Changes

=== Tattva ===

=== Tattva ===

• Diagnosis of a disease should be done thoroughly using the trividha pariksha consisting of aptopadesha (authoritative knowledge), pratyaksha (physical examination) and anumana (interpretation, evaluation and assessment).

* Diagnosis of a disease should be done thoroughly using the trividha pariksha consisting of aptopadesha (authoritative knowledge), pratyaksha (physical examination) and anumana (interpretation, evaluation and assessment).

Vidhi Vimarsha:

 

=== Vidhi Vimarsha ===

 

Trividharogavisheshavijnaniyam solely deals with the methods of clinical examination of the patient. Various types of examinations viz. rogapariksha, rogipariksha, trividha pariksha, shadvidha pariksha, ashtavidha pariksha, dashavidha pariksha are described in Ayurveda for the examination of the patient and the diagnosis of the disease. All these examinations do not go beyond the trividha pariksha described in this chapter. 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. 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 colour 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.  

Trividharogavisheshavijnaniyam solely deals with the methods of clinical examination of the patient. Various types of examinations viz. rogapariksha, rogipariksha, trividha pariksha, shadvidha pariksha, ashtavidha pariksha, dashavidha pariksha are described in Ayurveda for the examination of the patient and the diagnosis of the disease. All these examinations do not go beyond the trividha pariksha described in this chapter. 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. 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 colour 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.  

Acharya Charaka 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. [8]   

 

Charaka 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. [8]   

 

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 Acharya Charaka 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.

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 Acharya Charaka 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.

1. Agnivesha, Charaka, Dridhabala, Charaka Samhita Sutrasthana Adhyaya 11/17, Edited by Jadavaji Trikamji, Fifth Edition, Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 70.

1. Agnivesha, Charaka, Dridhabala, Charaka Samhita Sutrasthana Adhyaya 11/17, Edited by Jadavaji Trikamji, Fifth Edition, Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 70.

2. Agnivesha, Charaka, Dridhabala, Charaka Samhita Vimanasthana Adhyaya 4/3, Edited by Jadavaji Trikamji, Fifth Edition, Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 247.

2. Agnivesha, Charaka, Dridhabala, Charaka Samhita Vimanasthana Adhyaya 4/3, Edited by Jadavaji Trikamji, Fifth Edition, Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 247.

9. Agnivesha, Charaka, Dridhabala, Charaka Samhita Sutrasthana Adhyaya 10/8, Edited by Jadavaji Trikamji, Fifth Edition, Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 66.

9. Agnivesha, Charaka, Dridhabala, Charaka Samhita Sutrasthana Adhyaya 10/8, Edited by Jadavaji Trikamji, Fifth Edition, Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 66.

Glossary

=== Glossary ===

List of Technical Terms

 

==== List of Technical Terms ====

 

1. āptōpadēśaḥ (AptopadeshaH; आप्तोपदेशः ): The unimpeachable truth of enlightened men;  

1. āptōpadēśaḥ (AptopadeshaH; आप्तोपदेशः ): The unimpeachable truth of enlightened men;  

             the 1st proof of justifying knowledge  

             the 1st proof of justifying knowledge  

unseen facts is inferred on the basis of direct observation  

unseen facts is inferred on the basis of direct observation  

4. parīkṣa (parīkṣā, परीक्षा  ): investigation or examinations which leads to correct knowledge  

4. parīkṣa (parīkṣā, परीक्षा  ): investigation or examinations which leads to correct knowledge  

5. avibhāgavid (avibhAgavid,अविभागविद): A person who knows the complete subject

5. avibhāgavid (avibhAgavid,अविभागविद): A person who knows the complete subject

6. yōnim  (yonim, योनि): Source, Origin

6. yōnim  (yonim, योनि): Source, Origin

7. utthāna  (utthAna, उत्थान): the act of standing up or rising,

7. utthāna  (utthAna, उत्थान): the act of standing up or rising,

8. ātmānam  (AtmAnaM, , आत्मानम): Own

8. ātmānam  (AtmAnaM, , आत्मानम): Own

9. udarka  (udarka, उदर्क): Remote consequence, future result of the action

9. udarka  (udarka, उदर्क): Remote consequence, future result of the action

10. sandhisphuṭanam (sandhisphuTanama,सन्धिस्फुटनम): Joint Cracking or bursting sound  

10. sandhisphuṭanam (sandhisphuTanama,सन्धिस्फुटनम): Joint Cracking or bursting sound