Examination of the patient (rogi pariksha)

By touch the physician learns whether the patient's body, affected by aggravated doshas, is hot or cold, hard or soft, unctuous or dry, light or heavy or clear (viśada), and many similar points such as the movement of the pulse in the body, and whether these accord with the patient's nature or are deranged.

By questioning the physician learns which region the patient comes from, the family and lineage he was born in, the natural state of his body, the state of his digestive fire and how much food he can digest.

The questions also cover the force of the disease, the patient's strength, what food he wants, how wheat tastes to him (as printed), how stool and urine are passed, and which things suit his constitution and which do not.

The introduction says nidāna, pūrvarūpa (prodromal signs), rūpa (signs), upaśaya and saṁprāpti are called the five means of diagnosis (nidāna-pañcaka), and that diseases are to be examined by inspection (darśana), touch (sparśana) and questioning (praśna) in keeping with the nidāna-pañcaka; once the disease is determined, definite medicines or measures are to be planned knowledgeably on the basis of the principles of treatment. A footnote defines upaśaya as the use of medicines, food and conduct to examine hidden signs and lists its six kinds: hetuviparīta, vyādhiviparīta, hetuvyādhiviparīta, hetuviparyastārthakārī, vyādhiviparyastārthakārī and hetuvyādhiviparyastārthakārī.

Before treating, the physician is to understand thoroughly, by seeing (darśana), touching (sparśana) and questioning (praśna), the strength and weakness of the disease, whether it is curable or not, and every other point, and to report them to the king.

By sight the physician examines the shade (chāyā), form, marks and signs of the patient's body, whether the body is deformed or has some unusual feature, and whether the patient's temperament is extremely fierce or calm, and from these judges, following the earlier teachers, the decline or growth of life span.