This section is from the book "Holistic Medicine", by Shriniwas J. Kashalikar.
History therefore should not be viewed as mere indicator of die disease process.
This concept of history or symptomatology is important because it teaches us to consider and treat the patient as a whole and NOT merely the pathological change which is merely a fragment of the disease process and its background/playground /battleground.
This is important also because through this I leara to consider the quality of life the person lives with, rather than partial or total removal of die pathology I leam to treat a diabetic person with a characteristic personality and a characteristic social, family, cultural background and NOT merely diabetes mellitus.
This concept of diagnosis, history and symptomatology is very effective even in die field of engineering and hence the word diagnosis is used with similar meaning or interpretation in the field of engineering Thus 'diagnosis" of plane crash by engineers actually does in fact consider NOT merely the damage in the crash which may be considered analogous to pathological changebutconsiders causes (etiology), predisposing factors, human errors, construction of the plane, compatibility of the plane, pilot, etc. with intricate interrelationship of all the events and so on Thus the engineers who study the event/s so thoroughly and give amazing results happen to endorse our view of the disease processes as even complexes and also our concept of the diagnosis, as more complete and more effective.
As far as the clinical examination of the patient is concerned I have suggestions so as to make the diagnosis more complete.
I wish to point out that the concepts of AYURVEDA with respect to the physiognomy, pulse examination, determination of constitution (PRAKRUT1) effects of food (AHAARA), and effects of behavior |ACHAARA) have to be investigated, verified and incorporated in our routine examination of the patients The evaluation of a patient on the basis of Chinese understanding of human existence [including disease processes) has also to be studied and developed.
The need for evolving and coordinating these approach of clinical evaluation of a patient can be appreciated if I realize that many common signs such as dark circles around eyes, early graying of hair, perspiration in palms, or feet, stammering, the peculiar melanizaQon associated with pregnancy on the one hand and alcoholics on the other are hardly understood in terms of the physiological/ pathophysiological processes and mechanisms involved in them.
Many more signs can be shown to be poorly understood and hence inadequately interpreted.
A plethora of information is available on the above suggested methodological improvements, in regular textbooks of AYURVEDA as IU as other texts such as KAMASHASTRA of VATSYAYANA.
The access to fourth dimension' as claimed by or attempted by palmistry Astrology, numerology has to be verified so as to able to evaluate a patient more completely The development of dermatoglypics is one such fairly successful endeavor.
Before I pass on to the question of investigations I must take into account the therapeutic aspect of the doctor's dialogue with patient as well as that of the clinical examination made by a doctor.
The earing, consoling, reassuring, kind words of the doctor sprung from genuine concern for the patient and the healing warmth in the doctor's touch during examination have immense therapeutic value. This general and wise observation is confirmed by the patients world over, though NOT sufficiently endorsed by "double blind laboratory tests" or 'double blind clinical trials".
Let us now consider the investigations It is true that I have a massive number of investigative techniques at our disposal What is the scope and limitation of these techniques?
These techniques do reveal to us many physical and chemical phenomena inside the body with a very great fidelity Such revelation certainly adds to the understanding of the ailment/s.
But it must be remembered that while revealing the physical arid chemical aspects of the disease processes and the human body, the investigative techniques tend to mask the intrinsic resources of the patient himself/ herself which are so vital to the recovery or deterioration Since these resources are riot accessible to the techniques they are NOT adequately studied Due to miraculous achievements of transfusions, transplants, prosthesis and other physical/chemical manipulations incorporated in the various operative techniques the intrinsic potential of a patient in terms of recovery and possible derangements in the same are neglected or ignored!
It is necessary that I keep reminding ourselves that patients are NOT merely physical and chemical systems (though I do not understand anything beyond it) They are NOT therefore evaluated properly if I rely entirely on die observations of physical and chemical parameters.
Thus, lop sided emphasis on investigations and negligence towards patient's intrinsic potentials can mar our judgment with respect to diagnosis and the treatment This is especially important in the psychological, psychosomatic, gastrointestinal, neurological and to some extent cardiological disorders. Major surgeries may be performed or avoided inadvertently and disastrously due to lop sided dependence on present day investigations.
Though it is true that I do not have any equipment to quantify the patient's inner strength and our own inner growth, the chanting of die holy name does seem to help us understand, judge and even add to the inner power of the patient.
One of the major dilemmas that disturbs a thinking doctor is with respect to the consideration of the past and future behavior of the patient.
Let us clarify this point. Treatment of a patient who has committed a crime and treatment of a patient who subsequently 1 e after recovery commits a crime is likely to give a deep sense of frustration or depression to die treating doctor.
Obviously this is because I diagnose' as 111 as treat superficially and inadequately and in a mechanistic manner, leaving aside the major part of die ailment undiagnosed and untreated.
Holistic concept of diagnosis helps us to understand the disease process and its background/playground/ battleground more completely and thus enables us to treat it more completely. With this concept the doctor realizes the necessity of treating his own as 111 as the patient's inner aspects. He/she realizes die social hazards of the conventional inadequate diagnosis & treatment vis-a-vis social benefits of the more complete diagnosis and treatment The treatment of the inner aspects of the patient assures social welfare also This can relieve the doctor of his dilemma. This fundamental attitudinal and behavioral treatment is possible by chanting of the holy name as alluded to earlier.
Let us take an example of a person who has developed loss of power in his lower extremities.
Let us for the time being assume that I have accepted the idea of cleansing our inner being and trying to open our inner eyes.
In this case our objective would be to study:
1) Extent of functional deficit.
2) Immediate cause of this deficit viz. structural lesion.
3) Location and extent of the lesion.
4) Etiological or pathological.
5) Predisposing factors responsible for this pathological process such as trauma, tuberculosis, tumor elsewhere in the body This will give us an allopathic perspective of the ailment and an idea about allopathic treatment.
Next, I will try to study this from AYURVEDIC angle and evaluate it as VAATAVYAADHI This will suggest us AYURVEDIC modalities of treatment such as PANCHAKARMA BRUHAT V AATAC HINTAAM AM, MAH AAV AATAVIDHVANSA TRIFHALA and ASHVA-GANDHAA.
I should now evaluate the situation from HATHAYOGA point of view Thus. I will get a hint with respect to treatment of the ailment with BHU JANG AAS ANA, MAKARAASANA. SHALABHAASANA, NAUKAASANA, PAVANAMUKTAASANA etc, which stimulate the VAATA STHAANA region of umbilicus which is supposed to rem arkab 1 y and b eneficially affect the spinal cord function One may also think of PADMAASANA, VAJFAASANA etc Besides I may think of C HAND RAB HE DANA PRANAAYAAMA in case of spastic and SUR YAB HE DANA PRAANAYAM in case of flaccid paralysis One may think of BHASTRIKAA also in case of flaccid paralysis.
When I look at die patient from Chinese view point (G-J) I may realise that point 99 i.e. vertex and point 98 atlas could be the sites of acupressure benefits This as 111 as yoga view can be explained provisionally not on a strict anatomical basis but rather on the basis of bio electro physio logical fields and their interactions.
Homeopathy gives us yet another perspective of die ailment in terms of subtler and characteristic individual perceptions of the disease event complexes. This can suggest us a remedy e.g comum which can work in a way proposed in our hypothesis about the possible mechanism of action of homeopathic remedy, to be published in die international journal of homeopathy. From the point of view of AYURVEDIC philosophy I recognise the five KOSHAAS or planes of human existence as 111 as die life' after death These concepts however describe phenomena which are called AVYAKTA They are called AVYAKTA for two reasons. First is that they are not "manifested" and hence are not perceptible by five senses They are not even deducible intellectually. Second reason why they are called AVYAKTA is because they cannot be expressed by the languages which describe three dimensional qualities or quantities (mathematics is classically referred to as a language of quantities).
Methods of astrology, numerology and palmistry which claim to or try to reveal the AVYAKTA aspects of human life and disease are esoteric and not completely accessible to reason But their exploration with unbiased and unprejudiced approach is essential.
In my view astrology, palmistry etc should not be condemned as hoax or fraud These efforts signify the "extension" of three dimensional mapping and using mariner's compass or RADAR for smooth sailing in the unknown and unseen paths of time and also temporal aspects of human life extending in past and future I recognise the extreme degree of variability and subjective element intrinsic to these methods and hence do not propose to lend credibility to these at once.
I only suggest that various methods indigenous to different parts of the world have to be explored in order to comprehend the AVYAKTA more meaningfully, predictably and in the interest of Welfare of the mankind.
Techniques such as dowsing, planchette are in vogue just as various methods used by DE VARSHIS (The aboriginal / traditional individuals who 'Practice" consultation and treatment in AADHI DAIVIKA VYAADHIS.
Medical world while cleansing itself should also enrich itself from the careful and ongoing study of these various methods. It should minimize the element of obscurity and ambiguity which catalyses cheating St exploitation in the atmosphere of obscurity.
Holistic concept of diagnosis has m it a great promise for the HEALTH and Welfare of mankind.