Understanding our individual constitution, as we have seen, is one of the main
ways of keeping good health. Diseases, according to Ayurveda are caused by the
imbalance in the three doshas. The predominance of a dosha in an individual's
constitution indicates his or her vulnerability to a particular disease.
Diseases in Ayurveda are classified according to thee origin of their causes.
Diseases which originate from factors within the human body, including
psychosomatic diseases, are called adhyatmika. Adhyatmika diseases are further
divided into hereditary diseases, congenital diseases and those caused by the
aggravation of the doshas. Adhibhautika diseases are those whose origin can be
traced to external physical factors such as germs and accidents. Adhidaiveka
diseases are caused by the seasons, planetary influential, providential causes
and so forth.
The physician diagnoses a disease in an individual by an examination of the
patient based on three general methods. These methods are common to
understanding any phenomenon in the universe.
Direct observation or pratyaksha: This is done
through the senses: seeing, hearing, smelling, touching and tasting. A direct
contact between the senses and the object of examination is thus established.
Inference or anumana: Just as one deduces that there
is a fire when one sees smoke, one can make deductions in the observation of
certain substances under the microscope. For instance, the examination of stool
under a microscope will give clues about the state of the health of a person.
Authoritative statement or shabda: Experts have
bequeathed to us a legacy of authoritative statements regarding diseases. The
patient is interrogated closely to determine the exact nature of the diseases.
The patient's relatives too are questioned for in this way the patient's
previous history of diseases can be recorded. Fortified with the knowledge from
previously recorded cases and the findings of experts, the physician can make a
diagnosis.
Following these three principles, a brief examination of the patient proceeds
in three stages: visual observation or darshana, touch or sparshana,
interrogation or prashna. Another tool of diagnosis in Ayurveda involves the
eight-fold method of examination or ashtasthana pariksha which has the
following steps:
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Examination of the pulse or nadi pariksha:
Pulse examination is carried out with the help of radial artery. The index,
middle and ring fingers of the right hand are used in pulse examination. The
index figure is placed about the width of the patient's wrist below root of the
thumb, the other two fingers are placed next to the index.
Certain rules have to be observed in pulse examination.
(a) The examination should be carried out preferably in the morning after
ablutions, on an empty stomach. The pulse should not be examined immediately
after a bath, or oil massage, nor when the patient is hungry or thirsty. The
examination can also be carried out in the afternoon only if the patient has
not eaten for three hours.
(b) The pulse on the right hand of men and the left hand of women must be
examined.
(c) The doctor has to have total concentration.
(d) The examination of the pulse is at least repeated three times. Each time
the pulse is gently and evenly pressed, then the pressure is released. It is
important that the doctor feels the pulse of the patient and not the
capillaries of his own fingers.
(e) The pressure of the examining fingers has to be uniform.
The state of vayu is indicated by the pulse felt with the index finger. The
state is pitta is indicated by the pulse felt with the middle finger. The state
of kapha is indicated by the pulse felt with the ring finger. The physician
should wash his hands each time he has examined a pulse, so that the energies
are not transmitted.
If all three doshas are aggravated (the state of sannipata), the pulse movement
resembles that of a woodpecker. A healthy person's pulse is slow steady and
regular. A regular pulse beat of thirty times always indicates good prognosis.
While examining the pulse some other factors must also be taken into
consideration: vayu content in the body increases in the old stage, in the late
afternoon, late at night, two hours after eating, during summer or in the
beginning of the rainy season. Pitta content goes up during youth and middle
age, at noon, at midnight, while digesting food and in autumn and the amount of
kapha is more in the morning, in the evening, immediately after eating and in
spring. Children have more kapha in their bodies. During pregnancy, which is a
bi-cardiac stage, there is a kind of a double pulse.
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Examination of physical features:
Vayu-dominated patients normally have a rather dry and cracked skin and dry
hair. They do not like cold things. Pitta-dominated patients are frequently
thirsty and hungry. Their skin is hot to touch and often yellowish. The palms
and soles are frequently coppery in colour. They have somewhat less hair.
Kapha-dominated patients have compact joints, bones and muscles. They are never
excessively thirsty or hungry.
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Examination of the eyes: In case of vayu diseases,
the patient will complain of a burning sensation in the eyes. The eyes will
also be dry and smoky. Pitta type of diseases will manifest in a yellowish
tinge in the whites of the eyes, an aversion to light and a burning sensation.
Unctuous and dull eyes and kapha predominance.
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Examination of the tongue: Vayu aggravation is
indicated when the tongue is cold, rough and cracked. A red or bluish tinge
indicates pitta aggravation. And a white and slimy tongue indicates kapha
aggravation. The tongue is dark with eruptions when all the doshas are
aggravated.
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Examination of the skin: A cold skin indicates vayu
aggravation. When the skin is hot to touch, pitta is aggravated and a moist and
wet skin indicates kapha aggravation.
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Examination if nails: Cracked and dry nails indicate
vayu aggravation, while red or yellowish nails indicate pitta aggravation.
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Urine examination
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Stool examination
Applying these methods of examination, an experienced physician is able to
comprehend a general impression about the patient's individual constitutionand
which dosha or combination of doshas is affected. The treatment can thus be
broadly identified.
The physician may ask the patient a few questions. For example, if the
physician feels that a headache may be caused by a stomach problem he may ask
the patient about the food he ate the previous night. Interrogation is thus
also a tool of investigation and diagnosis. Ayurvedic classics caution the
physician against being very specific in naming the disease in a patient .
Names are attributed to some diseases purely in order to facilitate and aid the
physician in ascertaining and understanding the entire gamut of the remaining
diseases for which names are not furnished.
It is however essential to determinate the exact nature of a disease in order
to prescribe the proper treatment. Each disease must be studied with regard to
the following points:
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Causes of diseases or nidana.
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The premonitory signs or symptoms or purvarupa.
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The actual signs or symptoms or rupa.
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Exploratory therapy or upasaya.
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The mode of manifestation of the disease or samprapti.
Causes of disease may vary. Some factors may cause diseases to appear quite
early; others may have delayed effects; yet others may not be strong enough to
cause disease. There are also some which cause instantaneous effects, for
example strong poisons. Various types of diets, regimens and the effects of the
seasons are exogenous factors which cause disease. The endogenous ones are
attributed to the doshas and tissue elements.
Premonitory signs can be general or specific in indicating the nature of the
disease that will manifest itself. They provide a clue to the diagnosis of the
impending disease. At this stage some diet restrictions as well as
administration of medicines may avert the onset of the actual disease.
Exploratory therapy is carried out to arrive at the correct diagnosis of a
disease of doubtful identity. Actual signs and symptoms of the disease become
manifest if it is not averted during the premonitory stage. The signs and the
symptoms of the disease are related to the site of its origin or udbhava
sthana, the site of its manifestation or adhisthana and the path of
transportation or sanchara marga. All actual signs and symptoms are also
related to the doshas, tissues, enzymes and channels of circulation. The
importance of identifying these three aspects for treatment becomes apparent in
the examples discussed here.
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Causes & Diagnosis of
Diseases
