Rogi-roga prariksha. Patient examination.

In the previous verse, Baghbath listed three basic diagnostic tools, their meaning and use. These diagnostic tools should view disease gradually. First Nidan, i.e., finding the causes of disease, then Purvarupa, i.e., the initial symptoms of the disease, then Lakshana, i.e., the clear symptoms of the disease presence, Upashayaa, i.e., the clinical verifications of the disease, and finally Samprapti, i.e., the clear complex idea of the disease.

Thus Baghbath briefly outlined what - in order to comprehend the individual words - requires a broad scope of information and their understanding. The word Nidan includes the complex understanding of the metabolic process in the individual tissues. Nidan begins by understanding Hetu (what nourishes or supports disease). Hetu includes the complete science of psychology, mental behavior and human psychosomatics. Hetu includes also eating habits and lifestyle, life conditions and environment. Hetu includes the properties and effect of various toxins on human tissues. All this involves the Gunas or the Tridosha parameter respectively. In Nidan we comprehend and understand the behavior of the individual diseases. Ayurveda describes the basic diseases originating due to the disturbance of a Dosha, and lists diseases originating due to the combination of various Doshas. To exactly determine the diseases is the knowledge of Nidan.

Purvarupa - pragrup means the previous form. Each disease has its original condition. This requires distinguishing the Gunas of all the necessary and related factors around the human life.

Lakshana means that each disease has its own clear characteristics, just as cold and frost are the characteristics of winter. To distinguish these individual characteristics of a disease will facilitate the progress of its cure. For example, the disease called "coughing" may have the characteristic "dry" and may include fever, or more phlegm, or may involve blood. All these characteristics lead to distinguishing and specifying the causes and facilitate the selection of medicaments and procedures for the cure.

Upashayaa is the clinical verification of disease, finding what supports disease and what does not, including the patient's behavior, eating habits, mental condition and daily routine. For example, when a person has a swelling, we suspect the kidneys, so we have to check the diagnostics of the urine, eyes and tongue to find out what causes led to these changes. This may be not drinking enough water, consuming too much fatty food, stress, etc. Or with a person suffering from insomnia or osteoarthrosis, etc., the faeces have to be checked first and the related causes leading to the health condition have to be discovered. Thus, Upashayaa means carrying out the diagnosis of the waste products and tissues in order to specify the disease and consider a suitable cure. We call this Pathya - all that supports the cure of disease, and Apathya - all that supports the disease. This is a lot of knowledge that requires a deep understanding of the human physiology according to the Ayurvedic view.

Samprapti is the final opinion, which is exact, unmistakable, definite, clear, true, and comprehensive as to the specific disease of the particular patient. In Ayurveda, the diagnosis has to be carried out all the way through to Samprapti.

A symptom is an unambiguously perceptible deviation - Lakshan. Why this deviation has happened is what we must figure out, what might its source be, and we use the questioning of the patient to determine this. Then the practitioner's intellect works on how to restore the patient to normal, using his convictions, learning, experience and his trust in his own findings and process, on how to build a correct diagnosis. Once the solution is found and the patient is restored, we can celebrate!