To confirm, evaluate and treat a disease, physicians need to perform clinical examinations of patients – wherein textual knowledge (aptopadesa), direct perception (pratyaksha) and inference (anumana) are all very important components. The examination of patients can be carried out in the following manners:

Three fold Examination (Tri Bidha Pariksha)

Covers a general examination of the patient.

  1. Visual observation (Darshan)
  2. Tactile perception (Sparsha)
  3. Questioning (Prashna)

Eight fold Examination (Asht Bidha Pariksha)

Provides a clear picture of nature of ailment and patient's general condition.

Involves the examination of pulse, tongue, voice, skin, eye, general appearance, urine & stool.
  1. Examination of the pulse (Nadi pariksha):
    The foremost clinical art in Ayurvedic diagnosis it can provide deep insights into the history of the patient. The ideal time for pulse examination is early morning in empty stomach. But in case of emergency, it can be examined at any time of the day or night. An experienced Ayurvedic physician can assess your body's nature (Prakriti), pathological state (Vikriti), imbalances of body type, very subtle observations & even prognosis of disease through the pulse.

  2. Examination of the tongue (Jivha pariksha):
    Assessed through its doshic state, a Vata aggravated tongue is dry, rough & cracked, pitta suffered tongue is red with a burning sensation and kapha influenced it is wet, slimy and coated. Suggesting the state of the digestive system.

  3. Examination of the voice (Sabda pariksha):
    Healthy and natural when the doshas are in balance, the voice will become heavy when aggravated by kapha, cracked under pitta effect and hoarse & rough when afflicted by vata.

  4. Examination of skin (Sparsha pariksha):
    Also used for assessing the state of organs and tissue, palpation is an important clinical method for examination of skin. Noted for doshic influences, a vata aggravated skin is course & rough with below normal temperature, a pitta influenced one has quite high temperature and kapha affected it becomes cold & wet.

  5. Examination of eyes (Drka pariksha):
    Vata domination makes the eyes sunken, dry and reddish brown in colors. On aggravation of pitta, they turn red or yellow and the patient suffers from photophobia and burning sensations. High kapha makes them wet & watery with heaviness in the eyelids.

  6. Examination of general appearance (Akriti pariksha):
    The doshic influences that reflect on the face of the patient enables physicians to gauge the basic constitution and the nature of the disease.

  7. Examination of urine (Mutra pariksha):
    Both examination of urine sample and questioning of patient are important for assessing doshic influence. A modification of this is the oil (taila) drop (bindu) test (pariksha) in which the effect of an oil drop on urine sample suggests the curability of disease.

  8. Examination of stool (Mala pariksha):
    If digestion & absorption of food are poor, the stool carries a foul odour and sinks in water. Vata aggravated, the stool is hard, dry and grey / ash in colour. Excess pitta makes it green / yellow in colour and liquid in form. And high kapha lines it with mucus.

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Ten fold Examination (Dash Bidha Pariksha)

Related to the patient.

Covers body constitution, pathological state, tissue vitality, physical build, body measurement, adaptability, psychic constitution, capacities for digestion & exercise and age.
  1. Body Constitution (prakriti):
    Determined by relative predominance of doshas during foetal development the prakriti can be any of vatika, paittika, kaphaja, vata paittika, vata kaphaja, pitta kaphaja or samdoshaja.

  2. Pathological State (vikruti):
    Related to the biological history of the diseases in its entirety, it enables physicians to consider the signs & symptoms of the disease in order to assess the strength of the disease, the causes, the doshas, the affected body elements, body constitution, time and strength of an individual.

  3. Tissue Vitality (sara):
    Broadly speaking, there are seven vital tissues, namely lymph (rasa), blood (rakta), muscle (mamsa), adipose (meda), bone (asthi), bone marrow (majja) and reproductive tissue (sukra).

    Lymph in the skin is assessed by its smoothness, softness, clearness, thinness and whether the skin is covered with short, deep rooted and delicate hair.

    Percentage of blood in body is evaluated from the condition of the eyes, mouth, tongue, lips, nails and soles of the feet.

    When muscles are in perfect condition, the temples, forehead, nape of the neck, shoulders, belly, arms, chest, joints of the body, jaws and cheeks are covered firmly with the skin.

    People with healthy adipose tissue have oily skin and healthy hair, nails, voice and teeth. The health of bones is determined by pliable but firm forearms, chin, nails, teeth, ankles, knees and other joints of the body.

    Healthy bone marrow leads to good complexion and stout, long, round & stable joints. Those in whom the semen is perfectly healthy, are strong and cheerful.

  4. Physical Build (samhanana):
    Body examination is carried out by direct perception – a healthy body being well- built with symmetrical bones, strong & stable joints and enough flesh & blood.

  5. Body Measurement (pramana):
    In Ayurveda, body measurement is given in terms of finger breadth and any person in close proximity to the ideal measurements is termed as normal and healthy.

  6. Adaptibility (satmya):
    Indicating substances intrinsic to the body, it refers to two types of people - those that are strong, adjust easily to difficulties and have excellent digestive capacity and those that are generally weak, intolerant to change and can have only few food options.

  7. Psychic Constitution (satwa):
    Refers to the mind which controls the body in contact with the soul (atma). Depending on degree of mental strength, it is considered to be high, moderate or low. To know more about your body type,

  8. Digestive Capacity (ahara sakti):
    This has to be judged from the individual's capacity to ingest and digest food substances.

  9. Capacity for Exercise (vyayama shakti):
    Assessed by capacity for hard work, it is either low, moderate or high.

  10. Age (vaya):
    Broadly categorised into childhood, middle age and old age, it provides vital clues for the diagnosis & treatment and is a must consideration in clinical examinations.
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