Diagnostic practices for patient evaluation before Yoga Therapy is applied, as taught under the Gitananda Yoga Tradition.

1. VANAKAM

2.  PATIENT EVALUATION
 DWADASHA ROGA
LAKSHANAM ANUKRAMA
( C O N C E P T B Y D R . S W A M I G I T A N A N D A G I R I
G U R U M A H A R A J A , F O U N D E R - A N A N D A
A S H R A M , I C Y E R , P U D U C H E R R Y , I N D I A )
- P R E S E N T E D B Y S H V E T I K A K A U L
( P G S T U D E N T , C E N T E R F O R Y O G A T H E R A P Y ,
E D U C A T I O N A N D R E S E A R C H , M G M C R I ,
P U D U C H E R R Y )
YOGIC DIAGNOSTIC TOOLS

3. NEED for Yogic Diagnostic tools?
 Yoga therapy isn’t a symptomatic treatment.
For “tailor making” the treatment schedule, tracing the “root
cause” of the disease and the awareness regarding it is
imperative.
 Making the patient understand and accept the cause of
his problem and all other factors aggravating it is the only
way to prevent worsening of the condition, its relapse and to
facilitate conscious measures to adopt a healthier lifestyle.
 The inference drawn from the analysis makes for the
baseline of treatment.
Also, acts as reference points to assess progress in therapy
in order to make modifications/ advancements accordingly.
 These are extensive methods to understand one’s patient
wholly and not just on the usual physical parameters.

4. ROGA LAKSHANAM FORM
A tool developed by Dr. Swami Gitananda Giri Guru Maharaja, adopted by CYTER,
combining the modern medical diagnostic measures along with subtler measures to
assess the diseased state of patient.
The form contains 4 broad categories, namely-
 DARSHANAM
Sanskrit: Root ‘Dris’ (Sight) – the act of “seeing/ beholding” – to observe,
survey, witness, contemplate to look for all noticeable signs and symptoms.
 SPARSHANAM
‘Sparsha’- the sense of touch. To physically examine patient.
 PRASHANAM
‘Prashna’ - "question, query, inquiry"
To find out how patient expresses his problem and not how
you diagnose / see it.
 NADI PARIKSHANAM
‘Pariksha’ – ‘to probe, examine’ : Assessment based on the flow in the Nadis

5. DARSHANAM
 Weight / Height: _______________ Kg/cm
 BMI: _______________ Kg/M2
 Respiratory Rate: ______ bpm (sitting / lying down)
 Body Type: Endomorph / Ecto / Meso ; Apple / Pear / Hourglass
 Mood: Energized-Pleasant / Calm-Pleasant / Energized-Unpleasant /
Calm-Unpleasant
https://www.researchgate.net/figure/239949649_fig1_Figure-1-Four-basic-
mood-categories-based-on-the-PANAS-model-by-Watson-and-Tellegen
 Spine: Normal / Lordosis / Kyphosis / Scoliosis
 Gait: length of steps, stiffness of body, swiftness, L-R weight bearing,
arm/ leg swing, open or closed stance, equally paced steps, etc.
https://www.slideshare.net/prkhuman/gait-normal-abnormal
 Tremors: Body part/s ________ / ; duration ______ ; speed
_______ ; at rest/action ; severity _______
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-
Sheets/Tremor-Fact-Sheet
http://tremor.org.uk/essential-tremor-charactersitics.html
 Others: other physically noticeable aspects of his presence (Odor, Eyes,
Gaze, Skin, other body parts, posture/ stance, etc)

6. SPARSHANAM
 Body Temp: Hot / Normal / Cool / Cold (Peripheral / Core)
https://en.wikipedia.org/wiki/Human_body_temperature#Core_temperature
 Muscular Tone: Body Part ___________ : Low Tone / High
Tone; cramps https://en.wikipedia.org/wiki/Muscle_tone
 Signs of Anemia: Fatigue, pale skin, brittle nails, slow thrombosis,
Shortness of breath, Cold hands and feet, Racing or irregular
heartbeat, Chest pain
http://www.webmd.com/a-to-z-guides/understanding-anemia-symptoms#1
 Hydration: Increased thirst, Dry mouth, Dry skin, Headache,
Decreased urine output and volume, more yellowish than normal
http://www.emedicinehealth.com/dehydration_in_adults/page3_em.htm
 Joint mobility & Stability: Area; Mobility (Ankylosing /
Hypomobility / Normal / hypermobility / Instability)
 Lumps: Area ________; Size_____ ; Shape______ ; Consistency
______ https://patient.info/in/doctor/lumps
 Tenderness: Area ______

7. PRASHANAM
 Main Complaint:
Duration & Severity:
 Minor Complaints:
Duration & Severity:
 Appetite: frequency, quantity, quality (type of food),
regularity, satiety, skipping meals, affinity
 Sleep: Timely, quality, duration, dreams, snoring
 Bowel and Bladder: Timely, complete, Color, Pain, Odor,
Blood, related disturbances (flatulence etc), incontinence
 Medical History: (ailment & duration)
 Current Medications: (drug & dosage)
 Family History: Parents, Grandparents – (ailment)

8. NADI PARIKSHANAM
 Pulse rate: _____ (radial pulse / 60 sec)
 Type of Pulse: Speed; Intensity (pounding/ feeble);
Rhythm
 Peripheral Pulse: Area: Speed; Intensity; Rhythm
https://www.youtube.com/watch?v=qvVcG5fYZ04
 Blood Pressure: _____mmHg; R/L; sitting/lying;
manual/machine.
 Auscultation: action of listening to sounds from the
heart, lungs, or other organs, typically with a
stethoscope
https://www.youtube.com/watch?v=yLoxuhAD05M
https://www.youtube.com/watch?v=zdkYujPkeqo&t=136s
https://www.youtube.com/watch?v=TlgP8MzlMaw

9. DWADASHA ROGA LAKSHANAM ANUKRAMA
 A method developed by Dr. Swami Gitananda Giri
Guru Maharaja, adopted by CYTER based on Yogic
concepts of causes leading to disharmony
 This helps understand one’s patient in a holistic manner
 ‘Dwadasha’ stands for ‘Twelve’;
‘Roga’ for ‘Disease’;
‘Lakshanam’ for ‘characteristics’; and
‘Anukrama’ for ‘Methodology’.
These are the 12 diagnostic tools to understand the
reasons why disease has ‘surfaced’ / ‘manifested’ in a
person.

10. 1. Triguna : Sattva | Rajas | Tamas
2. Tridosha : Vata | Pitta | Kapha | V+P | P+K | V+K | V+P+K
3. Trivasna : Loka | Deha | Jnana
4. Prana: Prana | Apana | Vyana | Samana | Udana ; Akasha | Chitta
Naga | Kurma | Krikara | Devadatta | Dhananjaya
5. Abhyasa: Yatna (effort) | Deerga Kala (long time) | satkara (with
reverence towards the supreme- the ‘sat’ – absolute truth |
Nairantarye (uninterrupted/ continuous/ regular) |
Dridhbhumih (Determined) | stillness of vrittis (mental
fluctuations) during practice| Concentration on area of
practice | Vairagya (cravings ceased)
6. Jiva Karma: Daily routines to maintain healthy lifestyle –
yamas, niyamas, dincharya, raatricharya, ritucharya, occupationally

11. 1. Chetna: Quality of thoughts - positive, idealistic, and outgoing,
self-centered, disturbed
2. Vacha: Speech & expression- Clarity | Consistency | Coherence|
Refined | Emphasis (guttural, nasal, throat, heart etc)
3. Ahara: Food (body & mind) Guna | Mitahara | Frequency |
Quantity | Regularity | Specific to disease condition |
Ahara for Panchakoshas
4. Viprita Buddhi: Actions anti harmonious to oneself / one’s society
– addictions, harmful acts
5. Jiva vritti: Body rhythms – Bio rhythms, circadian rhythms,
periodicity of nasal cycle, periodicity and rate of heart, BP, Respiratory
rate, deep/ shallow breathing, sectional or complete breathing,
menstrual cycle, bowels and bladder.
6. Sankalpa: Vows, inclination to get better & live healthy,
icha-kriya-jnana shakti coordination

12. Some Practical Problems in Assessment
 The length of questionnaire for a beginner
 The necessary training of the therapist on these concepts and their
diagnosis
 The interest in / importance given by therapist to perform this
diagnosis
 The way to divide questions based on the time availability during
therapy classes, without losing patient’s interest & involvement
 Knowledge of how to put forth these questions and extract answers
from patients.
 The skills of Yoga Instructors/ Non-medical Yoga therapists in
handling the body assessment parameters
 The importance of scheduling repeat assessment after a month of
therapy
 to assess progress and results at end of therapy
 Maintaining timely, updated records
 Maintaining patient detail secrecy