Dr.Vilas Nanal
AVP

Introduction

• Nidaana Rogee Pareekshaa Trividha Pareekshaa
• Nidaana Roga Pareekshaa
• Asht`avidha Pareekshaa
• Das`havidha Pareekshaa
• Saadhyaasaadhyatva Pareekshaa

Introduction

The structure of Ayurveda is threefold:

• Hetu causative factors
• Linga symptomatology and
• Aushadha management

The first two form the Nidaana fold of the three folds. To manage any situation effectively it is imperative that one diagnosis it correctly in the first place. It is imperative to study the cause and the signs produced by them. The signs and symptoms under evaluation are physical, psychological, functional, structural, indicating complication or terminality of the disease. This study is the Nidaana while the management of the condition forms the Aushadha part. Various authors have described various methods of evaluation and we see a gradual evolution in the methods as Aakriti while later authors include them in their repertoire. This article would introduce the concept in brief to orient the reader with the logical and the complex structure of Ayurvedicdiagnostics.

Rogee Pareekshaa

There are two aspects to diagnosis the person who is suffering and the diseases he is suffering from. It is essential to evaluate both of them. We shall first elaborate about the patient. There are various ways described by the texts like

Vaagbhat`a advises Trividha Pareekshaa, it comprises of:

Dars`hana or inspection, the examination carried out without actually touching the person. This gives an idea about the predominant Dosha and it indicates those Lakshan`a_s / signs and symptoms which the patient cannot hide along with their location. These are signs and symptoms elicited using all other sense organs other than touch.

Various signs and symptoms evident by inspection are as under:

• Tvak / skin qualities
• Sweat like Medoroga, obesepeople tend to sweat; it is visible like their obesity,
• Glistening S`hlakshn`a Gan`d`a – Udara Poorvaroopa, in case of impending Ascitiesthe cheek bones glisten
• Dryness, scaling / like Eka Kusht`ha in Psoriasis the skin is extremely dry with a tendency to scale after scratching,
• Cracked like Paadadaari, as in cracked feet, palms of hands,
• Unctuous like Kapha Prakriti etc in Kapha constitution the skin is naturally soft, unctuous. It does not require any moisturizers to prevent its cracking.

Varn`a / skin color The skin color, it could be normal according to the constitution or it could be affected by the ongoing disease process like in Paan`d`u Ketakee Dhoolisannibha Varn`a / skin resembling the dull yellowish color of the pandanusflower, or itbecomes like turmeric in Kaamalaa / Jaundice.

Kaanti, Prabhaa / skin luster – The skin luster is dependent upon the Rasa Dhaatu and Jaat`haraagni, hence any malfunction of Agni and contamination of Rasa results in lackluster skin e.g. Nishprabha Tvak of Rasa Asaarataa

Jihvaa / tongue – inspection of tongue

• Paat`ala Varn`a / pink
• Aardra / moist
• Aayaama Vistaara Sampanna Tanvee / broad, long but thin tongue
• Kharas`parsha / rough
• Paridagdhaa Jihvaa of Sannipaata Jvara / as in typhoid fever
• Varn`ayuta of Mukha Paaka / mouth ulcers especially along the border
• Lipta / coated, the coating is easily removed
• Niraama clear, devoid of any coating
• Chitraa with patchy discoloration
• Saama coated but the coating returns after cleaning and stays, may be accompanied by foul smell of the mouth
• Peeta Varn`a yellow discoloration etc

Kesh`a / body hair

• Distribution uniform all over body or in isolated areas
• Naturally, soft, rough, supple, dry etc
• Density, thick, thin,
• Color shiny black, golden blond, Grey and other qualities as per Prakriti

Nakha / nails

• Color healthy pink, white, cyanosed, spots lines,
• Texture rough, smooth,
• Other qualities even, uneven, brittle, clubbing,
• Veetamaamsas`hon`ita Nakha / nail bed without adequate muscle and blood in them / spoon shaped

Svara / voice

• Quantities dry, agreeable, pleasant, and high pitched, resonating and as per Prakriti, compendia have described a battery of voices both normal and abnormal, their evaluation gives us an idea about the status of Vaata, Agni and the Svaravaha Srotas in the patient,
• Nature as per the constitution or the disease
• Speech as per the constitution. Stammering, stuttering, arrested, fast without breaks, slow and steady, firm, assured,
• Content adequate, confused
• Flow as per Prakriti linear progression, to its logical end, broken faltering etc. it gives us an idea about the mental status and higher control over the speech apparatus
• Sanna weak
• Sakta stuttering
• Chala fast, incoherent
• Jarjara Vaak broken of Vaata Prakriti,
• Anumaadi resonating,
• Gambheera Svara deep voice and speech of Kapha Prakriti and
• Svarabheda Vyaadhi / hoarseness

Netra / eyes

• Uniformity,
• Clarity, clouding, and other attributes,
• Sunken,
• Protruding,
• Squint,
• Presence of vessels,
• Red, yellow etc

Spanda / pulsation e.g. carotid in the neck, claudication, tremors, twitching etc and normally at Marma points, these are visible pulsation

S`hotha / swelling, oedema, localized or generalized, Vran`a, Vran`asraava, Bhagna, Sandhimukta etc.

Aakriti / physique,
Well built / Sunivisht`a Maamsa S`hon`ita,
Obese
Emaciated / Anivisht`a Maamsa S`hon`ita
Wasted / Tvagaasthis`hesha
Debility
Preoccupied / Vyagra
Stressed / Udvigna
Siraajaalayuta / visible and prominent vessels,
Decuitus postures adopted by the patient
Svinnagaatra

Dr.Vilas Nanal
Sr. Scientist AyuSoft. Pune

Last updated on May 26th, 2021 at 11:39 am