JEEVAK AYURVED MEDICAL COLLEGE HOSPITAL & RESEARCH CENTER�KAMLAPUR AKAUNI CHANDAULI U.P.

TOPIC – ASHTASTHANA PARIKSHA

PRESENTED BY –

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SHWETA SHAHI

SHANGALI KESHARI

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GUIDED BY –

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DR. G.D. GUPTA

DR. K.S. GIRHEPUNJE

DR. ABHINAV SINGH

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INTRODUCTION

• The disease diagnosis is the foremost activity when 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.

Aim and Objectives

1. To assess the diagnostic and prognostic aspect of disease with the help of Ashtavidha Pariksha.

2. To make the prognosis of diseases with the help of tools used in current era.

Ashtasthana Pariksha

Yogaratnakara has advocated Eight fold Examination -Ashtavidha Pariksha of a patient.

1. Naadi Pariksha (Pulse)
2. Mootra Pariksha (Urine)
3. Mala Pariksha (Stool)
4. Jiwha Pariksha (Tongue)
5. Shabda Pariksha (Voice and speech of the patient)
6. Sparsha Pariksha (Touch, skin, and tactile sense)
7. Druk Pariksha (Eyes and Vision)
8. Akriti Pariksha (General body build)

Nadi Pariksha

• Nadi Pariksha is very old ayurvedic technique of diagnosis available more than 2500 years
• Nadi precisely can diagnose Dosha, Mind, emotional imbalances and diseases.

Paryayas of Nadi

• Snayu, Nadi, Hansi, Dhamani, Dharani, Dhara, Tantuki and Jeevan Gyan.

Nadi Location

• Vata, Pitta and Kapha Nadi lies respectively under Tarjini (index), Madhyama (middle) and Anamika (ring) fingers of examining physician.

Nadi Types

• Nadi 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

Example of Nadi

• Normal Rakta = Guru, Uhna
• Ama Rakta = Guru, Manda
• Rakta Dosha = Guru, Khara
• Rakta Dushti = Guru, Deergham, Dhruta, Vegavati
• Many Nadi courses are offered like Basic Nadi, TANTU Nadi, Sankhya Nadi, Nakshtra Nadi, Agastya Nadi, etc

Nadi in more diseases

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• Vata Rakta = Sthira, Nischala, Krusha, Krura
• Grudhrasi = Sthula, Manda, Vakragamini
• Amavata = Manda, Pichchila, Gambhira, Sphutita, Vikampini
• Granthi = Sukshma, Shushka, Manda, Vishirnagamana
• Gulma = Vikampini, Paravatagati

Mutra pariksha

• The urine examination in Ayurveda is very wide Many qualities and parameters are used to examine urine and in Prameha many diseases are diagnosed on the same basis Sandra, Sandra Prasada, Sikata, Sukla, Ushna
• Ayurveda measuring temperature, specific gravity etc.

Urine appearance involving Dosha -

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 urine.
• Observations & conclusions are made on the basis of direction, shape & speed of spreading of oil drop.
• Sarpa (snake shape) Vata
• Chhatra (Mushroom shape) Pitta
• Muktaa (free shape) Kapha

Oil position in different diseased condition

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Mala Pariksha

• Examination of feces is helpful in the investigation of disease of gastrointestinal like detection of parasites.
• Other examinations involved are bacteriologic examination, chemical examination and microscopic examination.
• The colour, consistency, floating nature, smell, presence of blood or mucus in stool gives a lot of information about various dosha imbalances or diseases.

Mala Swarupa in different diseases

Jala Nimajjana Purisha Pariksha

• A specialized technique of stool examination, is conducted to detect the presence of Ama thereby inferring the status of Agni
• If stool sinks in water it has ama dosha and if not then it is normal.

Jihwa pariksha

• The colour, shape, coating of a tongue can be indicative of many digestive abnormalities.
• Commonly we observe only sama nirama condition
• Different areas of the tongue correspond to different organs of the body. Hence by correlating the location of the blemishes on the tongue, the Ayurvedic practitioner can determine which organs of the body are out of balance. The colour, size, shape, coating, anomalies, surface, mobility and local lesion are all noted.

Charactristics of tongue in different Doshik condition

Tongue features in different diseased condition

Shabda Pariksha

• This have a contradiction and confusionMany say that it is the sounds which we have to feel from the patient like intestinal gargling, Heart sounds, Plural rub, cripitus etc.
• Others say that the patient voice is to be evaluated as Deena, Gadagada, Kaphachada, etc.
• Both are appreciable

Sparsha Pariksha

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

Druk Pariksha

• Different types of eye features may reflect the personality of a person as well as the state of his health.
• The colour of the sclera, conjunctiva, size of eyeball, shape, and the area around the eyes give insight into various serious metabolic diseases.

Dosha in Akshi

• If your body is dominated by the Vata then the eyes look sunken, dry and smoky.
• On aggravation of Pitta, eyes appear red or yellow in colour and the patient suffers from photophobia and burning sensations.
• Kapha predominance eyes appear wet, lusterless and watery and a patient may feel heaviness in the eyelids.

Akriti Pariksha

• Examination of Akruti include Diagnosis of hair, nails and other body organs can reveal many signs which point towards different diseases.
• Kapha personalities have oily skin, well-built body and joints, tolerance to hunger, thirst, hardship, hot sun.
• 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.

Gait examination

• The gait will play a big role in Akruti examination - The method of examination is –
• a. Initial contact (heel strike)

b. Load response (foot flat)

c. Mid -stance (single leg stance)

d. Push off:

• Terminal stance (heel off)
• Pre swing (toe off)

Gait Analysis

1. Pelvic tilt: Normally, iliac crest on the side of swing leg drops approximately 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 leg
4. Width of base (horizontal distance between 2 feet during double support): Normally, 2-4 inches wide
5. 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