The Examination of patients

For the examination of any Phenomena in the Universe in general and the patient in particular, the following three methods are prescribed:

1. Pratyaksa (Direct observation)

This is done through the senses: seeing, hearing, smelling, touching, (tasting). A direct contact between the senses and the object of the senses is established.

2. Anumana (Inference)

When there is excessive dense smoke coming out of the windows of a house, the deduction is that fire is in that house. Similarly the observation of certain substances under a microscope (for instance stool or sputum) may allow for certain deductions regarding the state of health of a person. Inference is very important in medical practice.

3. Sabda (Authoritative statement)

Enlightened and experienced experts have left a treasure of authoritative statements regarding diseases. Equally the patient has to be interrogated closely to determine the exact nature of a disease. Eventually the patient's relatives have to be interrogated as well. In this way previously ex- perienced diseases, recurrences etc. are recorded.

A brief examination of a patient procedes in three steps:

1. Darśana (Visual observation)

2. Sparśana (Touch)

3. Praśna (Interrogation) 

For a more detailed examination the following eightfold method is prescribed:

1. Nādi-Parikşă (Pulse examination)

2. Mütra Parikşa (Urine examination) With these two we shall deal in more detail on the following pages.

3. Mala-Parikşă (Stool examination) For instance if stool sinks in water, there is much ama in the body, if it floats on water, there is no āma in the body.

4. Examination of Eyes

Those of a person suffering from vāyu diseases will be dry and smoky and the patient will complain of burning eyes. Yellowish tinge in the white of the eyes, aversion to light+ burning sensation indicate pitta type of diseases. Unctuous and dull eyes indicate kupha predominance.

5. Examination of the Tongue

When the tongue is cold, rough and cracked, vāyu is aggra- vated.

A red or blue tongue indicates pitta aggravation.

A white and slimy tongue indicates kapha aggravation.

If the tongue is black and there are thorny eruptions, all the doșas are aggravated.

6. Examination of the Skin

Skin hot to the touch indicates pitta aggravation.

Cold skin indicates vāyu aggravation.

Moist or wet skin indicates kapha aggravation.

7. Examination of Nails

For instance cracked and dry nails indicate vāyu.

Red or yellowish nails indicate pitta.

8. Examination of Physical Features

Vayu dominated patients usually have dry and cracked skin and hair. They do not like cold things and tend to be impatient, lacking in memory and intellect, but tend to be talkative.

Pitra dominated patients are frequently thirsty and hungry. Their skin is hot to the touch and often yellowish. Their palms of the hands, soles of the feet and face are frequently of coppery colour.. They tend to be egocentric and aggres- sive and have less hair. Frequently their hair has a reddish tinge. Kapha dominated patients have compact joints, bones and muscles, there is no excess of thirst, hunger, grief and pain.

The following aspects of patients need to be taken closely into consideration:

(a) Prakrti (Physical and psychic constitution)

(b) Vikyti (Nature of the disease of the patient)

(c) Sāra (Excellence of the tissue elements of the patient)

Samhati or sumhanana (Compactness of the patient)

(e) Pramaņa (Measurement of the patient)

(f) Sattva (The will power of the patient)

(g) Sātmya (The wholesomeness of the patient, for instance whether he is a drinker, vegetarian etc.

(h) Vayah (The age of the patient)

According to Ayurveda man should live 108 years. Age is divided into 10 stages, diseases dur- ing each of these stage s need different treatment. For instance, till the age of 10, kapha is aggrava- ted, from 10 to 20 years, the age of youth, pitta is aggravated. From 30 to 40 wisdom is gathe- red, from 40 to 50 metabolic changes take place and in old age vāyu tends to be aggravated.