Diagnosis in Ayurveda
In Ayurveda, the concept of diagnosis stems out of the belief that the body is constantly interacting between order and disorder in a balanced way; and diagnosis is the idea of regularly monitoring these interactions from moment-to-moment basis. Thus, diagnosis in Ayurveda is different from the concept of diagnosis in Western medicine, where the disease is identified after it presents in the body.[i]
The disease process is a reaction between the body humors, tridoshas and the dhatus or tissues. The symptoms of every disease are always related to the nature of imbalance among the tridoshas. Once this imbalance is identified, then balance can be re-established through Ayurvedic treatment and management.1,[ii]
Factors Influencing Diagnosis of Diseases
Diagnosis related decision making in Ayurveda is very complex and depends on evaluation of many internal factors that present themselves during a disease process, such as:[i]
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Body humors (Tridoshas)
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Body tissues (dhatus)
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Excretory products (malas)
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Digestive power (agni)
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Body channels (srotas).
Also external factors like pathogens or infection, season or weather and the patient’s lifestyle including diet, medication, smoking or alcohol and other such habits that are a part in vitiating his/her constitution, are involved in the expression of the disease.3
Methods of Diagnosis in Ayurveda
An Ayurvedic clinical examination includes three diagnostic methods (trividhapariksha):3
1. Inspection (Darshana): Involves observation of the body parts, for example, skin, hair, eyes, and tongue.
2. Palpation (Sparsana): Includes pulse & palpation of body parts (wrist pulse, abdominal palpation etc.).
3. Questioning (Prasna): Understanding the medical history, symptoms, mental and physical state of the patient are covered during the questioning stage.
Based upon this diagnosis, treatment and choice of herbs/compound formulae are prescribed.
Pulse Diagnosis – Nadi Pariksha
This is a unique science in itself that offers many insights into disease and general health. The pulse or Nadi, felt at the wrist is used as a definitive method to diagnose diseases in Ayurveda. The signals obtained from pulse on the wrist are specific for vata, pitta andkapha.[iv]
To check pulse, the arm and wrist of the patient is kept at rest and three fingers are placed on the wrist (as shown in the figure), just below the wrist bone and the throbbing movement of the pulse is felt and analysed.4
The position of the index finger represents the place of the vata dosha. When vata becomes predominant in the Prakriti or constitution of an individual, the index finger feels the pulse strongly. It is irregular & thin, pulse is felt like a snake-like motion; therefore, called the snake pulse which indicates aggravated vata in the body.1
The position of the middle finger denotes the pulse of the pitta dosha. When pitta becomes predominant in the constitution, the pulse is stronger under the middle finger. It feels active & excited &pulse is felt like the jumping of a frog; hence called the frog pulse. This pulse denotes aggravated pitta.1
When kapha becomes predominant, the throbbing of the pulse under the ring finger is most noticeable. The pulse feels strong and its movement resembles movement of a swan across a pond. It is called the swan pulse.1
Apart from the pulse, other observation techniques used to diagnose diseases in Ayurveda are examining the sense organs like tongue, eyes; facial skin; appearance of lips; nails etc. Additionally, there may be examinations of the urine, stools, sputum, sweat, heart, liver, kidney etc. in complicated cases.1
References
[i] Lad V. Ayurveda: The science of self-healing: A practical guide. Lotus press; 1984.
[ii] Patil V, Sapra UK. CLINICAL DIAGNOSIS IN AYURVEDA: CONCEPTS, CURRENT PRACTICE AND PROSPECTS. Journal of Ayurveda and Holistic Medicine (JAHM). 2013 May 18;1(2):1-7.
[iii] Kurande V, Bilgrau AE, Waagepetersen R, Toft E, Prasad R. Interrater reliability of diagnostic methods in traditional Indian ayurvedic medicine. Evidence-Based Complementary and Alternative Medicine. 2013 Sep 26;2013.
[iv] Kallurkar P, et al. Nadi Diagnosis Techniques. IJPMN, Volume 2, Issue 1, April -2015. 17-21