Vikriti Pariksha – Examination Of Disease

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Vikriti means an abnormality. It is an abnormal change taking place in basic physical and mental constitution of the body i.e Prakriti. Vikriti also means disease. It is a term which explains pathological manifestations in the body and mind.
Read – Prakriti – Ayurveda Body Types, Importance In Treatment And Remedies

Predominance of dosha is not always abnormal – Prakriti is made up of doshas. When a particular combination of doshas which make up body constitution are at increased levels, they show signs of increase and this is not pathological. This is because a person having predominance of a dosha(s) will obviously show their signs and they are normal. The predominance of one or more doshas itself is called prakriti. A particular dosha in spite of being increased in comparison to the other doshas in a state of prakriti would not cause diseases because it is merely an increase in that dosha as per the law of dominance of one’s constitution. We cannot call it an imbalance. Though it is a relative imbalance of doshas it is a healthy balance and contributes towards maintenance of health.

Example 1 – In Vata constitution person vata is predominant. This is not considered a pathological increase of vata. It also doesn’t cause diseases. Vata is just predominant in comparison to pitta and kapha and is normal to that person. Pitta and kapha are less predominant in comparison to vata.

Example 2 – In pitta-kapha constitution either pitta or kapha or both are predominant in comparison to vata. Vata is less predominant in comparison to pitta and kapha. It is normal and not pathological.

The other constitutions too shall be considered and understood in a similar way.

Knowledge of vikriti is essential for a physician for treating the diseases in a comprehensive way. This is because when vikriti happens, imbalances occur in the body components and cause disease. Examination of vikriti includes understanding the disease.
Read – Dosha Prakriti Theory And Modern Genetics

Examination of Vikriti

Disease shall be examined by understanding the below mentioned factors in relation to the pathology of that disease –

Hetu

Hetu means etiological factors of a disease. Exposure to etiological factors is essential for the onset of the disease process in the body. They will first cause imbalance of doshas. These vitiated doshas in turn will contaminate the tissues of the body, thus leading to the formation of diseases. The nature, quantity and strength of etiological factors determine the nature, quantity and strength of the disease. Also help the doctors to advise patients to keep away the causative factors.
Read – Nidana: Meaning, Word Derivation, Definition

Dosha

The diseases are caused due to imbalances in the doshas. These imbalances may be in individual doshas or relative to other doshas. Imbalance in a dosha will obviously cause its relative imbalance with the other two doshas. The qualitative and quantitative imbalance of doshas should be understood. This imbalance may be either in the form of pathological increase or decrease. Thus the deformity of disease process shall be examined by means of understanding the involved doshas in the pathogenesis of that disease.
Read – Tridosha Theory in Ayurveda

Dushya

Dushya means the components of the body which tend to get contaminated by the vitiated doshas. The tissues in healthy state are the body’s first line of defense. The quantity and number of tissues contaminated by the vitiated doshas determines the nature and prognosis of the disease. The extent of damage of the tissues also reflects lowering of strength and immunity of an individual. The status of tissues should be considered while examining the disease.
Read – Dhatu – 7 Body Tissues As Explained In Ayurveda

Prakriti

The constitution of the patient is called prakriti. The constitution of every person is made up of dosha(s) and the same doshas when imbalanced causes diseases. The people who are made up of a particular dosha / doshas constitution will be prone to get diseases caused by the same doshas in comparison to the other doshas. By knowing the constitution of a person it is easy to infer the kind of diseases that they would suffer from. Example – A vata constitution person is more prone to develop vata disorders if vata aggravating etiological factors are consumed on a regular basis. Vata people are more likely to get degenerative disorders. Pitta people are more likely to suffer from inflammatory disorders.

Examination of a disease from a prakriti perspective is very important because it helps the physician to know if the disease i.e. vikriti has been developed in the person of the same prakriti or different prakriti. This also determines the type of treatment to be undertaken and also the prognosis of the disease. Example – An obese person coming for treatment of obesity and weight reduction may not necessarily be of kapha constitution (kapha constitution people are more prone to suffer from overweight conditions, obesity and its complications). He or she may tell that they were born thin and grew up with the same body frame and suddenly have gained enormous weight in the last couple of years. This shows that it is a case of overweight or obesity manifesting in a vata constitution person. Obesity in a vata person and obesity in a kapha person will need different treatment approaches and both should be seen as different pathological entities.
Read – Effective Obesity Treatment, Remedies, Ayurveda Tips

The disease producing basic causative factors is also called prakriti. In other words those factors which have the nature of producing particular disease are called prakriti of those things or factors.

Desha

While examining the disease, the desha i.e. the land in which the patient lives should also be considered. This is because particular diseases are predominantly manifested in particular places. Vata diseases are predominant in desert-like lands. Kapha diseases in marshy and wetlands. By knowing the place where the patient resides we can infer the diseases they are prone to get.

The physician should also take into consideration about the below mentioned aspects regarding the place –
– place of birth, upbringing and currently residing place
– the number of geographical places the patient has been in recent time
– the places he frequents etc

All these have an impact on our health and disease. Some people live happy and healthy in the place of their origin and some people discover their health and happiness when they change their place of living. Same rule applies to diseases and suffering too.
Read – Examination of Desha: Habitat / Human Body

Kala

Kala means time factor. It includes many aspects of time like year, month, week, day, hour, minute and second. It also includes various seasons. Time factor should be considered while examining vikriti i.e. deformity / disease. Like land, the time factor too has an impact on disease and health. Aggravation of every dosha takes place at different parts of the day, year and season. The vitiation of dosha at particular points in relation to the time factor helps the physician to understand the disease and its manifestation and also to plan the treatment protocols accordingly.
Read – Kala – The Time Factor

Bala Bheda

Bala means strength, tolerance and also includes immunity. State of health and manifestation of diseases depend on the strength of the person. People having less strength and immunity are more prone for diseases. Similarly, the frequency of manifestation of diseases in a person lowers the strength and immunity.

Bala is of 3 kinds –

– Uttama bala – good strength – has good tolerance towards the disease
– Madhyama bala – moderate strength – has moderate tolerance towards disease
– Alpa / avara bala – less strength – has intolerance or less tolerance towards disease
Read – Bala Samprapti: Understanding pathogenesis Based On Causes And Symptoms

Lakshana

Linga or lakshana means signs and symptoms. Any disease is diagnosed by the signs and symptoms it presents. The disease should be examined for its signs and symptoms. The number and strength of signs and symptoms gives the physician a precise knowledge of the nature and strength of the disease and also its prognosis.

If the signs and symptoms of the disease are weak, the disease is also weak and so is its pathogenesis and can be treated easily. Similarly if the signs and symptoms of any disease are strongly manifested, the disease is difficult to treat or incurable.

If many or all signs and symptoms of the disease are manifested the disease is difficult to cure. Similarly if the disease is manifested with fewer signs and symptoms, the disease can be cured easily.
Read – Roopa – Symptoms: Definition, Types, Benefits of its knowledge

Need of examining the above said factors related to the examination of disease

The above said factors need to be examined while examining the disease because the strength and nature of the disease can never be understood without knowing in depth about these factors which reflect the disease to its fullest. Therefore it is very essential to understand these factors i.e. etiological factors, dosha, tissues, constitution, land, time factor, kinds of strength and symptoms in relation to the disease to understand the disease properly. Therefore the examination of the diseases shall be done from the perspective of these factors.
Read – Vyadhi (Disease) Definition, Meaning And Explanation

Strength of the disease

Balavan Vyadhi / Strong disease – the strength of the disease is said to be at its fullest (severe disease) when –
– doshas, tissues, constitution, land, time factor and strength are similar and
– etiological factors and symptoms are stronger and many

Madhya bala vyadhi – the strength of the disease is said to be moderate when –

– some among the doshas, tissues, constitution, land, time factor and strength are similar and some are dissimilar to each other and
– the etiological factors and symptoms are of moderate strength and quantity

Alpa bala vyadhi / weak disease – the strength of the disease is said to be weak when –

– doshas, tissues, constitution, land, time factor and strength are not similar to each other and
– etiological factors and symptoms are weaker and lesser

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