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Types of Ayurvedic Clinical examination

Introduction: Clinical examination is divided into two parts Roga Pareekshaa i.e. examination of disease and Rogee pareekshaa i.e. examination of the Patient. These examinations are of various types as follows:

Clinical Examination

Roga Pareekshaa(Examination of Disease)Rogi Pareekshaa(Examination of Patient) 
Nidaana Panchaka (Five Types of Examination)Trividha (Three Fold Examination)Asht`avidha (Eight Fold Examination)Das`havidha (Ten Fold Examination)
Hetu (Causative Factors of Disease)Dars`hana (Inspection/Observation)Naad`ee (Pulse)Dosha Prakriti (Body Constitution) Maanasa Prakriti (Pshycological Constitution)
Poorvaroopa (Prodromal Signs & Symptoms of impending Disease)Spars`hana (Palpation)Mala (Examination of faeces)Vikriti
Roopa (Signs & Symptoms of Disease)Pras`hna (Questions/Interrogation)  Mootra (Examination of urine)Saara (Qualitative assessment of Body tissues)
Sampraapti (Pathogenesis) Jihvaa (Examination of Tongue )Samhanana (Examination of compactness or firmness of the body / Tone)
Upas`haya-Anupas`haya (Symptoms Relived or Aggrevated by) S`habda (Examination of voice of the patient)Vyaamas`hakti (Capacity of Strenuous physical activity)
  Spars`ha(Palpation)Aahaars`hakti (Capacity of consumption and power of digestion of diet)
  Drik (Examination of Eye)Saatmya (Homologous to / Wholesome) Asaatmya (Unwholesome)
  Aakriti (General appearance / Build / Physique)   
   Sattva (Menal state)
   Pramaan`a (Anthropometric Measurements)
   Vaya (Chronological Age)

Examination of Disease: For thorough investigation of disease five types of information is needed. It is called as Nidaana PanchakaNidaana Panchaka consists of five tools for diagnosing a disease. They are Hetu (Information about Causative Factors), Poorvaroopa (Prodromal signs & symptoms), Roopa (Signs & symptoms), Sampraapti (Pathogenesis) and Upas`haya-Anupas`haya (Relieving or aggravating factors from food, drud and / or regimen).

  1. Hetu: Hetu means causative factor. Nimitta, Aayatana, Pratyaya, Utthaana, Kaaran`a and Nidaana are synonyms of Hetu. These are initiators of a disease. Actual disease development process starts afterwardsTo understand effect, role etc. of Hetu in disease development, they are classified into various types as follows:
    Type of Hetu
    Classification 1Classification 2Classification 3Classification 4Classification 5
    Sannikrisht`aAsaatmendriyaartha SanyogaVyaadhi HetuVyanjakaBaahya
    Viprakrisht`aPradnyaaparaadhaDosha HetuUtpaadakaAabhyantara
    VyabhichaareeParin`aamaUbhaya Hetu  
    Praadhaanika    
  2. Poorvaroopa: Means prodromal signs and symptoms. Theseare symptoms or indications of the imending disease. Before the actual onset of the disease some symptoms develop and they give clues about the forthcoming disease. Such symptoms are called as Poorvaroopa. There are two types of Poorvaroopa viz. Saamaanya (General) and Vis`hesha (Specific) Poorvaroopa.
    Saamaanya (General) Poorvaroopa: The symptoms which give a clue regarding the forthcoming diasease without giving an idea of predominant Dosha due to which particular symptoms occur is called as Saamaanya Poorvaroopa. E.g. AratiAruchi, Jrimbhaa etc. are Saamaanya Poorvaroopa of Jvara.
    Vis`hesha (Specific) Poorvaroopa: The symptoms which give a clue regarding the forthcoming diasease at the same time giving an idea of the predominant vitiated Dosha due to which particular symptoms occur is called as Vis`hesha Poorvaroopa e.g Angamarda, Jrimbhaa are Vis`hesha Poorvaroopa of Vaataja Jvara.
  3. Roopa: Means signs and symptoms of actual manifestation of disease. Thisis a group of signs and symptoms, which develop after the pathogenesis of disease e.g. Aruchi, Klama and Tiktodgaara etc., are Roopa of Amlapitta. By knowing Roopa physician get more clear idea about disease.
  4. Sampraapti: Means pathogenesis of disease. Theprocess of pathogenesis from Hetu Sevana till the manifestation of the disease is called Sampraapti .All the stages from the very contact of the body with etiological factor to the development of disease are called as Sampraapti. Ehnce it is a dynamic process. Thorough understanding of Sampraapti is very essential for deciding appropriate line of treatment. To understand pathogenesis of disease Sampraapti is divided in to five types i.e.

    Sankhyaa Sampraapti classificationaccording to main types of disease
    Vikalpa Sampraapti statement or identification of the Dosha subtype
    Praadhaanya Sampraapti statement of principal and the secondary Dosha
    Bala Sampraapti classification according to the strength of participating Dosha
    Kaala Sampraapti classification of pathogenesis according to time of onset and progress
  5. Upas`haya-Anupas`haya: For diagnosing disease, specific group of signs and symptoms are essential. But if the symptoms are feeble / masked or not well marked then physician has to adopt a trial and error method which is called as Upas`haya-Anupas`haya. Using this method physician can diagnose or differentiate disease or disease condition. It is one of the procedures to diagnose the involvement of Dosha e.g. hot water poured over the paining joint of a person so as to reduce the intensity of pain. It indicates the involvement of Vaata Dosha.

Upas`haya: A judicial use of drug, diet and regimen to relieve the disease symptoms is Upas`haya, the palliating factors. Suitable remedies, food articles and / or regimen those allay the disease from which the diagnosis can be made are known as Upas`haya. These are specific factors, which pacify the symptoms of a disease e.g. Pratamaka S`hvaasa relived due to cold wheather, food (mainly due to diet and lifestyle which has dominant cold attribute.).

Anupas`haya: These are the precipitating factors. They are a help in diagnosing a condition, which has masked symptoms. The entity viz. drug, diet or regimen, which aggravates the symptoms of disease, is called Anupas`haya. It is also a tool for diagnosis like Upas`haya. It has exactly opposite characteristic of Upas`haya e.g. Tamaka S`hvaasa agreevated due to cold wheather, food. (Mainly due to diet and lifestyle which has dominant cold attribute).

It is an important tool to diagnose a condition with masked symptomatology. It is classified in various ways as enumerated below:

Upas`haya BhedaAushadhaAahaaraVihaara
HetuvipareetaS`hun`t`hi in S`heeta JvaraMaamsarasa in Vaata JvaraTo advise Jaagaran`a to a patient who is suffering from Kapha Vriddhi due to Divaasvaapa
VyaadhivipareetaUse of Paat`haa or Kut`aja in AtisaaraUse of Masoora Kris`haraa in AtisaaraVirechana in Udaavarta
Hetu-VyaadhivipareetaUse of Das`hamoola Kvaatha in Vaataja S`hothaUse of Takra in VaataKaphaja Grahan`eeTo advise Jaagaran`a to patient who is suffering from Tandraa due to Divaasvaapa & Snigdha Aahaara
HetuvipareetaarthakaareeUpanaaha of Pittakara Ushn`a Dravya in Pittaja Vran`as`hothaPittakara Aahaara in Pittaja Vran`as`hothaTraasanaChikitsaa in VaatajaUnmaada
VyaadhivipareetaarthakaareeUse of Madanaphala in ChhardiUse of Milk as purgative in AtisaaraStimulating the root of tongue to create vomiting sensation in Chhardi
Hetu-VyaadhivipareetaarthakaareeUse of Agaroo in burnsUse of Paisht`ika Madya in Madaatyaya due to Gaud`ika MadyaTo advise swimming to patient who is suffering from Oorustambha due to Ativyaayaama

A) Examination of Patient: It comprises of Trividha PareekshaaAsht`avidha Pareekshaa and Das`havidha Pareekshaa.

a)  Trividha Pareekshaa: It consist of three fold examination i.e Dars`hana, Spars`ha and Pras`hn`a

  1. Darsh`ana: Dars`hana means observation / inspection. It is most important and authentic examination. Physician can observe color, secretions, oedema, infection, tumour etc. using Darshan`a Pareekshaa.
  2. Spars`ha: Spars`hana means palpation. It is useful for finding spleenomegaly, hepatomegaly, texture of skin etc.
  3. Pras`hn`a: Pras`hna means interrogation. For getting information about origin, progress, duration, nature etc. of symptoms and the disease physician has to ask various questions to patients. All such interrogation comes under this examination.

B) Asht`avidha Pareekshaa:- Asht`avidha Pareeksha provides a clear picture of nature of ailment and patient’s internal environment. It involves the examination of pulse (Naad`ee), tongue (Jihvaa), voice (S`habda), skin (Tvak), eye (Netra), general appearance (Aakriti), urine (Mootra) & stool (Mala).

  1. Naad`ee Pareekshaa: It is examination of pulse. An experienced Ayurvedic physician can assess the individual constitution, pathological state (Vikriti), imbalances of Dosha, very subtle observations and even prognosis of disease through the pulse. The ideal time for pulse examination is early morning on empty stomach. But in case of emergency, it can be examined at any time of the day or night. Following characteristics of Naad`ee are observed in examination:

    Asaadhya
    Chapala
    D`amaru
    Deergha
    Drita
    Gambheera Gati
    Hamsa Gati
    Kampa
    Kaphaja
    Ksheen`a
    Laghu
    Man`d`ooka Gati
    Manda
    Pittaja
    S`heeta
    S`hithila
    Saannipaatika
    Sarala
    Sarpa Gati
    Snigdha
    Sookshma
    Spanda
    Sthira
    Tiryak
    Ushn`a
    Vaataja
    Vakra
    Vegavatee
    Vyaakula
  2. S`habda Pareekshaa: It is examination of voice. Dosha affect the natural voice of an individual. Normal voice of the person is expected to be examined in Prakriti and Saarataa application and the altered voice in ill health is expected to be examined in S`habda Pareekshaa. Following characteristics of voice observed in S`habda Pareekshaa:

    Bhinna Kaansyatulya Svara
    Bhinna Svara
    Jarjara Svara
    Kshaama Svara
    Saanunaasika Svara
    Sakta Svara
    Sanna Svara
    Svara Graha
    Svara Haani
    Svara Kshaya
    Svara Raukshya
    Svara Saada
    Svara Vikritatva
    Svarabheda
    Vaisvarya
    S`heeghra Vaak
    Vaak Jad`atva
    Vaak Krichchratva
    Vaak Paarushya
  3. Spars`ha Pareekshaa: It is also known as palpation. Palpation is an important clinical method for examination of skin and organs underneath. The examination helps to identify the Dosha responsible for the sign as well as severity of the disease / pain etc. Following characteristics of skin observed in Spars`ha Pareekshaa:

    S`heetaspars`hayuktaTvak
    Spars`haadnyaanam
    Spars`haasahatva
    Kharaspars`hee Tvak
    S`heetaspars`hayuktaTvak
    Chala-Achala Granthi
    S`heetaspars`hayukta Granthi
    Spars`haasahatva (Sthaana:- Kan`t`ha)
    Spars`haasahatva (Sthaana:- Ars`ha)
    Spars`haasahatva (Sthaana:- Paada)
    Spars`haadynaanam (Sthaana:- Adhah Kaaya)
    Spars`ha Haani (Sthaana:- Med`hra)
    Spars`haasahatva (Sthaana:- Yoni)
    Spars`haasahatva (Sthaana:- Netra)
    Ars`haspars`ha Preeti
    S`habda Asthni (Spars`hamaane)
    Spars`ha Sahatva (Sthaana:- Ars`ha)
    Kharaspars`hee Kes`ha
    Spars`haabhilaashaa
    Parusha Spars`ha (Sthaana:- Mukha)
    S`heetaspars`ha Adnyaana (Sthaana:- Paada)
    Spars`haasahatva (Sthaana:- S`hira)
    Spars`haasahatva (Sthaana:- Sandhi)
    Spars`haasahatva (Sthaana:- Ura)
  4. Drik Pareekshaa: It is examination of eye of an individual. Dosha affect the eyes of an individual. Normal eyes of the person are expected to be examined in Prakriti and Saarataa application and the altered colour or appearance in ill health is expected to examine in this field e.g. In jaundice colour of sclera becomes yellow, in Arjuna a disease of eye it becomes red etc. Following characteristics ( Colour, Vision etc.) of eye observed in Netra Pareekshaa:

    Varn`a:– Taamra, S`hveta, Rakta etc.
    Sraava:– Raktavarn`ee, S`hveta, Ghana etc.
    Adhesions:– Granthi, Arbuda, Pid`akaa, S`hotha, Maamsaankura etc.
    Svaroopa: Paans`hupoorn`asadris`ha Netra, Yakritpin`d`asadris`ha Netra
    Vision:
    Adhah Drisht`i
    Chhatrasadris`ha Drisht`i
    Dagdhasadris`ha Drisht`i
    Drisht`i Kalushatva
    Drisht`i Naas`ha
    Drisht`i Saada
    Drisht`i Sankocha
    Drisht`i Stambha
    Hrasva Drisht`i
    Ksheen`a Drisht`i
    Oordhva Drisht`i
  5. Aakriti Pareekshaa: Aakriti is also known as general appearance of the patient. In many of diseases body looses its natural appearance, shape or form by which the disease can be identified e.g. in Haleemaka disease the patient looks like a frog (Bhekaabha), in Krosht`ukas`heersha knee joint appears like head of jackal. Following characteristics of appearance observed in Aakriti Pareekshaa:

    Ati Deergha
    Ati Hrasva
    Atikris`ha
    Atisthoola
    Brihad
    Laghu
    Anivisht`aMaamsaS`hon`ta
    Sunivisht`aMaamsaaS`honita
    Upachita
    Anupachita
  6. Mala Pareekshaa: Means stool examination. Physician has to watch for color, consistency, and quantity etc. of stool. Following characteristics of stool observed in Mala Pareekshaa:

    Varn`a(Colour):
    Aavila Malapravritti
    Anekavarn`ayukta Atisaara
    Arun`avarn`ee Malapravritti
    Haritavarn`ee Atisaara
    Haritavarn`ee Malapravritti
    Krishn`avarn`ee Malapravritti
    Mechakaabha(Varn`asadris`ha) Malapravritti
    Naanaavarn`ayukta Malapravritti
    Neelavarn`ee Malapravritti
    Paan`d`uvarn`ee Malapravritti
    Peetavarn`ee Drava Malapravritti
    S`hyaava Malapravritti
    Sarvavarn`ayukta Malapravritti

    Pramaan`a (Quantity): Adhika Malapravritti, Alpa Malapravritti

    Svaroopa:
    Achchha Malapravritti
    Aniyata Aama Mala
    Aniyata Bhinna Mala
    Aniyata S`hushka Mala
    Aniyata Vibaddha Mala
    Anjanasadris`ha Malapravritti
    AnnasahitaKrichchhra Malapravritti
    Annasahita Malapravritti
    Apakva Malapravritti
    Bhinna Malapravritti
    Chandrakasadris`ha Malapravritti
    Dagdhagud`asadris`ha Malapravritti
    Ghana Malapravritti
    Ghritasadris`ha Malapravritti
    Grathita Malapravritti
    Guru Malapravritti
    Jalasadris`ha Malapravritti
    Kardamasadris`ha Malapravritti
    Khara Malapravritti
    Ksheerasadris`ha Malapravritti
    Maamsadhaavanasadris`ha Atisaara
    Maamsadhaavanasadris`ha Malapravritti
    Mala Kaat`hinya
    Mala S`hosha
    Masheesadris`ha Malapravritti
    Mastulungasadris`ha Malapravritti
    Niraama Malapravritti
    Pakva Malapravritti
    Pakvaraktasadris`ha Malapravritti
    Pooyasadris`ha Malapravritti
    Rooksha Malapravritti
    S`heeta Malapravritti
    S`hushka Malapravritti
    Saama Malapravritti
    Saandra Malapravritti
    SamhatatvamPureeshasya
    Drava Malapravritti

    Pravritti:
    AlpaAlpa Abheekshn`a Malapravritti
    Alpa Alpa Sas`habda Malapravritti
    Krite Api Akrit Samdnyaa
    Mala Sanga
    Mala Vibandha
    Muhurmuhu Grathita Malapravritti
    Pravaahan`apas`hchaat Malapravritti

    Gandha (Smell):
    Aamagandhi Malapravritti
    Aamamatsyagandhi Malapravritti
    Durgandhi Malapravritti
    Kun`apagandhi Malapravritti
    Pootigandhi Malapravritti
    Pureeshagandhi Mootrapravritti
    S`havagandhi Malapravritti
    Visragandhi Malapravritti

    Associated Lakshan`a:
    Kapharaktayukta Atisaara
    Krimiyukta
    Pichchhaasahita Malapravritti
    Sadaaha Atisaara
    Sadaaha Malapravritti
    Sakapha Atisaara
    Sakapha Malapravritti
    Sarakta Atisaara
  7. Mootra Pareekshaa: Means urine examination. Physician has to watch for color, consistency, and quantity etc. of urine.Following characteristics of urine observed in Mala Pareekshaa:

    Varn`a(Colour):
    Aavila
    Arun`a
    Harita
    Krishn`a
    Naanaavarn`aykta
    Neela
    Paan`d`u
    Peeta
    Rakta
    S`hveta
    Sarva Varn`ayukta
    Vivarn`a

    Pravritti:
    Alpa Alpa
    Basti Peed`anapas`hchaat
    Srisht`a
    Bindush`ah Ajasra
    Muhur Muhuh
    Pravaahan`apas`hchaat
    Vegarahita

    Pramaan`a (Quantity): AlpaBahu/Adhika

    Gandha (Smell):
    Amla
    Durgandhi
    Kshaara
    Nirgandha
    Pureeshagandhi
    Visra

    Rasa:
    Amla
    Kshaaya
    Kat`u
    Lavan`a
    Madhura

    Svaroopa:
    Bhasmajalasadris`ha
    Chhaas`hapasadris`ha
    Masheesadris`ha
    Ghritasadris`ha
    Gorochanasadris`ha
    Ikshusadris`ha
    Vaalukaasadris`ha
    Suraasadris`haJa
    lasadris`ha
    Kshaarasadris`ha
    Laalaasadris`ha
    Lavan`ajalasadris`ha
    Madhusadris`ha
    Majjaasadris`ha
    Ghana
    Grathita
    Guru
    S`heeta
    Saandra
    Snigdha
    Vishada
    Tantubaddha

    Associated Lakshan`a:
    Lasikaasahita
    Malasansrisht`a
    Sas`hukra
    Saphena
    Sas`hoola
    Sarakta
    Sadaaha
    Pichchhaasahita
    Vasaashita
    Mootramaaragagata Jalsraava
    Mootramaarga S`hoola
    Mootra Poorva S`hukrasraava
    Mootra Pas`hchaat S`hukrasraava
  8. Jihvaa: Means examination of tongue. Tongue examination is important for assessing status of gastrointestinal tract. Following characteristics of tongue observed in Jihvaa Pareekshaa:

Varn`a(Colour): Peeta, S`hyaava, Krishn`a,

Other:
Saama

Niraama
Kan`t`akayukta
Maamsaankurayukt,
Sphut`ita
S`hotha(Oordva Bhaage)
S`hotha (Adho Bhaage),
S`haatana
Bahinissran`a
Antasaran`a

c) Das`havidha Rugn`a Pareekshaa:- This is set of ten parameters aimed at evaluating the individual for diagnosis and then assessing selected Dravya, Kalpa, Aahaara for compatibility for management. They are

  1. S`haareera Prakriti: Prakriti is the Ayurvedic profile or unique psychosomatic temperament of an individual, encompassing his or her physical, functional and behavioural characteristics determined at the time of conception. The varying proportions of Kapha, Pitta and Vaata Dosha determining the S`haareera Prakriti i.e. in the body type play a pivotal role. A body type is also termed as Personal Disposition or Physical Constitution. Types of Prakriti:
    Types of Dosha Prakriti
    a. Vaatapradhaana
    b. Pittapradhaana
    c. Kaphapradhaana
    d. Vaatapradhaana Pittaanubandhi
    e. Pittapradhaana Vaataanubandhi
    f. Kaphapradhaana Vaataanubandhi
    g. Vaatapradhaana Kaphaanubandhi
    h. Pittapradhaana Kaphaanubandhi
    i. Kaphapradhaana Pittaanubandhi
    j. Samaprakriti
    Maanasa Prakriti: It is described as psychological traits. This influences the individuals life style, his response pattern to a stimulus and thus the health too. Depending upon the nature these are categorized as SattvapradhaanaRajapradhaana and Tamapradhaana. Depending on these traits physician can guess the psychological health as well as behaviours in diseased condition. Physician can also judge the severity of signs and symptoms severity on the grounds of Maanasa Prakriti.
    Types of Maanasa Prakriti
    a. Sattvapradhaana
    b. Rajahpradhaana
    c. Tamahpradhaana
  2. Vikriti: Meanstransformed, altered, changed; deformed, disfigured and unnatural (M.W.) It should be examined by Hetu, Dosha, Dushya, Prakriti, Des`ha, Kaala, Bala, Hetu Bala, Lakshan`a Bala etc. to understand prognosis of disease.
    Prognosis of DiseaseE.g.
    Heena Bala VyaadhiWhen Dosha, Dushya, Prakriti, Desh`a and Kaala is uncommonsigns and symptoms are less then disease is in such condition is easy to cure.Dosha=Vaata, Dushya= Maamsa, Prakriti=Kapha, Desh`a=Aanoopa, Kaala= S`harada
    Madhya Bala VyaadhiWhen some of the factors from Dosha, Dushya, Prakriti, Desh`a and Kaala are common and some are uncommon and signs and symptoms are of medium intensity then in such condition disease is difficult to cure.Dosha=Vaata, Dushya= Maamsa, Prakriti=Kapha, Desh`a=Jaangala, Kaala= Hemanta
    Balavaana VyaadhiWhen Dosha, Dushya, Prakriti, Desh`a and Kaala is commonsigns and symptoms are severe then in such condition disease is very difficult to cure.Dosha=Vaata, Dushya= Asthi, Prakriti=Vaata, Desh`a=Jaangala, Kaala= Varshaa
  3. Dhaatusaarataa: Dhaatu means body constituents. These are seven in number and their qualitative assessment can be performed by Saarataa Pareekshan`a. Saara is the essence of that particular constituent. It reflects on various body parts in a positive manner by which it is assessed e.g. positive sign related to particular part indicates Saarataa of related constituent and absence of these signs indicate Asaarataa (devoid of Saarataa) of the same constituent. In Madhya Saarataa signs of both Saarataa and Asaarataa are present. Physician can also judge the signs and symptoms severity as well as prognosis of the disease on the grounds of Saarataa. Types of Saarataa are

    a. Rasa Saara or Rasa-Asaara
    b. Rakta Saara or Rakta-Asaara
    c. Maamsa Saara or Maamsa-Asaara
    d. Majjaa Saara or Majjaa-Asaara
    e. Asthi Saara or Asthi-Asaara
    f. Meda Saara or Meda-Asaara
    g. S`hukra Saara or S`hukra-Asaara
    h. Sarva Saara or Sarva-Asaara
    i. Sattva Saara or Sattva-Asaara
  4. Samhanana: Examination of compactness or firmness of the body is called as Samhanana Pareekshaa. Samhanana is one of the parameters to know the Bala (strength) of an individual. E.g. Pravara Samhanana implies good strength, Madhyama Samhanana impliesmedium strength and Avara Samhanana implies low strength. (It is the evaluation of Muscle power for this parameter.) Samhanana is mainly about Maamsa not bones, joints and ligaments; the individual should examine the tone, firmness of musculature and not density of bones. The parameters for this examination are: –

           Examination of bones: – for symmetry (Sama) and well separation or distribution (Suvibhakta).
           Examination of joints: – for firm closure or covering by ligaments.
           Examination of Flesh and Blood: – for well situation / condition.
  5. Aahaaras`hakti: It is defined as capacity of consumption and power of digestion of diet taken through out the day all together. Amount of intake of individual articles and all taken together is an indicator of Agnibala / Aahaaras`hakti. Time taken for digesting the ingested food is an indicator of Agnibala / Aahaaras`hakti. If both the capacities are good, Aahaaras`hakti is considered as Pravara (high)if these are medium Aahaaras`hakti is considered as Madhyama (moderate)and if these are poor Aahaaras`hakti is considered as Avara (low)Physical Strength (Bala) and life span (Ayu) is dependant of Aahaaras`hakti. Hence its assessment is important.
  6. Vyaayaamas`hakti: Any desired strenuous physical activity which results in increase in physical power and efficiency is Vyaayaama (exercise). During exercise appearance of sweat over forehead, armpits, joints and over nose and a need to breathe through mouth are the signs of half physical strength (Ardha S`hakti Vyaayaama). From this Vyaayaamas`hakti of anindividual can be assessed. The time taken by the individual to reach the Ardha S`hakti is to be noted on first visit and on subsequent visits to note the Upas`haya / Anupas`haya of the management. You are allowed to use your parameters to calculate it and expected to select the related result from the list provided in this field as Pravara (high), Madhyama (moderate) or Avara (low).
  7. Saatmya: Saatmya are those stimuli which are homologous to the internal environment and do not generate an adverse reaction in an individual, this is decided at the time of Prakriti formation. This is termed as Sahaja Saatmya while there are certain habits a person acquires during his life span; they also do not generate adverse reaction after being accustomed to them. These are termed as Oka / Abhyaasa Saatmya. Mostly it is related to food items such as ghee, milk, oil and meat soup and six basic tastes (sweet, sour, salty, pungent, bitter and astringent) of the food. If an individual can consume all the above mentioned substances without any adverse reaction in the body, its Saatmya is considered as high (Pravara)If an individual can consume some of the above mentioned substances without any adverse reaction in the body, its Saatmya is considered as moderate (Madhyama). If an individual can consume dry substances and only one taste of the six without any adverse reaction in the body, its Saatmya is considered as low (Avara). Saatmya is directly proportional to strength (Bala), capacity to tolerate pain (Kles`hasahatva) and longevity.
    Asaatmya: Any stimulus that elicits an adverse reaction in the internal environment, sense organs, mind and the soul or any of them is Asaatmya e.g. Asaatmya of particular substance like milk products, non-vegetarian food etc.
  8. Sattva: Sattvarefers to the mental state, which controls the body in collaboration with the soul. Depending on degree of mental strength, it is considered to bePravara (high), Madhyama (moderate) or Avara (low). Pravara Sattva is Sattva Saara. A person when capable of rationalising the situation he is in; in an objective manner and does not need any support moral or otherwise to face the situation is of Pravara Sattva.A person who can withstand the adverse situation on being consoled and cheered by others is of Madhyama Sattva. A person who cannot bear any change in the situation pleasurable or painful and who lacks the capacity to rationalise is possessed of Avara Sattva. Examination of Sattva is important for understanding his response to the condition he is in: in ill health as well as to judge the severity of the signs and symptoms for deciding the prognosis. (For details see C.Vi. 8/119)
  9. Pramaan`a Pareekshaa: In healthy individuals the normal proportions (Anthropometric measurements) of all body parts in terms of Anguli measurement are mentioned in classical texts. This examination is significant from the point of view of immunity and longevity. E.g.
     Deerghatva(Aayaama)Parikshepa (parin`aaha)Vistaara
    Paada14 angula6 angula6 angula
    Janghaa18 angula16 angula 
    Jaanu4 angula16 angula 
    Uroo18 angula30 angula 
    Vrushan`a6 angula8 angula 
    S`hepha6 angula5 angula 
    Bhaga 12 angula 
  10. Vaya: Various conditions of body which depends upon Kaala and Praamaan`a are called as Vaya. It is mainly divided in to three parts
VayaAge Group 
Baala1 To 25This group is again divided in to two sub groups.1) Up to sixteen years Dhaatu are not fully developed. There is dominance of Kapha in the body. 2) After sixteen years Dhaatu are in developing stage. (Anavasthita Chitta)
Madhya26 To 60Dhaatu are fully developed. Disease resisting power is at its peak. There is dominance of Pitta in the body. (Bala, Veerya, Paurusha, Paraakrama, Grahan`a, Dhaaran`a, Smaran`a, Vachana and Vidnyaana Sampannataa)
Jeern`aAfter 60Depletion of Dhaatu takes place with progressive increase of Vaata in the internal environment. There is dominance of Vaata. (Bala, Veerya, Paurusha, Paraakrama, Grahan`a, Dhaaran`a, Smaran`a, Vachana and Vidnyaana Asampannataa)

Disease prognosis, line of treatment depends upon age of the patient.

Importance of Das`havidha Pareekshaa: Selection of medicine is dependent upon Samhanana, Aahaaras`hakti, Vyaayaams`hakti, Saatmya, Sattva and Vaya of patient and condition of involved Dosha. e.g.

AushadhaSanhana,Aahaaras`hakti,Vyaayaams`hakti, Saatmya, Sattva, Vaya
Mridu AushadhaAvara
Madhya AushadhaMadhya
Teekshn`a AushadhaPravara

Thus Nidaana PanchakaAsht`vidha Pareekshaa and Das`havidha Pareekshaa are three pillars of clinical examination. In order to diagnose and treat the disease, physician should practise this examination.

Last updated on March 26th, 2021 at 12:26 pm

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