Ayurvedic diagnostics begins with the first handshake when greeting a new client. How does it feel? Is it firm or tentative, hard or soft, warm or cold, dry or moist?
Sparsha means contact through touch - Sparsha Pariksha is one of the eight Ayurvedic examination methods and a very special one. The therapist feels into the patient with his hands and recognises characteristics.
Palpation is one of the oldest examination procedures in medicine and, along with inspection (observation), auscultation (listening) and percussion (tapping), is one of the basic techniques of a modern clinical examination.
The most important structures that can be palpated are the skin and its appendages (hair and nails), the underlying fatty tissue, the muscles, bones, joints and deep-seated organs.
Ayurvedic pulse diagnostics, which we discussed at the beginning of this series of articles, is also part of palpatory diagnostics in a broader sense. However, due to its outstanding importance, it has been assigned its own pillar within the eight classical examination procedures.
Examination of the skin
Of all tangible structures, the skin took centre stage in classical Ayurveda - which is why even today „Sparsha Pariksha“ is often translated as skin examination.
The skin is not only the largest organ in our body, it is also of paramount diagnostic importance. No other organ allows us to perceive characteristics so directly - and use them to draw conclusions about the condition of the inside of the body.
Properties (Guna) are the key to understanding health and illness in Ayurveda. They are an expression of the five elements that make up every cell in our body. Properties are the basis of Vata, Pitta and Kapha, Agni, all body tissues, pathways and excretory products. If opposing properties such as hot and cold or light and heavy are in balance, health is the result - if the balance tips to one side, disorders are the consequence.
Examine yourself right away and choose an area of skin that you want to analyse - perhaps your forearm or face. Now close your eyes and simply feel.
- Firstly, place your hand on the skin and feel the temperature - is it hot, warm, neutral, cool or cold? The result provides information about the state of the fire element, which is the only one of the five elements that provides warmth.
- Now lift a fold of skin and release it again after a few seconds. Does it feel thin or thick, is it easy or difficult to lift? Does it remain lifted after you let go or does it immediately retract again? Here we test the properties easily (laghu) and heavy (guru).
- Now stroke over the skin and feel the dry properties (ruksha) or moist/oily (snigdha), rough (khara) or smooth (slakshna), hard (cathina) or soft (mridu).
A high Vata dominated skin feels light and thin, cold, dry, rough and hard. Strong Pitta heats the skin, produces sweat and some oiliness. Stands Kapha in the foreground, the cool skin appears soft and smooth, thick and moist.
Passive and active keying
The Passive buttons is only done with the skin - we place our hand on the body and feel possible movements underneath it. Ayurvedic pulse diagnosis is also based on passive palpation with three fingers at three depths.
The Active buttons takes place with the skin and muscles - our hand moves and feels the structures beneath it. Active palpation is significantly more efficient and therefore plays a major role in diagnostics.
Massage therapy is also palpatory diagnostics
During my twelve years of inpatient treatment work, we met with all the therapists in the team in the morning directly after the ward round at the patient's bedside, exchanged the latest experiences and planned the next steps.
The feedback from our massage department on each individual spa guest was particularly important - after all, the manual therapists were in direct physical contact with the patients for 1-2 hours a day. And an attentive therapist will miss the Ayurvedic full-body oil massage (Abhyanga) barely a square centimetre.
In South India in particular, Ayurveda doctors often massage their patients themselves, combining diagnostics and therapy in one. The centre there Kalari-therapy also takes diagnostic account of the condition of muscles, bones and joints and the resulting vital points (Marma) in detail.
In northern India, the tasks are distributed in a somewhat more traditional way, with doctors focusing primarily on diagnostics and prescriptions and only carrying out special, mostly invasive Panchakarma procedures or Ayurvedic surgery on their own.
The psychological dimension of haptic communication
I have fond memories of a series of „unpleasant“ dental appointments a few years ago. I'm sure you're familiar with those hour-long sessions with your mouth open, painful drilling and the horrible noises of the appliances being used. Many people even avoid going to the dentist for this very reason.
During my first session, I experienced something extraordinary: the dental assistant gently placed her warm hand on my shoulder before the start and during the entire treatment - and I felt so safe, protected and calm. My visits to the dentist became a kind of meditation and I still look forward to my annual check-ups today.
Touching others always means being touched. This is why touch creates an extraordinary closeness between therapist and client, which can be of great importance in the healing process. We can touch people deeply in the truest sense of the word - with a compassionate handshake or a warm embrace if the moment allows.
Through attentive, compassionate touch, fears can be alleviated, tensions released, states of restlessness pacified and a healing contact is created that goes beyond words. Sometimes patients give me feedback after an initial examination that they already feel better - before the actual „treatment“ begins. In holistic Ayurvedic medicine, the rigid boundaries between diagnosis and therapy simply dissolve at these moments.
With best regards from Bad Homburg,
Ralph Steuernagel
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