Ashtastana pariksha

Clinical Aspects of Ashtasthana Pariksha by Ayurmitra Nadi Bhishak Prof. KSR Prasad (Technoayurveda)

1. ClinicalAspectsof Clinical
 Aspects
 of
 
AshtasthanaPariksha
inin
AyurmitraNadiBhishak
Prof
KSR
Prasad(Technoayurveda)
Prof
. 
KSR
Prasad
 (Technoayurveda)
Guest Lecture @ RRAMCH, Humnabad, Karnataka
On
27
‐
07
‐
2020
On
 27
‐
07
‐
2020
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /

2. Idi
Clinical aspects of Ashtasthana Pariksha
I
ntro
d
uct
ion 
•The disease diagnosis is the foremost activity 
hihihdi
w
h
en ever a pat
ient approac
h
es w
it
h
 di
sease 
•The identification of the nature of an illness or 
other problem by examination of the 
symptoms is diagnosis 
•In medicine we do medical diagnosis 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
33

3. Mdildi i
Clinical aspects of Ashtasthana Pariksha
M
e
di
ca
l di
agnos
is
•M
ed
ica
l 
d
iag
n
os
is
(abb
r
e
vi
ated
 Dx
o
r D
S
)
 i
s
 t
h
e
 
edca dag oss
(abbe ated
o
S
)ste
process of determining which disease or 
condition explains a person's symptoms and 
signs. 
•It is most often referred to as diagnosiswith 
th
di l
ttbii liit
th
eme
di
ca
l
con
t
ex
t
 b
e
ing 
imp
li
c
it
.
•This diagnosis is –Clinical, Instrumental, 
Radiological Biochemical etc Radiological
, 
Biochemical
, 
etc
. 
•Ayurveda speaks different levels diagnostic 
methodssuchas
–
10
vidha
8
vidha
etc
methods
 such
 as
 
10
 vidha
, 
8
 vidha
, 
etc
. 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
32

4. Clinical aspects of Ashtasthana Pariksha
Name of Method Folds in Examination
1 DwividhaParikshaPratyaksha, Anumana
2 TrividhaParikshaDarshana, Sparshana, Prashna
3 Panchvidha ParikshaPanchendriya
4 Shadvidha ParikshaPanchendriya, Prashna
5 Ashtavidha ParikshaNadi, Mutra, Mala,Jihwa,
Shabda, Sparsha, Drik, Akruti
6 Dashavidha ParikshaPrakruti, Vikruti, Sara,
Sh
St
St
S
amva
h
ana,
S
a
t
mya,
S
a
t
wa,
Pramana, Vaya, Vyayamashakti,
Aharashakti
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
31
Aharashakti

5. Eiti
Clinical aspects of Ashtasthana Pariksha
E
xam
i
na
ti
on
•
Ayurvedafollowsthewaysof
diagnosing
Ayurveda
 follows
 the
 ways
 of
 diagnosing
 
disease and bring back to Normalcy 
•
Proper
clinicalexamination
facilitates
correct
•
Proper
 clinical
 examination
 facilitates
 correct
 
diagnosis 
Di i
dfdibd
•
Di
agnos
is an
d
 treatment o
f
 di
seases are 
b
ase
d
 
on the information derived from two areas:
–
Examination of the Patient (Rogipariksha)
–Examination of the Disease (Rogapariksha)
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
30

6. Ah h
Pikh
Clinical aspects of Ashtasthana Pariksha
A
s
h
tast
h
ana
P
ar
ik
s
h
a
Yo
g
aratnakarahas advocatedEi
g
htfold Examination ‐
g
g
AshtavidhaParikshaof a patient. 
1. NaadiPariksha(Pulse) 2
M
Pikh
(U i )
2
.
M
ootra
P
ar
ik
s
h
a
(U
r
ine
)
3. Mala Pariksha(Stool) 4
Jiwha
Pariksha
(Tongue)
4
.
Jiwha
Pariksha
(Tongue)
5. ShabdaPariksha(Voice and speech of the patient) 6. S
p
arshaPariksha
(
Touch
, skin
, and tactile sense
)
p
(,, )
7. DrukPariksha(Eyes and Vision) 8. AkritiPariksha(General body build)
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
29

7. 1
Ndi
Pikh
Clinical aspects of Ashtasthana Pariksha 1
. 
N
a
di
P
ar
ik
s
h
a
•
Nadi
Pariksha
isveryold
ayurvedic
technique
Nadi
Pariksha
is
 very
 old
 ayurvedic
technique
 
of diagnosis available more than 2500 years
•
Nadi
preciselycandiagnoseDosha,Mind,
Nadi
precisely
 can
 diagnose
 Dosha,
 Mind,
 
emotional imbalances and diseases.
•
Nadi
isobservedfrom
Jeevasakshini
at
Nadi
is
 observed
 from
 Jeevasakshini
at
 
Karamoola(Wrist) with 3 fingers 
•
Thestrength,rhythm,speed,andqualityof The
 strength,
 rhythm,
 speed,
 and
 quality
 of
 
the pulse are examined to reach the 
conclusion. 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
28

8. Ndi
T
Clinical aspects of Ashtasthana Pariksha
N
a
di
T
ypes
•
Nadi
isreferredtotwoimpulses
Nadi
is
 referred
 to
 two
 impulses
 
–The first one is Nerve generated electrical 
impulses from Ida, Pingalaand Sushumna
–The second is Hemodynamic generated blood 
wave in the radial artery  •The Messenger pulse or Dootanadiis also in 
practice
•The pulse have impact of food ingestion, 
seasons, and circadian rhythms 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
27

9. Clinical aspects of Ashtasthana Pariksha
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
26

10. Ndi
ii
Clinical aspects of Ashtasthana Pariksha N
a
di
exam
inat
ion 
•
Nadi
pariksha
isdonebyIndex Middleand
Nadi
pariksha
is
 done
 by
 Index
, 
Middle
 and
 
Ring finger –they represent Vata, Pitta and 
Kapha Kapha
•We need to observe 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
25

11. Depthidentification
Clinical aspects of Ashtasthana Pariksha
Depth
 identification
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
24

12. Jeeva
Sakshini
Clinical aspects of Ashtasthana Pariksha
Jeeva
Sakshini
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
23

13. PulsewaveInterpretation
Clinical aspects of Ashtasthana Pariksha
Pulse
 wave
 Interpretation
  
a,b,c,d,e wave of five component
a
b
c
e
a,b,c,d,e
 wave
 of
 five
 component
Vruddhatara Dosha or +2
Vruddha Dosha or +1
d
Baseline
Heena Dosha or ‐1
Heenatama Dosha or ‐2
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
22
b

14. Elf
Ndi
Clinical aspects of Ashtasthana Pariksha E
xamp
le o
f
 N
a
di
•
NormalRakta=Guru
Uhna
Normal
 Rakta
 =
 Guru
, 
Uhna
•Ama Rakta = Guru, Manda
khG
h
•Ra
k
ta Dos
h
a = 
G
uru, K
h
ara
•Rakta Dushti= Guru, Deergham, Dhruta, 
Vegavati
•Man
y
 Nadicourses are offered like Basic Nadi
, 
y
,
TANTUNadi, SankhyaNadi, NakshtraNadi, 
A
g
ast
y
aNadi
, etc
gy
,
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
21

15. Ndi
i
di
Clinical aspects of Ashtasthana Pariksha
N
a
di
in mor
di
seases 
•
VataRakta=
Sthira
Nischala
Krusha
Krura
Vata
 Rakta
 =
 Sthira
, 
Nischala
, 
Krusha
, 
Krura
•Grudhrasi= Sthula, Manda, Vakragamini
d
ihhil
Gbhi
•Amavata = Man
d
a, P
ic
h
c
hil
a, 
G
am
bhi
ra, 
Sphutita, Vikampini
•Granthi= Sukshma, Shushka, Manda, 
Vishirnagamana
•Gulma= Vikampini, Paravatagati
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
20

16. 2
M
ikh
Clinical aspects of Ashtasthana Pariksha 2
. 
M
utrapar
ik
s
h
a
•
TheurineexaminationinAyurvedaisvery The
 urine
 examination
 in
 Ayurveda
 is
 very
 
wide
•
Manyqualitiesandparametersareusedto
•
Many
 qualities
 and
 parameters
 are
 used
 to
 
examine urine and in Pamehamany diseases 
arediagnosedonthesamebasis are
 diagnosed
 on
 the
 same
 basis
 
–Sandra, Sandra Prasada, Sikata, Sukla, Ushna
f
•Ayurveda measuring temperature, speci
f
ic 
gravity etc. 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
19

17. Til
bid
ikh
Clinical aspects of Ashtasthana Pariksha
T
a
il
a 
bi
n
d
upar
ik
s
h
a
•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).  •
Asoilislighterthanurine oilspreadsoverthe
•
As
 oil
 is
 lighter
 than
 urine
, 
oil
 spreads
 over
 the
 
urine. 
•
Observations&conclusionsaremadeonthe Observations
 &
 conclusions
 are
 made
 on
 the
 
basis of direction, shape & speed of spreading of 
oil drop.
S
(kh)Vt
–
S
arpa
(
sna
k
e s
h
ape
)
 V
a
t
a 
–Chhatra(Mushroom shape) Pitta 
–
Muktaa
(
free sha
p
e
)
 Ka
p
ha  
(p)p
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
18

18. Tilbid
If
Clinical aspects of Ashtasthana Pariksha
T
a
il
a
bi
n
d
u
I
n
f
erence
•
Direction
Curableness
Direction
 
Curableness
 
•East  Sighramsukhi(Early curable) 
•
South
Kramen
sadhyam
(bl b )
•
South
 
Kramen
sadhyam
(
cura
bl
e step 
b
y step
)
 
•North  Curable (arogitasamprajayate)  •West  SukhaAarogya(Health 
&
Pleasure) 
•North‐East  masennashyati
(Must die in 1 month) 
•South‐East  Maranam(Must die) 
•South‐West  Maranam
(
Must die
)
 
()
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
17

19. Ch i i d
dh
Clinical aspects of Ashtasthana Pariksha
Ch
anges 
in ur
ine 
d
ue to 
d
os
h
as
•Color & Ph
y
sical a
pp
earance  Vitiated Dosha 
ypp
•Pandur(pale), Nila, Ruksha Vata 
•Rakta, Pita, Aruna(reddish)  Pitta 
•Snigdha, Safena, Pallava varitulya  Kapha 
•Shweta, Budbudabham Vata‐Kapha 
•Kalusha, Sarakta Kapha‐Pitta 
•Dhumrajalabha, Ushna Pitta‐Vata 
Kih
Mi h
Sit
•
K
r
is
h
na, 
Mi
s
h
ravarna
S
ann
ipa
t
a
•Snigdha, Ushna, Rakta  Rakta
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
16

20. hiidi dii
Clinical aspects of Ashtasthana Pariksha
C
h
anges 
in ur
ine 
d
ue to D
isease con
di
t
ion 
•
Tandula
toyavat
Ajrna
Tandula
toyavat
Ajrna
•Dhumra varna, Bahumutra Nava jwara 
h
•Ba
h
umutra Amavata
•Asruksadrusha(like blood),  pita Jirnajwara
•Rakta, Pita Kamala 
•
Pita
Sarakta
Pittaja
Mutrakruchchha
Pita
, 
Sarakta
Pittaja
Mutrakruchchha
•SapichchhaKaphajaMutrakruchchha
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
15

21. 3Ml
Pikh
Clinical aspects of Ashtasthana Pariksha 3
. 
M
a
la 
P
ar
ik
s
h
a
•
Directexaminationofthe
fecal
matterbythe
Direct
 examination
 of
 the
 fecal
 matter
 by
 the
 
naked eye can tell a lot about the digestive 
state of the body. 
•The colour, consistency, floating nature, smell, 
presence of blood or mucus in stool gives a lot 
of information about various dosha imbalances or diseases
•SaamaNiramacondition of the feces is noted 
specifically in Ayurveda 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
14

22. Jl
Ni jj
Pih
Pikh
Clinical aspects of Ashtasthana Pariksha
J
a
la
Ni
ma
jj
ana
P
ur
is
h
a
P
ar
ik
s
h
a
•
Aspecializedtechniqueofstoolexamination A
 specialized
 technique
 of
 stool
 examination
, 
is conducted to detect the presence of Ama 
therebyinferringthestatusofAgni thereby
 inferring
 the
 status
 of
 Agni
 
•If stool sinks in water it has amadoshaand if 
notthenitisnormal not
 then
 it
 is
 normal
.
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
13

23. 4
Jih
ikh
Clinical aspects of Ashtasthana Pariksha 4
. 
Jih
wapar
ik
s
h
a
•
The
colour
shape coatingofa
The
 colour
, 
shape
, 
coating
 of
 a
 
tongue can be indicative of many 
digestiveabnormalities digestive
 abnormalities
.
•Commonly we observe only sama
nirama
condition
nirama
condition
 
•But the exclusive tongue diagnosis 
bd
Chi d
can 
b
e ma
d
e 
–
Chi
nese ma
d
e a 
special efforts for it 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
12

24. Clinical aspects of Ashtasthana Pariksha
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
11

25. 5
Shbd
Pikh
Clinical aspects of Ashtasthana Pariksha
5
. 
Sh
a
bd
a
P
ar
ik
s
h
a
•
Thishaveacontradictionandconfusion This
 have
 a
 contradiction
 and
 confusion
 
•Many say that it is the sounds which we have 
tofeelfromthepatientlikeintestinalgargling to
 feel
 from
 the
 patient
 like
 intestinal
 gargling
, 
Heart sounds, Plural rub, cripitusetc.  
Oh h h i i i b
•
O
t
h
ers say t
h
at t
h
e pat
ient vo
ice 
is to 
b
e 
evaluated as Deena, Gadagada, Kaphachada, 
etc. 
•Both are appreciable 
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
10

26. 6
Sh
Pikh
Clinical aspects of Ashtasthana Pariksha
6
. 
S
pars
h
a
P
ar
ik
s
h
a
•
Thetactileperceptionortouchrevealsmany The
 tactile
 perception
 or
 touch
 reveals
 many
 
aspects
•
Cold,hot,smooth,rough,soft,hard Cold,
 hot,
 smooth,
 rough,
 soft,
 hard
 
perceptions, fever, edema etc. should be 
examined through tactile perception.
•Skin is –
–
moist
/
wet in Ka
p
ha diseases
,
 
/p ,
–Hot  in Pittajaand 
–rough and cold in Vatajadisorders
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
9

27. 7
Dk
Pikh
Clinical aspects of Ashtasthana Pariksha 7
. 
D
ru
k
P
ar
ik
s
h
a
•
Differenttypesofeyefeaturesmayreflectthe Different
 types
 of
 eye
 features
 may
 reflect
 the
 
personality of a person as well as the state of 
hishealth his
 health
.
•The colourof the sclera, conjunctiva, size of eyeball, 
shape,andtheareaaroundtheeyesgiveinsightinto shape,
 and
 the
 area
 around
 the
 eyes
 give
 insight
 into
 
various serious metabolic diseases.
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
8

28. Dhi
Akhi
Clinical aspects of Ashtasthana Pariksha
D
os
h
a 
in 
Ak
s
hi
•
IfyourbodyisdominatedbytheVatathenthe If
 your
 body
 is
 dominated
 by
 the
 Vata
 then
 the
 
eyes look sunken, dry and smoky.
•
OnaggravationofPitta eyesappearredor
•
On
 aggravation
 of
 Pitta
, 
eyes
 appear
 red
 or
 
yellow in colourand the patient suffers from 
photophobiaandburningsensations photophobia
 and
 burning
 sensations
.
•Kapha predominance eyes appear wet, 
ll d di fl luster
less an
d
 watery an
d
 a pat
ient may 
f
ee
l 
heaviness in the eyelids.
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
7

29. Di b di E
Clinical aspects of Ashtasthana Pariksha
Di
seases o
b
serve
d
 in 
E
ye
•
Prominent/bulgingeyescanbeasymptomof Prominent/bulging
 eyes
 can
 be
 a
 symptom
 of
 
thyrotoxicosis, 
•
Yellow
conjunctivacanbeseenincaseof
•
Yellow
 conjunctiva
 can
 be
 seen
 in
 case
 of
 
weak liver or jaundice, 
i
hi i dii
•prom
inent w
hi
te r
ing aroun
d
 ir
is represents 
joint degeneration with a probability of 
hii
art
h
r
it
is
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
6

30. 8
Akii
Pikh
Clinical aspects of Ashtasthana Pariksha 8
. 
Ak
r
it
i
P
ar
ik
s
h
a
Examination of Akrutiinclude Dia
g
nosis of hair
, nails and 
g,
other body organs can reveal many signs which point 
towards different diseases.
K h liti h il ki ll
b iltb d d
•
K
ap
h
a persona
liti
es 
h
ave o
il
y s
ki
n, we
ll
‐
b
u
ilt
 b
o
d
y an
d
 
joints, tolerance to hunger, thirst, hardship, hot sun.
•
Pittaja
personalitieshavestrongappetiteandthirst,
Pittaja
personalities
 have
 strong
 appetite
 and
 thirst,
 
fair complexion, they are brave, bold and egoistic and 
less hair.
•Vatajpersonalities are prone to many diseases and 
have split hairs and dry skin with DhusaraVarna, and 
theydislikecoldthingsandatmosphere. they
 dislike
 cold
 things
 and
 atmosphere.
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
5

31. Gi i i Clinical aspects of Ashtasthana Pariksha G
a
it exam
inat
ion 
•
Thegaitwillplayabigrolein
Akruti
The
 gait
 will
 play
 a
 big
 role
 in
 Akruti
examination –The method of examination is ‐
•
a Initialcontact(heelstrike)
•
a
. 
Initial
 contact
 (heel
 strike)
b. Load response (foot flat) cMid
stance(singlelegstance)
c
. 
Mid
‐
stance
 (single
 leg
 stance)
d. Push off: Til (hlff)
•
T
erm
ina
l stance 
(h
ee
l o
ff)
•Pre swing (toe off)
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
4

32. Gi l
Clinical aspects of Ashtasthana Pariksha
G
a
it cyc
le
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
3

33. Gi
Ali
Clinical aspects of Ashtasthana Pariksha
G
a
it 
A
na
lys
is
1.Pelvic tilt:Normally, iliac crest on the side of swing leg drops 
appro imatel 5ºbelo hori ontalatmid
stanceofoppositeleg
appro
x
imatel
y 
5º
 belo
w 
hori
z
ontal
 at
 mid
‐
stance
 of
 opposite
 leg
2.Pelvic rotation:Normally, during swing phase,  pelvis on ipsilateralside 
rotates 4º anteriorlyand the pelvis rotates 4º posteriorlyon op posite 
side
3.Lateral tilt:Normally, during stance phase, pelvis and trunk shifts 1 inch 
towards the stance 
p
hase le
g
pg
4.Width of base(horizontal distance between 2 feet during double 
support):Normally, 2‐4 inches wide
5
St id l th
(di t b t 2 ti h l t ik fth
5
.
St
r
id
e 
leng
th
(di
s
t
ance 
b
e
t
ween 
2
 consecu
ti
ve 
h
ee
l s
t
r
ik
es o
f
 th
e 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
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
2

34. MGi
Clinical aspects of Ashtasthana Pariksha
M
any 
G
a
its
•1st row 
(
from left to ri
g
ht
)
:
(g
)
•Scissoring gait, 
•
Ataxic
gait
Ataxic
 gait
, 
•Circumductiongait
2nd row 
(
from left to ri
g
ht
)
: 
(g)
•Gluteus maximusgait, 
•
Steppage
gait
Steppage
gait
, 
•Trendelenburggait
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
1

35. Clinical aspects of Ashtasthana Pariksha
Dr. K. Shiva Rama Prasad, at http://technoayurveda.wordpress.com /
0
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