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Line 404: − + − + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − Charak has described the entire clinical examination in this chapter. There is no fourth tool required for clinical examination except ''aptopadesha, pratyaksha'' and ''anumana''. In [[Ayurveda]], emphasis is given to the use of the five senses in examining a patient. First hand information gathered through the physical examination by five senses is critical to the process of diagnosis. These three types of examinations are also used to assess bad prognosis of the disease and to identify the ''arishta'' (signs and symptoms of imminent death) also. [Cha.Sa. [[Indriya Sthana]] 1/4] − Examinations like inspection, palpation, percussion and auscultation are part of ''pratyaksha pariksha''. Nowadays, various new techniques like X-ray, USG, CT Scan, MRI etc. are in use that help augment ''pratyaksha pariksha''. Abnormal findings suggest the underlying pathologies in the body with the use of ''anumana pariksha''. But over-dependence on technology has made the doctors move away from the use of their sensory perception and from prima facie clinical diagnosis. Excessive use of technology makes the process of diagnosis more complicated, costly and time consuming. The most important disadvantage of using technology is that it is reducing the use of logic and reasoning (''yukti'') by a physician. It also has influence on the doctor patient relationship. The most important thing which has been described by Charak is to enter in to the soul of the patient to make correct diagnosis and is somewhere missing due to excessive use of technology. Proper use of ''trividha pariksha'' by a physician with required use of technology, will help him to reach up to the diagnosis immediately, correctly and will also be cost effective to the patient.
Trividha Roga Vishesha Vijnaniya Vimana (view source)
Revision as of 11:26, 2 September 2020
, 11:26, 2 September 2020→Vidhi Vimarsha (Applied Inferences)
The experience based knowledge by authorities (aptopadesha) gives all the details of the disease i.e. its causative factors, pathogenesis and treatment and thus, provides all the theoretical knowledge of the disease which is helpful during clinical examination.
The experience based knowledge by authorities (aptopadesha) gives all the details of the disease i.e. its causative factors, pathogenesis and treatment and thus, provides all the theoretical knowledge of the disease which is helpful during clinical examination.
==== Direct observation (Pratyaksha) ====
==== Direct perception (Pratyaksha) ====
Knowledge by direct observation (pratyaksha) deals with direct examination of the patient by the physician. The physician has to use all his senses during the examination, in which he has to look for various signs and symptoms, changes in the color etc. Any information collected through ''anumana'' and ''pratyaksha'' cannot provide all the details of existing pathologies in the body. Now the physician has to use his own intellect and tries to establish the relation between the signs and symptoms and the likely pathologies in the body. He has to use his logic and reasoning and apply it properly in finalizing the vitiated ''doshas'' in the body. ''Anumana'' helps the physician to deduce and draw inferences where it is not possible to visualize or see, in order to draw certain conclusions or understand causation of an ailment.
Knowledge by direct perception (pratyaksha) deals with direct examination of the patient by the physician. The physician has to use all his senses during the examination, in which he has to look for various signs and symptoms, changes in the color etc. Any information collected through inference (anumana) and direct perception (pratyaksha) provide only limited details of existing pathologies in the body. Now the physician has to use his own intellect and tries to establish the relation between the signs and symptoms and the likely pathologies in the body. He has to use his logic and reasoning and apply it properly in finalizing the vitiated [[dosha]] in the body.
==== Inference ====
Inference (anumana) helps the physician to deduce and draw inferences, where it is not possible to visualize or see, in order to draw certain conclusions or understand causation of an ailment.
The methods of clinical examination are comprehensively described in this chapter. In [[Ayurveda]], emphasis is given to the use of the five senses in examining a patient. First hand information gathered through the physical examination by five senses is critical to the process of diagnosis. These three types of examinations are also used to assess bad prognosis of the disease and to identify the [[arishta]] (signs and symptoms of imminent death) also. [Cha.Sa. [[Indriya Sthana]] 1/4]
=== Updates from Ayurveda texts ===
In other texts of Ayurveda, various references of one type, two types, three types, four types, six types, eight types, ten types, eleven types, and twelve types of examination of the patient are described. Some important are as given below:
i)In Sushruta samhita,three fold like inspection(darshana), palpation (sparshana) and interrogation (prashana) are described. Six fold examination (5 sense (indriya) and interrogation (prashana pareeksha)) is also described.
ii)Yogaratnakar text describes eight fold examination viz. pulse(nadi), bowel habit/stool examination (mala), urine examination (mutra), tongue (jihwa), sound (shabda), touch (sparsha), sight (drik) and features (akriti). This is widely used in general examination of the patient.
=== Contemporary methods ===
Examinations like inspection, palpation, percussion and auscultation are part of direct perception (pratyaksha pariksha). Nowadays, various new techniques like X-ray, USG, CT Scan, MRI etc. are in use that augment direct perception. Abnormal findings suggest the underlying pathologies in the body with the use of inference (anumana pariksha). But over-dependence on technology has made the doctors move away from the use of their sensory perception and from prima facie clinical diagnosis. Excessive use of technology makes the process of diagnosis more complicated, costly and time consuming. The most important disadvantage of using technology is that it is reducing the use of logic and reasoning ([[yukti]]) by a physician. It also has influence on the doctor patient relationship. The most important thing which has been described is to perceive in to the soul of the patient to make correct diagnosis and is somewhere missing due to excessive use of technology. Proper use of the three types (trividha pariksha) by a physician with required use of technology, will help him to reach up to the diagnosis immediately, correctly and will also be cost effective to the patient.
=== Principles of knowledge of new diseases (anukta vyadhi) ===
The disease which are not described in the Ayurveda texts or newly introduced disease can be identified by applying the principles described in this chapter. It can be applied for knowing the complete details of the newer diseases including treatment.
=== Fundamental principles of clinical research ===
This chapter also mentions fundamental principles of clinical research. The methods of diagnosis of disease and examination of patient can be applied in clinical research.
=== Scope of further research ===
There is a wide scope of research on the following topics and concepts described in this chapter:
# Principle of Clinical Research in Ayurveda
# Clinical Diagnosis in Ayurveda
# Principle of development of tools for examination of the patients
# Principle of detailed description of newer/unknown diseases
=== Related chapters ===
[[Tistraishaniya Adhyaya]] , [[Rogabhishagjitiya Vimana]]
== Further reading ==
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