JEEVAK AYURVED MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTER

Topic: Dashavidha Pareeksha

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Guided by- Batch- Final year Presented by

• Dr.GD Gupta (2019-20) 1. Pooja verma
• Dr. kamod Girhepunje 2. Zakiya Khatoon
• Dr. Abhinav Singh

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Dashavidha Pareeksha

Introduction�

• The word "Ayurvedo" is a synonym of "life-knowledge For acquiring this life knowledge acharya Charaka in viman sthang 8 chapter "rog bhisagjeetlya adhyaya" has explained aatura pareeksha under the heading desho pareeksha. Although acharya Charako starts with aatura pareeksha which means patient assessment but it can be done for healthy individual as well for the knowledge of life.
• General physical examination and history.taking has been given its due importance in medical field for ethical and methodological approach in diseased and healthy individuals. It is recommended atleast once a year after 50 years of age to determine the general status of health. It works on both preventive and curative levels Le identifying any issues that may become medical concerns in the future and check for possible diseases.

It has a role play for provisional diagnosis and for overall health status outcome via comprehensive approach for the patient.

Aatur pareeksha has been given utmost Importance before starting treatment in Ayurveda.Table.neof Ayurveda & tolster Medicine.

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Aatur pareeksha has been given utmost Importance before starting treatment in Ayurveda.Table.neof Ayurveda & tolster Medicine.

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"रोगमादौ परीक्षेत ततोऽनन्तरमौषधम्र्मा"

herey states that roga pareeksha, rogi pareeksho and aya pareeksha is to be done in the beginning of the treatment for its successful outcome. Aacharya Charaka has given in detail the objects of the roga-rogi pareeksha under doshvidha pareeksha.

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Objectives

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• State Dashavidha pareeksha
• Asses Dashavidha pareeksha
• Describe importance of Dashavidha pareeksha

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Dashavidha pareeksha

बलस्य दोषस्य च प्रमाणं बलदोषप्रमाणम्।

तस्मादातुरंपरीक्षेतप्रकृतितश्च, विकृतितश्च, सारतश्च, संहननतश्च, प्रमाणतश्च, आहारशक्तितश्व, व्यायामशक्तितश्च, वयस्तश्चति, बलप्रमाणविशेषग्रहणहेतोः||९४

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• Prakriti
• Vikriti
• Sara
• Satva
• Satmya
• Samhana
• Ahara shakti
• Vyayama shakti
• Vaya

देशस्तुभूमिरातुरश्च ॥९२॥ तत्रभूमिपरीक्षा आतुरपरिज्ञानहेतोर्वास्यादौषधपरिज्ञानहेतोर्वा|

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Here desha is of 2 types-

1. Bhumi desha (place)
2. Aatura desha (patient)

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Examination of patient is conducted for the knowledge of lifespan or degree of strength.Weak patients are not able to bear intensely potent drugs.

On the other hand, the drug having low potency and potency and applied to stron patients having severe disorders becomes ineffective.Hence the patients should be examined by dasha vidha pareeksha

Dashavidha Aatura Pareeksha

आतुरस्तुखलुकार्यदेशः। तस्यपरीक्षा आयुषः प्रमाणज्ञानहेतोर्वास्याद्, बलदोषप्रमाणज्ञानहेतोर्वा। तुत्रतावदियंबलदोषप्रमाणज्ञानहेतोः; दोषप्रमाणानुरूपोहिभेषजप्रमाणविकल्पोबलप्रमाणविशेषापेक्षोभवति । सहसाह्यतिबलमौषधमपरीक्षकप्रयुक्तमल्पबलमातुरमृतिपातयेत्; नह्यतिबलान्याग्नेयवायवीयान्यौषधान्यग्नि क्षारशस्त्रकर्माणिवाशक्यन्तेऽल्पबलैः सोढुम्ः असह्यातितीक्ष्णवेगत्वाद्धितानिसद्यः प्राणहराणिस्युः।

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• Patient is the substratum of the act (karyadesha).
• Examination of the patient is conducted for the knowledge of life span or the degree of strength and morbidity.
• The variations in dosage and potency of prescribed drugs is according to the degree of morbidity and the degree of strength of patient, because if potent drug is administered suddenly by a physician having not been examined properly, it may kill the weak patient.
• The weak patients are not able to bear intensely potent drugs which are predominant in agni and vayu or cauterization, application of alkali and surgical operation.
• They may cause instantaneous death due to unbearable and over intense impulse of the drug.

• Keeping this fact in mind, the physician should treat the weak patient with drug which is not harmful, mild, delicate, and progressively strong in order, without complication and not creating any emergent condition, particularly ladies, because they have unstable, soft, bere and timid heart, they are mostly delicate, weak and dependent on others.
• On the other hand, the drugs having low potency and applied by one who has not been examined properly in strong patients having severe disorder becomes ineffective.
• Hence the patient should be examined in respect of constitution (prakriti), morbidty (vikriti), constitution of dhatu (sara), compactness (samhanana), measurement (pramana), suitability (satmya), psyche (sattva), power of intake and digestion of food (aharashakti), power of exercise (vyayamashakti) and age (vaya) for the knowledge of the degree of strength

• Thus the strength of individuals can be classified depending upon the superiority, mediocrity and inferiority of the above mentioned factors, viz. prakruti (Physical constitution), sara etc. except vikruti or morbidity.
• Ten-fold examinations should be done to understand the overview of patient's condition in relation to diseases person must be carried out scientifically and methodically in a systemic planned manner to get a derisible and satisfying successful results.

Prakriti parikisha

• Prakruti-Pareekshna is an integral part of Dashavidha Pareeksha.
• a It includes both Shareer & Manasik Bhavas.
• Bala (strength), Agni (digestive fire), Satwa (mental strength) and Satmya (beneficial to health) are nothing but constituents of Prakruti.
• Prakriti is the Swabhava or nature of an individual and it is an inherent characteristic.
• Foetus is dependent on many factors such as Prakriti of Shukra (sperm), Shonit (ovum), Kala (time of conception) and Garbhashaya (uterus).

• Prakriti is also affected by the food habits and life style followed by the mother at the time of conception and during the entire gestational period.
• These factors are in turn completely dependent on the Dosha.
• Thus, foetus is dependent on the Dosha and its Prakriti is decided by the predominant
• Dosha/Doshas at the time of conception. The one or more Doshas predominant in the above said factors forms the Janmajaat Dosha Prakriti (body constitution by birth) of the foetus.
• Hence some persons are of Kapha / Pitta/ Vata constitution or balanced Tridoshaja constitution by birth

• The favourable and unfavorable things (Pathyapathya) for particular type of Prakriti could be advised to the individual on the basis of Prakriti.
• E.g. The Vata Prakriti individual should not consume dry, rough, cold, astringent substances. Rather one should take oily, warm, sweet substances.
• Similarly, Pitta Prakriti individual should avoid hot, sour, salty substances and the social environment that will raise his anger.
• Kaphaj individuals should be asked to take regular exercise and to avoid cold environment.
• Equally balanced (Sama) Prakriti is usually healthy and remain disease free and even if gets diseased; recovers soon. So, knowledge of Prakriti has prime importance in both healthy and diseased persons.

• Recently, few studies observed genetic bases for prakruti. Construct of prakruti has been correlated to human leukocyte antigen (HLA) gene polymorphism.
• Biochemical profiles and hematological parameters exhibited differences between prakruti types.
• A significant association between CYP2C19 genotype and major classes of prakruti types was observed.
• Another study showed platelet aggregatory response, and its inhibition by aspirin varied in the different prakruti subtypes.
• This prakruti related evidence is likely to have a significant impact on personalized medicine.
• However, there is a lack of quantitative studies such as reliability of prakruti assessment
• Based on the combination of one or more bioentities, seven types of prakruti are described as vataja, pittaja, kaphaja, vatakaphaja, vatapittaja, pittakaphaja, and vatapittakaphaja.
• Prakruti analysis helps in prioritizing any nurturing, presentive, and curative regimen specific to an individual.
• Thus, prakruti-based prescription helps to enhance the therapeutic effect of a regimen and to reduce the unwanted effects of the drug

Vikriti Pareeksha

• Patient examination should be done with respect of vikriti as well. Vikriti is vikara (disorder or pathological manifestation). The disorder should be examined in terms of the strength of the cause (hetu), dosha(vitiating factors), dushyo(vitiated factors), constitution (prakriti), place (desha), time (kala) and the symptoms.
• The severity of the disease cannot be known without knowing the strength of the cause etc. factors.
• The disease having common dushya, constitution, place and time along with strongcause and severity of symptoms is more, then such diseases are severe.
• The contrary is mild. The moderate disse has similarity in one of the dosha, dushya etc. and as such moderate strength of cause and severity of symptoms
• In brief vikriti refers to morbidity of the susceptible individual and it is also helps to ascertain the strength of the pathogenesis factors responsible for the manifestation of disease and also helps to predict the prognosis of the disease.
• The vikriti pareeksha is stated for dosha Bala pramana of atura. For the assessment of vyadhi - hetu (cause), dosha, dusya, prakruti, desha, kala and Bala must be observed with their sub-types also. The vyadhi Bala is assessed by the intensity of etiology (hetu), symptoms of diseases parameters.
• They are collectively described as the conditions namely of easily curable (sukhsadhya), moderately curable (krichsadhya) and in-curable (asadhya)

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Sara Pareeksha

• सारतश्चेतिसाराण्यष्टौपुरुषाणांबलमानविशेषज्ञानार्थमुपदिश्यन्ते; तद्यथा-त्वग्रक्तमांसमेदोऽस्थिमज्जशुक्रसत्त्वानीति ||१०२||
• Moreover a patient should be examined in respect of sara i.e. (best qualities of body tissues).There are eight types of sara in human beings which are described here for the knowledge of degree of strength such as-tvak, rakta, mamsa, meda, asthi, majja, shukra and sattva
• The eight components of Sara are examined and levelled in terms of relative qualities viz.
• ➤Pravara (Excellent or superior)
• ➤ Madhyama (Medium)
• ➤ Avara (Inferior)

• Aim of Sara Pareeksha is assessment of Bala (strength) of children in accordance to Ayurveda.
• In reference to Sara, we observe or assess the Bala or strength of body partsand their functions as per the Dhatu (as the organs or body parts are formedfrom the Dhatu, so the qualities of Dhatu reflect the strength of specific organ/s, body parts etc. and their function.
• Therefore, with the help of Sara examination we assess the functional and anatomical qualities of the specific Dhatu forming organs or body parts).
• We also evaluate the strength of memory, intellect; illness and temperature bearing capacity, age assessment, knowledge, patience, money or immovable property retaining capacity (richness/poor/prosperity) etc. and plan the treatment accordingly
• According to modern knowledge sara can be considered as the optimum degree of genetic code of an individual's DNA with respect to particular dhatu.
• Genetic code is the system of storage of genetic information's is chromosomes of living cells that instructs the machinery for polypeptide synthesis to insert a living cells that instruct the machinery for polypeptide synthesis to insert a particular amino acid in response to the nucleotide sequence of genetic material

• In our body every individual's DNA has the different genetic code.
• So, we can say, the quality of Dhatus of every individual will depend upon the genetic code of the individual's DNA.
• If the genetic code of the individual's DNA with respect to that dhatu is optimum, the formation of the particular dhatu in the body will be of verygood quality.
• Sarva sara purusha has the optimum degree of the genetic code with respect to all dhatus

Samhanana pareeksha

• संहूनूनतक्षेतिसृहुनन, संहतिः।, संयोजनमित्युकोऽर्थः। तत्रसम्सुविभक्तास्थि, सुबद्धसन्धि, सुनिविष्टमांसशोणित, सुसहर्तशरीरमित्युच्यते। तत्रसुसंहतशरीराः पुरुषाबलवन्तः, विपर्ययेणाल्पबलाः, मध्यत्वात्संहननस्यमैध्यबलाभवन्ति ॥ ११६
• Samhanana, Samhati and Sama-Yojana are the synonyms. Compactness of the body is known as Samhanana.
• It reflects the compactness qualities of the body. In other words, compactness varies person to person.
• According to body compactness, Samhanana is classified as
• Pravara
• Madhya
• Avara

• Samhanana helps in prevention of diseases
• Criteria for the assessment of the Samhanana or Samhati or Samyojana.
• The person, who fulfills the following criteria, is known to have well proportionate body.
• Smooth-uniformly well-defined bones
• Well-fixed joints
• Well oriented or placed muscles
• Well circulated blood in younger children
• These features should be considered in accordance to growth for age

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• Pravara samhanana -Symmetrical and well demarcated bones, well joints, well bound muscles blood, strong built, excellent strength
• Madhyama samhanana Moderately symmetrical and demarcated bones, moderately joints, moderately bound muscles blood, moderately built, moderately strength
• Avara samhanana-Weakly Symmetrical and demarcated bones, Weakly joints, Weakly bound muscles blood, Weak built, Weak strength

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Pramana Pariksha

• One should examine the body measurements.
• The Utsedh (Height), Wistar (breadth) and Yama (length) of the body parts st measured in terms of one's own fingers (Angul).
• The entire body measures eighty four fingers in height and also in breadth such individuals possess longevity, strength, immunity, happiness, supremacy, wealth and other desired facilities.
• Those having body with less or more measurement have qualities contrary to these
• The person having normal measurements are endowed with longevity, physicalstrength, immunity, happiness, luxury, wealth and other desired things.Those having short or long body than normal are devoid of above said virtuesFor clinical assessment it can be subdivided into
• Pravara Pramana- standard measurement criteria excellently height, lengt and breadth.
• Madhyama pramana- standard measurement criteria moderately height, length and breadth.
• Avarapramana- standard measurement criteria lesser extent height, length and breadth.

Satmya

• One should also examine the compatibility of the patient to various thing: Compatible are those things which on constant use have wholesome effer on the body. Satmya here refers to Oka Satmya which is habitual adaptati made by the body to the administered potentially antigenic material.
• It is like conditioning the body to adapt to the certain things which are not usually well tolerated by the body by practicing it daily.
• For e.g., butter is not tolerated by many people. But by making it a habit, one can overcome the intolerance.
• Allergic response may occur if one is not compatible to certain things
• According to Dalhana, Satmya is of two types: Aahar.
• Satmya (Dietary compatib and ViharSatmya (Lifestyle compatibility).
• Aahar Satmya is again divided into six types those are Eka (one), Dauo (Two), Tri (three),Chatur (Four), Pancha (Five), Shad (Six) Ras Satmya
• Vihar Satmya is divided into Kayik Vyayam (Body exercise), Vachik Vyayam (Speechexercise), Mansik Vyayam (Mental exercise).
• Habits and addiction play important role in the development of disease. Addiction of tobacco in any form can lead to ischemic heart disease. Smoking can also lead to COPD.
• Addiction of alcohol can lead to cirrhosis of liver. Hence, history regarding habits and addictions should be carefully sought

Satmya Pareeksha

Satva Pareeksha

• Psyche is the Mana. Mind or psyche along with the soul controls the body of a Satva.
• Satva Pareeksha is a Manobala or mental stamina examination.
• Satva is of three types-

■ Pravara or anybody having excellent psyche does not puzzled by the onset of disease originated pain and tolerate well in comparison to other types of Satva.

■ Least tolerance, for the similar degree of painful condition in a disease, is found in Avara (least capacity) Satva child/person.

■ Madhya Satva person can perform the work after counseling, while an Avara Satva person/child does not satisfy by self or any other and has intolerance to mild disease, suffered with fear, greediness etc. and becomes unconscious just by looking blood etc.

Ahara Shakti

• आहारष्ट्रशक्तितश्चेत्आिहारशक्तिरभ्यवहरणशक्त्याजरणशक्तयाचपरीक्ष्या; बलायुषीह्याहारायत्ते ||१२०||

The Ahar Shakti should be examined by assessing

• Abhyavaran Shakti (One's ability to eat the given quantity of food)
• Jaran Shakti (One's ability to digest the given quantity of food).It is tested and interpreted by Pravar (High), Avar (Low), Madhyam (Medium) value
• Sama Agni (Good digestive fire) individuals remain in balanced state and hence remain healthy.
• Tikshn Agni (High digestive fire) individual as can digest everything in little time also relatively remains healthy. But if they continue to consume Pitta increasing aetiology then they are likely to suffer from disease like Bhasmak Roga (Bulimia), Amlapitta (GERD) etc.
• Mandagni (weak digestive fire) individuals are prone to diseases
• Vishamagni (abnormal digestive fire) individuals are always unhealthy and have gastric trouble.

Vyayama Shakti

व्यायामशक्तितश्चेति व्यायामशक्तिरपि कर्मशक्त्या परीक्ष्या। कर्मशक्त्या ह्यनुमीयते बलत्रैविध्यम् ॥१२१॥

कर्म भारवहनादि, तत्र शक्तिः कर्मशक्तिः ॥ १२१॥

• The vyayama shakti(power of exercise) should be examined by the capacity for work.
• Vyayama shakti is an important component of dasa vidha pareeksha. It is alone a competent for assessment of bala.
• For the assessment of vyayama shakti three parameters were selected which are breath holding exercise, stepping exercise, measurement of basal pulse rate
• Pravara vyayama shakti - Individual possess a excellent exercise endurance
• To advice rehabilitation programme person should have a good power of exercise.
• These persons able to do a physiotherapy technique without much difficulty, this helps for faster recovery. These kinds of individual are able to perform heavy exercise.
• Madhyama vyayama shakti-Individual possess a moderate power of exercise.
• Person follows the physiotherapeutic technique moderately as a result it hampers the quicker relief.
• Moderate medicaments must be prescribed to gain desirable results

Vaya Pareeksha

• Childhood is determined up to sixteen years when the dhatus are immatur sexual character are not manifested;
• the body is delicate, unstable with incomplete strength and predominant in kapha dosha.
• This again with dhatus in developing stages and unstable mind remains up to thirty years. Mild medicaments may be employed.
• The middle age is assessed by strength, energy, virility, acquisition, retention, recollection, speech, understanding and qualities of all dhatus having reached the normal limit, with proper physical and mental strength, without degeneration in qualities of dhatus, with predominance of pitta dhatu and is up to 60 years.
• Stronger medicaments may be employed to gain the success