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 ( Tri) fold ( Bidha) Examination ( Pariksha )
Covers a general examination of the patient.
Eight ( Asht) fold ( Bidha) Examination ( 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.
Ten ( Dash) fold ( Bidha) Examination ( 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.
Indian medicine names three main causes of disease – Asatmendriartha-samyoga, pragyaparadha,and parinama ie 'overuse', 'disuse' or 'misuse’ of faculties; 'errors in judgement'; and influence of seasonal changes are general causes which produce disease’
Exessive use of sense-objects
Non use of sense-objects
Wrongful use of sense-objects
It is the Ayoga ,Atiyoga and Mithyayoga of karma or action which has been defined as any effort of the body ,mind and speech and also any harmful or undesirable action perpetrated by anybody,who has lost his understanding ,intellect or memory.
It is another name of Kala or time ,inflance of seasonal changes produce the disease.
Diseases are classified primarily as Sarira and Manasika.These are also classified as Nija and Agantuja and also classified based on sadhya and sadhyatwa .Susrutha gave an exhaustive classification,he said that anything wich afflicts the body inclding mind is a disease and than that afflication or pain may be of thee types ie –Adhyatmika ,Adhibhautika,and Adhidaivika
This is physical and is of three types, they are
1. Genetic ( Adibalapravritta)
Consists of ailments as obstinate skin diseases, hemorrhoids, diabetes, tuberculosis and asthma that arise primarily due to defects in the sperm ( sukra) of the father – when it is called pitrija or the ovum ( sonita) of the mother – when it is termed matrja.
Undigested food, abnormal behaviour, addiction of any type and stressful situations affect the reproductive elements of both the male and female, resulting in a defective foetus.
2. Congenital ( Janmabalapravritta)
Caused essentially due to nutritional disorder ( rasakrita) and unfulfilled cravings of the mother during pregnancy ( dauhrdya)
If diet and / or conduct of the mother aggravates vata, the foetus might end up with deformities as kyphosis (hunchback), blindness and dwarfism; increased pitta may cause alopecia and yellowish pigmentation of skin; and enhanced kapha might result in albinism.
3. Constitutional ( Doshabalapravritta)
Arise out of any dietary or behavioural disturbance brought about by an imbalance in any one of the three vital physical energies ( Tridoshas) or the three vital mental energies ( Trigunas).
Thus constitutional disorders are of two types : somatic ( Sharirika) & psychic ( Manasika).
This is due to any disturbance in the physical environment of a man .It is of one type
Traumatic ( Sanghatabalapravritta)
Undergoing any trauma causing experience – external or internal – leads to this.
External trauma is induced by injuries inflicted by sharp instruments and bites of animals or venomous insects.
Stress and overstrain lead to internal trauma.
This is due to act of God.This is of three types ie
Seasonal ( Klabalapravritta)
Brought about by changes in the nuances of seasonality.
Sometimes the body fails to adjust itself to the sudden and abnormal climatic changes – extreme cold might lead to frostbite and rheumatic disease. While extreme heat may cause sunstroke or fever.
.Infectious and Spiritual ( Daivabalapravritta)
Either born out of natural calamities as lightning, earthquakes, floods and the invisible, malignant forces of nature.
Or contacted through sexual & physical intimacy and sharing of food, plates, bed, clothes, towels and cosmetics with effected friends & relatives. Or as a result of sheer jealousy.
Natural ( Swabhavbalapravritta)
Even the healthiest of people are struck by hunger, thirst, sleep, death or senility.
Brought about by functional, organic and natural changes in the body.
According to Ayurveda, health is a state of balance between the body, mind and consciousness. Within the body, the three doshas, seven dhatus, ; three malas, or wastes; and agni, the energy of metabolism. Disease is a condition of disharmony in any of these factors. The root cause of imbalance, or disease, is an aggravation of dosha, vata-pitta-kapha, caused by a wide variety of internal and external factors. According to the attributes of these different etiological factors the bodily humors become aggravated and start to accumulate at their respective sites. If the provocation continues, the accumulated dosha reaches a state of overflowing the original site and spreads throughout the body. The aggravated dosha then enters and creates a lesion in a specific weak tissue where pathological changes are manifested in the organ or system.
The early signs and symptoms ( purvaroopa) provide useful warnings and the opportunity for taking necessary action before a disease can assume dangerous magnitudes. The main signs and symptoms ( roopa) reflect the true nature and intensity of the disease. Another oft used method of diagnosis is exploratory therapy ( upasaya) which uses diet, medicines and routines to detect diseases otherwise difficult to diagnose. Acting either against the cause of disease or the disease itself or producing relief. For example a swelling that is alleviated by an oily & hot massage, is obviously caused by an imbalance of vata.
The imbalance of doshas and the course they follow to cause disease is termed samprapti or pathogenesis. Since diseases develop in distinct stages, a good knowledge of those helps in early recognition of disease. Ayurveda thus elaborates a six stage process for diagnosis called Kriya (action) Kal (time). The first 4 stages being unique to Ayurveda in that they permit recognition and elimination of the disease before it ventures into differentiated clinical symptoms.
One who knows the various stages of pathogenesis accumulation ( sanchaya), provocation ( prakopa) spread or migration ( prasara), deposition or augmentation ( sthana samshaya), manifestation ( vyakti) and the differentiation ( bheda) is entitled to be a physician.
Stage One: Accumulation ( Sanchaya)
Weak digestive power and excess of dosha is responsible for such a condition.
Here toxins ( ama) produced by improper digestion collects in the gastro-intestinal (GI) tract.
Toxins resulting from a kapha imbalance accumulates in the stomach, those associated with a pitta imbalance collects in the small intestine, and that related to vata malfunction amasses in the colon
Due to the presence of one of these toxins, mild and ill-defined symptoms may show.
We should recognise and eliminate the cause instead of ignoring or suppressing it.
Causes aversion to similar things and attraction for contraries.
Stage Two : Aggravation ( Prokapa)
the accumulated, stagnant doshas are now `excited’ by factors as ahara, vihara & seasons.
The toxins amass in such degree to get provoked in the site of production in the GI tract.
Stage Three : Spread ( Prasara)
In this stage, the toxins accumulated in the GI tract start overflowing.
Generally, up to this stage the damage is entirely reversible and restoration of doshic balance can be achieved with proper measures. Or there may be spontaneous prashama (remission) influenced by seasonal changes. Thus there is sanchaya of pitta in rainy season, prakopa in fall and prasara in early winter. Based on degree of excitation, it might even passed the stages of prashama or prasara.
Stage Four : Agumentation ( Sthana Samshraya)
Overflowing toxins migrate, entering and taking refuge in localised, weak or defective dhatus thereby leading to malfunction and structural damage.
It is from here that specific degenerating disease and susceptibilities to serious infections begin.
Stage Five : Symptom Manifestation ( Vyakti)
Differentiated symptoms first begin to appear from the location.
Manifested symptoms being used by modem medicine for classification & diagnosis of disease.
Stage Six: Complications/Differentiation ( Bheda)
The disease having taken taken years or even decades to reach this final stage, becomes chronic.
Offers detailed understanding of the group of symptoms thereby making clear nature of disease. Might act as predisposing factors for the spread of other diseases.