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Patient Examination – Rogi Pariksha

Shanti Gowans
Clinical examination of the disease and its condition (roga) and the diseased (rogi) together form the basis of a comprehensive protocol of examination and are critical for comprehensive treatment to be planned and administered.

The constitution of a person from conception is known as Prakruti. It is the balanced state, or state of health for a person.

The imbalanced state is known as a person’s Vikruti.  The cause and subsequent development of an abnormal condition or of a disease in medicine is known as etiopathogenesis (plural etiopathogeneses), from the words: etiology + pathogenesis.
etiology: the science of finding causes and origins (of a disease)
pathogenesis: the production or development of a disease
For an acurate assessment, you need to differentiate between a person’s constitution from conception (prakruti), and their current state (vikruti).

The systems and channels in the body, known as srotas also need to be assessed. This is known as srota pariksha.

This article is about examination of a patient. There are many tools and ways for assessment in Ayurvedic practice, in which examination of a patient, or Rogi Pariksha is conducted in Ayurveda.
Then the patient can be assisted and brought back to balance for them, which in Ayurveda is their constitution at conception, their prakruti. They can also be educated about preventing illness by understanding their constitution and living in accord with its parameters.

• Dwividhya Pariksha is two fold assessment. It includes:
– that which is seen and perceived by the doctor directly, pratyaksha
– inference, anumana

• Trividhya Pariksha is a three step assessment. It includes:
– inspection, darshana.  Darshan is a way of seeing, and a blessing. It is observing things as they are, without judgement or comparison. The Ayurvedic practitioner must develop ‘darshan’.
– Touch, palpation, percussion, auscultation or by feeling the diseased area, sparshana.
– Questioning and interrogating the patient, prashna.

• Chaturvidhya Pariksha is four fold assessment
– that which is seen and perceived by the doctor directly, pratyaksha
– inference, anumana
– Application of knowledge learnt through the science (shastra) and teachings,aptopadesha
– Situational application of wisdom and knowledge, yukti.

• Shadvidhya Pariksha is six step assessment
– Examination by seeing/inspection, chakshurindriya dwara pariksha
– Examination through smelling, ghranendriya dwara pariksha
– Examination through hearing, shravanendriya dwara pariksha
– Examination through taste, jihvendriya dwara pariksha
– Examination through touch, sparshanendriya dwara pariksha
– Interrogation, prashna pariksha

• Ashtavidhya Pariksha is eight step assessment, and includes examination of
– Pulse, nadi
– Tongue, jihva
– Eyes, netra or drik
– Stool, mala
– Urine, mutra
– Voice, sabda
– Skin, twak, touch, sparsha
– Structure, build, gait, decubits, akriti

• Dasavidha Pariksha is ten step assessment. You must ascertain:
– The basic constitution (the physical and mental makeup) of the patient acquired at birth. This is known as their prakruti.
– The changes occurring in the patient’s basic constitution, together with various changes taking place in different parts of the body or mind or both in relation to their basic constitution. This is known as the patient’s vikruti. Vikruti is the abnormal deviation or imbalances of their Prakruti.
– The essence of the tissues, status, quality and quantity etc. This is known as sara.
– The compactness of the body, samhanana.
– The measurements and dimensions of the body parts and components (anthropometry) to differentiate between normal and abnormal mathematics of the body. This is known as pramama.
– The compatabilities related to the patient and wholesomeness developed by habits which result in suitability and are conducive to the health of that patient (homologation). This is known as satmya.
– The psyche and mental parameters, such as the mental strength, tolerance levels, emotions and moods of the patient. This is known as satva.
– The patient’s capacity regarding food intake, such as appetite, digestion and metabolic capacity. This is known as Ahara shakti.
– The exercise capacity and tolerance of the patient. This is known as vyama shakti.
– The age of the patient,vaya.
– The physical build, strength and immunity of the patient. This is known as Bala. Their endurance, compactness and stamina will need to be factored in too