For proper diagnosis, the disease itself must be examined. We must determine the qualities, symptoms and sites of the disease. There are five approaches for this:
- Causative factors (Nidana)
- Preliminary symptoms (Purvarupa)
- Primary signs and symptoms (Rupa)
- Means of alleviation (Upashaya)
- Disease pathogenesis (Samprapti)
Pathogenesis has already been discussed. Upashaya requires some clarification. In certain diseases, diagnosis becomes difficult or may not even be possible. In such cases, the patient is given certain exploratory treatments in order to see how the disease responds to them. Such methods are called Upashaya or “means of alleviation”. By trying out certain herbs or therapies on a patient and noting the response that occurs, we can get a better idea of their real condition and how to treat it in the long run.
The program of examination for the patient should consist of:
- Factors that aggravate the disease
- Causative factors
- Signs and symptoms
- Stage of aggravation
- Continuity of disease
- Lessening of disease
- Name and classification of disease
- Rules of treatment
The diagnosis of the particular disease is based upon these methods but Ayurveda also places a great emphasis on methods for determining the dosha behind the disease. These are useful for both the experienced and the beginning practitioner. In this respect, Charaka states:
“When classified according to cause, pain, color, site, form and nomenclature, the number of diseases becomes countless. A physician need not be ashamed if he is unable to name all diseases as there can be no definite standardization of nomenclature for disease.”
The same provoked dosha produces various diseases according to its location, by which tissues it has entered into. For example, Vata entering into the blood causes gout, while entering into the bones causes arthritis. Therefore, treatment should be initiated after diagnosing the nature of the disease relative to the dosha and the tissue affected, as well as by other special factors. Merely to know the modern medical name for a disease is not enough to determine the appropriate Ayurvedic treatment.
The great complexity of diseases .can be explained by imbalances of the three doshas. In this way, Ayurveda can treat diseases in a direct manner that goes right to the cause and does not become concerned with unnecessary details. Through understanding Vata, Pitta and Kapha along with their normal and abnormal states, we can understand and treat all possible diseases, even if we do not know their specific forms or manifestations. This is the great beauty and simplicity of Ayurveda, which makes it so enduring as a system of medicine. ‘It places the key to health and disease in our own hands.