Nidan

A physician’s job is to know the human body and its functions in terms of Prakritisthata (homeostasis). The four cornerstones of diagnostic medicine, each essential for understanding homeostasis, are: anatomy (the structure of the human body), physiology (functions of Dosha, Dhatu and Mala), pathology (what can go wrong with the anatomy and physiology) and psychology (thought and behavior). Once the doctor knows what is normal and can measure the patient’s current condition against those norms; she or he can then determine the patient’s particular deviation from homeostasis and the degree of deviation. This is called diagnosis. Once a diagnosis has been reached, the doctor is able to propose a management plan, which will include treatment as well as plans for follow-up.

From this point on, in addition to treating the patient’s condition, the doctor educates the patient about the causes, progression, outcomes, and possible treatments of his ailments, as well as providing advice for maintaining health. In the beginning, most of the students and practitioners find that it is very difficult to diagnose a disease on the basis of Ayurvedic principles or if they manage to diagnose, they still may not feel satisfied.

I think we have failed to teach and train the students to perform Ayurvedic diagnosis. It is so simple, clear, and easy-to-do Ayurvedic diagnosis, provided that the students have qualities such as intuition, knowledge, examination skill, logical thinking, and continuous practice. It is essential to get the direct training from the Guru in order to become perfect in Ayurvedic diagnosis, as evidenced by Vagbhata’s citation. Proficiency comes by continuous practice, just like the genuineness of diamonds, etc. cannot be known by mere reading of books. Aptopadesha, Pratyaksha, and Anumana Pramana are the methods used for understanding the stage, state, and site of Dosha. Complete knowledge cannot be obtained by knowing fragmentary knowledge. Ayurveda advises examining the person as a whole, treating as a whole, and using the drug as a whole.