Through sparshanendriya the natural and unnatural touch of the body should be examined. Though the factors related to rasanendriya should be sensed through gihwa but it is acknowledged through anumana instrad of prathyaksha. The impairment of the taste of the body is inferred when yuka(lice) appears in the body. If flies are attracted towards the body it indicates the sweetness of the body. Acharya sushrutha says the different kinds of information about the disease obtainable through srotrendriya (Su.Su.10/5) Those obtainable through eyes are bala varna ayu etc(Su.Su 10/5) The knowledge obtain through jihva are rasa visesha of prameha etc (Su,su.10/5) The knowledge get through tongue are gandha visesha of vrana etc (Su.su.10/5)
ANUMANA PARIKSHA Anumana means inference,is perceived by purva pratyaksha. It is of three types related to present, past as well as future. For example, fire is inferred from the smoke, sexual intercourse from pregnancy. These two belongs to the inference of the present and past respectively. Similarly one can infer the forth coming fruit of a tree from the seed on the basis of frequent observation about the production of the fruits from the seeds through direct perception(Ch.su.11/21-22) Factors to be observed by anumana The factors to be examined by anumana are explained in Ch.v.4/8 Achrya Charaka mainly explain the two methods of examination are pratyaksha pariksha and anumana pariksha. While according to Susrutacharya the two methods of examination are panchendriya pariksha and prasna pariksha. The knowledge obtainable through prasna pariksha are desa, kala, jati, satmya etc (Su.su.10/5) 2. TRIVIDHA PARIKSHA
Vagbhatacharya gives a beautiful description about the three methods of examination of patient. The three techniques are darsana(inspection), sparsana(palpation) and prasna (history taking). (A.h.su.1/22)
DARSANA The things are identified by direct observation through the visual faculty is termed as Darsana pariksha Acharya Arunadatta in sarvanga sundara vyakhya gives the examples of darsana pariksha are pita sukla varna in kasa meha etc. (Ar.A.h.su.1/22) The features looked up in this aspects are vrana, samsthana, pramana, chaya, mutra, purisha, chardi. Bhavaprakasa incorporates netra, jihva and mutra pariksha under Darsana pariksha.(Bh.pr.pu.kh.7) Sparsana Examination of patient by palpatory methods. Eg;- jwara through santapa Gulma by means of palpable mass (Arunadatta) The features observed by this means are sitatwa/ ushnatwa, spanda, slakshna, kharasparsa. Bhavamisra includes nadi pariksha under sparsana pariksha. PRASNA Interogation is one of the method of examination. The synonyms like sula, arochaka, chardi, icha, dvesha, nature of koshta, nature of swapna and amaya pravrti etc are examined through the interrogation of patient.(Arunadatta) Shad vidha pariksha Susruta mention that the trividha pariksha is not possible to acquire the complete knowledge of roga and is achieved through six methods.(Su.su.10/5). They are;Sparsanendriya pariksha
Srotrendriya parikshapariksha Rasanendriya pariksha Chakshurindriya pariksha Khranendriya pariksha Prasna pariksha ASHTASTHANA PARIKSHA The examination of eight specific sites of patient is explained in Yogaratnakara. They are nadi, mutram, malam, jihva, sabdam, sparsa, drik and akrti. NADI PARIKSHA The term nadi means the passage/ channels of various bodily constituents that connects various functional aspects and is indicative of the alteration from its normalcy. The physician gently holding the elbow of the patient with left hand the physician must feel the pulse or nadi with his right index , middle and ring fingers kept in opposition, slightly below the thumb. The left hand of women and right hand of men is examined. Nadi pariksha is contraindicated for those who just taken bath, immediately after consumption of food, hunger, thirst, exposure to sun, exhaustion due to exercise. NADI PARIKSHA STHANAS Hastha nadi Pada nadi Kandha nadi Nasa nadi karna nadi Akshi nadi Jihva nadi Medra nadi
NADI GATHI In the morning – sigdha During noon- ushna In the evening- slow down Vata nadi- having vakra gati. Resembling the movements of sarpa, jalauka Pitta nadi – movements of manduka/kaka/kulinga Kapha nadi- slow, stable,resemble the movement of hamsa, kapota,paravata,kukkuda,gaja,mayura MUTRA PARIKSKA This is one of the trimala. Whose function is to clear the excessive kleda out of the body. DOSHANUSARA PRAKUPITHA MOOTHRA LAKSHANAM (YO.R) Vata prakopa – the color becomes pandura or pale or transparent Pitta prokopa – raktha varna. kapha prakopa- phenam dvanthvajam –tri doshaja prakopam sannipatam- krishnam CHANGES IN RASA: In amla meha- amla rasa Madhu meha- Madura kashaya rasam Ikshu meha- maduram Haridra meha- katu rasa Ksara meha- katu lavanam or ksara rasa JIHVA The examination of tongue is done to see the status of digestive system normally but it also suggestive of many general features of the body. In the case of vataja vikara, tongue becomes sheeta , khara. In the case of pittaja vikara, tongue becomes rakhta and syama. In case of kaphaja vikara, tongue becomes subhra and atipichilla.
In normalcy the tongue has a copper like glow and moisture (A.s.saa.8/32) eg: In ama condition becomes upaliptha Protrusion of jihva is seen as a complication of vamana (su. Chi. 84/12) MALA PAREEKSHA The elimination of digestive waste products from the body is a regulation procedure to keep the system Healthy and the excreted waste products are known as pureesha or mala. Vata prakopa- Krishna varna, hard , dry. Pitta prakopa – asitha varna, alohitha varna Kapha prakopa- sitha varna, PUREESHA is vibhanda in poorva roopa of atisara, arsa, udara, jwara. Kaphaja atisara – durgandhayktha Pittaja atisara- visra gandha Ama atisara- ama gandha yuktha SHABDHA PAREEKSHA Abnormal sounds are usually found in conditions like swasa , kasa, hikka, asthibhanga, anthrax koojana, etc. In case of kaphaja vikara voice becomes guru. In case of pittaja vikara, voice becomessputa.
SPARSHA PAREEKSHA In pittaja rogii ushna is perceived Vata rogii- sheetala sparsha. Kapha rogi aardra sparsha.
DRIK PAREEKSHA In aggravation of vata, eyes become duuma, aruna, rooksha, neela, chanjalya…
In pittaja aggravated condition, - haridra, raktha, malina, dahayuktha etc. In kaphaja eye disorders – swetha , dhavala, snigda, kanduyuktha.
AKRITHI PAREEKSHA The judgement of ones disease status by the examination of ones body features.
DHASAVIDHAVPAREEKSHA One must examine the patient with reference to prakruti, vikruti, sara, samhanana, pramana, satmya, satwa, aahara sakthi, vyayama sakthi and vaya, to avoid fallacies in chikitsa(C. vi. 8/94) PRAKRUTHI- it is defined as the dosa avastha which will remain stable during ones lifespan without any change. Its manifestation is not depended on the nidana. May be produced by adrista. The factors influencing, the formation of formation of prakruti are the nature of sukra and shonita, ahara and vihara of mother during garbhavasta, and nature of garbasaya.
There are seven types of prakruti which are vata, pitta, kapha, dvandvaja and samadosha prakrutii. The samadosha is ideal one.
VIKRUTI(c. vi.8/101) It involves the examination of morbid manifestation with reference to specific hetu , dosha, and dhatu involved in samprapthi, prakruti, desa, kala, By the enumeration of vikruthi , charaka has open the door to the roga pareeksha.
SARA(c.vi.8/102) The term sara signifies the purest form of the dhatu, The 8 types of sara are enumerated to determine the bala of the individual One should examine the individual with reference to his saratha, The successive sara purusha are comparatively superior Thus the satwa sara is the superior and sarva sara lakshana is considered as best. The sara purushas are tvak sara, raktha sara, mamsa sara, medho sara, asthi sara, majja sara, sukra sara, satva sara, sarva sara.
Samhanan(c.vi.8/116) It means the compactness of the body Samhati and samyojana are used as synonyms.
This is characterized by symmetrical, well developed and divided bones, compact joins, well bound muscles and blood. The individual having well compact body, will be best owed with strength and one who is having least compactness will be weak and in moderate compactness. Person will be moderately strong.
PRAMANA(c.vi.8/117) Examination of measurement of body parts,
SATMYA(c.vi.8/118) The wholesomeness developed by habits, which result in the conduciveness to the health. It is termed as Oka satmya.
SATVA(c.vi.8/119) It refers to mind and it regulates the body due to its association with the soul. Depending upon the the strength, it is of three types, i.e pravaara, madyama, and avara.
AHARA SAKTHI(c.vi.8/120) The capacity of food intake , this corresponds to digestive capacity. The intake of food and there digestive capacity is examined as they are the determing factors of bala and ayu.
VYAYAMA SAKTHI(c.vi.8/121) The capacity for exercise of a patient. It is determined by ones capacity to do a work. The three types of bala are inferred through the ability of person to perform work. VAYA(c.vi.8/122) It refers to the state of body with refers to the kala, duration expanded from birth of individual. It can be classified into bala, madya and jeerna. Acc. to vagbhata acharya , for the pareeeksha of rogii, dasa viddha pareeksha is explained in dosha bediya adyaya of a. s 12/66. DOOSHYA- elements including dhatu, upadhatuand mala. DESHA- patients body and nature of area in which patient resides. BALA – trividha bala. KALA- refers to temporary factors, should undererstood on the basis of vyadhi and rogi ANALAM – functioning of jataragni, PRAKRUTI- ones own body constitution SATVA- refers to mind, helps to evaluate intensity of disease of disease SATMYA- habits VAYA- Age AHARA-Dietary regiments.
