Ayurvedic Diagnosis in Simple Terms

This post is to share a bit about the complexity of Ayurveda in Diagnosis. It may make you realize that Ayurveda is not a diet plan based upon dosha and there is alot more to it than a checklist to figure prakriti. This is only diagnosis as per the individual and not diagnosis of a disease which is just as complex, if not more.

Dashvidha Pariksha:
Incorporating two separate views – from Ashtanga Hrudaya and Yogaratnakar. Yogaratnakar is a more modern book with diagnostic and surgery. A later book with more clinical approach that was written after the main ancient texts (granthas).

Yogaratnakar:
Vikruti – imbalance state of dosha/dhatu
Vyayam Shakti – strength/endurance of physical stamina/strength
Aahar Shakti – strength of digesting food) ->
Prakruti – constitution of individual ->
Vaya – age of individual kala of individual ->
Satva -> Mind
Satmya – certain habituated food and herbs -> (asatmya – increases conditions by creating imbalance)
Sara – strength of dhatu
Samhanan – general physical makeup/build (lean weak thin big – physical fitness
Pramana – measurements like height and weight

Astang Hrudaya:
Dushyam – the one which gets vitiated (dosha/dhatu)
Desham – where the person is living: climate
Bala – strength
Kala – here refers to seasonal climate
Agni – digestive strength
Prakruti – original balance of constitution
Vaya – age
Satva – Mind
Satmya – Foods, etc that are eaten daily, habitual, lifestyle as well
Aahar – what food habits are they having

The way we understand the samprapti (pathogenesis) after diagnosis, is after coming to the conclusion about which vyadhi (disease) so called Vyadhi Vinichaya – Concluding Diagnosis. Not only the name of the disease, but how it has occurred (samprapti or etiology and path of process and creation of the disease)

Race or religion can show a little bit about lifestyle choices. This is difficult in America due to vast amounts of information and ideas of health and habits, but in india you can understand what common foods are for south or north Indian so can ask leading questions about hetus. This is an easy explanation of the corruption of health of the modern world as it moves into smaller countries and infects cultures much like the Christian missionaries have done in a similar vain, destroying what a cultures traditions are as it moves towards modern globalization.

Address – for desham – understand in one sense what their area is like

Birth date, time, location/place – second part to understand desham. At time of birth itself will have some effect on their birth – understand time, understand ritu, understand kala, with location can understand what climate.

Prakruti – Single dosha is rare as a single dosha is afflicted with weakness and disease and those lives are short. May see combination of 2 or perhaps 3 doshas – some who are equally balanced in all. If someone has tridoshic constitution may only have very minor ailments due to some intake of food or lifestyle, but some people may go 20 or more years without needing treatment. Hearing at age of 80, balanced lifestyle.

Kala – what is the present ritu (season) – if you understand that there is a kapha problem in a grishma ritu and you give heating herbs will have more of an effect – seasonal understanding helps to prescribe herbs and treatments

Desham – Sadharan, janghal or anup – which climate is this like where they live PRESENTLY which will affect prognosis and treatment.

Sara – directly mention the sara of dhatus – can have sara of more than one dhatu.

Samhanan – 3 options which we have to pick in a typical terminology of ayurvedic case taking:
– Pravara – superior/strong
– Madhyam – medium or moderate
– Avara – weak or inferior
Ex. Lean and thin – weak with no energy would be avara
Obesity would be madhyam – not only about physical bulk but strength

Pramanam – body size or measures – weight and height (all measurements technically, but genertally would only take height and weight)

Satmya – mentioned in two ways – herbs and foods that are satmya but not healthy in excess or daily, or certain asatmya food. Then after, must come to a decision about this using these three (see above) :
Pravara satmya – can eat anything no problem
Madhyam Satmya – only one thing may cause reactions
Avara satmya – a whole list of food issues
Ex. Treating acidity issues – how does your body respond to tikta/bitter things? If ok, then madhyam, but totally intolerant to any pungent is avara satmya. How many foods triggers the response IN RELATION TO THE PROBLEMS ONLY (the present imbalance). Not in relation to the other bad habits – certain things that are always unwholesome – that should not be taken daily: mustard, alcohol, etc…

Satva – how the patient is mentally, recovery from surgery, response to medication and treatment.
Pravara Satva – responds well.
Avara Satva – always complaining.
Madhyam Satva – complains but does it.

Agni Bala – strength of agni – classified in two ways:
1. Power of Digestion – in terms of quantity. If sedentary person, sitting around a lot, may not requires 5 chapatis and 2 bowls of rice. But with that quantity if he is digesting well and not putting on weight, classified as pravara agni bala. Some people eat very less – digestion is ok with that quantity of food. Average exercise and work, but eat very moderately and are very healthy. Quantity wise what are they eating? How many times are they eating, what are they eating in general?

2. Power of digestion – Jaran Shakti – Hunger – Every time feels hungry at next meal – good to average or very poor. Also includes some frequency of indigestion – if I eat heavy then I have indigestion.

Vyayama Shakti – endurance of muscles – history of regular exercise. walk 100 steps and back and then check pulse rate. No change = Pravara, lots of change = avara

Vaya – age – very important in relation to doshas and doshas related to vyadhi, also important to decide whether can undergo panchakarma or not

Aahar – detail of timings of meals including snacks. What each meal often is – breakfast lunch dinner etc. nonvegetarian? Specific aahar around finding hetu. Quantity of water also.

Aam – finding presence of aam – if yes, what are the symptoms – agni mandya/lack of appetite, heaviness, coating – all 5 symptoms or just some or none. Will define knowledge to build what treatment to take

Nadi – pulse. Not in original texts of Ayurveda but brought in later. Not a foremost point of diagnosis like it has been touted to be. It is just one of the many.

Mala – Wastes – nature: consistency of mala “well formed, hard, semi solid, liquid” Frequency “erratic, regular etc.”, Bowel habits: how many times a day does he eliminate
Varna – color
Dependency on stimulants like tobacco/smoke, coffee or dependency on psyllium or triphala – taking for months or years
Mutra – urine. Frequency/no. of times in day AND night both. Varna/color.
Tongue – Samata or Niramata – with or without coating (aam)

Shabda – sound – strength of speech of individual that describes physical overall strength. Generally the strength of speech defines the health of the individual. Again classified as Pravara, Madhyam, Avara shabda.
– Any other clinical observations – heartbeats, respiratory sounds, crepitus in knees, other noises

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