It only takes 100 milliseconds: the first, decisive impression. We look into the eyes and face of the person we are meeting and immediately make an intuitive judgement about trustworthiness, likeability, attractiveness and approachability.
We also utilise the psychology of first impressions in Ayurvedic diagnostics. The more experienced the diagnostician, the more accurate the first impression. Even after a one-hour anamnesis, this often does not change much, only the certainty with which a first judgement is made increases.
The inspection of a patient's eyes (Drika) and face (Akriti) are among the last two of the eight examination procedures (Ashtavidha Pariksha) of Ayurveda medicine.
Stable, relatively unchanging characteristics indicate constitutional dominance (Prakriti); variable, changeable characteristics are mainly used to diagnose deviations (Vikriti) and diseases (Roga). Most bony structures are unchangeable, colours and functions are changeable.
Drika Pariksha - Eye diagnostics in Ayurveda
The eyes are the seat of Pitta (Alochaka) and thus an expression of our fire element. Ojas, the subtle essence of tissue formation, radiates through them and they convey information about the state of the three spiritual qualities sattva, rajas and tamas.
In Ayurveda, we examine the eyes macroscopically, in contrast to the microscopic iris diagnostics used in Western naturopathy.
The five most important structures to be assessed are:
- The eyeball
- The eyelids
- The eyelashes
- The sclera
As always, all characteristics can be categorised into the three groups of Vata, Pitta and Kapha according to their respective dominance:
The eyes dominated by Vata have a small eyeball, which often appears sunken and nervous. The eyelids are dry, droopy and drooping - they lack the necessary tone. The eyelashes are few and rough, the lash line often has gaps. The sclera is cloudy or greyish. Vata eyes always seem to be in motion, unsteady, wandering, searching.
Eyes with Pitta dominance are characterised by their brilliance, the eyeball is of medium size. Sensitivity to light and a tendency to redden the eyeball, eyelids and sclera are two central characteristics of the Pitta eye. Yellow colouration is also attributed to Pitta. Those affected often experience a burning sensation. The eyelashes are sparse but oily. The demanding, piercing, penetrating gaze of Pitta remains in the memory of the observer.
Kapha resembles the large, beautiful, moist and sparkling eyes of a cow according to Indian tradition. The eyelids are heavy and voluminous, the eyelashes long, thick and oily. Kapha dominant sclerae are bright white or pale. The eyes radiate a certain calmness and serenity. Kapha eyes are traditionally the symbol of attractiveness and loving kindness.
Akriti Pariskha - Face diagnostics in Ayurveda
Akriti stands in the wider context for the overall impression of the patient and in the narrower sense for the face, head and countenance.
On the head, the forehead, hair, temples, ears, eyebrows, nose, cheeks, lips, teeth, chin and neck are primarily assessed. Outside the head, the thorax, hips, arms and legs, hands and feet are of diagnostic importance.
Strong Kapha can be recognised by the voluminous structures: the broad and prominent forehead, the strong hair and bushy eyebrows, the large Buddha ears with strong earlobes, a voluminous nose, strong cheeks, the pout, the pronounced chin and the broad neck are characteristic features. The picture-book teeth are white, large, straight and resemble a string of pearls.
The Kapha thorax is large and broad, the epigastric angle formed by the two costal arches is obtuse, i.e. over 90 degrees. Large breasts in women and a large pectoral muscle in men are typical Kapha characteristics. The hips are protruding in a feminine way, arms and legs are pronounced in their muscle and fat content, tendons and blood vessels are barely visible underneath. Soft, strong hands and feet complete the Kapha picture. All joints are large and stable.
The pronounced Pitta are always recognisable by their warm colours (red and yellow), heat and shine. The structures are usually muscular, athletic and of medium stature. The thin and rather greasy hair tends to turn grey prematurely; in men, early baldness is common. The teeth are medium-sized and yellowish in colour. The skin is characterised by an increased tendency to pigmentation, warmth and perspiration.
High Vata expresses itself in slender, delicate and dry structures and is usually diametrically opposed to the characteristics of Kapha. The forehead, cheeks and lips are narrow, the temples sunken, the nose and ears small and delicate, hair and eyebrows thin and dry, the chin weakly developed. Vata teeth are small, rough, greyish and often misaligned. The 82 facial muscles are controlled by Vata and are in excessive motion.
The neck, hips and thorax are narrow, the epigastric angle is acute and therefore less than 90 degrees. The woman's breasts are small and the muscle mass on her arms and legs is low. Tendons and blood vessels are clearly visible under the skin. Delicate joints on the hands and feet clearly indicate Vata dominance.
Eyes and face are valuable diagnostic tools in Ayurvedic practice. Their analysis begins at the very first moment of the encounter and runs unconsciously during every anamnesis and examination.
Diseases can cover up constitutional characteristics, but the constitutional signs always appear at relevant points. During Ayurvedic therapy, both examinations serve to monitor the progress.
Indirectly, all people are face diagnosticians and unconsciously analyse the characteristics of their fellow human beings - for more security, harmonious relationships and to discover like-minded people.
Trust your first impression!
With best wishes for your health,
Ralph Steuernagel
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