Issue : 01 DOI : 10.5281/zenodo.8147277
INTERNATIONAL
JOURNAL
OF
DIAGNOSTICS
AND
RESEARCH
Volume : 01
Copyright @ : - Dr. Reshma Pawar Inter. J.Digno. and Research IJDRMSID0014 | ISSN : 2584-2757
13
Abstract
This study delves into the profound Ayurvedic concept of Shadvidha Pariksha, which revolves around the holistic state of health .
The study draws attention to the spectrum of Rogi Pariksha, encompassing diverse paradigms such as Dwividha Pariksha,
Trividha Pariksha, Chaturvidha Pariksha, Panchvidha Pariksha, Shadvidha Pariksha, Ashtavidha Pariksha, and Dashvidha
Pariksha. Of particular focus is the Shadvidha Pariksha, which offers a comprehensive view of Roga Pariksha and Rogi Pariksha
for accurate diagnosis and prognosis. This ancient technique, expounded by Sushruta, employs a six-fold examination approach.
In essence, Shadvidha Pariksha serves as a important diagnostic tool in Ayurveda, providing a deep understanding of the patient's
constitution, imbalances, and disease manifestations. By employing this technique, Ayurvedic practitioners can offer personalized
and effective treatment strategies aimed at restoring balance and promoting overall well-being.
Keywords: Shadvidha Pariksha, Sparshanendriya ,Rasanendriya
Corresponding author: Dr.Reshma Pawar
Article Info: Published on : 15/04/2024
P
ISSN No. : 2584-2757
Volume : 01
Issue : 03
Publisher
ROGANIDAN VIKRUTIVIGYAN PG ASSOCIATION
FOR PATHOLOGY AND RADIODIGNOSIS
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Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Exploring Ayurvedic Concept of Shadvidha Pariksha : A Literature Review
Dr.Reshma Pawar
1
, Dr.Ujwala Pawar
2
1
PG Scholar,Department of Rognidan and Vikrutividnyan, Government Ayurved College & Hospital, Nanded.
2
Professor& Head Dept. of Rognidan and Vikrutividnyan, Government Ayurved College & Hospital, Nanded.
Cite this article as: - Dr.Reshma Pawar
(2024) ; Exploring Ayurvedic Concept of Shadvidha Pariksha : A Literature Review;
Inter.J.Dignostics and Research 1(3) 13-20, DOI:10.5281/zenedo.10972582
Introduction:
It is important to diagnose the disease by using
appropriate techniques and accordingly treat the
disease. To do so complete understanding of
science is essential to get mastery and supremacy in
clinical methods.
A comprehensive clinical examination is the basis
for proper diagnosis of disease and a proper
diagnosis of disease is the basis for planning a
proper treatment protocol.
There are 2 main methods explained in Ayurveda
for the diagnosis of disease one is Roga Pareeksha
and another is Rogi Pareeksha In order to do both
Pareeksha, physician should develop technical
skill, scientific knowledge and human
understanding.
[1]
Importance Of Pareeksha:
It forms basis of treatment protocol.
It helps in proper diagnosis of disease.
Helps in proper assessment of disease step by
step .
In knowing the prognosis.
Helps in knowing the condition of the patient
physically and mentally .
Literature Review:
,
,
"Disease should be diagnosed first and then the
rational therapeutic measures should be employed.
Physician, who starts the treatment without
diagnosing a disease, succeeds by chance even if he
is expert in medicine.”
[2]
(.
.21/20-21)
G
A
R
V
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14
Shad Vidha Pareeksha :
Shad vidha Pareeksha is view on Roga pareeksha
and Rogi pareeksha for diagnosis and prognosis of
disease, has described by Susruta helps to acquire
complete knowledge of patient through six fold
examination technique i.e pancha ghnanendriya
pariksha and prashna pariksha.
[3]
| (
.
.10/4)
1. Shrotendriya Pareeksha
2. Sparshanendriya Pareeksha
3. Chakshurendriya Pareeksha
4. Rasanendriya Pareeksha
5. Ghranendriya Pareekshax
6. Prashna Pareeksha
Chakshurendriya Pareeksha
[4,5,6,7]
:
,
,
; ( .. 4/70)
(.. 25/22)
(
.
.10/5)
, , , ,
( - ..
. 1/22)
The yellow,white,red,colour of body fluid such as
urine (mutra), vomitus (chhardi), stool (vit),
sputum (shthiwan) should be inspected.
Following elements to be inspected:
1. - Colour of the body
2.
, Colour of
the body fluids (Ex. Urine, Vomitus, etc.)
3. - Size and Shape
4. - Proportion
5. - Lusture
6.
-Look or Constitution of Patient
7. - Nutrition (Wasting /
Healthy) - Sensory Motor
Activities
8. - Power
9. - Features of the Diseases
10.
- Ayu Laxanas
Inspection is an active process. It is done with the
eyes and the intellect. It begins with the initial
greeting and continues whole through the entire
data collection process. Even as the examiner starts
interrogating the patient, the inspection begins
through active observation. Specifically, one must
note the patient's facial expression in relationship to
physiological activities and to the questions asked
by the examiner.
The process of diagnosis begins when we watch
patients walks into the consultation room. Things
which are detected with help of Sight,Varna,
Samsthana, Pramana, sharira Upachaya, natural
and unnatural changes in the body and other
findings examined visually like sign of the disease.
[8]
It also comes under Darshana pareeksha.
.E.g-
1. Akshikuta Shotha in Mrudbhakshana janya
Pandu
2. Avila netra in Arditha
3. Haridra netra in Kamala
4. Vakra gati in gridrasi
Close observation of the details of the patients
appearance, behavior, movement, facial expression,
mood, body habitués, conditioning, skin conditions
like petechie, eye movements, abdominal
counter(flat, rounded, protubent, scaphoid,
distended) It also helps to detect age, change in
colour, structure, size, shape, deformities,
extremities edema, gait, symmetry appearance,
nutritional status, height, weight, symmetrical
respiration, any scars, visible masses, swelling,
tumor etc.,
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Sparshandriya Pareeksha:
Palpation ( )
Palpation Examination As Per Acharya Charaka
A.
( ..
4/7)
Touch in healthy and diseased states should
be assessed through palpation.
[C.Vi.4/7]
B.
(.. 25/22)
Softness (mardava), hardness (mardav
viparyaya), coldness (shaitya), warmnness
(shaitya viparyaya) etc should be assessed
by palpation. [C. Chi.25/22]
C.
(..3/4)
The physician who is keen to know the remaining
life span of the patient by way of palpation then he
should palpate the entire body of the patient. While
doing so, he should record the following things:
[9]
Whether there is loss of pulsation in the
body areas which are constantly pulsating?
(
)
Whether the body parts which are usually
warm are getting cold? (
)
Whether the body parts which are usually
smooth are feeling rough ? (
)
Whether there is feeling of loss of sensation
on palpation ? (
) Whether
the joints are felt loosened or dislocated on
palpation ? ( )
Whether there is loss of skeletal mass on
palpation ? ( )
Whether there is profuse sweating? (
)
Whether there is generalized stiffness?
()
Any other palpable sign appearing without
any reason ? (
)
Palpation Examination As Per Acharya
Arundutta :
( ..
. 1/22)
By touching with the palmer surface of the hand,
one should feel the temperature, tumour abscess
swelling and also the coldness, hotness, rigidness,
pulsations, soft or rough surface etc. in disease like
fever, tumour, abscess.[Arundutta on A.H.Su, 1/22]
Palpation Examination As Per Acharya
Sushruta:
(
.
. 10/5)
Cold, Hot, Smooth, Rough, Soft, Hard etc. tactile
perceptions in fever, edema etc. should be assessed
through palpation. (Su.Su. 10/5)
It can also considered as Sparshana Pareeksha and
Anumana Pareeksha.
Sheeta, Ushna, Shlakshna, Karkasha, Mrudu,
Kathinata of skin.
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Shita Sparsha
Ushna Sparsha
Pandu
Jwara
Raskshaya
Raktapitta
Low Blood Pressure
Pitta Dominence
Hypoglycemia
Hyperglycemia
Dehydration
Krodha
Excessive Sweating
High Blood Pressure
Mrudu Sparsha
Kathin Sparsha
Medoroga
Kartakarbuda
Shotha
Gulma
Jalodar
Padshotha in Slipada
Medoja and Kaphja
Galgand
Deformity in Bones
Slakshna Sparsha
Karksha Sparsha
Madhumeha
Pandu
Medoroga
Vatodara
Kaphaj Shopha
Dhatukshaya
Medoj Shopha
Vataja Shopha
Shrontendriya Pareeksha:
(.. 4 / 7)
"Bowel sounds, Joint crepetations and other
peculiar sounds produced in the body should be
examined through auscultation." [C.Vi4/7]
The other peculiar sounds described in Ayurvedic
science are as follows:
Shwas - Bhastrika Dhman Wat
Noisy Blowing sound of respiration
Tamak Shwas - Kapot Eva Koojanam
Loud wheezing resembling the sound of
pigeons.
Maha Shwasam - Matta Vrushabh Eva
Laborous noisy respiration like that of angry
bull.
Kasa - Bhinna Kansya Tulya
like the sound made by striking the bronze pot.
Krukkaj Kasa - Whoop like sound in
whooping cough.
Swarabheda - Gardabha wat swara
Donkey like voice in Hoarseness of vocei
Hridroga - Hritdrava Eti Dad Dadika
The Dhad Dhad sound in tachycardia.
( Su.Su. 10/5)
This method of examination helps to identify
abnormalities in various disease by hearing.
E.g-
1. Gargling sound in abdomen, Atopa in
Amatisara, Adhmana in Udavarta.
2. Sandhi Sputana i.e cracking sound,
cerpitus in the joints.
3. Change in the voice of Patients like
swara bedha found in vataja kasa,
Anuswara in Medaja galaganda, Khara
swara in Vataja Kasa.
4. Abnormal sounds produced in various
disease like Hikka, Swasa, Kasa..
Auscultation:
Auscultation is general term refers to the process of
hearing to sounds within boby during examination.
Eg. Examination of lungs, heart, abdomen
1. B/I air entry, abnormal sounds of lungs like
wheezing, ronchi, crakling and stridor
2. Heart sounds, abnormal heart sounds like
murmur
3. Abdominal sounds like bowel sounds,
peristaltic sounds, gurgling sound,
rumbling sound
4. Voice of patients like horseness of voice,
diminished voice
Ghranendriya Pareeksha:
Normal and abnormal smells of the whole body
may be detected by organs of smell.While
describing the Arista laxanas it is said that the
smell of different flowers if arising from the body it
indicates recent death of person.
| (
.
.10/5)
E.g.
Durghanda Kapha in Kshayaja Kasa
Asya putita in pittja Arochaka
Gatra dourgandha in dusta vruna, Medho
roga
Gandha naasha in Apeenasa, Dusta
Pratishyaya
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Fruity-scented breath in Diabetic keto
acidosis
Halitosis found in GERD, inflammation of
gum, URTI, Sinus infection.
Fishy smell in Advanced Kidney and liver
diseases.
(..4/7)
The normal and abnormal odour of patient's body
and body contents should be examined by nose.
Following odour abnormalities could be noticed in
body and body fluids. The odour of alcohol is easily
recognizable on the breath. The odour of diabetic
ketoacidosis is sweet. That of uremia is ammonical
or fishy. That of hepatic failure is mousy.
(.. . 10/172-73)
"The pregnant woman whose body odour is like
that of a bird or a goat and who have severe pallor
and in whom there is desire to eat peacock flesh has
to undergo caeserian section as there is no body
power to bear down during labour pains”
[10]
(.. . 10/171)
The pregnant women in whom there is a lumbar
stiffness,vaginal pain,foul smell in mouth, delirium
and who eventually gets comatosed; doesn't
survive. [K.S.K.10/171]
The one who emits a scent of different flowers in
day and night and who is encircled by the plant
creeper tendrils is said to be carrying bad prognosis.
Such patient cannot survive more than a year.
Similarly one who emit same scent of individual
flower is also said to be carrying bad prognosis.
The one who emits unpleasant and untimely smell
is also said to be carrying bad prognosis. [C.In. 2/8-
16]
Rasanendriya Pareeksha:
(..4/7)
Although taste is a sensation, it cannot be directly
examined on patient. By interrogating the patient,
the taste of his or her mouth could be known. By
observing the lice on patient's body, physician
should infer the pathological taste of the body. By
observing the flies on patient's body physician
should assume sweet taste of the body. If there is
doubt of disease being Raktapitta, the little amount
of blood should be fed to either dog or crow. If they
taste it then it is the pure blood. If they do not
means it is the Rakta-Pitta.
(
.
.10/5)
This method of examinaton is difficult to
implement so indirect method of Rasanendriya
parikshan has been given by noticing the behavior
of insects like ants, flies etc.,
Though this method is an Anumana Pariksha it can
be substituted for Pratyaksha as it is difficult to do
with physician's tongue.This method of
examination can be supported by Prashna
Pareeksha Desease in which vitiation of
Rasanendriya is found can be assesed by anumana
with the help of
Prashna pareeksha -
Arochaka in Jwara, Amlapitta, Vataja
Arsha, Grahani etc.,
AsyaMadhurya in Kaphaja Amlapitta,
Kaphaja jwara
Asya vairasya in Arochaka, Jwara
Jivha lepa in Kaphaja Amlapitta
Rasa Vikruti (Taste Alteration)
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(.. 2/19-22)
The examiner, who is interested in knowing the
remained life span of the patient with respect to
taste, should inquire about it to the patient. It can
also be inferred. The body taste of the person, who
is about to die, changes in two ways. In some
patients, it becomes unpleasant whereas in some it
becomes exceedingly sweet. Flies, lice, stinging
insects and mosquitoes get away from the body of
the patients who have unpleasant taste. Whereas, in
some patients, taste becomes exceedingly sweet and
flies are constantly attracted towards them even
after bath and application of cosmetics.
Prashna Pareeksha:
(Interrogation -The art of history taking)
Interrogation is the beginning of doctor-patient
relationship. Obtaining a proper history from the
patient largely depends on their faith in the doctor.
So as earlier mentioned doctor must put the patient
at ease by virtue of his caring and friendly attitude
and should encourage the patient to talk freely.No
particular technique is usefui in all the situations.
Approach varies as per the state of the patient and
time available. In modern medicine, the
interrogation as a tool of examination of the patient
was introduced by American physician Benjamin
Roch (1745-1813) whereas in Indian medical
science (Ayurveda) it has been mentioned before
2000 BC very systematically and scientifically. As
per Sushruta the various information related to the
patient required for reaching the diagnosis of a
disease should be obtained by interrogating the
patient.
Interrogation As Per Acharya Sushruta
According to acharya Sushruta following things
should be noted through interrogation:
, , ,
,
,
,
(
.
. 10/5)
1. Desham (Address/Residence)
2. Kalam (Age and Season)
3. Jatim (Caste and Gender)
4. Satmyam (Compatibility of Habits and
Addictions)
5. Atanksamutpattim (History of present
illness)
6. Vedana Samuchhayam (Presenting
Complaints)
7. Balam (Strength/Power)
8. Antaragnim (Appetite)
9. Vat Pravrutti va Apravrutti (Passage of
flatus - Present/Absent)
10. Mutra Pravrutti va Apravrutti (Urination-
Present/Absent)
11. Purisha Pravrutti va Apravrutti
(Defecation-Present/Absent)
12. Kal Prakarsha (Duration and aggravation
of illness)
13. Adi (Family history, occupational history
etc.)
14. Cha (And)
( -
.
. 10/5)
As per Dalhan, and Cha' stands for Genito urinary
discharge examination etc
Interrogation As Per Acharya Charaka
:
( .. 25/23)
(.. 4/8)
As per acharya Charaka following points should
be asked through interrogation
Hetu (The actiological factors consumed)
Arati (Nature of discomfort/pain)
Satmya Asatmyata (Compatible and allergic
food)
Agni Bala (Appetite strength)
Grahani Mrudu Darunatwa (The bowel
movements and hard/soft stool)
Abhipraya (Feelings)
Dukha (Pain/Complaints)
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Sukha (Happiness)
Swapna Darshanam (Types of dreams)
Dwishta Eshta (Liked and disliked things)
Interrogation As Per Acharya Bhela :
[11]
||
(...4/ 4-6)
1. Matru Pitru Samacharam (Family History)
2. Satmyam (Compatibility)
3.Garbhen Dauhrudam (Obstetric History)
4. Vyadhikal Parinamam (Duration of the illness)
5. Shakrit Vivarnata (Stool colour changes)
6. Mutra Vivarnata (Urinary colour changes)
7. Purvarupam (Prodromal features)
8. Samuthanam (History of present illness)
9. Sharir bala (Physical strength)
10. Agnibala (Digestive power)
11. Janmadesha (Area of residence/birth)
12. Vyayam Nishtha (Habit of exercise)
13. Uchit/Anuchit Bhojan (Dietary habits)
14. Matra/Amatre Bhojan (Quantity of diet)
These fourteen point information and any other
information should be noted from the patient and
his relatives during history Taking
Discussion :
Clinical Examination is crucial in clinical medicine,
starting with a thorough observation of the patient
and then planning suitable therapeutics. Sushruta
emphasizes the importance of clinical examination,
which includes both Roga and Rogi observation.
Shadvidha Pareeksha meets the goals of diagnosing
and prognosing diseases, covering everything from
history-taking to systemic examinations. Effective
treatment hinges on accurate diagnosis, which in
turn relies on skilled patient examination using
various diagnostic tools. Ayurvedic texts and
modern science offer numerous diagnostic
techniques, with Shrotendriya, Chakshurendriya,
Sparshanendriya, and Prashna Pareeksha being
likened to modern techniques like Auscultation,
Inspection, Palpation, and Interrogation.
Conclusion :
The exploration of the Ayurvedic concept of
Shadvidha Pariksha in this literature review
underscores its significance in diagnosing and
prognosing diseases comprehensively. The holistic
approach of Shadvidha Pariksha, considering
physical, mental, and spiritual aspects, offers
valuable insights for modern healthcare. This
ancient technique, combined with modern
diagnostic practices, can lead to more effective and
personalized healthcare strategies focused on
restoring balance and promoting overall well-being.
References:
1. https:// www.slideshare net/ Dr. Soubhagya
Japal/shadvidha pareeksha.
2. Agnivesa, charaksamhita, Edited with
Vaidya manorama, Hindy commentary,
translated to marathi by vd. vijay kale,
Acharya vidhyadhar Shukla, chaukhamba
Sanskrit Pratisthan, Delhi, volume 1, Sutra
sthana ,chapter 21, verse 20-21.
3. Sushruta Samhita, Hindi commentary by
Dr. Anantram sharma, chaukhamba
surbharati Prakashan, varanasi, volume 1.
Sutrasthana, chapter 10, verse 4.
4. Agnivesa, charaksamhita, Edited with
Vaidya manorama, Hindy commentary,
translated to marathi by vd. vijay kale,
Acharya vidhyadhar Shukla, chaukhamba
Sanskrit Pratisthan, Delhi, volume 1,viman
sthana, chapter 4, verse 7.
5. Agnivesa, charaksamhita, Edited with
Vaidya manorama, Hindy commentary,
translated to marathi by vd. vijay kale,
Acharya vidhyadhar Shukla, chaukhamba
Sanskrit Pratisthan, Delhi, volume 2,chikitsa
sthana, chapter 25, verse 22.
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6. Sushruta Samhita, Hindi commentary by Dr.
Anantram sharma, chaukhamba
surbharati Prakashan, varanasi, volume 1.
Sutrasthana, chapter 10, verse 5
7. Ashtanga Hridaym, sri Arundatta Teeka,
chaukhamba orientalia varanasi, Ashtanga
Hriday sutrasthana, chapter 1, verse 22
8. https:// www.slideshare net/ Dr. Soubhagya
Japal/shadvidha pareeksha
9. Agnivesa, charaksamhita, Edited with
Vaidya manorama, Hindy commentary,
translated to marathi by vd. vijay kale,
Acharya vidhyadhar Shukla, chaukhamba
Sanskrit Pratisthan, Delhi, volume 1, Indriya
sthana ,chapter 3, verse 4.
10. Kasyapa samhita, vidyotini Hindi
commentary, by Nepalrajguruna, pandit
Hemraj sharma, chaukhamba-sanskrit series
Banaras, khila Sthana, chapter 10 verse 172-
173.
11. Maharsi Bhela, Bhela samhita, Hindi
commentary, by Sri Abhay katyayan,
chaukhamba Surbharati prakashan, viman
sthana, chapter 4,verse 4-6.
ISSN : 2584-2757
DOI : 10.5281/zenedo.10972582
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