An Overview of Ayurvedic Examination Methods
Ayurveda is said to be Samakaalina Shastra. It means the science of all times. A physician approaches a patient and a disease with various methods of examination. To understand the status of the dosha and dhatu, the pathogenesis of a disease diagnostic methods are essential which further leads to proper execution of treatment for the specific disease.
There are two ways of examination methods to be followed in the practice of Ayurveda. One is the Rogi pariksha (the methods of examination of a patient) and the other is the Roga pariksha (the methods of examining a disease).
To understand the disease, it is essential to examine a patient because the disease resides in the patient and that is termed as ‘Vyadhi Adhishtana’. Thus, methods of examining a patient will lead to understanding the course of the disease and its treatment.
The word ‘Pariksha’ has two words in it, one is the ‘iksh’ which means to view or to consider and the other is its prefix word ‘pari’ which means from all sides. Thus, Pariksha is a process of viewing an object from all sides.
Ayurvedic Examination Methods
The description of methods of examination is classified in the following ways:
- Dwividha pariksha (two-fold examination)
- Trividha pariksha (three-fold examination)
- Shadvidha pariksha (six-fold examination))
- Ashtasthana pariksha (eight sites of examination)
- Dashavidha pariksha (ten-fold examination)
- Dwividha pariksha: These are the two methods of examination of the patient.
- Pratyaksha pariksha:
This is the direct perception method of examination done with the use of sense organs except the tongue. Those include darshana (visual), sparshana (tactile), shabda (auditory), and ghrana (olfactory)modes of examination. Here, the physician with the help of sense organs and intellect analyses the condition of the patient, knows the pathogenesis, and concludes the disease and plans for the treatment.
- Anumana pariksha:
This is the inferential knowledge to understand the path of the disease based on the complaints that a patient gives or from the observations made. For instance, if the patient complains of poor appetite and aversion towards food, an inference can be made that the problem is in the digestion and metabolism process. In case the patient complains of weight loss, then, the inference is made that the kapha dosha is decreased in the body. Thus, even when there is direct perception happening, the use of an inferential method to examine the patient and the disease is done to arrive at the precise conclusion of the disease and its treatment.
- Pratyaksha pariksha:
- Trividha pariksha: The three-fold examination is done using the darshana (observation method), sparshana (palpatory method), and prashna (interrogatory method).
- Darshana pariksha – this is the observation of a patient with respect to the gait, the color changes, the deformity, disproportionate limbs, or any other structures, etc. For instance, pallor is the specific feature observed in patients with anemia, short footsteps are a disturbance of the gait in patients diagnosed with Parkinsonism, etc.
- Sparshana pariksha – The palpatory method of examination. The physician touches the body parts to evaluate the condition. For example, fever can be evaluated when the body is touched and feels warmth and certain organ enlargements can be assessed by this method. Local rise of temperature in case of inflammation, pain in any part of the body, etc. is felt through palpation.
- Prashna pariksha – This is the interrogatory method in which the patients are asked various questions to derive the course of the disease. A detailed history of the patient is noted with reference to age, gender, occupation, onset of the disease, familial history, etc. If the patient complains of headache, interrogated to know if it is one-sided to rule out migraine. Patients with diabetes are asked about their familial history, varicose veins are commonly seen in people who stand for a long time like teachers, traffic policemen, etc. Thus, the interrogation method helps in diagnosing the disease.
- Shadvidha pariksha: These are the six-fold methods of examination. The examination is done in a patient with respect to the five sense organs and the interrogation method.
- Sparshanendriya pariksha – The examination is done of the skin to assess loss of tactile sensation in certain neurological conditions like paralysis, feeling of excess burning sensation in diseases of pitta dosha, abnormal sensations like crawling of ants in patients of diabetes, etc.
- Shrotrendriya pariksha – The assessment of hearing organs for deafness, tinnitus, reduced hearing, etc.
- Ghranendriya pariksha – The nose is examined to find any loss of smell in certain infectious conditions like COVID-19, etc.
- Darshanendriya pariksha – Assessment of the eyes for blurred vision, loss of vision, diplopia, etc.
- Rasanendriya pariksha – Loss of taste in high-grade fever, feeling of excess sweet taste in the disorders caused due to increased kapha dosha, etc.
- Prashna pariksha – this is the interrogation of the patient regarding the history of the patient, disease course, onset, symptoms, etc.
- Ashtasthana or Ashtavidha pariksha: Eightfold examination in Ayurveda is explained where the examination is done in eight different sites to diagnose a disease.
- Nadi pariksha – The pulse examination which reveals the pathological condition. In Ayurveda, depending on the movement and speed the type of dosha involved in the clinical condition can be told. If the speed of the pulse is fast and like snake movement then it is vata dosha, when the pulse beats like a jump of a frog it is pitta dosha, tachycardia is a condition if the pulse rate is too high and that may be due to underlying cardiac problem, etc.
- Mala pariksha – the examination of stool is done to assess underlying pathology depending on its color, smell, consistency, appearance, etc. In case of presence of froth in the stools indicates vata dosha disorder, clay-colored stool is seen in obstructive jaundice, etc.
- Mutra pariksha – The urine examination is done for the assessment of parameters like changes in color, frequency, appearance, consistency, etc. Ayurveda explains a unique method to assess the disorder of specific dosha. It is called ‘Tailabindu pariksha’ (oil-drop test). In this test, a drop of Tila taila (sesame oil) is put over the urine that is collected freshly in the morning in a clean earthen pot. The pattern of moving of the oil determines the dosha involved. The umbrella pattern indicates pitta dosha, mukta (pearl) – like movement is indicative of kapha dosha, and so on.
- Akriti pariksha: The examination of general appearance, etc.
- Shabda pariksha: The hearing capacity, any deformity, discharge from the ears, etc are examined in the ears.
- Drik pariksha: The eyes are assessed for changes in colour, size, changes in structure, etc.
- Sparsha pariksha: The skin is observed for texture, dryness, lesions, temperature, tactile sensation, etc.
- Jihva Pariksha: The tongue is examined for shape, color, coating, sensation of the taste, etc.
- Dashavidha pariksha – These are the ten-fold examination methods.
- Prakruti – the physical constitution of the body formed by the three doshas. Based on the dosha involved in the formation of the physical constitution the person gets affected with the specific diseases.
- Vikruti – The assessment of dhatu, mala, and mental status is done which are involved in the manifestation of disease along with the dosha.
- Sara – The assessment of qualitative and quantitative aspects of dhatu helps in diagnosing the diseases.
- Samhanana – The physique of a person, the compactness of the body is assessed to know the nutritional built-up of an individual.
- Pramana– The anthropometric examination like the weight, height, and circumference of the mid-arm, abdomen, head, and other body parts helps in diagnosing disease and the nutritional requirement in nutritional deficiencies.
- Vyayama Shakti – The capacity of an individual to perform physical exercise helps in assessing the cause of underlying endocrine disorders, etc.
- Satva – The mental health of a person with respect to anxiety, depression, and aggressiveness is assessed to diagnose and treat mental disorders.
- Satmya – The adaptability of a person to a particular place, food, climate, etc. factors help in treating a patient both physically and mentally.
- Ahara Shakti – The digestion capacity of a person helps in the assessment of digestion-related problems and administration of the diet, etc.
- Vaya – The age of a person clarifies the condition of the body and mind, specific diseases that are age-related, etc.
The Ayurvedic examination methods explained in the classics of Ayurveda are unique. The methods help in assessing any disease by considering the factors like dosha, dhatu, and mala. These reside in various body parts and hence the assessment of the body based on the methods mentioned helps in proper diagnosis and plan of treatment. The methods assess the disease’s condition and the person having the disease. The examination methods are focused on direct and inferential perception, observation, palpation, and interrogatory methods, eight types of examination that include five sense organs, pulse, urine, and stools. The dashavidha pariksha is a broader way of examining a patient and the disease which includes the dosha, etiology, anthropometry, mental status, capacity to perform the physical activity and digesting the food, adaptability, age, etc. Ayurvedic examination can be adapted for better practice and treatment the diseases which is individual-specific.