“Rogamadou pariksheta tatoanantaramoushadham” (Charaka sutrasthana 20/20)
Ayurvedic texts suggest to diagnose the disease first and then to think over the treatment. For proper diagnosis of the disease and disease condition, patient’s different patho-physiological conditions are examined under the broad heading Ashtavidha pariksha (8 types of investigations).
Ashtavidha pariksha include the following:
Among the above mentioned diagnostic procedures, Mutra pariksha, (examination of urine) has been given special attention to in some of the medieval texts like Yogaratnakar, Basavarajiyam, Chikitsasara etc. Along with the examination of color, appearance and consistency of urine, a special technique for the examination of the Mutra, Tailabindu pariksha, was developed to diagnose disease conditions and to find out about their prognosis. For this, the patient’s early morning (around 5 o’clock) urine sample is to be collected either in clean oval shaped open earthen pot ora clean glass vessel. This should be maintained in a stable condition and closely and carefully examined during sunrise. For this, one drop of Tila taila (sesame oil) is slowly dropped over the surface of urine without causing disturbance under sunlight. The patterns’ and the distribution of the oil drop on the urine are then considered to determine the diagnosis and prognostic features of the disease.
Diagnosis of the disease by the examination of urine
By appearance of urine
- Diagnosis of Dosha involvement
- In “Vata” aggravated diseases, urine of the patient appears as Pandu varna (whitish) or slightly ‘Nilam’ (Bluish).
- In Kapha dominated conditions urine becomes “Phenayukta”, i.e., frothy or Snigdha(cloudy).
- In Pitta aggravation urine appears yellowish or Rakta varna (reddish).
- In case of rakta-aggravation urine become Snigdha, Ushna (hot) and resembles blood.
- In Dwandaja, i.e., a state of combined Dosha aggravation, mixed colours are seen in the appearance of the urine as per the Dosha involved in the diseases causation.
- In Sannipata state urine becomes Krishna varna (blackish).
- Diagnosis of disease involvement
- In the case of diseases related to ‘Ajirna’ (indigestion), urine appears like Tandulodaka(rice water).
- In Navina Jwara (acute fever) urine appears ‘Smoky” and the affected passes more urine (Bahu Mutrata)
- In Vata-Pitta jwara – urine is smoky, watery and hot.
- In Vata Shlesmajwara – urine is whitish with air bubbles.
- In Shlesma-Pitta jwara – urine is polluted and is mixed with blood.
- In Jirna (Chronic) jwara – urine becomes yellowish and red.
- In Sannipata jwara – urine appears in mixed shades depending on the Dosha involvement
Also, it is said that if urine is placed in a glass jar and appears reddish in the bottom, the patient is suffering from Atisara(diarrhoea). If the urine has particles appearing like the droplets of ghee, it indicates Jalodara(Ascites). In Amavata (Rheumatoid arthritis), urine appears as Vasa (fat) or Takra (buttermilk). In Vata jvara, urine appears reddish or kunkuma (saffron) in colour, and in excessive passage of stools’, urine becomes yellowish.
By shape of the spread oil drop
- Diagnosis of Dosha involvement
- If Tailabindu takes a snake like image in the urine, it is Vata roga.
- If urine takes an “Umbrella” shape it is Pittaja roga.
- If urine spreads like Pearl (Mukta) it is Kaphaja roga.
Also, it is said that if the Vata is predominant, then the Taila attains Mandala (circular shape); in Pitta diseases it attains Budbuda (bubbles) shape; in Kapha diseases it becomes Bindu (globule or droplet) and in the Sannipata the Taila sinks in the urine.
- Diagnosis of disease involvement
- If the dropped Taila bindu takes a Chalini (sieve) shape in the urine sample and then spreads, it is a definite indication of ‘Kuladosha” (genetic disorder).
- If the dropped Taila bindu takes the image of human being (narakaram) or skull it indicates ‘Bhutadosha’ and is treated accordingly.
Prognosis of disease by the examination of urine
By spreading nature of the oil
- If inserted oil spreads quickly over the surface of urine, that disease is Sadhya (curable or manageable).
- If the oil does not spread it is considered as Kashta sadhya or difficult to treat.
- If the dropped oil directly goes inside and touches the bottom of the vessel, then it is regarded asAsadhya or incurable. Also, in another text it is mentioned that if the oil does not spread and remains as a droplet in the middle of the urine the disease is considered incurable.
By spreading direction of the oil
- If the oil spreads in the direction of Purva (east) the patient gets relief.
- If the oil spreads in the south direction, the individual will suffer from jwara (fever) and gradually recovers.
- If the oil spreads in the northern direction, the patient will definitely be cured and become healthy.
- If the oil spreads towards the west, he will attain Sukha and Arogya i.e. happy and healthy.
- If the oil spreads towards the Ishanya (Northeast), the patient is bound to die in a month’s time; similarly, if the oil spreads into Agneya (Southeast) or Nairutya (Southwest) directions, or when the instilled oil drop splits, the patient is bound to die.
- If the oil spreads on to Vayavya (Northwest) direction, he is going to die anyway.
By spreading shapes of the oil
- It is a good prognosis if the oil creates the images of Hamsa (swan), lotus, Chamara (chowri composed of the tail of Yak), Torana (arch), Parvata (mountain) elephant, camel, tree, umbrella and house.
- If the taila attains the shape of a fish, then the patient is free of dosha and the disease can be treated easily.
- If the drop of the taila attains the shape of Valli (creeper), Mrdanga (a kind of drum), Manushya(human being), Bhanda (pot), Chakra (wheel) or Mriga (deer) then the disease is considered as theKashtasadhya (difficultly curable).
- If the spreading oil creates the shapes of tortoise, buffalo, honey-bee, bird, headless human body,astra (instrument used in surgery, like knife etc), Khanda (piece of body material) physician should not treat that patient as that disease is incurable.
- If the shape of the drop of taila is seen as four-legged, three-legged, two-legged that patient will die soon.
- If the shape of the drop of taila is seen in the shape of Shastra (sharp instruments), Khadga (sword),Dhanus (bow), Trishulam (type of weapon with three sharp edges) Musalayudham (pestle),Shrugala (jackal), Sarpa (snake), Vrishchika (scorpion), Mushika (rat), Marjara (cat), arrow,Vyaghra (tiger), Markata (monkey) or Simha (lion), then it is understood that the patient will die soon.
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