DETERMINATION OF METHOD, TOOLS AND SENSORY ORGAN IMPORTANCE IN SYSTEMIC EXAMINATION

DETERMINATION OF METHOD, TOOLS AND SENSORY ORGAN IMPORTANCE IN SYSTEMIC EXAMINATION

• Systemic examination in the context of Rachana Shareera aims to analyze the structure and function of individual body systems in a methodical manner.

• Classical Ayurvedic texts emphasize the role of Indriyas (sensory organs), Pareeksha Vidhi (methods of examination), and Yantras (tools or instruments) for proper assessment of body systems.

• In modern anatomy, systemic examination involves observation, palpation, percussion, auscultation, and specialized diagnostic tools.

METHOD OF EXAMINATION (PAREEKSHA VIDHI)

• Darshana, Sparshana, Prashna are the three main tools of Trividha Pareeksha used for examining the body.

  DARSHANA (INSPECTION)

  • Visual observation of physical features such as posture, color, swelling, asymmetry.

  • Useful in examining skin, eyes, gait, and deformities.

  • Sanskrit Reference:
    दर्शनस्पर्शप्रश्नैस्तु यथासम्भवमात्मनः।
    रोगिणश्च विशेषेण परीक्षां समुपाचरेत्॥
    (Charaka Samhita, Vimanasthana 4/4)

  SPARSHANA (PALPATION/PERCUSSION/AUSCULTATION)

  • Palpation assesses temperature, tenderness, consistency, pulsation.

  • Percussion detects underlying fluid, air, or solid mass.

  • Auscultation is used for heart, lung, bowel sounds.

  • Sanskrit Reference:
    स्पर्शात्तु ज्ञायते शोफो रूक्षता स्निग्धता तथा।
    (Ashtanga Hridaya Sutrasthana 12/23)

  PRASHNA (INTERROGATION)

  • Involves systematic questioning to know symptoms, duration, aggravating or relieving factors.

  • Important in systemic history taking before physical examination.

  • Sanskrit Reference:
    प्रश्नैश्च लक्षणं ज्ञेयं पूर्वरूपं च लक्ष्यते।
    (Charaka Samhita, Vimanasthana 4/5)

TOOLS OF EXAMINATION (YANTRAS & MODERN INSTRUMENTS)

• Ayurvedic View:

  • Traditional tools include Nadi Yantra, Mutra Patra, Jihva Patrika, Prakriti Pareeksha Chart.

  • Observation of sensory responses by stimulation with natural tools like ushna-jala, sheetala-jala, sparsha etc.

• Modern View (as per BD Chaurasia):

  • Stethoscope – for auscultation of heart and lungs.

  • Sphygmomanometer – for measuring blood pressure.

  • Tuning Fork – for auditory examination.

  • Reflex Hammer – for testing deep tendon reflexes.

  • Ophthalmoscope – for eye examination.

  • Otoscope – for ear and tympanic membrane examination.

  • Pen Torch – for pupillary reflex and oral cavity examination.

  • Thermometer – to measure body temperature.

  • Measuring Tape & Weighing Scale – for anthropometric measurements.

  • Snellen Chart – for testing visual acuity.

IMPORTANCE OF SENSORY ORGANS (INDRIYA) IN SYSTEMIC EXAMINATION

• Each Indriya (sensory organ) plays a crucial role in perception during systemic examination:

  CHAKSHURINDRIYA (VISUAL ORGAN)

  • Observes physical characteristics, asymmetry, swelling, deformities, rashes.

  • Detects discoloration, gait, facial expressions, posture.

  TVAKINDRIYA (TACTILE ORGAN)

  • Perceives warmth, tenderness, texture, rigidity, or softness.

  • Important in Sparshana Pareeksha.

  GHRAANINDRIYA (OLFACTORY ORGAN)

  • Identifies odor of wounds, discharges, breath (useful in diagnosis of conditions like prameha).

  RASAANINDRIYA (GUSTATORY ORGAN)

  • Evaluates taste disturbances during history taking, helpful in diagnosing Jwara, Agnimandya etc.

  SHROTRINDRIYA (AUDITORY ORGAN)

  • Useful in auscultation (heart, lung, bowel sounds) and assessing patient’s speech.

  MANAS (MIND AS A PERCEPTIVE FACULTY)

  • Coordinates all sensory inputs to derive meaningful understanding.

  • Important in interpreting responses during systemic examination.

• Sanskrit Reference:
  चक्षुः श्रोत्रं घ्राणं रसनं त्वक् च पञ्चमे।
  पञ्चेन्द्रियाण्येतानि स्युः बौद्धिकं च मनोऽपि च॥
  (Indriya Vijnana)

INTEGRATION WITH MODERN HUMAN ANATOMY (BASED ON BD CHAURASIA)

• BD Chaurasia emphasizes the regional anatomy and systemic anatomy approaches.

• Systemic Examination includes:

  • Nervous System: Cranial nerve exam, motor-sensory testing, reflexes.

  • Cardiovascular System: Inspection of chest, palpation of apex beat, auscultation for murmurs.

  • Respiratory System: Observation, chest expansion, breath sounds.

  • Digestive System: Abdominal palpation, auscultation of bowel sounds.

  • Musculoskeletal System: Range of motion, deformity check.

  • Endocrine System: Thyroid palpation, observation of signs like tremors, hair loss.

• Importance of clinical correlation with anatomical structures for diagnosis is highlighted.