Tri Bidh Pariksha

Physicians need to perform clinical examinations of patients to confirm, evaluate and treat a disease, – wherein textual knowledge (aptopadesa), direct perception (pratyaksha) and inference (anumana) are all very important components. The examination of patients can be carried out in the following manners :

Three (Tri) fold (Bidha) Examination (Pariksha) Covers a general examination of the patient.
Involves :

1. Visual observation (Darshan)
2. Tactile perception (Sparsha)
3. Questioning (Prashna)

Visual observation (Darshan)
This is the first method of clinical assessment. It can be defined as the method to know the nature of disease by examining the patient externally. In this method, the person is totally assessed by the physician and notes the enlarged or shrinked body parts, age, symptoms, strength, colour, shape of the body, dryness or excessive oiliness and colour and features of eyes.

Tactile perception (Sparsha)
In this method, the physician examines a person by touching. There are various factors that cannot be understood by inspection and can be known by palpation. Palpation should be started from the organs near the organ to be examined rather than directly approaching the affected part. The tactile perception helps in understanding the reflexes, rigidity or softness of different organs, temperature of the body, texture of the skin, any swelling and tumour, flatulence and stages of different wounds and ulcers.

Questioning (Prashna)
This is one of the important aspects of diagnosis. For this examination, the physician is required to be fearless, learned, intelligent, experienced, compassionate and patient. Interrogation is of two types: general and specific. The general interrogation includes the following points :

Name, age and address of the patient
Sex
Profession
Present complaint
Duration of the complaint
History of the previous illness
Family history for diseases like hypertension, diabetes, epilepsy etc
Individual history – addictions, habits, habitat etc
Progress of the present complaint
Any specifications regarding the disease

The specific interrogation includes the following points :
Profession
Financial status
Addictions, diet and habitat
Congenital anomalies
Hereditary diseases
Previous history of any diseases
Psychological abnormalities
Pediatric problems