Our tour of Ayurvedic examination methods and diagnostic techniques began with pulse diagnosis and led us through tongue inspection, analysis of the excretions, examination by hearing and feeling, to eye and face diagnosis.
Our journey now concludes with the Ayurvedic anamnesis, Prashna Pariksha called. Prashna means question, Pariksha Examination. The word „anamnesis“ comes from the Greek and means „memory“. The therapist systematically questions the patient in order to record and analytically understand their history of suffering.
The anamnesis (Prashna Pariksha) and the 8 examination procedures (pulse, urine, stool, tongue, audible, tactile, eyes and face) using the five senses of the therapist (Panchendriya Pariksha) together form the Ayurvedic diagnosis (Nidana).
Classical Ayurveda does not describe a system of anamnesis guidance. My presentation is therefore based on the experience of my teachers and colleagues and my own 20 years of practice.
Time for people and dialogue
Initial anamnesis in Western medical practices often takes no longer than 15 minutes, during which the main complaints take centre stage. This is followed by physical, instrumental and laboratory examinations in order to finally make a diagnosis.
In Ayurvedic medicine Roga Pariksha, the examination of the disease(s), only one, less important side of diagnostics. The more important side is Rogi Pariksha, the examination of the sick person. Our focus is not on the disease, but on its carrier with its constitution and entire biography.
The most important asset of our diagnostic work is time and undisturbed attention. This is the only way we can empathise with the person as a whole, recognise causes and effects and develop a joint strategy to resolve suffering.
The admission form
When patients visit my practice for an initial consultation, they bring two hours with them. After a personal greeting and a brief introduction to the procedure, they fill out a three-page Admission form from.
This raises Personal data, Health parameters (for example, current medication intake, previous operations, allergies and intolerances, physical or psychotherapies in the past) and basic information on the current situation. Nutrition (for example, the nutritional system followed to date, number and content of meals and drinks) and Lifestyle (for example work and leisure times, sleeping habits and exercise).
The intake form considerably reduces the time needed for the subsequent personal interview. However, I recommend that you only collect specific data and facts via questionnaires and that you collect all intimate, sensitive information in a direct conversation.
After 15-20 minutes I ask the patient to come into my consulting room.
The anamnesis interview
What brings you to me? I prefer to use this question as an introduction to my anamnesis interview, which is made up of 7 anamnesis areas:
- The Medical history records current symptoms using all W questions: Since when? Why did they occur? Where localised? How characterised? What improves, what worsens?
- The Therapy anamnesis records measures implemented to date and their results.
- The Vegetative anamnesis includes the most important physiological parameters such as appetite, thirst, defecation and urination, menstruation, sexuality, temperature sensation and sweating behaviour as well as sleep architecture and energy levels.
- The System anamnesis covers previously unmentioned abnormalities within the framework of a head-foot scheme. The orientation can be based either on Western organ systems or on Ayurvedic structures (tissue, circulation pathways).
- The Family history records the health status of parents, grandparents, siblings and children and possible indications of hereditary predispositions.
- The Biographical anamnesis is dedicated to recording significant events in individual phases of life and contains information on professional life, social relationships, acute and chronic stress.
- The Spiritual anamnesis identifies personal values, convictions and beliefs and their significance for the joint therapy.
As therapists, we are in recording mode, listen attentively and ask specific questions. After recording all the symptoms (the clinical picture = Linga), we ask ourselves which causes (Hetu) can be recognised ayurvedically and how the complaints have developed (pathogenesis = Samprapti).
Ayurveda diagnostics is primarily based on the assignment of determined characteristics (guna) from the anamnesis and examination to the Tridosha Vata, Pitta and Kapha and Agni, the body fire. We therefore pay particular attention to the how and what-improves/what-deteriorates questions. These lead us directly to the Guna.
The duration of an initial consultation varies between 60-90 minutes depending on the patient's concerns. This is followed by a physical examination.
Finally, I summarise all the diagnostic findings for the patient in understandable language and together we agree on the first three treatment goals by which we can measure the success of our therapy.
The therapy plan
A written report of findings and treatment plan can now either be prepared directly or submitted by post within a week. I usually prefer the direct option. This gives the patient about half an hour to relax and reflect on the consultation.
The therapy plan includes all eight pillars of Ayurveda medicine as required:
- Recommendations for constitution- and condition-appropriate nutrition
- Measures for targeted lifestyle changes
- Prescription for dietary supplements from the Ayurvedic range of forms
- Integration of rejection procedures in an outpatient or inpatient setting
- Application of manual therapies such as massages, oiling and hydrotherapy
- Statement on possible surgical interventions from an Ayurvedic perspective
- Psychosomatic and somatopsychic interventions
- Subtle processes to strengthen trust and inclusion of the big picture
Once all open questions have been clarified, the therapy can begin. We will arrange a follow-up appointment to evaluate the measures taken in 3-6 weeks' time and clarify possible communication channels in the event of any queries at short notice.
Successful treatment is not only the result of applied therapeutic measures. The power of healing is significantly influenced by the patient's relationship with the therapist. Our empathetic anamnesis creates an essential basis for this. The time required for this is worth its weight in gold.
With best wishes for your health,
Ralph Steuernagel
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