Charaka and his observations on the “Signs and Symptoms of approaching death”

Post written by: Ramesh Venkatraman

Today’s healthcare model is all about “evidence-based-medicine” where you will be asked to get a scan done, or subject yourself to a test before the physician even pronounces a verdict on what afflicts you, leave alone start a treatment regimen. Gone are the days when your doctor used to “touch” and “feel” your limbs or forehead, shine a torch into your mouth, or ask you to stick your tongue out before recommending a medicine. It is in this context that Charaka’s observations on the “Signs and Symptoms of approaching death” make for interesting reading. This article only lists the physical signs mentioned in Charaka’s Samhitha. It is the author’s belief that the other signs, symptoms border on the superstitious and may not be appreciated in today’s context.

The physical signs that can be noted through observation of the patient on deathbed or sudden changes that are premonitory in nature include:

1. Sudden loss in physical strength and sensory functions
2. Discoloration of face, nails, eyes, urine, feces, hands, and feet
3. Sudden appearance of malodor in a deteriorating patient
4. Loss of pulsation in body parts that had pulsations earlier, coldness in parts that were earlier warm, harness of what was soft, muscle wasting, instability in the joints
5. Very deep or very shallow breathing
6. Matted eyelids
7. Displaced teeth with white concretions
8. Absence of or very low pulse in the neck
9. Matted eyelashes, glassy, glazed appearance of eyes with eyelids either permanently open or closed
10. Bluish tinge under the nails
11. Absence of cracking sound when the fingers are bent
12. Discoloration of the abdominal wall
13. Severe fatigue, anxiety, confusion, restlessness, severe thirst along with drastic loss in appetite
14. Stiffness in the jaws and neck
15. Back becomes rigid and arched

Reference: The legacy of Charaka by M. S. Valiathan