Methods to Assay the Causes of a Disease

(iv) Yukti (Reason):

‘Yukti’ means intellect or reason or understanding of an object. It is an experimental confirmation. It is defined as the knowledge of intellectual perceptions or understanding of an object or event which sees the things produced as a consequence of a combination of multiple causative factors, valid in the three known time phases (past, present and future) and is also helpful to achieve the three objects or goals of life (virtue, wealth and lust) is known as ‘yukti’ (reasoning). Just as the growth of crops depends on the combination of several factors such as water, ploughing, seed and season, so is yukti (reason) a rational and fruitful combination of all constituent factors. These four means of pramana (gain in knowledge), based on yukti (reasoning) helps to alleviate diseases if combined and used rationally. The essential factor in the successful treatment of a disease is ‘yukti’ (reasoning).

(B) Examination by Interrogation):

If physicians do not get accurate information through inference, then they can gather the information from the patient by questioning. It is known as examination by interrogation. The following information can be obtained by taking the history of a patient: their likes and dislikes of food, favourite food according to taste; types of dreams in sleep, type of sleep; nature of bowel movements (mild, medium or hard); causes of disease, location of pain, increasing or decreasing time of disease intensity, favorable or unfavorable conditions, information about excretion of feces, urine, flatus; age and birth place of a patient.

On the basis of these pramana, a physician can examine the patient rationally. If a physician is not able to examine the patient properly, if he is unable to gather perceptions by sensory organs, and if he gets wrong answers while interrogating, then as a result, due to improper reasoning, a physician is unable to rationally confirm the disease. When all these facts do not allow the physician to define the nature of a disease, the physician gets confused. Due to a wrong diagnosis, the treatment of a disease can be misguided and not ascertained.

The examinations involved in the above perception, inference and so on can briefly be divided into the following six ways.

1. Ausculatory examination by means of ears (The act of hearing): To ausculcate the gurgling sound of the intestines, heartbeat and 2. so Tactileon. examination by means of skin (The act of touch): From coolness, warmth, hardness, touching the wounds, acne and by pulse examination, a physician can obtain the knowledge of disease.

3. Ophthalmic examination by means of eyes (The act of vision): Examining the disease by observing patients body color, complexion, splendour, sustenance, weakness or emaciation.

4. Gustatory examination by means of tongue (The act of taste): Examining the taste through inference or hypothesis.

5. Olfactory examination by means of nose (The act of smell): By the odor of the body and different organs, odor from wounds or abscesses. For example, body odor or pungent smell from sweat helps to examine the disease.

6. Disease examination by interrogation: By asking questions to the patient or their family and taking the history of a patient. By means of these pramanas (valid knowledge), a physician can completely examine and diagnose a disease and can prescribe an effective treatment and attain success in his work.

Different Methods of Disease Examination

Besides examining the disease on the basis of ‘pramana,’ Ayurveda describes different methods for appropriate and accurate diagnosis, including:

(A) Nidana Pancaka (The Five Signs of Diagnosis): This includes the etiology, preliminary symptoms, manifested symptoms, exploratory therapy and pathogenesis.

(B) Satkriyakala (The Six Stages of Manifestation of Disease): Due to different seasons and varying climatic conditions throughout the world, diseases occur due to the vitiation of dosas. For the correct diagnosis and right treatment of the vicious disease cycle, proper understanding of the stages of disease manifestation is necessary. These six stages, which include accumulation, aggravation, dissemination of dosa, site of manifestation, symptom manifestation and differentiation and chronicity of a disease require specific management of the disorder.

(C) Astavidha Parikisa (The Eight Ayurvedic Methods of Disease Examination): The diagnosis of a disease on the basis of dosa, identification of the nature of disease, whether curable or incurable, including pulse examination and other examination methods is Astavidha Pariksa. They are elaborated as follows:

(A) Nidana Pancaka: The Five Signs of Diagnosis

On the basis of ‘Pramana,’ a physician examines a disease and gathers knowledge about its nature. If a physician acquires accurate information regarding the nature of the disease, its type and the cause of aggravation or the place of origin (dosas, dhatus, malas, srotas and agni), then the acquired knowledge is more than enough for the appropriate line of treatment at the first instance based on Ayurvedic norms. After this information, a physician needs to examine the following factors.

(i) Etiology (Causes of disease)

(ii) Preliminary symptoms (Those that occur before the onset of a disease)

(iii) Manifest symptoms (Actual signs of a disease)

(iv) Exploratory therapy or Therapeutic suitability (Using medicines, a diet and lifestyle that oppose the disease and its causes)

(v) Pathogenesis (Appearance of a disease)

These are collectively termed ‘Nidana Pancaka’ a group of five signs for the diagnosis of a disease. At the initial stage, none of the diseases becomes clearly apparent. First of all, there is a deep relationship between the cause of the disease and the body.

Later on, as a result of these causes, some preliminary signs or changes are manifest, by which a skilled physician can infer about a disease that will occur. Then steadily, specific symptoms of the disease are manifest differently. At this stage, disease spreads in different ways throughout the body. On this basis, information about the disease is obtained.

(Excerpted from the book ‘ A Practical Approach To Th Science Of Ayurveda: A Comprehensive Guide For Healthy Living’ authored by Acharya Balkrishna)