Diagnosis
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Ayurvedic
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Basics
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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)
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Weak digestive
power and excess of dosha is responsible for such a
condition.
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Here toxins (ama) produced by improper digestion collects in the
gastro-intestinal (GI) tract.
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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.
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Due to the
presence of one of these toxins, mild and ill-defined symptoms may
show.
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We should
recognize and eliminate the cause instead of ignoring or suppressing
it.
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Causes
aversion to similar things and attraction for contraries.
Stage Two:
Aggravation (Prokapa)
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The
accumulated, stagnant doshas are now `excited’ by
factors as ahara, vihara & seasons.
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The toxins
amass in such degree to get provoked in the site of production in
the GI tract.
Stage Three:
Spread (Prasara)
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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)
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Overflowing
toxins migrate, entering and taking refuge in localized, weak or
defective dhatus thereby leading to malfunction and
structural damage.
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It is from
here that specific degenerating disease and susceptibilities to
serious infections begin.
Stage Five:
Symptom Manifestation (Vyakti)
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Differentiated
symptoms first begin to appear from the location.
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Manifested
symptoms being used by modem medicine for classification & diagnosis
of disease.
Stage Six:
Complications/Differentiation (Bheda)
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The disease
having taken years or even decades to reach this final stage,
becomes chronic.
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Offers
detailed understanding of the group of symptoms thereby making clear
nature of disease.
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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.
Involves:
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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