Ashtastana pariksha

Clinical Aspects ofClinical Aspects of
Ashtasthana Pariksha
inin
Ayurmitra Nadi Bhishak
Prof KSR Prasad (Technoayurveda)Prof. KSR Prasad (Technoayurveda)
Guest Lecture @ RRAMCH, Humnabad, Karnataka
On 27‐07‐2020On 27‐07‐2020
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com/

I d i
Clinical aspects of Ashtasthana Pariksha
Introduction
• The disease diagnosis is the foremost activity
h i h i h diwhen ever a patient approaches with disease
• The identification of the nature of an illness or
other problem by examination of the
symptoms is diagnosis
• In medicine we do medical diagnosis
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com/ 33

M di l di i
Medical diagnosis
• Medical diagnosis (abbreviated Dx or DS) is the ed ca d ag os s (abb e ated o S) s t e
process of determining which disease or
condition explains a person's symptoms and
signs.
• It is most often referred to as diagnosis with
th di l t t b i i li itthe medical context being implicit.
• This diagnosis is – Clinical, Instrumental,
Radiological Biochemical etcRadiological, Biochemical, etc.
• Ayurveda speaks different levels diagnostic
methods such as – 10 vidha 8 vidha etcmethods such as 10 vidha, 8 vidha, etc.

Name of Method Folds in Examination
1 Dwividha Pariksha Pratyaksha, Anumana
2 Trividha Pariksha Darshana, Sparshana, Prashna
3 Panchvidha Pariksha Panchendriya
4 Shadvidha Pariksha Panchendriya , Prashna
5 Ashtavidha Pariksha Nadi, Mutra, Mala, Jihwa,
Shabda, Sparsha, Drik, Akruti
6 Dashavidha Pariksha Prakruti, Vikruti, Sara,
S h S t S tSamvahana, Satmya, Satwa,
Pramana, Vaya, Vyayamashakti,
Aharashakti
Aharashakti

E i ti
Examination
• Ayurveda follows the ways of diagnosingAyurveda follows the ways of diagnosing
disease and bring back to Normalcy
• Proper clinical examination facilitates correct• Proper clinical examination facilitates correct
diagnosis
Di i d f di b d• Diagnosis and treatment of diseases are based
on the information derived from two areas:
– Examination of the Patient (Rogi pariksha)
– Examination of the Disease (Roga pariksha)

A h h P ik h
Ashtasthana Pariksha
Yogaratnakara has advocated Eightfold Examination ‐g g
Ashtavidha Pariksha of a patient.
1. Naadi Pariksha (Pulse)
2 M P ik h (U i )2. Mootra Pariksha (Urine)
3. Mala Pariksha (Stool)
4 Jiwha Pariksha (Tongue)4. Jiwha Pariksha (Tongue)
5. Shabda Pariksha (Voice and speech of the patient)
6. Sparsha Pariksha (Touch, skin, and tactile sense)p ( , , )
7. Druk Pariksha (Eyes and Vision)
8. Akriti Pariksha (General body build)

1 N di P ik h
1. Nadi Pariksha
• Nadi Pariksha is very old ayurvedic techniqueNadi Pariksha is very old ayurvedic technique
of diagnosis available more than 2500 years
• Nadi precisely can diagnose Dosha, Mind,Nadi precisely can diagnose Dosha, Mind,
emotional imbalances and diseases.
• Nadi is observed from Jeevasakshini atNadi is observed from Jeevasakshini at
Karamoola (Wrist) with 3 fingers
• The strength, rhythm, speed, and quality ofThe strength, rhythm, speed, and quality of
the pulse are examined to reach the
conclusion.

N di T
Nadi Types
• Nadi is referred to two impulsesNadi is referred to two impulses
– The first one is Nerve generated electrical
impulses from Ida, Pingala and Sushumna
– The second is Hemodynamic generated blood
wave in the radial artery
• The Messenger pulse or Doota nadi is also in
practice
• The pulse have impact of food ingestion,
seasons, and circadian rhythms

N di i i
Nadi examination
• Nadi pariksha is done by Index Middle andNadi pariksha is done by Index, Middle and
Ring finger – they represent Vata, Pitta and
KaphaKapha
• We need to observe

Depth identification
Depth identification

Jeeva Sakshini
Jeeva Sakshini

Pulse wave Interpretation
Pulse wave Interpretation
a,b,c,d,e wave of five component
a
b c
e
a,b,c,d,e wave of five component
Vruddhatara Dosha or +2
Vruddha Dosha or +1
d
Baseline
Heena Dosha or ‐1
Heenatama Dosha or ‐2
b

E l f N di
Example of Nadi
• Normal Rakta = Guru UhnaNormal Rakta = Guru, Uhna
• Ama Rakta = Guru, Manda
k h G h• Rakta Dosha = Guru, Khara
• Rakta Dushti = Guru, Deergham, Dhruta,
Vegavati
• Many Nadi courses are offered like Basic Nadi, y ,
TANTU Nadi, Sankhya Nadi, Nakshtra Nadi,
Agastya Nadi, etcg y ,

N di i di
Nadi in mor diseases
• Vata Rakta = Sthira Nischala Krusha KruraVata Rakta = Sthira, Nischala, Krusha, Krura
• Grudhrasi = Sthula, Manda, Vakragamini
d i h hil G bhi• Amavata = Manda, Pichchila, Gambhira,
Sphutita, Vikampini
• Granthi = Sukshma, Shushka, Manda,
Vishirnagamana
• Gulma = Vikampini, Paravatagati

2 M ik h
2. Mutra pariksha
• The urine examination in Ayurveda is veryThe urine examination in Ayurveda is very
wide
• Many qualities and parameters are used to• Many qualities and parameters are used to
examine urine and in Pameha many diseases
are diagnosed on the same basisare diagnosed on the same basis
– Sandra, Sandra Prasada, Sikata, Sukla, Ushna
f• Ayurveda measuring temperature, specific
gravity etc.

T il bi d ik h
Taila bindu pariksha
• Urine collected in a round low bottom vessel and
a drop of oil is dropped in the collected urine very
lightly with the help of grass (truna).
• As oil is lighter than urine oil spreads over the• As oil is lighter than urine, oil spreads over the
urine.
• Observations & conclusions are made on theObservations & conclusions are made on the
basis of direction, shape & speed of spreading of
oil drop.
S ( k h ) V t– Sarpa (snake shape) Vata
– Chhatra (Mushroom shape) Pitta
– Muktaa (free shape) Kapha ( p ) p

T il bi d I f
Tailabindu Inference
• Direction CurablenessDirection Curableness
• East Sighramsukhi (Early curable)
• South Kramen sadhyam ( bl b )• South Kramen sadhyam (curable step by step)
• North Curable (arogita samprajayate)
• West Sukha Aarogya (Health &Pleasure)
• North‐East masen nashyati (Must die in 1 month)
• South‐East Maranam (Must die)
• South‐West Maranam (Must die) ( )

Ch i i d d h
Changes in urine due to doshas
• Color & Physical appearance Vitiated Dosha y pp
• Pandur (pale), Nila, Ruksha Vata
• Rakta, Pita, Aruna (reddish) Pitta
• Snigdha, Safena, Pallava varitulya Kapha
• Shweta, Budbudabham Vata‐Kapha
• Kalusha, Sarakta Kapha‐Pitta
• Dhumrajalabha, Ushna Pitta‐Vata
K i h Mi h S i t• Krishna, Mishra varna Sannipata
• Snigdha, Ushna, Rakta Rakta

h i i d i di i
Changes in urine due to Disease condition
• Tandula toyavat AjrnaTandula toyavat Ajrna
• Dhumra varna, Bahumutra Nava jwara
h• Bahumutra Amavata
• Asruk sadrusha (like blood), pita Jirna jwara
• Rakta, Pita Kamala
• Pita Sarakta Pittaja MutrakruchchhaPita, Sarakta Pittaja Mutrakruchchha
• Sapichchha Kaphaja Mutrakruchchha

3 M l P ik h
3. Mala Pariksha
• Direct examination of the fecal matter by theDirect examination of the fecal matter by the
naked eye can tell a lot about the digestive
state of the body.
• The colour, consistency, floating nature, smell,
presence of blood or mucus in stool gives a lot
of information about various dosha
imbalances or diseases
• Saama Nirama condition of the feces is noted
specifically in Ayurveda

J l Ni jj P i h P ik h
Jala Nimajjana Purisha Pariksha
• A specialized technique of stool examinationA specialized technique of stool examination,
is conducted to detect the presence of Ama
thereby inferring the status of Agnithereby inferring the status of Agni
• If stool sinks in water it has ama dosha and if
not then it is normalnot then it is normal.

4 Jih ik h
4. Jihwa pariksha
• The colour shape coating of aThe colour, shape, coating of a
tongue can be indicative of many
digestive abnormalitiesdigestive abnormalities.
• Commonly we observe only sama
nirama conditionnirama condition
• But the exclusive tongue diagnosis
b d Chi dcan be made – Chinese made a
special efforts for it

5 Sh bd P ik h
5. Shabda Pariksha
• This have a contradiction and confusionThis have a contradiction and confusion
• Many say that it is the sounds which we have
to feel from the patient like intestinal garglingto feel from the patient like intestinal gargling,
Heart sounds, Plural rub, cripitus etc.
O h h h i i i b• Others say that the patient voice is to be
evaluated as Deena, Gadagada, Kaphachada,
etc.
• Both are appreciable

6 S h P ik h
6. Sparsha Pariksha
• The tactile perception or touch reveals manyThe tactile perception or touch reveals many
aspects
• Cold, hot, smooth, rough, soft, hardCold, hot, smooth, rough, soft, hard
perceptions, fever, edema etc. should be
examined through tactile perception.
• Skin is –
– moist/wet in Kapha diseases, / p ,
– Hot in Pittaja and
– rough and cold in Vataja disorders

7 D k P ik h
7. Druk Pariksha
• Different types of eye features may reflect theDifferent types of eye features may reflect the
personality of a person as well as the state of
his healthhis health.
• The colour of the sclera, conjunctiva, size of eyeball,
shape, and the area around the eyes give insight intoshape, and the area around the eyes give insight into
various serious metabolic diseases.

D h i Ak hi
Dosha in Akshi
• If your body is dominated by the Vata then theIf your body is dominated by the Vata then the
eyes look sunken, dry and smoky.
• On aggravation of Pitta eyes appear red or• On aggravation of Pitta, eyes appear red or
yellow in colour and the patient suffers from
photophobia and burning sensationsphotophobia and burning sensations.
• Kapha predominance eyes appear wet,
l l d d i f llusterless and watery and a patient may feel
heaviness in the eyelids.

Di b d i E
Diseases observed in Eye
• Prominent/bulging eyes can be a symptom ofProminent/bulging eyes can be a symptom of
thyrotoxicosis,
• Yellow conjunctiva can be seen in case of• Yellow conjunctiva can be seen in case of
weak liver or jaundice,
i hi i d i i• prominent white ring around iris represents
joint degeneration with a probability of
h i iarthritis

8 Ak i i P ik h
8. Akriti Pariksha
Examination of Akruti include Diagnosis of hair, nails and g ,
other body organs can reveal many signs which point
towards different diseases.
K h liti h il ki ll b ilt b d d• Kapha personalities have oily skin, well‐built body and
joints, tolerance to hunger, thirst, hardship, hot sun.
• Pittaja personalities have strong appetite and thirst,Pittaja personalities have strong appetite and thirst,
fair complexion, they are brave, bold and egoistic and
less hair.
• Vataj personalities are prone to many diseases and
have split hairs and dry skin with Dhusara Varna, and
they dislike cold things and atmosphere.they dislike cold things and atmosphere.

G i i i
Gait examination
• The gait will play a big role in AkrutiThe gait will play a big role in Akruti
examination – The method of examination is ‐
• a Initial contact (heel strike)• a. Initial contact (heel strike)
b. Load response (foot flat)
c Mid stance (single leg stance)c. Mid‐stance (single leg stance)
d. Push off:
T i l (h l ff)• Terminal stance (heel off)
• Pre swing (toe off)

G i l
Gait cycle

G i A l i
Gait Analysis
1. Pelvic tilt: Normally, iliac crest on the side of swing leg drops
appro imatel 5º belo hori ontal at mid stance of opposite legapproximately 5º below horizontal at mid‐stance of opposite leg
2. Pelvic rotation: Normally, during swing phase, pelvis on ipsilateral side
rotates 4º anteriorly and the pelvis rotates 4º posteriorly on opposite
side
3. Lateral tilt: Normally, during stance phase, pelvis and trunk shifts 1 inch
towards the stance phase legp g
4. Width of base (horizontal distance between 2 feet during double
support): Normally, 2‐4 inches wide
5 St id l th (di t b t 2 ti h l t ik f th5. Stride length (distance between 2 consecutive heel strikes of the same
foot): Equal for both legs
6. Step length (distance between heel strike of one foot to the heel strike
of another foot: Equal for both legs

M G i
Many Gaits
• 1st row (from left to right):( g )
• Scissoring gait,
• Ataxic gaitAtaxic gait,
• Circumduction gait
2nd row (from left to right): ( g )
• Gluteus maximus gait,
• Steppage gaitSteppage gait,
• Trendelenburg gait

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