(iii) Mala pariksa (Fecal examination)
In Ayurveda, examination of the stool is a diagnostic tool used to understand the disease. The color of the stool is also helpful in determining the nature of the disease. If the stool is thick with a bluish black color, it emphasizes a predominance of Vata dosa. In this condition, the stool is hard and dry. If the patient is constipated, he/she will excrete rough, frothy stool in small and dry pieces. An excess of Pitta dosa gives the stool a green or yellow color and it is liquid in form. A white color indicates a Kapha disorder. In such patients, the stool is cool, generally well-formed, in sufficient quantity and lined with mucus. If the stool is thick and bluish black with whiteness, it indicates Vata and Kapha dosas. If the stool is yellowish and well-formed but excreted in small pieces, it is an indication of Vata and Pitta dosas being aggravated.
If digestion and absorption are functioning normally, the stool is well-formed and will float in water. But if digestion is improper, the stool sinks and can be sticky and slimy, containing undigested food and with a bad odor. This is an indication of ama and toxins within the system.
Also Read: Different Methods of Disease Examination
If the stool is white and have a severe unpleasant smell, it denotes the onset of ascites. If the stool is black or bluish-black with a severe purulent smell and immediate treatment is not available, then the patient will not survive and death is definite. So an Ayurvedic physician can determine the nature, curability and incurability of the disease on the basis of color, form and smell of the stool.
(iv) Netra pariksa (Ophthalmic examination)
By observing the color of the eyes and other conditions, a physician can determine the nature of disease. Vata predominant eyes are small, dusty, dry, sunken and nervous with drooping eyelids, dry and with scanty lashes, and with unsteady pupils and burning sensation in the eyes.
In Pitta dosa, the eyes are moderate in size, sharp, lustrous and sensitive to light (photophobia) with burning sensation. The lashes are scanty and oily and the iris is yellow or red in color. According to Ayurveda, eyes derive their energy from the basic fire element. The fiery energy in the retina results in sensitivity to light. Thus, people of Pitta constitution, having an abundance of fire in the body, often have eyes that are hypersensitive to light. An excess of Kapha dosa gives white color to the eyes. The eyes are large, beautiful and moist with long, thick and oily eyelashes with excessive discharge, lusterless and sleepy with heaviness in the eyelids and unsteady pupil.
A combination of symptoms appears in the eyes of the patient if any two dosas provocate. If the eyes are bluish-black in color in sannipatika dosa (all three dosas get aggravated together) and vision is stable, then the eyes look sleepy. If the eyes are red or black in color and look fearful, then the patient is incurable. So ophthalmic examination plays an important role in knowing the cause, curability and incurability of the disease.
(v) Jihva pariksa (Tongue examination)
The tongue is an organ of taste and speech. Besides, it is a sensory organ, hence observation of the tongue is an important part of the examination. Tongue examination also helps a physician to determine the condition of a patient. If the tongue is cold, numb, dry, rough and with crevices, it indicates that Vata dosa is predominant. If it is red or blue in color with a burning sensation and prickliness, it indicates predominance of Pitta dosa. In Kapha vitiation, the tongue is white in color, wet, cool, slimy, heavy and thickly coated. If the tongue is black in color, dry, rough, bitter, with crevices, burning and prickliness, it indicates aggravation of sannipatika dosa.
A coating covering the tongue indicates toxins in the stomach, small intestine or large intestine. If only the posterior part is coated, toxins are present in the large intestine. If the middle part of the tongue is coated, toxins are present in the stomach and small intestine. Examination of the tongue is also helpful to know about the condition of fever, curability and incurability of a disease.
(vi) Svara pariksa (Voice examination)
If the voice becomes rough and hoarse, it indicates predominance of Vata dosa. If the voice is clear and loud, it denotes Pitta dosa. If the voice becomes heavy and hoarse, it indicates that Kapha dosa is predominant.
(vii) Sparsa pariksa (Tactile examination)
Vata aggravated skin is coarse, rough and dry with below normal temperature giving a sensation of coolness. Pitta influenced skin has a high temperature. If the skin becomes oily, cold and moist, it indicates that Kapha dosa is predominant.
(viii) Akrti pariksa (General appearance and nature examination)
Besides the above-said examinations, some other points are also helpful for a physician to know the nature of the disease.
In the Vata aggravated individual: The appearance of skin and hair is rough and dry, the skin is cracked and the hair has split ends. Their nature is not amicable; they lack patience, memory, and intellect; they are very talkative, and their liking is for cold substances.
In the Pitta aggravated individual: The appearance of the skin is yellowish and hot; the palms, soles of the feet and face resemble the color of copper; they have less bodily hair, and the hair are golden in color. Their nature is short-tempered and egoistical.
In the Kapha aggravated individual: The appearance of the skin is white, and they have well-formed joints, bones, and muscles. According to their nature, such individuals are not much affected by hunger, thirst, grief, and pain.
Other than the above-mentioned eight examinations, some physicians also diagnose the causes of disease by examination of the mouth and nails too.
- Asya (mukh) pariksa (Oral cavity (mouth) examination)
Aggravation of Vata dosa is indicated by a sweet taste in the mouth. Aggravation of Pitta dosa is indicated by a bitter taste. A sweet-sour taste denotes the provocation of Kapha dosa. If taste is of mixed type, this is an indication of provocation of tridosa. Indigestion is reflected by a taste resembling ghee, and oiliness and stickiness in the mouth. An astringent taste indicates dyspepsia (weak digestive fire).
- Nakh pariksa (Nail examination)
A physician can also determine the nature of disease by observing the patient’s nails. Aggravated Vata is the cause of blue nails. Excess Pitta dosa gives red or yellow color to the nails. White color indicates the predominance of Kapha dosa. If the nails are yellow or red with a bluish haze, it indicates vitiation of both Vata and Pitta dosas. If the nails become yellow or white it indicates vitiation of Kapha and Pitta dosas. If the symptoms of all three dosas are visible, it indicates sannipatika roga and the nails are blue, yellow, green or white with a reddish haze. Such a condition reflects incurability of a disease. Symptoms of abdominal disorders are reflected by white spots visible on the nails and fragile skin near the nails. Hence, by means of nail examination, a physician can also diagnose and identify the disease.