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Critical evaluation of ayurvedic sparsha pariksha (palpation) in diagnosis of diseases wsr to gastrointestinal system palpation

Dr. Subhash D. Waghe

Ancient Ayurvedic acharyas have described many clinical methods to diagnose the disease. Sparsha Pariksha (Palpation) is one of them. Different Ayurvedic acharyas like Charaka, Sushruta, Bhela have mentioned different parameters to be examined by palpation such as Softness hardness, coldness, warmness, rigidness, pulsations, tactile perceptions in disease states like fever, tumour, edema, abscess, organomegaly, skin lesion etc. As per acharya Chakrapani Dasa, the flexion and extension difficulty of extremities and softness and hardness of palate, tongue etc should examined with palpation. In book called ‘Yogaratnakara’, the general tactile feeling doshik diseases is mentioned. Acharya Vinodlal Sen had described the methodology of hepatosplenic palpation in his book ‘Ayurved Vigyan’. Modern science had described the palpation of Gall bladder and Kidneys apart from liver and spleen. There are many pathological conditions which can be diagnosed on the basis of tactile perception of the lesion. In general, tenderness or guarding during organ palpation, indicates underlying inflammatory painful condition. For e.g. infective hepatitis may give rise to tender hepatomegaly. The stony hard touch of lump indicates malignant growth as observed in disease Arbuda (Malignant tumour) and Kaphaj/Sannipatik Gulma (malignant abdominal tumour). The movement of lump on palpation also gives idea about the nature of, the disease.The malignant tumours are usually fixed and stable. The palpation may give idea about the state of temperature either local (inflammatory edema) or general (fever). The palpation also gives idea about the size and shape of the lesion. It also gives idea about regularity or irregularity of the lesions. Generally malignant tumours are irregular in shape as like hepatocellular carcinoma (Yakritodara). To indicate the irregularity of the lesion, Ayurveda used adjectives like back of the tortoise (Kacchap Prishthawat). The dryness and smoothness of the skin lesions can also be felt with palpation. The palpation examination can also give some idea about emergency conditions such as intestinal obstruction in which abdominal rigidity is observed. On the basis of guidelines given by Acharyas in [S.Su.10/5] and [C.Vi. 4/7]; the palpation criteria for the gastrointestinal system can be framed It is observed and concluded that palpation as tool of examining the patient is very well described in Ayurveda. Preliminary clinical diagnosis of some of the diseases.; particularly gastrointestinal can be made using palpation as method of examination.

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