Ayurveda is often called as a
samakaalina sastra (a science
of all times). The fundamentals of this ancient science
are simple and easily applicable to all eras. In fact, a
majority of modern medical science principles are based
on the fundamentals of Ayurveda. One cannot help but wonder
at the profound wisdom and observational skills of the early
Ayurvedic physicians, who could fathom the deepest secrets
of the human body and mind even in the absence of technology.
Ayurveda’s success can be attributed to its organized
and methodical ways, a good example being Ayurveda’s
clinical methods. A proper diagnosis forms the basis for
effective treatment, whereas ignorance of disease or improper
diagnosis leads to inefficient treatment. In Ayurveda, the
diagnosis and treatment of diseases are based on the information
derived from two areas:
- examination of the patient (rogi pariksa)
- examination of the disease (roga pariksa)
Rogi pariksa or the examination of a patient consists
of three steps:
- Darsana – examination by inspection
- Sparsana – examination by touch
- Prasna – examination by interrogation
The process of diagnosis begins even as the patient walks
into the consultation room. In addition to gathering information
from specific questions about symptoms, lifestyle, diet
and medical history, the physician systematically observes
other features that may provide clues to the cause and duration
of the illness. A sharp observation of the patient’s
gait, physique and appearance conveys a lot of information
about his general condition. This is called “darsana pariksa” or observation.
“Sparsana pariksa” is examination by touch
(sparsa). The physician can evaluate several factors through
the medium of touch. He can assess the temperature of the
body, feel the margins of swellings in skin, read and note
the characteristics of pulse, or check for organ enlargements.
The conventional clinical methods of palpation and percussion
are examples of tactile examination.
For an overall picture of the illness, a detailed interrogation
of the patient and his family member or relative is necessary.
This is “prasna pariksa” (prasna = question).
It is always favorable to allow the patient to relate the
entire history of the ailment in his own words.
Darsana, sparsana and prasna together comprise “Trividha Pariksa” – the threefold method of clinical
examination. An elaborative version of the above is the
“Astavidha Pariksa” or the eightfold method
of patient examination that includes the following eight
factors: Nadi (pulse), Mala (frequency, color, consistency
of bowel movements), Mutra (urine – color, frequency,
burning sensations), Jihva (tongue), Sabda (voice and speech
of the patient), Sparsa (touch, skin and tactile sense),
Drik (eyes and vision), and Akriti (general body build,
eg: lean, obese, muscular, etc.).
The entire demeanor of the patient during the consultation
provides valuable information to the physician. Emotional
state and nature, strength and vitality, intelligence, and
character can all be ascertained from attire, posture, body
language, breathing patterns and even gait and bearing.
The primary goal of clinical examination in Ayurveda is
to locate the unbalanced doshas that caused the disease.
The methods employed by the physician (observation, touch
and interrogation) are all aimed at identifying the dosha
disturbance. For example, a person with hot, flushed skin
and symptoms such as burning sensations, fever, digestive
disorders or urinary infections has a disturbance of pitta.
Dry, cracked, rough skin that is cold indicates an imbalance
of vata. Fluid retention, swelling, moist skin, dull, watery
eyes and symptoms such as chest congestion are kapha related
A clinical diagnosis resulting from these examinations,
along with a clear understanding of the pathogenesis of
the disease, aids in accurate diagnosis and treatment.
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