Stage 1: Diagnosis - understanding the patient;
Diagnosing the "doshas"
Stage 2: Treatment
Stage 3: End of treatment ; guidelines for
I shall be brief since readers will have already
understood that practice is not what is primary here, but
rather the quality of the practitioner's training and the
complex adaptation of Ayurveda to each individual.
With the knowledge acquired in the previous pages, we can
now proceed to the stages that need to be undergone between
the person who seeks treatment or training in Ayurveda and
the practitioner who is competent in this tradition.
The practitioner tries to understand the lifestyle, diet and
problems of the person who has come to seek help.
He discovers the balances and imbalances of the doshas and
also sees the three attributes, "gunas," at work
- "sattva" (essence, purity), "rajas"
(activity, achievement), and "tamas" (resistance,
inertia) - in the patient's tastes, diet, hygiene, lifestyle,
choices and emotional relationships. Through these systems,
the practitioner discovers many aspects of the patient's life.
- Dosha Vata (approximate
meaning - wind, movement) regulates energy, life, movement,
air, space, light at all levels (physical, psychological,
emotional, intellectual, spiritual, etc.) The zones of the
body primarily affected by dosha Vata are the digestive zones,
the skin, hearing, etc. Dosha Vata is not separate from the
other attributes; it animates, favors, or disturbs them and
the balance of the whole is what is important. Different types
of foods strengthen or complicate these roles.
- Dosha Pitta (approximate
meaning - digestion) characterizes the processes of growth,
development and digestion. An examination of the patient's
habitual diet is therefore important: the practitioner's task
is to discover the digestive pathology and encourage a return
to an optimal state.
- Dosha Kapha (approximate
meaning - cohesion) regulates all the zones of the body which
are involved, physically and psychologically, in the function
The practitioner studies the imbalances of the doshas.
Each dosha can manifest itself in one of five forms:
Dosha Vata: apana-prana-saman-udana-vyana
Dosha Pitta: alochaka-brajaka-pachaka-ranjaka
Dosha Kapha: avalambaka-bodhaka-kledaka-slashaka-tarpaka
The doshas act in a specific manner on a particular part of
the body and manifests ("vyakti") itself there.
Pathological manifestations of doshas are as follows:
- "bheda" or diversification
- "prakopa" or aggravation
- "prasara" or expansion
- "sancaya" or accumulation
These manifestations can be:
- "antar marga" : external to the body
- "bahya marga" : internal
- "madhyama" : in the central nervous system
The treatment program will be effected through the five "purifications"
("panxha karma" or "shodhana") with the
goal of regeneration ("rasayana").
After the period of time needed to collect and study the above,
a new phase begins: that of the "first treatment"
based on the diagnosis. This can last one or two weeks and
requires several meetings.
Since Ayurveda focuses on balance, treatment and re-evaluations
have to take into account the patient's reactions, and whether
they are slow or fast.
Treatment can involve foods, herbs and plants, dietary counseling,
lifestyle counseling, oils ("snehana") and massages
("abhyangan"), breathing techniques, etc.
Sometimes a cleansing treatment is necessary: this is called "panchakarma" and consists of three stages:
- a gradual beginning : "purvakarma"
- main treatment : "pradhanakarma"
- final or post-cleaning phase : "paschatkarma"
The massages ("abhyangan"), with ayurvedic oil, are given on a traditional table made of special wood ("dhroni")
This can involve a hand massage, or application of oil on
the patient's forehead, head ("shirodana") or other
parts of the body. "Shirodana" is often done three
days before the end of a treatment.
The goal is to enable a patient to discover
himself, his constitution, energies, positive or negative
balance ("madhyamaka"), and to understand Ayurvedic
cuisine so that he will be able diagnose and treat himself
in order to live a healthy life. This is a pro-active process,
not like passive intake of medication.
The whole process takes place in an atmosphere,
place and relationship which constitute the dynamic that enables
the diagnosis and treatment. Studies of the psychology of
relationships and therapies have shown to what extent the
transference of problems is a rich tool in the therapeutic
relationship. It is a rich, positive phenomenon which sets
the ground for the patient's improvement and return to a state
It should, of course, be stressed that, parallel to this process, conventional treatment of a patient's pathology, based solely on a medical diagnosis, should proceed as normal. Both disciplines are valid and separate.