Dashavidha parikshya bhavas (दशविधपरीक्ष्यभावाः)

Acharya Charaka in Vimana sthana of Charaka Samhita has mentioned Dashavidha parikshya bhava which literally translates to ten-fold examination factors. These are essential as a process to reach to the conclusion of any objective. While prescribing a treatment to a certain patient, these play a significant role to understand the pathology behind the patient, reach to the diagnosis, and plan a treatment at the end as well. Dashavidha parikshya bhava is a skill possessed by a physician which helps make the process of treatment much easy.

The purpose of dashavidha parikshya bhava is to obtain complete knowledge about the physician, patient, medicine. Adopting a certain line of treatment with due consideration of all the factors which are related to the patient precisely describes dashavisdha parikshya bhava (which are karana, karana etc)

परिचयः॥ Introduciton

Charaka Samhita includes certain adhyayas that are chiefly to enhance the skills of an Ayurveda physician as a clinician. Such topics derive their froundations from Darshana shastras and other branches of contemporary knowledge systems. One such topic in Charaka Samhita is specifically added by Acharya Charka which is known as 10 means of knowledge. These are the factors involved in management of any diseases of patient by a doctor. The 10 factors involved are as below,

इमानिखलुतावदिहकानिचित्प्रकरणानिभिषजांज्ञानार्थमुपदेक्ष्यामः|ज्ञानपूर्वकंहिकर्मणांसमारम्भंप्रशंसन्तिकुशलाः| ज्ञात्वाहिकारण-करण-कार्ययोनि-कार्य-कार्यफलानुबन्ध-देश-कालप्रवृत्त्युपायान्सम्यगभिनिर्वर्तमानःकार्याभिनिर्वृत्ताविष्टफलानुबन्धंकार्यमभिनिर्वर्तयत्यनतिमहतायत्नेनकर्ता||६८|| (Char. Samh. 8.68)

Meaning: Now I shall explain some topics for the knowledge of physicians because the wise commend initiation of all actions with prior knowledge. If after knowing well karana, karana, karyayoni, karya, karyaphala, anubandha, desha, kala, pravritti and upaya one proceeds for some action, he obtains the desired fruit and subsequent benefit in that without any great effort

These 10 means of knowledge for a physician are listed below,

Pariksha Bhava	Description
Kaarana	The doer/ physician
Karana	Means of action or tools/ Medicine, surgery etc
Karyayoni	Source of action/ disease manifestation
Karya	Action/ application of treatment
Karya phala	Result of the action/ restoration of health
Anubandha	Consequence/ longevity
Desha	Habitat/ habitat of drug and Individual or patient
Kaala	Time/ transformation
Pravrutti	Consistency/ initiation of action
Upaya	Planning/ plan of care or treatment

दशविधपरीक्ष्यभावाः॥ Ten means of knowledge

कारणम्॥ Karana

Kaarana means cause. If freedom or cure from disease is considered as an objective or an action here it can not take place without a cause. Thus the cause is described first.

तत्रकारणंनामतद्यत्करोति, सएवहेतुः, सकर्ता||६९||

Karana is the doer and here it is the physician. Here physician is mentioned first because without a Vaidya the following assessment cannot be done. A physician or a Bhishak or a Vaidya must have certain qualities as mentioned by Acharya Charaka in Vimanasthana, (Char.vima.8.86)

1.      A Bhishak must be knowledgeable well versed in scriptures.

2.      Is experienced and have received practical training in treatment protocols.

3.      Is qualified enough to attain balance otherwise deranged bodily dhatus(tissue)

4.      Is very skillful

5.      Maintains hygiene

6.      Possesses required instruments and medicines for treatment.

7.      Has awareness about the consequences of treatment.

करणम्॥ Karana

Any action can be completed with the help of necessary tool/equipment required to perform that action.

करणंपुनस्तद्यदुपकरणायोपकल्पतेकर्तुःकार्याभिनिर्वृत्तौप्रयतमानस्य||(char.vim.8.70)

Karana is means of tool or the equipment which aids the action, here it is the medicine or the treatment. Treatment is of three types fundamentally which are, daivavyapashraya, yuktivyapashraya and Satvavajya chikitsa or treatment modality. However among these 3 types only first 2 viz. Daivavyapashraya and Yuktivyapashraya are included under tools since only in these 2 types some medicine or herb or mantra or gem is given as an intervention to carry out changes.

कार्ययोनिः॥ Karyayoni

कार्ययोनिस्तुसायाविक्रियमाणाकार्यत्वमापद्यते||७१||

Karyayoni is the source and in this context, it is the source of the treatment which is manifestation of the disease. Imbalance of the doshas, dushyas etc in the body represents the karyayoni.

कार्यम्॥ Karya

Karya literally means activity or action.

कार्यंतुतद्यस्याभिनिर्वृत्तिमभिसन्धायकर्ताप्रवर्तते||७२||

Karya is the fundamental objective, the object of accomplishment, and in this context normalcy or equilibrium of doshas, dhatu etc and achieving healthy state of body-mind is called as Karya.

कार्यफलम्॥ Karyaphala

The fruit or result of some action is known as Karyaphala.

कार्यफलंपुनस्तद्यत्प्रयोजनाकार्याभिनिर्वृत्तिरिष्यते||७३||

Karyaphala is the expected result or the outcome. And here it means the desired outcome of the treatment which is attainment of good health.

अनुबन्धः॥ Anubandha

After completion of any action its impact remains for a period of time. If the action is related to person or his body or mind the impact of action will be reflected on that person for a certain period of time and impact is known as Anubandha

अनुबन्धःखलुसयःकर्तारमवश्यमनुबध्नाति कार्यादुत्तरकालंकार्यनिमित्तःशुभोवाऽप्यशुभोभावः||७४||

Anubandha is the long-term effect which can be good or bad occurring after the action is performed which means the longevity of life that occurs after the appropriate treatment by a doctor. And bad effects can be termed as udarkas (adverse effects or consequence).

देशः॥ Desha

Desha literally means a region or country or place. With reference to a certain action where that action takes place would be considered as a desha.

देशस्त्वधिष्ठानम्||७५||

Desha is adhisthana or a habitat. Desha is of two types Atura (human body) desha and Bhoomi (environment/land of residence of a person) desha.  Dashavidha pariksha which are Prakriti, vikriti etc are examined under Atura desha (human body). Bhoomi desha is a fundamental concept and precisely is categorized as Anupa desha(), sadharana desha() and jangala desha(). Basically, where an individual or the patient stays is of importance to an Ayurveda dosctor (Vaidya) which according to Ayurveda shastras determines the strength of the patient, possible imbalances in body components, status of agni an doverall health. Also, the medicinal herbs which grow in different desha or habitat have certain distinct properties as well and varied level of potency of some level. (char.vima.8.93teeka)

कालः॥ Kala

Kala literally means time. But some peculiarities of Time are applicable and

कालःपुनःपरिणामः||७६||

Kala refers to constant transformation and, in this context, it refers to season and stages of diseases according to Ayurveda shastras. Kala where it refers to season or rutu(which are six, Vasant, grishma, Varsha, sharad, hemanta, shishira) is understood for the purpose of shodhana karma (evacuation therapy)or panchakarma according to the specific rutu where it is indicated. For example, vamana is indicated in Vasant Rutu.

Kala in patients is understood as disease awastha (doshapaka awastha is an isolated concept in ayurveda shastra) or stages of the disease. This determines the manifestation of the disease and treatment to be administered. (char.vim.8.128)

Kala is also understood as aushadha sevana kala which refers to the Time which determines when to take medicines. (asht.hrud.sutr13.37)

प्रवृत्तिः॥ Pravrutti

प्रवृत्तिस्तुप्रतिकर्मसमारम्भः| तस्यलक्षणंभिषगौषधातुरपरिचारकाणांक्रियासमायोगः||१२९||

Pravrutti literally means consistent efforts. In this context it refers to the initiation of the action towards the attainment of the objective that is well being of the patient.  This is accomplished with the accurate arrangement of the Bhishak(physician), Aushadh(medicine), Atura(patient), and paricharak(attendent).

उपायः॥ Upaya

उपायःपुनर्भिषगादीनांसौष्ठवमभिविधानंचसम्यक्|तस्यलक्षणंभिषगादीनांयथोक्तगुणसम्पत्देशकालप्रमाणसात्म्यक्रियादिभिश्चसिद्धिकारणैःसम्यगुपपादितस्यौषधस्यावचारणमिति||१३०||

Upaya refers to planning, and in this context, it means plan of care. With proper skills of the bhishak and accurate planning of care, along with consideration of desha(place), kala, pramana etc success is attained.

Application of Dashavidha Parikshya Bhavas in Ayurveda practice

In research

Dashavidha parikshaya bhava is a way or method of accomplishment of task or reaching a certain objective. This is systemic method of research from ayurvedic perspective which restricts intellectual wandering with a definitive structure. Thus, this is considered as an ancient method of research.(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6891990/)

In Treatment

These 10 examination factors are considered as a way of determination of the lifespan of the patient. This systemic evaluation from the physician’s point of view helps in the assessment of strength of the patient which in turn determines the strength of the drug to be administered. As a process this helps reach the final objective which is happiness after the roga(disease).(char.vim.8.94)

In pathology (ayurvedic)

Dashavidha parikshya bhava determines the process of a manifestation of the disease in the patient. Appropriate understanding of the karyayoni along with other factors defines certain crucial aspects of Ayurvedic Pathology.