Acquiring Knowledge About the Diseases: An Important Tool for the Physicians 

Dr. Dilip Kr. Goswami. MD (Ayurveda), Ph.D*

*Corresponding Author: Dr. Dilip Kr. Goswami, MD (Ayurveda), Ph.D,  Associate Professor Agada Tantra and Vidhi Ayurveda (Toxicology and Forensic Medicine) Govt. Ayurvedic College, Guwahati,Assam, India.

Received Date:  May 15, 2021

Publication Date: June 01, 2021

To start treatment of a disease with an expectation of success a confirm diagnosis is important. A confirm diagnosis can only be expected when a meticulous examination of the patient is done. The different steps of expert patient examination can be considered as – (1)History taking, (2)General examination and (3)Systemic examination which are to be followed by (1)Provisional diagnosis (formation of a hypothetic opinion about the process of the disease development ), (2)Differential diagnosis (to think about the other diseases that have close similarity on signs –symptoms, aetiology etc. with the provisional diagnosis and try to exclude the other conditions ) and (3)Diagnosis (ultimately the disease is made confirm to be of one category and name ). To arrive at the diagnosis now-a-days the help of the laboratory investigations, X-ray, Ultrasonography, CT Scan etc. are taken wherever felt necessary. 

Looking back to the ancient Indian system of medicine “Ayurveda” it is observed that, during those days the facility of investigation was too less. In most of the times an idea about the character of the stool, urine, vomitus, blood (in case of haemorrhage) etc. were developed by asking questions to the patient. Hence it is to be admitted that, during those days the responsibility of a physician was far more in reference to diagnosis. An expert and experienced physician only can collect correct and beneficial informations from the patient.

In the ancient classics of health science more stress and attention was given on examination of the disease (Rogapariksha) which can be considered as the unique concept. As said the detail knowledge of the disease helps the physician to guess the severity and effect of the disease which is an important tool for preparation of a treatment schedule.

The scholars advice to perform the examination of the disease in the following five points (fivefold examination of disease – Panchanidana) –

(1) Nidana (Aetiological factors) : - A person suffers from disease due to violation of the healthy rules of food and behavior. Hence to know about the causative factors of the disease the patient should always be asked about the food, exercise, behavior etc. he/she made before the attack of the present situation. For the purpose some questions, like (1)have you taken any food that you have not taken previously which was followed by the development of the present  signs and symptoms ? (2) have you got exposure to any environment which you don’t think to be homologus to you? (3) Have you done any work (in respect of time and duration) that you have not done previously? etc. are to be asked and the answers should be noted and analysed sincerely.

(2) Purbarupa (Prodromal symptoms): - Most of the diseases show some mild symptoms before appearance of the full-blown diagnostic characters. The feelings of the person concern (patient) before some days of becoming “diseased” helps in developing an idea about the diagnosis. Example – Anorexia, feeling of fullness of abdomen, gargling sound in the abdomen followed by loose stool directs towards indigestion.

(3) Rupa (Signs and symptoms): - The signs and symptoms presented by the patient reaching to the physician indicates diagnosis, severity and character of the disease. Example – feeling of hotness and burning sensation of the body characterized by 1020F temperature indicates fever.

(4) Upashaya (Therapeutic test): - Some diseases show reduction / aggravation on exposure to some diets, regimens and behaviours. It gives an idea about the character of the disease and guides towards diagnosis and proper management. Example – A person, when gives the history of increase of the signs and symptoms after food indicates Gastric ulcer. Sometimes some medicines are also becomes necessary to prescribe to the patient keeping under observation to know about the character of the diseases. The common and ideal question to get information on this point from the patient is – Have you observed any aggravation /decrease of the signs and symptoms after/before taking food / environment / behavior etc. If the answer is yes the detail about the diet, environment, behaviour etc. are to be enquired.

(5) Samprapti (Pathogenesis): - After gathering informations said till now an idea on the process of development of the disease should be postulated which includes the informations like – (1)the causes of the disease,(2)the course of development and the signs-symptoms indicating the beginning of the disease process, (3)the character of the disease that helps in giving a nomenclature, (4)the diets, environment and behavior to be advised to the patient during treatment and (5)the process of beginning, spread (if any), selter (site) and the mechanism of development of the disease.

THE ABOVE DISCUSSION INDICATES THAT, THE ANCIENT INDIAN PHYSICIANS WERE NOT BEHIND IN STUDY, OBSERVATION AND FOLLOW-UP OF THE DISEASE AND PATIENT. THEY GAVE MAXIMUM EFFORT TO COME TO A DECISION ABOUT THE PATIENT AND THE DISEASE WITH THE AIM TO ADVICE EFFECTIVE TREATMENT. THE CONCEPT OF 5 FOLD EXAMINATION (PANCHANIDANA) OF THE DISEASE CAN BE CONSIDERED AS AN UNIQUE AND IMPORTANT CONCEPT OF THE ANCIENT INDIAN SCHOLARS OF HEALTH SCIENCE.

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Volume 2 Issue 6 june 2021

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