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Diagnosis Process

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Ayurvedic Medicine

Prakriti / Constitution

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Ayurvedic Medicine


The imbalance of doshas and the course they follow to cause disease is termed samprapti or pathogenesis. Since diseases develop in distinct stages, a good knowledge of those helps in early recognition of disease. Ayurveda thus elaborates a six stage process for diagnosis called Kriya (action) Kal (time). The first 4 stages being unique to Ayurveda in that they permit recognition and elimination of the disease before it ventures into differentiated clinical symptoms.

One who knows the various stages of pathogenesis accumulation (sanchaya), provocation (prakopa) spread or migration (prasara), deposition or augmentation (sthana samshaya), manifestation (vyakti) and the differentiation (bheda) is entitled to be a physician.

Stage One: Accumulation (Sanchaya)

  • Weak digestive power and excess of dosha is responsible for such a condition.
  • Here toxins (ama) produced by improper digestion collects in the gastro-intestinal (GI) tract.
  • Toxins resulting from a Kapha imbalance accumulates in the stomach, those associated with a Pitta imbalance collects in the small intestine, and that related to Vata malfunction amasses in the colon.
  • Due to the presence of one of these toxins, mild and ill-defined symptoms may show.
  • We should recognize and eliminate the cause instead of ignoring or suppressing it.
  • Causes aversion to similar things and attraction for contraries.

Stage Two: Aggravation (Prokapa)

  • The accumulated, stagnant doshas are now `excited’ by factors as ahara, vihara & seasons.
  • The toxins amass in such degree to get provoked in the site of production in the GI tract.

Stage Three: Spread (Prasara)

  • In this stage, the toxins accumulated in the GI tract start overflowing. Generally, up to this stage the damage is entirely reversible and restoration of doshic balance can be achieved with proper measures. Or there may be spontaneous prashama (remission) influenced by seasonal changes. Thus there is sanchaya of Pitta in rainy season, prakopa in fall and prasara in early winter. Based on degree of excitation, it might even passed the stages of prashama or prasara.

Stage Four: Agumentation (Sthana Samshraya)

  • Overflowing toxins migrate, entering and taking refuge in localized, weak or defective dhatus thereby leading to malfunction and structural damage.
  • It is from here that specific degenerating disease and susceptibilities to serious infections begin.

Stage Five: Symptom Manifestation (Vyakti)

  • Differentiated symptoms first begin to appear from the location.
  • Manifested symptoms being used by modem medicine for classification & diagnosis of disease.

Stage Six: Complications/Differentiation (Bheda)

  • The disease having taken years or even decades to reach this final stage, becomes chronic.
  • Offers detailed understanding of the group of symptoms thereby making clear nature of disease.
  • Might act as predisposing factors for the spread of other diseases.

Examination Process

To confirm, evaluate and treat a disease, physicians need to perform clinical examinations of patients – wherein textual knowledge (aptopadesa), direct perception (pratyaksha) and inference (anumana) are all very important components. The examination of patients can be carried out in the following manners:

Three (Tri) fold (Bidha) Examination (Pariksha)

Covers a general examination of the patient.


1.  Visual observation (Darshan)

2.  Tactile perception (Sparsha)

3.  Questioning (Prashna)  

Examination Process 

Eight (Asht) fold (Bidha) Examination (Pariksha)

Provides a clear picture of nature of ailment and patient's general condition.

Involves the examination of pulse, tongue, voice, skin, eye, general appearance, urine & stool.

1.  Examination of the pulse (nadi pariksha):
The foremost clinical art in ayurvedic diagnosis it can provide deep insights into the history of the patient. The ideal time for pulse examination is early morning in empty stomach. But in case of emergency, it can be examined at any time of the day or night. An experienced ayurvedic physician can assess your body’s nature (prakriti), pathological state (vikruti), imbalances of body type, very subtle observations & even prognosis of disease through the pulse.

2.  Examination of the tongue (jivha pariksha):
Assessed through its doshic state, a Vata aggravated tongue is dry, rough & cracked, Pitta suffered tongue is red with a burning sensation and Kapha influenced it is wet, slimy and coated. Suggesting the state of the digestive system.

3.  Examination of the voice (sabda pariksha):
Healthy and natural when the doshas are in balance, the voice will become heavy when aggravated by Kapha, cracked under Pitta effect and hoarse & rough when afflicted by Vata.

4.  Examination of skin (sparsha pariksha):
Also used for assessing the state of organs and tissue, palpation is an important clinical method for examination of skin. Noted for doshic influences, a vata aggravated skin is course & rough with below normal temperature, a Pitta influenced one has quite high temperature and Kapha effected it becomes cold & wet.

5.  Examination of eyes (drka pariksha):
vata domination makes the eyes sunken, dry and reddish brown in color. On aggravation of Pitta, they turn red or yellow and the patient suffers from photophobia and burning sensations. High Kapha makes them wet & watery with heaviness in the eyelids.

6.  Examination of general appearance (akriti pariksha):
The doshic influences that reflect on the face of the patient enables physicians to gauge the basic constitution and the nature of the disease.

7.  Examination of urine (mutra pariksha):
Both examination of urine sample and questioning of patient are important for assessing doshic influence. A modification of this is the oil (taila) drop (bindu) test (pariksha) in which the effect of an oil drop on urine sample suggests the curability of disease.

8.  Examination of stool (mala pariksha):
If digestion & absorption of food are poor, the stool carries a foul odor and sinks in water. vata aggravated, the stool is hard, dry and gray / ash in color. Excess Pitta makes it green / yellow in color and liquid in form. And high Kapha lines it with mucus.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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