Diagnosis: Classical Ayurveda Approach
In Ayurveda, attention is paid to the nature and directly observable attributes of the disease process itself and to the pattern of doshic disturbance in the individual. Understanding the disturbance, or "vitiation" of the individual's normal doshic is the essence of Ayurvedic diagnosis and forms the basis for the therapeutic approach.
As has been stated above, in addition to assessing the doshic vitiation, the physician also must understand the tissues affected, the srotas involved, the patient's social circumstances, the emotional tendencies, personality traits, and the general state of the patient's health and life. Clearly, this information gathering demands an extensive interrogation and physical examination which Ayurveda teaches as a two-part approach:
- Diagnosis of the patient (Rogipareeksha)
- Diagnosis of the disease (Rogapareeksha)
Rogipareeksha: Diagnosis of the Patient
The first of these, rogipareeksha, is the true strength of Ayurvedic diagnosis. It includes the physician's judgment regarding the patient as a whole, his temperament, discipline, habits, digestive capacity, intelligence, hereditary traits, emotional set, finances, support system, desire to heal, and of course his constitutional type. Charaka also described a ten-fold methodology for this aspect of Ayurvedic diagnosis which is still in use today precisely as outlined below:
Ten-fold Ayurvedic Diagnosis (Rogipareeksha)
- Constitution (Prakriti).
- Doshic Vitiation (Vikriti).
- Quality of Tissues (Sara).
- Body Compactness (Samhanana).
- General Stature and Physical Proportionality (Pramana).
- Physical Strength (Vyayama Shakti).
- Adaptability (Satmya).
- Emotional Balance (Sattva).
- Digestive Capacity (Ahara Shakti).
- Rate of Aging (Vaya).
Rogapareeksha: Diagnosis of the Disease
The diagnosis of the disease, rogapareeksha, is aimed toward assessing the nature of the disease and is divided into three main activities:
- Prashna (Interrogation)
- Panchendriyapariksha (Physical examination using the five senses)
- Ashtavidhapariksha (Specialized "Eight-fold" Ayurvedic examination). Below in table form:
Ayurvedic Eight-fold Examination (Rogapariksha)
- Examination of the complexion
- Examination of the eyes
- Examination of the speech and voice
- Examination of the tongue
- Examination of the skin
- Examination of the stool
- Examination of the urine
- Examination of the pulse
These three activities are applied to assess the nature of disease using the following rational and orderly approach. First one identifies the cause(s) of the disease (Nidana). Next, one evaluates the stage of progression of the disease or pathogenesis (Samprapti). This is followed by careful observation of any very early signs of disease (Purvarupa) and the overt symptoms of the manifest disease condition (Rupa). Finally, we derive additional information about the disease from how it responds to therapeutic interventions which are administered, i.e. response to treatment (Upashaya).