CASE STUDY FORMAT - Ayurveda Institute UK€¦ · AYURVEDA INSTITUTE UK 3 FEMALE REPRODUCTION STATUS: e.g. menopausal ... (lymphatic system) RAKTA SARA (blood) MAMSA SARA (muscle)

AYURVEDA INSTITUTE UK

1

CASE STUDY

Name of student: Course group: DALNC 2018

PART ONE

Date of Appointment:

Time of Appointment:

PERSONAL DETAILS (Confidential)

FIRST NAME:

SURNAME:

ADDRESS:

TELEPHONE NO:

EMAIL ADDRESS:

DATE OF BIRTH:

AGE:

LIVES WITH PARTNER:

MARITAL STATUS

GENDER: Male/Female

DEPENDANT(S)

AGE:

GENDER:


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OCCUPATION:

GP's NAME:

GP's ADDRESS:

GP's TELEPHONE NO:

SMOKING:

ALCOHOL:

DRUGS:

PATIENT HISTORY

OTHER THERAPIES:

CURRENT MEDICATIONS:

PAST MEDICATIONS:

PAST MEDICAL HISTORY:

Operations

Infections

Anaesthetics

Miscarriages

Smears

Any Other

FAMILY HISTORY:

Heart Disease

Diabetes

Hypertension

Asthma

Cancer of breast

Cancer of stomach

Others :


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FEMALE REPRODUCTION STATUS:

e.g. menopausal

MENSTRUATION:

Age of onset :

Cycle (how many days) :

Duration :

Dys-menorrhoea :

Menor-rhagia :

Clots :

COMPLAINTS

MAIN COMPLAINTS:

(where, what, when why, how)

OTHER COMPLAINTS OR PROBLEMS including:

Violence

Abuse

Self abuse

Libido

Psychiatric illness

CURRENT SYMPTOMS:

(where, what, when, why, how)

ANY PAIN – (1 TO 10)

a) Burning

b) Throbbing

c) Dull ache

d) Sharp

HISTORY OF CURRENT SYMPTOMS/PROBLEMS:


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ONSET OF DISORDER:

(when did you first notice the symptoms

and what were they?)

THEN:

NOW:

POSSIBLE RELATED CAUSES:

(eg.)

Stress at work

Stress at home

Bereavement

CONSTITUTION CHART – VERSION 1

V P K Vata Pitta Kapha

Body frame

Slim

Medium Large

Body weight

Low

Medium Overweight

Chin

Thin, angular

Tapering Rounded, double

Cheeks

Wrinkled, sunken

Smooth, flat Rounded, plump

Eyes Small, sunken, dry, active, black,

brown, nervous

Sharp, bright, grey green, yellow, red, sensitive to light

Big, blue, beautiful, calm, loving

Nose Uneven shape, deviated septum

Long pointed, red nose-tip

Short rounded, button nose

Lips Dry, cracked, black brown tinge

Red, inflamed, yellowish

Smooth, oily, pale, whitish

Teeth Stick out, big, roomy, thin gums

Medium soft, tender gums

Healthy, white, strong gums

Skin Thin, dry, cold, rough, dark

Smooth, oily, warm, rosy

Thick, oily, cool, white, pale

Hair Dry, brown, black, knotted, brittle,

scanty

Straight, oily, blond, grey, red, bald

Thick, wavy, curly, oily, luxuriant

Nails Dry, rough, brittle, break easily

Sharp, flexible, pink, lustrous

Thick, oily, smooth, polished


5

Neck

Thin, tall

Medium Big, folded

Chest

Flat, sunken

Moderate Expanded, round

Belly

Thin, flat, sunken

Moderate Big, Pot bellied

Belly-button Small, irregular, herniated

Oval, superficial Big, deep, round, stretched

Hips

Slender, thin

Moderate Heavy, big

Joints Small, often cracking

Moderate Large, lubricated

Appetite

Irregular, scanty

Strong, unbearable Slow but steady

Digestion

Irregular, forms gas

Quick, causes burning Prolonged, forms mucous

Taste Sweet, sour, salty

Sweet, bitter, astringent Bitter, pungent, astringent

Thirst

Changeable

Surplus Sparse

Elimination

Constipation

Loose Thick, oily, sluggish

Physical activity

Hyperactive

Moderate Slow

Mental activity

Hyperactive

Moderate Slow, dull

Emotions Anxiety, fear, uncertainty

Anger, hate, jealousy Calm, greedy, attachment

Faith

Variable

Extremist Consistent

Intellect Quick but faulty response

Accurate response Slow exact

Memory Recent good, remote poor

Distinct Slow and sustained

Dreams

Quick

Fiery, war, violent Lakes, slow, romantic

Sleep

Scanty

Little but sound Deep, prolonged

Speech

Rapid unclear

Sharp penetrating Slow, monotonous


6

Financial Poor, spends on trifles

Spends money on luxuries

Rich, good money preserver

Total

CONSTITUTION CHART – VERSION 2

1. General Appearance.

Vata Pitta Kapha

Face Thin/tall/petite/bony

Medium build Large/round

Chest Flat Medium

Rounded/large

Eyes Thin/long/sleepy Penetrating/sharp

Round/large

Nose Long/uneven Rounded

Large/round

Tongue Long/pointed Medium/shiny

Large/thick

Ears Tiny/large Medium

Large/thick

Eyebrows Hairy/grey Rainbow shape/medium

Thick/bushy

Eyes Muddy/dry Clear

Clear/watery

Chin Pointed/sharp Symmetrical

Rounded

Teeth Brittle/crooked/uneven Small

Large/white

Facial hair None Shiny/scant

Thick/dark

Facial skin Dry/wrinkles Oily/shiny/red/warm

Moist/oily/smooth/cool

Lips Thin/dry Medium/red

Thick/fleshy

Shape of Face

Pointy Medium Round


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2. Physiological Makeup.

Appetite Irregular/erratic Regular/sharp

Frequent/dissatisfied

Digestion Quick/flatulent Quick/acid producing

Slow/ama producing

Metabolism Quick/absorbs little Fast/absorbs well

Slow/absorbs well

Elimination Infrequent/dry/constipated Frequent/loose

Regular/slow/bulky/moist

Menses Irregular Regular

Regular/long cycle

Blood Flow Light/short periods Heavy/5 days

Heavy/5-7 days

P.M.T. Weepy/emotional Angry/aggressive

Lethargic/sleepy

Fertility Low Average

High

Sex/Libido Frequent/quick Premeditated/organised

Prolonged/caring

3. Mental Aspect.

Mind Quick imaginative Focused/productive

Slow/steady

Quick Efficient

Slow

Memory Short term/photographic Sharp

Slow

Stress level Short term Long term

Hardly ever

Mental immunity

Impatient Intolerant Patient/tolerant

Intelligence Moderate Very good

Slow/steady

4. Emotional State.

Anxiety Anger

Lazy

Creative Focused

Long term planning

Forgetful Alert

Strong memory

Disorganised Organised

Organised

Insecure Jealous

Relaxed

Panicky Agitated

Calm

Intolerance to pain Tolerant to pain

Good pain threshold

Open/Social Private Fairly private


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Lacks will power Good will power

Strong will power

EVALUATION

EVALUATION BY PHYSICIAN:

PATIENT’S PRAKRUTI:

PATIENT’S VIKRUTI:

PATIENT’S DISORDER (disease):

PHYSICIAN’S ASSESSMENT:

PRAMANA (means of knowledge)

a) PRATYAKSHA :-

(direct observation with sense

organs, e.g. sight, touch,

hearing, smell, taste) e.g. pallor

cold clammy skin, pain, etc


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b) ANUMANA (Inference)

(Come to a fair and correct

conclusion, e.g. raised temperature

a limp rigor, shakes, etc.)

c) SABDA (Authoritative statement)

(with knowledge of findings)

Susruta’s statement :-

Charaka’s statement :-

Vagbata’s statement :-

Madhava’s statement :-

PROVISIONAL DIAGNOSIS:

COMMENTS:


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PART TWO

ASHTA VIDA PARIKSHA

(Eight fold method of examination)

1. NADI (pulse)

Should not be checked after a massage, taking food or alcohol,

sunbathing, sitting close to a fire, hard physical labour or exercise, sex or

while hungry or thirsty

Right and left should be checked

NADI GATHI

(Pulse rate)

RT

LT

Vata - 75 – 90 beats/minute

Pitta - 70 – 80 beats/minute


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Kapha - 60 – 70 beats/minute

NADI YATI

(Pulse rhythm)

RT

LT

Vata - Index finger – Fast narrow,

feeble, cool, irregular – like the

movement of a snake

Pitta - Middle finger – Excited,

prominent, hot, moderate and

regular. It is active and jumpy

like the movement of a frog

Kapha - Ring Finger – slow, strong,

Steady, soft regular, warm. It is

slow and resembles the gliding of

a swan

Extract taken from Dr. Vasant Lad

“Ayurveda, The Science of Self Healing”

Lotus Press

NADI AKRUTI

(Pulse quality)

RT

LT

RT

LT

Weak Strong

Regular Irregular

2. MALAS (Bodily wastes)

MUTRAM

(Urine)

Scanty and concentrated

Pale yellow and medium

Very transparent, copious with mucous

Frothy

Very hot and steamy

Frequency

Cloudy and smelly

How many times do you urinate during the day

How many times do you urinate during the night


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3(a) PURISHA

(Faeces)

Dark and hard (constipated)

Medium colour and semi-soft

Diarrhoea – greenish, yellowish or red tinge

Long (in one go)

In uniform sections, e.g.

Does it sink

Does it float

Any Other Pattern?

3(b) SVEDA

(Sweat)

Scanty

Normal

Profuse

Is it odoriferous, if so is it:

Sweet

Sour

Pungent

4. JIVA

(Tongue)

Furred - if so, where?

Back Central Right Left

Mid Central Right Left

Front Central Right Left

Cracked (mid central and front)

Tremor

Teeth indentation surround tongue

Colour - was it? Yellow

Whitish

Dark Blue Black

5. SHABDA

Speech :

Feeble

(Sound) Fast

Slow

Bowel Sound

Heart Murmur

Cracking joints

Others:


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6. SPARSHA

Skin

Dry

(Touch) Moist

Oily

Cold

Affected Limbs or area Hot

Burning sensation

Tingle

Pins and needles

Hands and Feet Cold

Warm

Hot

Clammy

7. DRUCK

Excessive blinking

(Eyes) Drooping upper eye lid Gives strength of majja Prominent Dhatu (bone marrow) Hypersensitive to light

Pale conjunctiva

Yellow conjunctiva

Brownish black spots in the iris

White rings around the iris

Conjunctivitis

Very small pupil

Very dilated pupil

8. AKRUTI

Limbs

(General appearance Thin of body) Fat

Bony

Very short (dwarfism)

Very tall (gigantism)

In pain (expresses in the face)

Very broad (thick set)

DASAVIDHA PARIKSHA

(ten fold method of examination)

(in part only)

SARA DHATUS

(body tissues)

Balanced Imbalanced Comments


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RASA SARA

(lymphatic system)

RAKTA SARA

(blood)

MAMSA SARA

(muscle)

MEDA SARA

(adipose tissue)

ASTHI SARA

(bone)

MAJJA-SARA

(nerve & marrow

tissue)

SUKRA SARA

(male and female

reproductive tissue)

MANAS PARIKSHA

Observations. S R T Sattva Rajas Tamas

Spiritual Practice Regular Irregular Never

Spiritual Power For humanity Selfish Destructive

Mental clarity Easy Moderate Difficult

Mental peace Good Moderate Rare

Satisfaction Usually satisfied Partly satisfied Seldom

Behaviour Gentle Aggressive Destructive

Communication Good Controlling Difficult

Commitment Total Partial Never

Concentration Good Fluctuating Poor


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Will power Good Variable Low

Knowledge Good Variable Low

Memory Good Variable Low

Forgiveness Easy Difficult Poor, Holds a grudge

Cleanliness Good Moderate Poor

Sexual activity Infrequent,

Spiritually based

Variable Heavy

Donations Anonymous With name,

Attachment

For Gain

Depression Rarely Moderate Often, Prolonged

Emotions Honest Denial Suppressed

Attachment Little Moderate Much

Fear Rarely Moderate Often, Prolonged

Anger Rarely Moderate Often, Prolonged

Greed None Moderate Often, Prolonged

Confusion Rarely Moderate Often, Prolonged

Pride Little Moderate Much

Hate None Moderate Much

Grief Rarely Moderate Often, Prolonged

Love Unconditional,

Universal

Selfish love Obsesses

Sensory

perception

Clear Agitated Interrupted

Speech Clear, Calm,

Peaceful

Fast, Restless,

Agitated

Slow, Monotonous

Sleep Light, Sound, Alert

sleep

Interrupted,

Disturbed

Deep

Upon waking Happy, Fresh Disturbed, Worried Drowsy, Heavy

feeling

Physical activities Moves with

awareness

Hyperactive,

Moments

Sluggish, Dull

movements

Exercise Gentle Yoga,

Walking,

Swimming, Daily

exercise

Aggressive,

Occasional exercise

Heavy, Difficult,

Hates to exercise

Facial expression Calm, Contented,

Happy

Mixed Dullness

Eyes Calm, Clear Restless, Active Dull, Gloomy

Diet Vegetarian, Loves

all 6 tastes in

moderation, 1-2

Eats meat some

times, Loves hot

spicy food, 2-3

Heavy meat eater,

Loves sweets,

cheeses in excess, 4-


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meals a day meals a day 5 meals a day

Digestion Good, Normal Variable Slow

Elimination Regular Irregular Sluggish

Drug & Alcohol

use

None Social, Occasionally Frequently

Total.

Functions (a) DI High I.Q.

(Intellectual

capacity) Low I.Q.

Normal I.Q.

(b) DRUTHI Good

(Retention

of Poor

Knowledge) Intermittent

(c) SMRUTHI Long Term

(Memory) Short Term

Long & Short

Term

AHARA SAKTI

(Eating habits and digestive power)

(a) How long does it take to digest food? (b) Do you feel sleepy/lethargic after food?

If yes, for how long?

(c) Do you become excessively thirsty after meals? (d) Do you eat because you are hungry? (e) Or do you eat because it is mealtime? (f) When do you become active after eating? (g) Do you drink fluids with your meal? (h) Do you eat microwave meals? (i) Do you eat fast food? (j) Do you eat leftovers? (k) Where do you eat your meals:

(i) In front of TV.

(ii) In bed

(iii) At the table

TIME OF MEALS: Breakfast

Afternoon meal

Evening meal

Snacks Is your eating habits Regular Irregular

EXAMPLE OF DAYS MENU


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Breakfast Afternoon Evening Snacks Liquids

STATE OF AGNI

(Digestive power)

(a)

Extracts taken from Scott Gerson “Ayurveda The Ancient Indian

Healing Art” Element Books Ltd.

TIKSHAGNI (Sharp)

(seen in Pitta individuals) Appetite is strong as is the circulation and digestion. Impurities tend to

accumulate in rasa, rakta dhatus. Diarrhoea is common. Immune

system is good but tendency towards febrile and inflammatory

disorders.

(b)

MANDAGNI (Mild)

(seen in Kapha individuals)

Exhibits sluggish digestion, poor appetite and tendency towards weight

gain. Circulation is slow. Increased incidence of congestion,

bronchitis, influenza and common viral infections.

(c)

VISAMAGNI (Irregular)

(seen in Vata individuals)

Displays periods of extreme hunger and then loss of appetite.

Produces intestinal distension, constipation, and abdominal pain.

Resistance to disease is irregular causing chronic and disabling

diseases of the bones and nervous system.

(d)

SAMAGNI (Regular)

Occurring in individuals whose doshas are well balanced. Normal

appetites and bowel movements, excellent energy and directness of

speech.

VIYAYMA

(tolerance for exercise)

PRAVARA (Superior)

MADYAMA (Medium)

AVARA (Inferior)


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PART THREE


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DIAGNOSIS OF DISORDER AND CORRECT CONCLUSION

(1)

DOSHA :-

(2)

DHATUS (tissues) :-

(3)

NIDHANA (causes) : -

(4)

CHIKITSA KRAMA (Treatment Regimes)

Deepana (decrease digestive fire)

Pachana (decrease ama)

Shodana (detoxification)

(5)

AHARA (Food)

VIHARA (Lifestyle)

AUSHADA

(medicine)

COMMENTS

DATE

TREATMENT/EVALUATION

FOLLOW-UP


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Documents

CASE STUDY FORMAT - Ayurveda Institute UK€¦ · AYURVEDA INSTITUTE UK 3 FEMALE REPRODUCTION STATUS: e.g. menopausal ... (lymphatic system) RAKTA SARA (blood) MAMSA SARA (muscle)