshinam disham yaati) during inauspicious days (durdine)” and wakes up immediately (pratibudhyate tatraiva) after getting such a dream, that person will not survive (na sa jeevati). Days on which solar and lunar eclipse, earthquakes, cyclones, storms, wars, rainy and cloudy days, and other natural disasters occur are considered as inauspicious. The word “durdina” denotes inauspicious days, which are considered as bad omens.[62] Durdina in the present verse denotes two different versions, “nightmares occurring on durdina” (durdina as a causative factor of nightmares) and durdina as a thematic content of nightmares (nightmares containing visual imagery or themes of durdina). Themes of disaster or calamity (durdina) are consistent findings in men's nightmares (swapna). Nightmares are defined as very disturbing dreams (swapna) in which the unpleasant visual imagery and emotions (durdina as dream content?) cause the person to wake up (pratibudhyate tatraiva). Bad dreams are defined as very disturbing dreams that do not cause a person to awaken. The only difference between nightmares and bad dreams is the waking criterion (pratibudhyate tatraiva).[55] In present verse the word “pratibudhyate tatraiva” denotes nightmares (disturbing dreams causing a person to awaken). A stressful event (natural disasters-durdina or death of significant other) can be a cause of more frequent nightmares (swapna).[57] Themes of nightmares (swapna) include negative content such as being chased, threat of physical harm, failure, injury, death, interpersonal conflicts, falling, witnessing violence or horror, natural disaster (fire or flood in one's house or neighborhood, earthquakes, war, the end of the world, etc.) (durdina), accidents and being paralyzed (durdina as a thematic content of nightmares).[63] Disaster (durdina) is a sudden, calamitous event, causing great loss, destruction, devastation to life (na sa jeevati) and property. Disasters are traumatic and associated with a high degree of psychological disturbance (na sa jeevati). Nightmares (swapna), exhaustion, insomnia, cardiovascular strain, increased physical pain, reduced immune response, vulnerability to illness etc., are the sufferings caused by the disasters (durdina as a causative factor of nightmares).[64]Dakshinaam disham” in the present verse denotes inauspiciousness or impending death as explained in previous verses.

“Bhaasairbarhivaraahaishcha--na sa jeevati taadrusha” (Verse 14and15)

If the content of day dream (divaa swapne) include themes such as “riding animals such as vulture (bhaasa), peacock (barhi), pig (varaaha), dog (shvana), buffalo (mahisha), and horse (vaji), eating flesh of animals (rhinoceros and related species), and having dishevelled hair (prakeerna kesha), such a dreamer will not survive (na sa jeevati). Dreams during daytime (divaa swapna) with either too long or short duration have minimum effect (Alpa phala). Day dreams are generally considered as futile.[9] The vast majority of recurrent dreams (swapna) contain one or more negative themes involving confrontations with monsters, animals (varaaha, shvana, mahisha, vaji, etc.) or zombies.[65] Some of the nightmares also included pet animals (shvana?).[63] Person travelling towards south (dakshina dishaam) riding a dog (shvana) or an ass will die (na sa jeevati) of Rajayakshma. Circumvention by owls or dogs (shvana) indicates death (na sa jeevati) or affliction with fatal condition.[61] Animal forms seen in dreams are considered as ancient gods (the Celtic horns and salmon, the Viking bears, the Egyptian pigs and river horses, crocodiles and cats, the Roman wolves, and eagles) (varaaha, vaji, bhaasa, etc).[66] Most animal dreams (swapne varaaha, shvana, mahisha, etc) are negatively toned. Dreams including dogs could be either positive or negative or neutral. Individuals who have had negative experiences with dogs (shvana) in their waking life would also have more negatively toned dog dreams (swapne shvana).[67] Animal figures in dreams (swapne varaaha, shvana, mahisha etc) represent oedipal desire according to Freud.[68] Animals such as cats, dogs (shvana) and horses (vaji) are closer to us than wild animals and they appear in dreams by having some symbolic representation.[69] Animal dreams (swapne varaaha, shvana, mahisha etc) have fascinated mankind for ages and it has been found that children dream more often about animals (dogs, cats and horses) (shvana and vaji) than adults. Most dreamer-animal interactions in dreams are negative.[70]

Animals are found quite often in dreams, and speculations about their meaning are manifold. Waking-life experiences of dreamer with animals may get reflected in his dreams.[71] It has been found that dreams with animal figures (swapne varaaha, shvana, mahisha, etc) have a great deal of activity that is often of a violent nature and the dreamer experiences fear. If the animal figure (swapne varaaha, shvana, mahisha, etc) in dreams initiates any response to the dreamer, it is some form of threat or hostility (na sa jeevati?).[72] Corpses are attacked by many predatory and scavenger animals such as pets, domestic dogs (shvana), cats, ants, rodents, and many species of birds such as vultures (bhaasa), eagles, ravens, magpies, and others (barhi?).[73] Daytime dreams (divaa swapna) may yield their results within 6 months.[61] Seeing animals and birds in dreams seems to be a warning sign indicating impending death. Some of the animals (shvana) or birds (bhaasa) explained in the present verse are predatory and omnivorous in nature (bhaasa, barhi, and shvana) and they can be seen near cemeteries or burial grounds (they are associated with corpses and may denote or symbolically represent impending death in dreams) (na sa jeevati). Dreaming of eating raw meat of animals (gandam cha khadgam cha swapne chaashnam) may denote hardships (na sa jeevati?). Dreaming of eating flesh of huge animals (such as rhinoceros and its related species) (gandam cha khadgam cha swapne chaashnam) may also denote the cravings of dreamer towards eating nonvegetarian foods to correct the underlying deficiency (cachexia? or Tuberculosis? or sarcopenia?) (na sa jeevati?). Dreaming of a wild pig (varaaha swapne) could bear negative connotations (na sa jeevati?). Prakeerna kesha (dishevelled hair) in dreams also denote misfortunes and considered as bad omen as explained in previous verses (7, 9, and 10).

“Ya swapne purusha--na sa jeevati taadrusha” (Verse 16)

A person (purusha) dreaming (swapne) about wearing or holding black (kaala) or yellow (peeta) colored clothes (vastramruchati), singing (gaayati), dancing and doing other such type of activities (cheshtayan), that person will not survive (na sa jeevati). Dream color (kaala or peeta swapne) is a symbol that combines or condenses with dream imagery to add additional meaning and that meaning is influenced by culture, personal experiences, and emotions (gaayati, nrutyati, roditi, etc). Color (kaala or peeta) paints the dreams (swapna) with emotion (gaayati). Yellow (peeta) color represents cheerfulness, exhilaration, uninhibited expansiveness, arousal, and spontaneous enjoyment of action (gaayati and cheshtayati). Yellow color also represents hope and a desire to escape from existing difficulties (na sa jeevati?). Yellow color (peeta) may induce the physiological changes such as increasing blood pressure and respiratory rate (na sa jeevati?). Black color (kaala) stands for nothingness, extinction, ultimate surrender, extreme compensation, and protest. Black color is a symbol of grief and may represent disease or death (na sa jeevati?).[74] Singing and other activities in dreams may denote mood lability or Mania. Absurd combinations of ideas (gaayati, cheshtayati, and kaala peeta vastramruchati) are the characteristic features of dreams (swapne) in insanity. Dancing with euphoria symbolically represents excessive abnormal involuntary movements (seizures?), restlessness or agitation (dementia and delirium?), or some other neurological or neuropsychiatric condition.[9] The present verse Peeta vastramruchati, gaayati and cheshtayati in dreams denote positive emotion but with negative consequences (na sa jeevati). Singing (gaayati) in dreams (swapne) and other such pleasurable activities counteract or reduces or neutralizes the idea of impending death (na sa jeevati) (dream mechanisms try to counteract anxiety provoking ideas such as disease or death with positive emotions such as dancing and singing).[9] Positive emotions (gaayati and cheshtayati) are the most common content of ELDVs (na sa jeevati).[60]

“Ya swapne veetakaamopi--na sa jeevati taadrusha” (Verse 17)

A person (ya) dreaming (swapne) about drinking (pibati) of Vaaruni (a specific type of alcoholic beverage) (even though he is not desirous of drinking it) (veetakaamopi) and wearing a colorful thread around his neck (chitrakanthagune), that person will not survive (na sa jeevati). Dreams (swapne) disclose to us what we do not wish to admit to ourselves (vaaruni pibati), and that we therefore unjustly condemn them as lying and deceptive (veetakaamopi?). Unconsciously dreamer (ya) speaks the language of truth (vaaruni pibati) through dreams (swapne). No dream can be imagined whose beginnings have not already passed through the mind during waking hours of a dreamer in the form of wish, desire, or impulse (vaaruni pibati). The dream (swapna) fulfills several wishes (vaaruni pibati) and it can be recognized as a wish fulfillment.[54] As per present verse, the dreamer do not wish to drink alcoholic beverage during waking hours, but he sees drinking alcoholic beverage in dreams. During waking hours, the dreamer may deny or suppress the wish or desire to take alcohol (veetakaamopi), but dreams may reveal his hidden wish or desire (vaaruni pibati) (wish fulfilling dream). Dreams (swapna) of patients suffering with alcohol dependency are more negatively toned in nature. During detoxification, most of the alcohol dependency patients (ya) had a dream (swapna) about taking alcohol (vaaruni pibati). Most patients who dreamt of alcohol also consumed alcohol in their dreams (swapne vaaruni pibati), and it was accompanied by feelings of guilt (veetakaamopi?), fear, helplessness, anger, and frustration.[75] An alcoholic dependent patient (ya) having dreams of taking alcohol (swapne vaaruni pibati) but denying it during waking hours (veetakaamopi) and ultimately succumbing to death (due to alcohol-related complications such as cirrhosis of liver) (na sa jeevati). Wearing a necklace or jewelery or a colorful thread around the neck in dreams (swapne chitrakanthagune) may denote “hanging” or “death (due to suffocation or asphyxia)” (na sa jeevati?).

“Aakulaapam nadeem swapne--neeroga sharadaam shatam” (Verse 18)

A healthy (neerogi) person (yo maanava) dreaming (swapne) about swimming against strong water currents (akulaapam) of a river (nadeem) and succeeds in it will survive up to 100 autumns or 100 years (jeevet sharadaam shatam), whereas a diseased person or a patient (saroga or rogi) dreaming of same will survive only for a week (jeevet saptaaham). In the present verse, though the situation in dream is same (swimming against strong water currents of a river), the consequences are different (jeevet sharadaam shatam or jeevet saptaaham) based on the health condition of a dreamer (neerogi or sarogi). To dream of swimming (swapne) is an augury of success if the dreamer (yo maanava) finds no discomfort in the act but if the dreamer feels going down in water or struggling (aakulaapam nadeem), much dissatisfaction will going to happen to the dreamer (jeevet saptaaham?). To swim under water (yo maanava avagaahet aakulaapam nadeem swapne) indicate struggles and anxieties (jeevet saptaaham?).[47] Swimming in dreams may also denote bed wetting in children or full bladder.[54] A patient who dreamt of swimming under water and performing breaststrokes (akulaapam nadeem?) in dreams (swapne) had regularly repeating central apnoeas (multiple apnoea episodes) with hyperventilation (jeevet saptaaham?) in sleep recordings.[76] Swimming against strong currents of a river in dreams (aakulaapam nadeem swapne) symbolically may represent a chronic or fatal disease by which the patient (sarogi) struggles and ultimately dies (jeevet saptaaham). The same dream in a healthy person (nirogi) may represent the physical fitness or stamina of a dreamer (jeevet sharadaam shatam).

“Swapne snaataanuliptasya--sa shastrena vinashyati” (Verse 19)

If a person (yasya purushasya) dreams (swapne) about his body (gaatrasya) getting spoiled due to falling off or fading away or drying off (bhramshet) the applied medicinal paste over the body (anuliptasya gaatrasya) after taking bath (snaatasya), such a person (sa) will die due to weapon injuries (shastrena vinashyati). In “Gomaya churneeyam indriyam” (12th chapter) of Charaka indriya sthana, there is a similar verse stating that, “herbal paste (anuliptasya) applied all over the body gets dried off (bhramshet) earlier on the chest when compared to other body parts indicate impending death of that person (vinashyati) within 15 days.” Chest (applied medicinal paste over it) getting dry off (anuliptasya bhramshet) earlier compared to other body parts denote regional vasodilation or hyperthermia caused by hyperperfusion, hypermetabolism, and hyper vascularization.[16] In present verse (verse 19) the same condition (anuliptasya bhramshet) occurs in dreams (swapne). Falling off or drying off of the applied herbal paste (anuliptasya bhramshet) all over the body (gaatrasya) in dreams (swapne) may represent higher body temperature (hyperthermia or hyper metabolism or hyper vascularisation etc., seen in inflammatory or infectious pathologies or carcinomas) (vinashyati?). Bodily stimuli are present at all times, and it is generally assumed that the mind is more accessible to them during sleep than in the waking state. The general aggregate of bodily sensation must undoubtedly be included among the dominant dream stimuli of internal bodily origin.[54] To spill perfume or to break a bottle of perfume or oppressed by it are inauspicious and foretells that dreamers' most cherished wishes and desires will end disastrously.[47] Internal organic or somatic stimuli may be the source of dream documented in present verse (verse 19) and also foretells inauspiciousness such as impending death of a dreamer by firearm or weapon injuries. From verse 6 to verse 19 various dreams and their consequences were documented by Maharshi Bhela [Table 2].

“Etat indriya vignaanam--nrunaam vidyaat vichakshana” (Verse 20)

Physician (bhishak) having ultimate experience and knowledge (samyak anupashyati) in indriya vignaana (prognostic science) can properly assess the prognosis of his patients (jeevitam cha mrutyum cha nrunaam) and he is considered as best physician (vichakshana). Experienced physicians (samyak anupashyati) have shown better performance (vichakshana) than less experienced physicians while prognostication.[25]


  Conclusion and Implications Top


Pushpeeyam adhyaya is the 11th chapter of Bhela indriya sthana which consists of 20 verses. The word “pushpeeyam” denote a specific odor having a prognostic significance. Estimating prognosis based on the odors emitted by a patient is a unique method invented by Ayurvedic sages thousands of years ago. Various disease specific VOCs emitted by patients (pushpeeyam) have been identified recently. Verse no 1-5 represent various conditions such as VPDs (erythropsia, photopsia, hyperchromatopsia, achromatopsia, metamorphopsia etc.), CBS, ABS, retinal and vitreous detachments, ELDVs, hypnagogic visual hallucinations with sleep bruxism, TLE, OLE, pilomotor seizures and psychiatric or neuropsychiatric conditions. Verse no 6-19 deals with various dreams along with their prognostic significance. Various dreams such as bad, inauspicious, neutral, wish fulfilling, nightmares, day dreams, lucid dreams, bizarre or absurd dreams and dreams having animal figures and colors along with their consequences (either death or survival) are documented in “Pushypeeyam adhyaya.” Analysis of dreams with the help of “Freud's interpretation of dreams” principles has revealed that, the dreams documented in “Pushpeeyam adhyaya” (from verse no 6-19) seems to be rationale. Further studies such as dream content analytic studies, survey studies, prospective or retrospective cohort studies and sleep studies are required to authenticate the dreams mentioned in “Pushypeeyam adhyaya.” Various questionnaires or scales can be developed based on the contents or dream descriptions available in “Pushypeeyam adhyaya.” Palliative care is still in its infancy in India and most patients are having painful and undignified deaths with unaddressed symptoms. Prognostic estimation based on odors emitted by patients (pushpeeyam) and analyzing dreams (swapna vignaana) of patients are having paramount importance (due to their cost-effectiveness, non-invasiveness, and feasibility) in resource-poor settings. Various hypotheses generated by the present work may pave the way for future research studies.

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Conflicts of interest

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