Advanced Nidana Prashana (Inquiry into Disease Cause) – Integrating Ayurveda & Modern Medicine
Introduction
Nidana Prashana is the first and most crucial step in disease diagnosis, as it helps determine the root cause (Nidana) of a disease. According to Ayurveda, diseases arise due to improper diet (Ahara), lifestyle (Vihara), mental factors (Manasika Bhavas), and genetic predispositions (Sahaja). In modern medicine, this aligns with etiological inquiry, risk factor assessment, and differential diagnosis.
A detailed Nidana Pariksha enables a practitioner to:
✅ Identify the primary cause of the disease (Hetu).
✅ Determine the stage of disease progression (Shatkriya Kala).
✅ Classify the disease based on dosha, dushya, and srotas involvement.
✅ Plan a personalized treatment approach (Nidana Parivarjana – Avoiding the Cause).
1. Ayurvedic Concept of Nidana (Disease Causation)
Ayurveda classifies the causes of disease into three main categories:
| Category | Definition | Example |
|---|---|---|
| Asatmya Indulgence (Improper Dietary & Lifestyle Habits) | Unwholesome food and habits disturb doshas | Excess spicy food → Pitta imbalance → Gastritis |
| Pragyaparadha (Intellectual Error/Negligence) | Ignoring bodily signals, emotions, and seasonal guidelines | Suppressing hunger → Agni (digestive fire) imbalance → IBS |
| Parinama (Environmental & Seasonal Impact) | Climate, time, and age-related changes affecting health | Winter cold exposure → Kapha aggravation → Respiratory illness |
Detailed Classification of Nidana
| Type of Nidana | Definition | Modern Equivalent | Example |
|---|---|---|---|
| Samavayi Nidana (Intrinsic Cause) | Direct, inseparable cause of disease | Genetic/Hereditary Factors | Diabetes, Hypertension |
| Asamavayi Nidana (Associated Cause) | Indirect factors that support disease | Lifestyle & Environmental Risk Factors | Smoking → Lung Cancer |
| Nimitta Nidana (Triggering Cause) | Immediate causative factor | Infection, Trauma | Virus → Influenza |
🔎 Clinical Application:
- Helps differentiate genetic, environmental, and lifestyle-related diseases.
- Guides preventive medicine & risk factor modification.
2. Shatkriya Kala – Six Stages of Disease Development
The Nidana approach in Ayurveda follows six progressive stages (Shatkriya Kala), which are comparable to the modern pathogenesis model.
| Shatkriya Kala (Stage of Disease) | Dosha Involvement | Modern Pathology Equivalent | Clinical Relevance |
|---|---|---|---|
| Sanchaya (Accumulation) | Doshas begin to accumulate due to improper diet/lifestyle | Subclinical Stage | No major symptoms, mild discomfort |
| Prakopa (Aggravation) | Doshas increase beyond normal levels | Pre-symptomatic Stage | Mild signs (e.g., acidity, bloating) |
| Prasara (Spread) | Doshas overflow and start affecting other dhatus (tissues) | Disease Progression | Early clinical symptoms |
| Sthana Samshraya (Localization) | Doshas settle in weak body parts, causing specific disease symptoms | Tissue Damage | Chronic gastritis, mild arthritis |
| Vyakti (Manifestation) | Clear disease symptoms appear | Diagnosable Disease | Peptic ulcer, arthritis |
| Bheda (Complication) | Severe or irreversible pathology develops | Organ Failure, Metastasis | Perforated ulcer, Rheumatoid arthritis |
🔎 Clinical Application:
- Helps in early disease detection & prevention before organ damage occurs.
- Guides dosha-based management to prevent disease progression.
3. Nidana Prashana – Advanced Clinical Inquiry
A structured questionnaire is essential for systematic history-taking. Below is a detailed sample question set based on Ayurvedic Nidana principles, correlated with modern medicine.
🔹 A. Dietary History (Ahara Nidana)
| Question | Clinical Relevance | Ayurvedic Significance |
|---|---|---|
| Do you consume very spicy, sour, or fermented foods regularly? | Can indicate gastritis, acid reflux | Pitta aggravation → Peptic ulcers |
| How often do you eat processed, fried, or oily foods? | Risk for obesity, diabetes, heart disease | Kapha-Meda Dushti (Lipid imbalance) |
| Do you have irregular meal timings or skip meals frequently? | Affects metabolism, gut health | Agni Dushti (Digestive Fire Imbalance) |
| Do you consume cold foods or refrigerated items frequently? | Can cause indigestion, slow metabolism | Kapha accumulation → Sluggish digestion |
| Do you consume excessive sweets, dairy, or heavy foods? | May contribute to insulin resistance, obesity | Kapha dosha increase → Diabetes risk |
🔹 B. Lifestyle & Daily Routine (Vihara Nidana)
| Question | Clinical Relevance | Ayurvedic Significance |
|---|---|---|
| How often do you exercise or engage in physical activity? | Sedentary lifestyle increases disease risk | Lack of Vyayama → Kapha stagnation |
| Do you sleep late at night or have irregular sleep patterns? | Disrupts hormonal balance, weakens immunity | Vata-Pitta aggravation → Insomnia, stress |
| Do you work in stressful conditions or experience frequent anxiety? | Increases risk of mental & cardiovascular diseases | Pragyaparadha → Vata-Pitta imbalance |
| Do you suppress natural urges (urination, thirst, hunger)? | Affects organ function & digestion | Udavarta → Vata Dushti (Nervous system imbalance) |
🔹 C. Environmental & Seasonal Influence (Parinama Nidana)
| Question | Clinical Relevance | Ayurvedic Significance |
|---|---|---|
| Have you recently traveled to a different climate zone? | Can cause infections, allergies | Unfamiliar weather → Seasonal imbalance |
| Do you experience seasonal allergies or respiratory issues? | Indicates immune hypersensitivity | Kapha-Vata aggravation (Allergic rhinitis, Asthma) |
| Do you experience joint pain worsening in cold weather? | Can indicate arthritis, fibromyalgia | Vata increase → Joint degeneration |
🔹 D. Psychological & Emotional Health (Manasika Nidana)
| Question | Clinical Relevance | Ayurvedic Significance |
|---|---|---|
| Do you frequently feel excessive stress, worry, or sadness? | Can indicate anxiety, depression | Manasika Roga (Mental Health Disorders) |
| Do you have mood swings or emotional instability? | Associated with hormonal imbalances | Vata-Pitta fluctuation |
| Do you feel fatigued, lack motivation, or experience brain fog? | May suggest burnout, chronic fatigue | Ojas depletion (Vitality loss) |