Whenever you go to a doctor, at first, he asks you a series of questions then examines you, sometimes he asks you to get some tests done, writes a prescription and tells you to come back the next day. Why seeing a doctor seems to be complicated? Can’t they just give medicines and relieve us from this plight?
This whole process is done for recognizing the disease you are having. Your examination and test reports tell the doctor what’s normal & what’s not; to what degree is your abnormality. This is called Diagnosis.
Ayurvedic Diagnosis involves the identification of causes of disease and their co-relation with signs & symptoms. Diagnosis is made through objective and subjective clinical examination.
An objective examination is what doctor observes in patient and subjective is what signs the patient tells to the doctor. Ayurvedic Diagnosis is quite simple and does not require costly laboratory investigations.
Once an Ayurvedic diagnosis has been reached, the doctor is now able to propose a perfect Ayurvedic treatment plan for you. Proper diagnosis is essential for disease treatment.
So, what is Ayurveda diagnosis?
In Ayurveda, diagnosis goes beyond the limit of findings of what is wrong with the patient. It includes everything that can be involved in the expression of diseases such as tridoshas, dhatus (body tissues), mala (excretory products), Agni (digestive fire) and srotas (body channels).
Ayurveda gives equal importance to the examination of the patient, along with that of disease. Therefore, it also considers unhealthy factors, season, place, diet, drug, daily regimen of the patient that may have led to the development of the disease.
Unlike modern medicine where the sophisticated techniques like MRI, CT Scan, X-Rays, ECG, etc. aid in the diagnosis, Ayurvedic Diagnosis depends on the physician’s knowledge of authoritative Ayurveda texts, his keen observation skills, and valid logical inference.
Several Ayurvedic scholars have given several diagnostic methods which help the physician to diagnose disease. Let’s understand them in detail.
What are different Ayurvedic diagnostic methods?
Ayurveda does not accept the germs as the primary cause of a disease. It believes that disharmony in doshas, dhatus, and mala causes disease.
Ayurveda describes many types of diagnostic methods like two-fold, three-fold, four-fold, five-fold, six-fold, eight-fold, and ten-fold examinations. Among this five-fold, eightfold and ten-fold analysis is essential and are still followed.
Looking at the importance of dosha imbalance, Ayurveda suggests five points by which all diseases can be adequately diagnosed. These five diagnostic tools are known as Pancanidana.
The panca nidana utilizes nidana, i.e., causative factors as a central part involved in dosha imbalance. Thus, it also helps in identifying the type of dosha entangled in causing disease. These five tools are:
Nidana is the etiological factors responsible for the full expression of disease. The importance of this factor lies in the fact that the complete cure of an ailment is possible only through the avoidance of the causes responsible for damaging the corresponding doshas.
These sources of disease could be diet, lifestyle, environmental factors, injuries, etc. Moreover, if the signs & symptoms of two or more diseases bear a close resemblance, a definite diagnosis can be made with the aid of etiological factors involved.
In Ayurveda avoidance of causative factors is the first line of treatment.
Purvarupas are the mild, indistinct initial symptoms produced in the evolution of the disease. These could be general or specific for any particular disease.
Purvarupa provides clues regarding the forthcoming disease, its nature, and severity. Hence, appropriate treatment can be started immediately to either prevent the disease or at least minimize its severity.
Rupa is the clear cut signs and symptoms of a disease. It specifies the doshas involved in the pathology of a disease, the site of, and helps make a differential diagnosis.
It is the employment of drugs, food, or activities causing relief when used either against the cause of the disease or the disease or stimulating the disease.
In short, it is trial therapy and is applied to confirm the disease when symptoms are marked, and diagnosis is dubious. Sometimes medicine may excite illness or symptoms.
Any of these practices resulting in cure or relief is Upashaya, and the opposite is anupshaya.
Samprapti refers to the pathway of the disease manifestation. Thus it informs us about the dosha involved and the site where dosha gets imbalanced.
This approach considers each stage of disease development as a diagnostic tool. The one underlying factor responsible for most diseases is a metabolic abnormality.
Ashtavidha pariksha (Eight diagnostic tools)
The examinations of eight points that can lead to the correct Diagnosis of diseases are:
- Nadi – pulse is examined to determine the movement & site of imbalanced doshas
- Mutra – urine tested by the presence of a foreign body, its color, amount, etc.
- Mala – stool’s consistency, color, quantity, presence of blood, mucus, etc. are seen
- Jihva – tongue examination for its color, shape, movement, sense of taste, etc.
- Srotra – ear, and capacity of hearing is examined
- Sparsha – skin is monitored by touch, color, temperature, presence of tumors & wounds
- Drik – the eye is tested for its proper dilation & constriction, color, luster, discharge
- Akriti – body & face is observed for physical changes like pallor, bluishness, leanness, puffiness, and expressions of emotions
In exceptional circumstances where the above techniques are not enough, Diagnosis is made by instruments. Ayurvedic branch of surgery makes the most of Diagnosis through surgical instruments (yantra).
Sushruta, Father of Surgery, has described instruments like Nadi yantra and Shalaka yantra especially for visualizing the affected organs, finding out hidden disorders and shalya (foreign objects).
Ayurvedic examination of the patient
A patient constitutes the site of administering therapies to bring doshas back to normal. He should be examined to determine if the disease could be cured or not. It also helps to decide the dosage of therapy.
The patient is examined to get an idea about ten factors,
- body type
- intensity of morbidity
- the excellence of tissue elements i.e., strength
- compactness of organs
- size of parts of the body
- psychic conditions
- power of intake & digestion of food
- exercising capacity
To assess the degree of intensity of a diseased examining the above factors is essential. Because a strong person suffering from a severe disease, weak medicines administered without examination are useless.
The same way, a weak patient, should be treated with mild remedies not to upset the patient or produce any complications. But how to examine the patient?
The patient is to be examined by
- Darshana – Inspection / to see
- Sparshana – Palpation/ to touch & feel
- Prashna – Interrogation/ to converse
The external appearance of the patient, locally visible defects, color, facial expression, eyes, tongue, etc. indicates the intensity of suffering. Most of the instrumental investigations come under Darshana.
Sparshana helps to infer abnormal heat, cold, hardness, softness, roughness, etc. at the affected body parts. It also helps to detect lumps and swellings.
Through prashna, one can know about the probable causes of disease, duration of onset, initial symptoms & symptoms after disease expression, and factors that influence disease. The nature of bowels, likes & dislikes, food habits, etc. of the patient is asked.
It is impressive that Ayurveda so simply summarises the limitless techniques of examination of the disease and patient. All methods of investigation, however advanced they may be, can be seen as only extensions of these primary protocols.
However, in several Ayurvedic texts, many types of examinations are described. But in short, all can be summarised in the above mentioned three-fold examination.
Examination of disease
To determine the exact nature of the illness, it is necessary to ascertain the quality of bio-energies, tissues, body wastes, body channels, and digestive fire involved in the formation of disease.
Examination of disease is equally important as of the patient. On inspecting the nature and strength of disease, its extent of curability, as well as seriousness, can be determined. This information helps the doctor to decide the period of the treatment.
While examining a patient, a physician determines the following details for every disease,
- Exciting factors of disease
- Mode of expression
- Nature, gravity, acuteness
- Sensation of pain
- Intensity of symptoms
- Factors relieving the symptoms momentarily
- Naming the disease
- Prediction of course of the disease
All these factors help in comparing & contrasting among diseases with the same clinical presentations and directs to the correct Diagnosis of a specific illness after removing doubts among suspected multiple diseases.
Importance of Diagnosis
Treatment solely depends on the diagnosis. If the wrong disease is diagnosed, then the treatment is useless as it not only worsens the condition of the patient but also the illness that the patient has, becomes life-threatening.
Therefore, a physician should first examine the patient & disease carefully and then treat the patient skilfully.
The accurate Diagnosis helps in planning precise treatment for destroying the disease from its root and thereby, prevents the recurrence of that disease. Early and correct Diagnosis saves money and the mental stress of the patient.
Ayurvedic Diagnosis aims to administer proper medications in the right dosage, which varies from place to place and season to season.
Today with the evolution of advanced techniques like MRI, CT Scan, X-Rays, ECG, Endoscopy, etc. Diagnosis can be made at an early stage without any stress on the physician.
If these tools can be integrated with the understanding and skill of Ayurvedic clinical Diagnosis, then the disease could be effectively eliminated. This approach could be a boon to the ailing humanity.