In ancient India, there were no diagnostic imaging techniques such as ultrasound, X-rays or magnetic resonance imaging. Traditional Ayurvedic doctors were therefore reliant on examining health and illness using their five senses.
Dr Arora from Rishikesh, my first Ayurveda teacher, gave me a piece of advice in 1994: "Learn to hear, feel, see, taste and smell your patient - only then can you understand him.
Today's high-tech diagnostics are of great benefit; the smallest corners of the body can be illuminated and treated in a targeted manner. However, if a person's sensory perception is neglected, valuable information is lost and holistic treatment is impossible.
After the first three articles in this series dealt with the Feel (palpation) of the pulse, the See (inspection) of the tongue and the analysis of excretions, we now turn to the Listen to.
The most important sounds of man
It is so exciting to listen to people attentively. The two most important, highly individual sounds are the voice and breathing sounds. Together they form a concert whose Ayurvedic decoding is of great diagnostic value.
Voice also conveys mood, which is why psychological diagnostics benefit from the therapist's attentive ears.
Depending on the patient's state of health, other sounds from the joints, digestive organs, respiratory tract and heart can also be heard. Stethoscopes have been used as diagnostic tools for 200 years in order to be able to perceive quiet sounds without having to place the ear on the patient's chest or stomach.
The sound world of Vata
If Vata dominates constitutionally or due to a disorder, the voice becomes weak, seems somewhat breathy and you have the impression that speaking takes strength. The increasing dryness favours hoarseness and increases the need to clear the throat. Vata speeds up the pace of speech, sometimes overturning words. In addition to speed, another characteristic of Vata is rigidity and inhibition, which can be expressed in stuttering.
Breathing also speeds up with Vata dominance and becomes shallower as a result. Shortness of breath and breathlessness are particularly noticeable under stress. Breathing and speech become asynchronous, which causes Vata to increase further.
The dryness of Vata favours degenerative processes in the musculoskeletal system, which manifests itself in pronounced rubbing, crunching and cracking noises in the joints. Adjusting the joints only provides psychological relief, but increases the wear and tear.
The movement of Vata leads to air accumulation in the digestive tract with wind and gurgling noises that can often be heard with the naked ear.
The sound world of Pitta
A predominance of Pitta often leads to a clear, louder and penetrating voice with clear articulation. Sometimes it appears pressed with a harsh vocalisation. The pace of speech is also often accelerated, but Pitta rarely loses the thread and gets carried away with his arguments.
The breathing of a person dominated by Pitta is medium-fast and medium-deep, often focussing too much on inhalation. A groan or sigh is often audible - as an expression of inner tension, irritability and impatience.
Joints and the digestive tract do not necessarily manifest themselves in noticeable noises when Pitta increases.
The sound world of Kapha
The general sound of Kapha is calm, peaceful, harmonious and even. The use of the voice is soft and always well „oiled“, the tone colour is soothing. If mucus accumulates in the respiratory tract, there may be an urge to clear the throat or cough with expectoration. The path from Kapha to Ama is close - when Ama is present, the saliva of those affected sounds sticky, which is noticeable every time the mouth is opened.
The pace of speech is slow, rarely communicating more verbally than necessary. The breathing rate is also slow with a greater depth of breath. Exhalation is emphasised and creative pauses in breathing are frequent. As a result, a communication partner dominated by Kapha has a calming and de-escalating effect, in contrast to Vata and Pitta.
Joint and digestive noises are rare, as Kapha is not prone to wear and tear or excessive movement.
Recognising diseases by sound
Numerous diseases have specific sound patterns. These are particularly important for therapists working in internal medicine. Many cardiovascular diseases, respiratory problems and gastrointestinal disorders can be differentiated auditorily.
Paediatricians and gerontologists are also particularly reliant on their senses, as young children and old people are less able to provide information.
Auditory diagnostics and therapy
A particularly exciting phenomenon in the world of hearing is the feedback effect. The faster Vata, more penetrating Pitta or calmer Kapha speaks, the stronger the respective Dosha increases.
This means that auditory diagnostics can be utilised directly for therapeutic purposes through opposite reinforcement. For example, conscious breathing exercises to deepen and slow down as well as rhetoric training can reduce Vata quickly and sustainably.
Pitta can learn to integrate softness and calmness into its communication - this change alone can lower blood pressure by 10-20 mmHg. And Kapha can be stimulated and set in motion through active speaking and breathing exercises.
Ayurvedic diagnostics is therefore also music to the ears of the therapist, who sets the new beat like a conductor and thus supports a healthy sound as an expression of inner balance.
With best wishes for your health,
Ralph Steuernagel
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