Probably the most important form of patient examination practiced in Ayurveda is the eightfold examination (Ashtavidha Pariksha). These provide a good idea about the nature of the illness and’ the condition of the patient. The eight factors examined are :-
1. Examination of the Pulse
The term “nadi” literally means a tube or channel through which something flows. Texts dealing with Yoga philosophy use this term for the nerves. In the context of the eightfold examination, nadi refers to the arteries. Pulse examination (Nadi Pariksha) is the examination of the arterial pulses at certain points on the body.
The early hours of the morning are the best time for pulse examination. It can be misleading or incorrect if done after the patient has taken food, exercise or a bath, after taking intoxicants, having sex, sleep or when afflicted with hunger, thirst, anger, grief or worry.
The radial pulse at the wrist is best suited for examination. The pulse on the right hand is selected for men and on the left hand for women. The physician should place the first three fingers (index, middle and ring) of his right hand on the pulse at the wrist of the patient. The fingers of the physician should be placed softly but firmly so that even slight movements of the pulse can be felt. The examination is better done three times with an interval of several seconds in between.
The main factors to be noted during pulse examination are pulse rate (Spandana Samkhya), pulse character (Gati) and pulse qualities (Gunas). The pulse rate is the number of beats per thirty seconds (pala) or double the amount per minute as follows :-
|Newborn Child||112 per mintue|
|3 – 7 years||90 per minute|
|30 – 50 years||75 per minute|
The pulse character is described as resembling the movement of certain animals and birds. Vata pulse is said to be like a snake, Pitta like a frog, and Kapha like a swan. Pulse qualities like warm, cold, soft, hard, thin, thick, full; empty, collapsed, volume and spiral movement can be ascertained by careful palpation.
Abnormal or Disease Pulse
- In conditions of Vata aggravation, the pulse resembles the movement of a snake or leech and is irregular, unsteady and neither hot nor cold.
- In Pitta conditions, it is like the movements of a frog, crow, sparrow, crane or quail, and is warm, rapid, thin and soft.
- In Kapha conditions, it is like the movement of a swan, pigeon, dove, cock, peacock, or elephant and is steady, cold, thick, and full or hard.
2. Examination of the Tongue
The tongue provides important information on the health of a person, particularly for the diagnosis of digestive disorders. By examining the tongue, one can infer the state of Vata, Pitta and Kapha, the plasma, blood and the digestive fire.
When Vata is high, the tongue is dry, rough and cracked. When Pitta is aggravated, the tongue is reddish in color with sores or ulcers and a burning sensation. During Kapha imbalances, the tongue becomes coated, white and slimy. In anemia, it loses its normal color and becomes white and smooth. When Agni is impaired, the tongue becomes coated with a white layer (Ama) that cannot be removed by washing or scraping, and the breath is usually unpleasant.
3. Examination of the Voice
The voice of a person reveals much about their strength and weakness and the doshas involved. It is particularly important for diseases of the head throat and lungs, which often impair the vocal organs.
4. The Skin – Examination by Touch
This method is related to palpation and mainly notes normal or abnormal conditions through the skin. The skin is the largest organ in the body. It is closely connected to and reflects the conditions of Rasa Dhatu or’ the plasma. As the Rasa is the dominant bodily tissue, the skin reflects what is occurring in the body as a whole.
The skin of a person with a Pitta disorder is hot and a little oily, possibly inflamed. The skin of one with a Kapha disorder is cold and damp, and generally pale. The skin of one suffering from a Vata disease is cold, dry or rough, with possible darkish discolorations.
5. Examination of the Eyes
Examination of the eyes of a patient provides much information about the condition of the doshas. Red or inflamed eyes, along with sensitivity to bright lights or sunlight, reveal Pitta conditions. Kapha conditions are revealed by mucus in the eyes or by watering of the eyes along with cloudy vision. Vata problems manifest by dryness and tremors of the eyes.
6. General Appearance
The general appearance of the patient reveals much about their condition, including the luster of the skin or the posture of the person. Here also comes examination of the different systems of the body, which are looked at according to their function and external appearance. For many Ayurvedic doctors, this method is more important than pulse diagnosis. Each system, alo11g with its relevant functions and organs, is examined in various ways, with reference particularly to the predominant doshas and the qualities of damaged or healthy tissues.
7. Examination of the Urine
Examination of the urine is a special diagnostic tool in Ayurveda. The urine sample should be collected in a clean vessel, preferably in a sterilized glass jar, tumbler or test-tube, taken directly at the time of urination after avoiding the first few drops.
Sesame Oil Drop Urine Examination – Taila Bindu Pariksha
A small quantity of urine is taken in a broad-mouthed glass vessel and kept undisturbed in a place free from wind, sun and other disturbing factors. A moderate-sized drop of sesame oil is then taken with a stick and allowed to fall on the surface of the urine from a height of two or three inches, gently and without disturbing the urine. The condition of the oil drop should be carefully observed for its spread and the different shapes or patterns that it assumes.
8. Examination of the Stool
The stool provides information about the condition of the doshas the tissues and the food digested both in healthy and diseased states. Hence, Ayurveda advocates its examination as a diagnostic tool especially in disorders of the digestive and excretory systems.
If the digestion and absorption of food is normal, the stool is well formed and floats on water this indicates that there is no Ama ‘in the body. On the contrary, if digestion is not correct, the stool does not float on water but is slimy, with various colors, contains undigested food particles, and has a bad odor. This indicates Ama in the system. Examination of the stool can be carried out to check for abnormal blood or fat or for the presence of parasites.