Ayurvedic diagnosis is multi-faceted and coordinates and translates signs from many factors. Some of which (as outlined previously) include the seasons; tastes; smells; the dominant dosha subtype of a patient; the presenting symptoms and their relationship with the Elements and their connected organs; even the time at which the symptoms are most heightened. As a result, Ayurveda outlines three procedures for diagnosis conducted during consultation:
1. Observation (Dashana): Observing an area of the body (eyes/iris/ ear/tongue/facial signs/lips/fingernail & toenail etc) to ascertain the exact cause of disease.
2. Palpation (Spashana): Probing, touching, or tapping the body (pulse reading, auricular (ear point palpation), body and abdominal marma point palpation). Palpation of the whole abdominal area can identify localised areas of pain or inflammation according to the anatomical position of the underlying organ. i.e., pain identified under and around the diaphragm could indicate an issue with the liver. Palpation of the lymph nodes can identify congestion in the lymphatic system. Referred pain (a pain connected to but distal from the impacted area via nadis) is an important factor with palpation, i.e., lung dysfunction can exhibit pain on the left side of the shoulders opposite to the liver.
3. Questioning (Prashna): Identifying information about the patient through questioning. Understanding family history for example, can be very useful context to ascertain common hereditary conditions.
PULSE DIAGNOSIS, HUMORAL PULSES & PULSE QUALITIES
Accurate pulse diagnosis (taken at the site of the radial bone/artery in the arm) is a fine art and contains three positions (on both wrists) highlighting the conditions of the three humours. An Ayurvedic practitioner will read all three Dosha positions on the wrist with their first, middle and ring finger, each finger positioned on the relevant order of the Doshas (see below illustration for detail). Varying pulse qualities will determine an imbalance in the Dosha that is being read. The more prominent the pulse, the more unbalanced the aggravated humour associated to that pulse will be:
Traditionally the pulse of a male is taken on the right wrist as in accordance with the right side of the body being Pitta (male) and vice versa for females (Kapha side). However, as per best practice, pulses should be read on both sides of the body, and the pressure of each finger reading the pulse should be even in pressure.
ORGAN PULSES
As the pulses reflect the balance/imbalance of the Doshas, they also must demonstrate the conditions of each associated major organ via the Nadis carrying Pranic currents. Deep pressure on the pulses detects the condition of the solid organs whereas superficial pressure detects hollow organs. The location of the organ within the body depicts its location on the radial pulse.
TONGUE DIAGNOSIS
The tongue also acts as an important visual tool for ayurvedic diagnosis, revealing information on the doshas and so their associated Elements and organs. The colour & coating on the tongue can also indicate an aggravation of the doshas: If a very thin or non-existent coating portrays a healthy person:
EAR DIAGNOSIS
As with the tongue and pulses, the ear also acts as an important accessible site for diagnosis and a site for treatment of massage and or needling via the nadis. Tender spots on specific sites on the ear indicate the associated dosha imbalances and their corresponding organs. An imbalance in an organ reflects distention of blood congestion in the ear. A problem in the leg for example, can be diagnosed by pressing the leg area of the ear with a fine blunt instrument. This may show sensitivity or tenderness/pain. A needle in this area might result in the release of blood, demonstrating congestion in the related organ of the ear.
