Sushruta Samkhita claims that:

 "An Ayurvedic doctor should compare the influence of doshas, the age of the patient, his or her prakriti (nature), hunas (state of soul), vital energy, vital power, mental status, the food he’s eating, his pulse, three Malas (ama of the body)  by questioning the patient about his health. Only then can the Doctor commence the treatment".  Each of these aspects influences the correct diagnosis.
 

Ashtanga Khridaya Samkhita claims

 "The Doctor has to analyse the reason for the disease,the  state of the organs, the distortion of the doshas, the area in which the condition appeared and procedures which can help to eliminate them.  He, who regards the state of dhatu and ama, the place of their execution, takes into account the time of year which can give rise to the disease, the body structure and resistance to various diseases, mental capability, eating habits and all the other areas of the patient's life, and only then  starts treatment, will never make a mistake".
(Vahbhata, Ashtanga Khridaya Samkhita 1.12.36 – 38)
 
Octagonal (asta-bidha) examination (pariksa)
 
An Octagonal survey provides a clear picture of the nature of the disease and the general condition of the patient. It includes checking of the pulse, tongue, voice, skin, eyes, general form, urine and stool. 
 

Examination process

1. Examination of the pulse (nady parishya)

The checking of the pulse is one of the greatest clinical arts in Ayurvedic diagnostics. It allows the physician to understand the history of the patient’s disease. The best time period for checking the pulse is early morning. Diagnostics is better and more effective when the stomach is empty. In critical situations it can be done at any time of day or night. An experienced Ayurvedic doctor will learn your prakriti and the nature of your body, its pathological state (vikriti), type of body disbalance (doshatype) and even anticipate the progress of the disease. 

2. Tongue examination (jivkha pariksha)

 In case of Vatta, the tongue is dry. In case of Pitta, it is red and hot. In case of Kapha, it’s wet and covered with saliva.

3. Voice examination (shabda pariksha)

A healthy and normal pitch of voice is low when kapha dominates. It is sharp and high, when pitta is strong. It’s rude and hoarse, when vatta dominates. 

4. Skin examination (sparsha pariksha)

Palpation is an important clinical method for testing the skin. When it is necessary to pay attention to the dominant dosha: the predominance of Vatta makes the skin dry and rough with a low temperature, the predominance of Pitta leads to increased skin temperature, and the predominance of Kapha causes moist and cool skin..

5. Eye examination (drishau pariksha)

 The dominance of vatta makes the eyes sunken, dry and reddish-brown. When pitta is stong, they turn red or yellow, and the patient suffers from photophobia and a burning sensation. When Kapha is predominant it makes the eyes moist and watery with a feeling of heaviness in the eyelids.

6. General examination

 Face, expressing the influence of doshas, lets the doctor analyse the general constitution of the patient and the nature of  the disease. 

7. Urine examination (mutra pariksha)

To assess the impact of the doshas during this examination, it is important to conduct a urine test and interview the patient. The test (pariksha) involves dropping (bindu) oil (tile) onto the urine. This test can display the existence of any disease or  illness in the organism of the patient.

8. Stool examination (mala pariksha)

 If the digestion and assimilation of food functions badly, the stool has a bad smell and sinks in water. Under the dominance of vatta, the stool is hard, dry and has a grey colour. The dominance of pitta makes the color green or yellow. The predominance of kapha makes it slimy.

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