Roga, Rogi Pareeksha: Examination Of Disease And Patient

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
A comprehensive clinical examination is the basis for proper diagnosis of a disease. A proper diagnosis of the disease is the basis for planning a proper treatment protocol. 

According to Ayurveda, the clinical examination is twofold. It should be methodically done including these two stages of examination. They are as below mentioned.

Comprehensive Clinical Examination or Pareeksha takes place in 2 different steps. They are:

Roga Pareeksha

1. Roga Pariksha – disease examination
Understanding the nature of the disease helps in accurate diagnosis of the disease. The disease should be examined to know –

  • Vyadhi Swabhava – The quality and nature of the disease
  • Vyadhi Pramana – Quantity or magnitude of the disease
  • Nidana Jgnana – The causes of the disease
  • Poorvarupa Gnana – Premonitory symptoms of the disease (symptoms which occur before the manifestation of the disease)
  • Rupa Gnana – Signs and symptoms of the disease
  • Upashaya-Anupashaya Gnana – Aggravating and pacifying factors of the disease
  • Samprapti Gnana – The process of formation of the disease
  • Saadhya-Asaadhyata Gnana – Prognosis of the disease (curability and non-curability of the disease)
  • Upadrava-Udarka Gnana – Complications and Sequel of a disease

Nidana Panchaka

Nidana panchaka – Tools for disease examination:
Nidana Panchaka (5 tools starting with Nidana) are the key tools used for Roga Pareeksha or diagnosis of the disease and knowing the nature of the disease. They are as below mentioned:

  • Nidana – helps us to learn about causative factors of the disease, the knowledge of which is the key to know why and how the disease process was initiated
  • Purvarupa – Premonitory symptoms of the disease which help in knowing the disease in the earlier stages of its manifestation
  • Rupa – Signs and Symptoms of a disease which help in understanding the manifested disease
  • Upashaya-Anupashaya – Identifying a disease or diagnosing it on the basis of trial and error method after analyzing the aggravating and pacifying factors operating on a disease
  • Samprapthi – It helps in knowing the story of the disease. We can understand the process or steps in which the chain of events leading from ‘exposure to causative factors’ to the ‘manifestation of the disease’ occurs, i.e. pathogenesis of the disease.

Rogi Pareeksha

Rogi Pareeksha (Aaatura Pareeksha) – patient examination:
Rogi Pareeksha and Roga Pareeksha together would complete the protocol of a comprehensive clinical examination. Rogi Pareeksha should be done to know –

  • Prakriti – Basic constitution (physical and mental makeup acquired at birth) of the patient
  • Vikriti – The changes occurring in the basic Prakriti or the morbid changes taking place in different parts of the body or mind or both in relation to Prakriti. Vikriti is the abnormal deviation or imbalances of the Prakriti.
  • Sara – Status, quality and quantity of the tissues
  • Samhanana – Compactness of the body
  • Pramana – Measurements of the body parts and calculations of components to differentiate between normal and abnormal mathematics of the body
  • Satmya – Compatibilities related to the patient, wholesomeness developed by habits which result in conduciveness to the health
  • Satwa – Mental strength, tolerance levels, emotions and moods of the patient (mental parameters)
  • Aahara Shakti – Assessment of metabolism and digestion capacity
  • Vyayama Shakti – Exercise tolerance of the patient
  • Vaya – Age of the patient
  • Bala – Physical built strength and immunity of the patient. The endurance, compactness and stamina of an individual also can be accessed.
  • Read related: Complete Pulse Diagnosis Method As per Ayurveda Textbook

Tools of Rogi Pareeksha –
There are many ways in which Rogi Pareeksha or examination of the patient is conducted. They are as below mentioned:

Dwividha Pareeksha

Dwividha Pareeksha or 2 fold diagnosis
– Pratyaksha (as seen and perceived by doctor directly) &
– Anumana (Inference)

Trividha Pareeksha

Trividha Pareeksha or 3 fold diagnosis
– Darshana (Inspection)
– Sparshana (Palpation/Percussion/Auscultation or by feeling the diseased area) &
– Prashna (Questioning or interrogation)

Chaturvidha Pareeksha

Chaturvidha Pareeksha – 4 fold diagnosis
– Pratyaksha – as seen and perceived by the physician
– Anumana – inference
– Aptopadesha – application of knowledge learnt through shastra (science) and teachings
– Yukti – situational application of wisdom and knowledge

Shadvidha Pareeksha

Shadvidha Pareeksha – 6 fold diagnosis
– Chakshurindriya dwara pareeksha – examination by seeing (inspection)
– Ghranendriya dwara pareeksha – examination through smelling
– Shravanendriya dwara pareeksha – examination through hearing (auscultation)
– Jihvendriya dwara pareeksha – examination through taste
– Sparshanendriya dwara pareeksha – examination through touch
– Prashna pareeksha – interrogation

Ashta Sthana Pareeksha

Ashta Sthana Pareeksha (8 fold diagnosis) includes examination of
– Nadi (Pulse)
– Mala (Stool)
– Mootra (Urine)
– Jihwa (Tongue)
– Shabda (Sounds)
– Sparsha (Touch)
– Drik (Eye)
– Akriti (Built, gait, decubits etc)

Dashavidha Pareeksha

Dasha Vidha Parreeksha (10 types of patient examination):
– Prakriti – Examination of physical constitution of the patient
– Vikriti – Examination of morbidity
– Sara – Examination of essence of dhatus (tissues)
– Samhanana – Examination of compactness
– Pramana – Examination of measurements and dimensions of organs and tissues (Anthropometry)
– Saatmya – Examination of suitability (homologation)
– Satva – Examination of mind or psyche (mental faculties)
– Ahara shakti – Examination for ‘capacity of food intake’
– Vyayama shakti – Examination for ‘capacity of exercise’
– Vaya – Examination of age

Benefits of Pareeksha

Rogi Pareeksha and Roga Pareeksha together forms the basis of a comprehensive protocol of examination wherein the exact nature of the disease and diseased would be clearly known. Pareeksha helps in –

  • Proper diagnosis of a disease
  • Proper assessment of disease process, step-by-step
  • Knowing the prognosis and thereby getting a clear idea of one’s limitation in terms of handling a case. It helps the physician to decide if he can handle the case or if it would be wise enough to refer the case to related specialties.
  • Helps in knowing the condition of the patient (physical and mental)
  • Helps in planning a comprehensive treatment (including diet and lifestyle recommendations) protocol

Just Before Finishing –
A comprehensive treatment can be planned and administered only if the diagnosis of a disease is properly made and the condition of the diseased known. For this to happen, the physician should be well versed in the knowledge of clinical examination. Therefore, clinical examination of the ‘disease and diseased’ form the cream of clinical success
Click to Consult Dr Raghuram Y.S. MD (Ayu)

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