About Diagnosis

Whatever be the system of Medicine, a good doctor is distinguished from a bad doctor, by his diagnostic ability. A doctor should be able to identify the disease, the causative factors and treat with medicines that are suitable to the constitution of the patient.
Charaka samhita says ?The physician who is of sound mind and understanding should know accurately the diseases from the view points of aetiology, symptomatology etc?.
Ayurveda means science of life (Ayur ? life, veda ? knowledge) The basic theory of this ancient system is that the universe is composed of five basic elements ? Earth, Water, Fire, Air and Ether. These five elements (Pancha Bhutas) are represented in the human body as the ?doshas?, ?dhatus? and ?malas?.
There are three types of doshas in the body ? Vata, Pitta and kapha. Vata controls movements of the body, breathing, sensations nerve impulses, secretion, excretion etc. Vata also influences thoughts, anxiety on psychic levels. Pitta maintains digestion, metabolism, body temperature, visions, appetite, memory, intelligence, courage etc. Kapha binds the body, provides material for physical structure, lubricates the joints, provides firmness to limbs etc.
Ayurveda believes that good health results when these three remain in equilibrium and ill health results when this equilibrium is upset. At the same time, Ayurveda asserts that each individual has his own uniqueness.
In Ayurveda, the diagnosis methods are well detailed, indicating various techniques for properly diagnosing the various diseases.
Preliminary diagnosis starts with the case history of the patient. The patient?s medical record, including that of his parents is seen through. Patient?s body constitution somatic make ? up, Gastric capacity and age factors are evaluated. The patient then undergoes an objective examination. He is physically examined from head to toe. His nails, eyes including eye brows, eye lashes, nose, teeth, hands, feet etc, are all examined. The entire body is palpated to find out the abnormalities. Eight important points, pulse, Urine, Faeces, tongue, Voice, touch, vision and appearance are checked. The physician tries to find out which particular organ or entire system is cold or hot, moist or dry, light or heavy sensitive or insensitive, rough or smooth, rigid or loose etc. Special attention is paid to Body odours. The urine is examined at the place where it was voided, for sediments or whether ants are crawling. Oil is dropped into the urine to know its density. The faecal matter is examined for its appearance, colour, odour, consistency, presence of parasites etc. To know the state of digestion, motion is passed in to a receptacle with water and observing whether it floated or sunk in water. This sort of pathological check ? up helps in evaluating the state of disease, its ?Nidana? (aetiology) and samprapthi (pathology) etc.
The physician also studies the state of body fluids blood, flesh, fat, bones, semen etc. The various other factors are also taken in to consideration. These factors are doshas, the site, extent of vitiation, the place where patient lives, his physical strength, the prevailing season, his digestive capacity, temperament, moral strength, age, his food habits, physical work and exercises etc.
The art of reading a patient?s pulse is the hall mark of a good ?Vaidya?. An experienced ayurvedic physician can correctly diagnose a disease just by reading the pulse. Pulses from both wrists are taken. The ayurvedic physician then can understand the particular dosha, the patient is suffering from, Pressure is applied to the radial artery below the thumb with three fingers to see whether it is the vata, pitta or kapha which is responsible for the patient?s disease. Ayurvedic texts have given detailed descriptions about pulse reading and inference of diseases.
An examination of the patient?s tongue will indicate, to certain extent, the disease of the patient as given below. Pale tongue ? anaemia, Yellow tongue ? a liver disorder, Blue ? problems with the heart, White ? kapha imbalance, Red or yellow green tongue ? pitta imbalance, Black or brown ? Vata imbalance.
A study of the complexion and eyes is also included in the diagnosis. Face is the mirror of the mind. Disease is manifested on the face in the form of lines, wrinkles, etc.

In addition, attention is paid to assess the state of digestion of the patient. The gastric juices give an indication of the state of the patient. For example the blockage of bile duct brings on jaundice and scanty urine shows increase of urea in blood.
In the final stage of diagnosis, the Ayurvedic practitioner studies the mental state of the patients, consistent with the belief that mind can affect the body.
Ayruveda believes that physical or mental disturbances show them selves in the body or mind, through vitiation of Tri ? doshas. Vata disturbances destroy mind ? power and give rise to anxiety, fear and grief. In pitta vitiation, lust, grief & fear increase bile content. The vitiation of kapha induces lethargy and greed. The diseases like epilepsy, hysteria, diarrhea insomnia, delusion, insanity, fever etc. are considered as mental disorders.
Only when above mentioned detailed diagnosis is made, the Ayurveda doctor starts his treatment that composes of therapy for the body as well as mind. Charaka?s dictum ?Purify, Pacify and remove the cause? is the hallmark of Ayurvedic treatment.
Ayurvedic practitioners also take into account the basic nature of individual. Ayurvedic term ?Prakriti? means the basic nature of the individual patient, the perfectly balanced body. The affected state of the person is called as ?Vikruti?
You may wonder that in these days of advanced medical diagnosis wherein, for example, a sophisticated ultra ? modern, state of art ?64 slice heart scan? is available, what relevance the traditional diagnostic modes have. These modern methods evolved as a natural progress of mankind. Had we not been under colonial rules for hundreds of years, the growth of Ayurveda would not have been halted. Now there is a renaissance. Ayurvedic scientists are trying to utilize modern methods of diagnosis.