What is diagnosis in Ayurveda?

What is diagnosis in Ayurveda? It is more than understanding which dosha is causing the problem.

Note that there are two types of diagnose in Ayurveda:
 Determining the constitution or birth type of the person (prakriti pariksha)
 Determining the imbalance or disease of the person (vikriti pariksha)

Diagnosis (vikriti pariksha) is a question of understanding where the dosha is moving to, which pathway it is using and if it is mixed with mala (waste) or ama (non-digested food).

The study of diagnosis in Ayurveda is understanding the pathology of DOSHA, DHATU, MALA and their combination with ama, if it is present. Diagnosis is both a science and an art. Failure to recognize the logical progression of dosha will lead to failure in diagnosis as will the incapacity to understand the patient and their SATMYA. Dosha increase or decrease is one aspect, failure of the doctor to not understand their patient is a question of Satmya and will prevent the pathology from being understood.

The biggest misunderstanding I find when teaching is that people do not recognize that diagnosis in Ayurveda is based on a very logical and scientific methodology. Ayurveda uses three methods to get a broad approach to understanding the patient.

Vikriti Pariksha or Diagnosis consists of three steps:
1. Questioning (Prashnana)
2. Observation (Darshana)
3. Touch (Sparshana)

Each of the three methods is equally important! One is not more important that another.

All forms of diagnosis can be fit into these three categories. For example, a blood test is just another form of observation. Most modern tests combine some form of touch to receive the data that is then observed – thus, observation of the data is the diagnostic goal.

Ayurveda is open to all data that helps give a larger view of what is happening to the patient. It is important to put all clinical data from modern sources under the function of Doshas rather than using it to draw conclusions separate from the Ayurvedic data. For example, blood analysis that indicates hormone imbalances can show that there is a problem with the function of either Majja or Shukra Dhatu. Excessive levels would tend to show Kapha problems and deficient or varying levels Vata problems and that overall both Dhatus are controlled by Kapha indicating some possible problem with Kapha. Pitta could also be implicated through poor liver function which filters and regulates hormones; or Pitta could create an inflammatory environment that causes either an insufficiency or excess of hormones.

The main problem beginners have is that they are impressed by practitioners that "seem" to have "magic" powers of diagnosis. Of course the pulse diagnosis - which is totally subjective - is open the the most mystical side of Ayurvedic diagnosis. People are also quick to exploit this as well. Pulse or Nadi Pariksha is classified as one of the methods of touch or Sparshana in Ayurvedic diagnosis. It should not be given more importance than any other method of diagnosis - even other forms of touch.

The most important factor when taking pulse is knowing that each Dosha is responsible for its own set of functions that allow the body to operate. Each finger placement is showing us the functions of each Dosha in a general way and each level of the pulse shows us those functions in a specific way. You must have a very good understanding of Ayurvedic anatomy and physiology and to have memorized dosha functions. Doshas always express their normal set of gunas! If these have been memorized then it will come clear to you with time and practice.

The best way to learn the characteristics of any imbalance is to take the pulse of the person when they are sick. For example, taking the pulse of 10 people with bronchitis will give you the characteristics of bronchitis for any kind of Prakriti. Imagine taking 100 or 1000 pulses of people with bronchitis after which you would be able to identify anybody with all the different forms of bronchitis. Taking the pulse is like this example – it has more to do with practice than with any special skill. The same thing is true with any kind of problem such as premenstrual pain, diverticulitis, constipation or anything else. Therefore, in conclusion, the most important thing to remember about pulse diagnosis is to practice!

The most important factor overall in diagnosis is to give 33% importance to Questioning (Prashnana); 33% importance to Observation (Darshana); and 33% importance to Touch (Sparshana). It is the synthesis of these three methods that will give a real diagnosis that will establish a real therapeutic goal and help you - the practitioner - to give a real treatment protocol to help the patient.

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 Ayurvedic Medicine for Westerners series of textbooks

Application of Ayurvedic Treatments Throughout Life (Volume 5)

Dravyaguna for Westerners (Volume 4)

Clinical Protocols and Treatments in Ayurveda (Volume 3)

Pathology & Diagnosis in Ayurveda (Volume 2)

Anatomy and Physiology in Ayurveda (Volume 1)