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1


VATA PITTA KAPHA
1 Performs activity /
Very quickly/ With moderate speed/ Slowly /
2 Motivated, enthusiastic and excitable / Very easily / Moderately / Slowly /
3 Moods / Change quickly / Change quickly and intense / Non-changing and steady / ,
4 Learns / Very quickly / Somewhat / Slowly /
5 Quality of mind / Quick, creative and imaginative, but restless / , , , , Sharp, penetrating intellect / , Stable / ,
6 Memory / Good short-term / Medium / Good long-term /
7 Digestion / Inconsistent, varies between weak and strong / , Usually strong / Weak and slow /
8 Appetite / Variable, can skip meals occasionally / , Strong, consistent appetite, not comfortable skipping meals / , , , Usually mild, can skip meals without discomfort / , ,
9 Quantity of food eaten / Variable / - Likes large meals / Likes small meals /
10 Taste preferences / Sweet, sour and salty / , , Sweet, bitter and astringent / , ,
Pungent, bitter and astringent / , ,
11 Thirst /
Varies /
Frequent / Very rarely /
12 Food preferences / Warm, moist foods / , Cool foods / Warm, dry foods / ,
13 Drink preferences / Hot / Cold / Hot /
14 Frequency of bowel movement / Irregularly / Two or more times a day / Regularly /
15 Consistency of feces / Hard, dry stools / , Loose stools / Well-formed, soft stools /
16 Perspirations / Moderate / Profuse with body odor /
Slight
/
17 Sexual desire / Small / Small to moderate / Abundant /
18 Amount of sleep / Usually 5-6 hours / 5 – 6 Usually 6-8 hours / 6 – 8 Usually 8 hours or more / 8
19
Quality of sleep / Light, easily interrupted / , Deep and uninterrupted / , Deep and heavy / ,
20
Type of dreams / Fear, flying, running, jumping, climbing trees and mountains / , , , , Anger, violence, struggle, war; fire, lightning, the sun; gold and light / , , , , , , , Water, lakes, rivers, oceans; clouds, swans, flowers and romance / , , , , , ,
21
Response for challenge / Uncertain, worried and indecisive / , , Angered, irritable and inpatient / , , , Clear, stable and patient / ,
22
Speech / Fast, omitting words and digressing / , Fast, clear and precise / , , Slow, clear and sweet / , ,
23 Gait / Fast, with a light step / , Medium speed, with precise, determined step / , Slow, steady and fluid / , ,

 


 

2


VATA PITTA KAPHA
1 Shape of face / Thin, bony and elongated, plan looking / , ,
Oval, angular with medium fullness / , , Round, full and attractive / ,
2 Complexion / Dark, brownish or black / Fair, reddish or coppery / Light, clear and whitish / ,
3 Involuntary bodily movements / Twitching, jerking and fine tremors / , , , Body is usually still / Body is usually still /
4 Body weight /
Light, five to ten pounds below normal / , Normal, medium weight / Heavy, five or more pounds above / ,
5 Build / Lean, thin, tall or short / , Medium build, medium height / , Thick, large, fleshy or plump / ,
6 Texture or quality of skin / Dry, coarse, rough, cracked or scaling and birthmarks / , , , , Soft, delicate and sensitive with freckles, moles / , , Soft, smooth and oily / , , ,
7 Skin moistness / Dry / Moist and slightly oily / Oily /
8 Body temperature /
Low, cold extremities / , High, always feels warm / , Low, body feels cool / ,
9 Stamina /
Short / Moderate / Strong /
10 Shape and quality of eyes and lashes / , Small, bulging and deep-set with thin, scanty eye lashes / , , , Sharp, intensive and penetrating with brown, blond or coppery lashes / , , , , , Large, attractive and full with long thick lashes / , , ,
11 Dominate hue of sclera /
Dark / Yellow or reddish / White, glossy /
12 Peculiar characteristics of eyes / Dry, frequent blinking / , Light-sensitive, easily reddened / , Teary or runny /
13 Teeth / Very small or protruding, crooked, easily cracked / , , , Moderate size, yellowish / , Strong and large, white / , ,
14 Nails / Short, rough brittle, dark and lusterless / , , , , Slightly oily, coppery or pink in color / , Long, thick and well-rooted, soft, glossy and white / , , , ,
15 Lips / Dark, dry and cracked / , , Soft, pink or copper-colored / , Full, thick, moist and oily / , ,
16 Size and shape of fingers / Very short or very long, stubby and thick / , Medium length, square or oval-shaped / , Medium length, elegantly shaped / ,
17 Color and texture of hair / Thin, coarse, dry and wiry, darker in color or balding / , , Thin, fine, soft, blond or red, early graying / , , , Thick, glossy, firmly-rooted, wavy and black / , , , ,
18 Body hair / Scanty / Moderate / Thick and plentiful / ,
19 Joints / Loose or rigid, pronounced, crack and pop / , , Smooth, flexible well knit / , , Strong, well hidden / ,
20 Veins / Prominent or branching, close to surface / Neither hidden nor prominent / Deep and hidden /
21 Chest / Long, sunken, thin ribs easily visible / , Medium in length, medium thick, ribs not so visible / , Broad, strong and covered with flesh or fat / , ,
22 Body odor / Little or no smell or perspiration / Strong, armpits smell fetid / None /
23 Tongue / Dark, brownish, thick, rough and very cracked on the sides / , , , , Pink or dark red, soft and long / , Light pink, heavy and moist / ,

 

 

3

(, , () , , , .)
1. Did you have any of the common children’s diseases? / ? , :
2. Where you born with any disability? / ? , :
3. Have you had any accidents? / ? , :
4. Have you undergone any operations? / - ? , :
5. Do you have any complaints at present? / ? ():
6. Family history / () :


Alive / Dead / () Disease or course of dead/
Father/ Mather/
Brother/ Sister/
     

 

1. At what did you experience first signs of puberty? / ?
under 12 years / 12 12 – 18 years / over 18 years / 18
2. Is your menstrual cycle regular? / ?
- yes / - no /
3. How many days does your menstruation? / ? ():
Do you feel there is any relationship between your illness and your menstrual cycle? / , , )? - yes / - no /
4. What is your mental state around the menstruation period? / ?
Abnormal / Normal / : Before / During / After /
5. If you had children, was the delivery normal? / , ?
Abnormal / Normal / : First / Second /
6. Have you noticed new symptoms after pregnancy? / - / ?
- yes / - no / If so, what symptoms? / , ? ():

, .
23 2013 .
: 0
 
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