“How long will it take, doctor?”
This is the most popular question in my clinic. Beating “Can I eat ice cream?” by a small margin.
Unlike ice cream, which can be dealt with by a stern look and a lecture on kapha, the prognosis question requires something far more nuanced: honesty without discouragement, precision without promises, and a little bit of humour to keep the patient’s hope from collapsing like a badly rolled chapati.
Prognosis, or sadhyasadhyata in Ayurveda, is not a crystal ball prediction. It’s an art. A science. A gut feeling sharpened by years of seeing patterns in people — their bodies, minds, habits, and histories. Charaka tells us that a good physician should first know whether a disease is sadhya (curable), kashta sadhya (difficult to cure), yapya (manageable but not curable), or asadhya (incurable). That doesn’t mean the patient understands it instantly—usually it takes three explanations, a kitchen analogy, and a gentle reminder that Google is not a vaidya.
I just wanted to tell you about Sridhar. He walked into my clinic one rainy Thursday with a bloated belly and Google in his pocket.
“Doctor, I have liver cirrhosis. What’s the prognosis?”
I looked at his tongue (pale), his eyes (yellow), and his file (thicker than a legal notice). I also looked at his wife, who glared like she wanted to give him asadhya roga right there.
“Do you drink?”
“Rarely,” he said.
“Every day?”
“Only since retirement.”
I smiled. His liver was angry. His agni (digestive fire) was weak. His rasa and rakta dhatus were suffering. And yet, his spirit? Strong. His will? Playful. His wife? Determined.
I told him, “We’ll call it krichhra sadhya. It’s difficult but possible. But only if your wife becomes your new bartender.”
Ayurveda doesn’t just label a disease. It listens. It observes. Prognosis isn’t about reading numbers from a lab report but about reading the person in front of you.
I often quote a Sanskrit verse: “Rogi rogam na roopena, gunair vetti vichakshanah.” — A wise physician understands the disease not just by its symptoms but by its qualities.
You see, two patients with diabetes may have the same fasting sugar but entirely different outcomes. One is anxious, overworked, binge-eating murukku at midnight, and not sleeping. The other is calm, practices yoga, and grows his bitter gourd. Guess whose prognosis is better?
Unlike the black-and-white “You have 6 months to live” prophecy style of diagnosis found in movies, Ayurvedic prognosis is layered, like a well-folded masala dosa. It’s never just about the disease; it’s about you, your Prakriti, Agni, Bala, vyadhi bala, srotas, aama, satva, satmya, your life choices, food habits, and whether you watch Arnab Goswami at dinner (which, believe me, has health consequences).
Research on psychoneuroimmunology shows that mental health affects immunity and healing. Satva bala, the strength of the mind, is a critical prognostic factor in Ayurveda. Even modern oncology acknowledges that a positive attitude improves outcomes. And yet, no blood test today will measure satva. But we can feel it.
Satva bala is the quiet resilience in a patient who smiles despite the pain, asks thoughtful questions, and drinks the bitter decoction without flinching. It’s the strength not to be defeated by the diagnosis. I remember Pushpa, a cancer patient, quietly paying for a poor stranger’s medicine at the pharmacy counter. That’s satva bala. It’s not cheerfulness; it’s courage. It’s not denial; it’s discipline. And it matters more than an MRI.
I had an elderly man with chronic kidney disease. His daughter wanted a “natural cure.” I explained the situation gently, using the word Yapya. He needed dialysis, but Ayurveda could support him. She said, “So, you’re saying he won’t get better?” I said, “He might not get cured, but he can suffer less. He can eat better, sleep better, feel better.” She looked at her father and said, “Then that’s what we’ll do.” The hardest part is not declaring a disease as Asadhya. It’s holding the space for dignity, balance, and compassion when you do. Ayurveda doesn’t end at cure. It extends into sukhaayu—quality of life.
I often explain shatkriya kala—the six stages of disease—in simple ways that my patients can relate to. If the illness is in the early stages, like sanchaya (accumulation) or prakopa (aggravation), the chances of full recovery are high. But if it reaches bheda (complication), then we may only be able to manage it, not reverse it.
Patients understand this better when I draw it like a ladder. “You’ve fallen from the third rung,” I tell them. “But we can still climb back up.”
I remember a schoolteacher who came to me in tears. She had asthma, and her doctors told her she’d need steroids for life. “Is there no other way?” she asked, almost in tears.
“There is,” I said. “But you’ll have to walk every day. Cut down on foods that increase kapha. Learn to manage your breath. And undergo virechana—a cleansing therapy.”
She wiped her eyes and began. One month later, she’s off inhalers. Every summer, she comes by the clinic—not with questions, but with ripe mangoes and a wide smile.
There are clues the body gives—small, silent alarms. Skin that has lost its glow, a dry tongue, or a confused, vacant gaze often tells me that the body’s inner balance is disturbed. In Ayurveda, we call this dosha dushti—when the body’s natural energies go out of sync. And when these imbalances start harming the deeper tissues, it’s called dhatupaka. Think of it like this: the body is a house. Dosha dushti is like a short circuit; dhatupaka is when the wiring starts to burn the walls.
What worries me most are subtler signs—a sluggish tongue, no real hunger, a pulse that’s out of rhythm, and tiredness that test reports can’t explain. These point to a weak agni—your inner fire, the force that digests, transforms, and heals.
When agni is weak, nothing works. Not medicines, not hope, not even prayers. People with strong, healthy bodies have lost vitality when their agni fades. It’s like a fire that’s burned out—once bright and warm, but now cold and dim. The way we assess agni is simple. We look at your appetite, digestion, energy levels, and mood. If you’re feeling sluggish, have poor digestion, or feel tired all the time, that’s a sign your agni may be low. That’s the most significant warning sign I look for. Because no matter what the illness is, real healing starts only when that inner fire is rekindled.
You’d be surprised at how much the body reveals when you know how to look. A soft pulse suggests low vata, and a harsh cough in the morning hints at accumulated kapha. Foul breath can point to ama. Dry, cracked heels may indicate dehydration or poor fat metabolism. Recurrent mouth ulcers often come from pitta aggravation and unprocessed anger. An ashy complexion? Check for rakta vitiation. Frequent sighing tells me the heart and mind are burdened. An unsteady gaze during questioning? That’s a mind not ready to heal. A hand that trembles when reaching for the prescription hints at internal anxiety. Loud swallowing is sometimes udana vata in distress. I have noticed that people who say “I’m fine” too quickly are often not. These are the body’s gentle nudges—signals that something deeper needs attention before it becomes a scream.
How do we decide if something is sadhya, yapya, or asadhya? Not with a machine, but through a layered reading of the body’s signs, the disease’s stage, and the person’s overall vitality. Ayurveda teaches us to examine roga bala (the strength of the disease), rogi bala (the strength of the patient), kala (time), desha (location), vyadhi avastha (stage of illness), and most importantly, satva bala (mental resilience). When I notice signs like a dull gaze, foul breath, or weak pulse, I don’t just note symptoms—I evaluate depth, chronicity, and reversibility. A bright-eyed patient with chronic illness but strong digestion, stable mind, and family support might get labelled as sadhya. In contrast, a fatigued, hopeless, ama-laden patient with erratic habits may lean toward asadhya—unless the spark of will is reignited. Prognosis, in Ayurveda, is an interpretive art grounded in these observations, not just fixed protocols.
Modern medicine packages prognosis as a percentage: “You have a 40% chance of recovery.” Ayurveda works differently. We study shatkriya kala—six stages of disease development—and catch it early, often before symptoms start. This early detection is called nidanarthakara roga avastha
Understanding this helps prevent the disease from becoming a headline in your life.
In the Instagram era, prognosis has become a different challenge. Patients now arrive with hashtags: “Doctor, I saw this reel on turmeric latte curing asthma in 3 days. Thoughts?” I resist the urge to sigh like a monk.
In one case, a young woman came for PCOS. She had tried every influencer diet. Keto. Paleo. Raw papaya juice on Sundays. Her prognosis? Not about ovaries — about understanding that discipline beats detox fads. We worked on her ahara (diet), vihara (lifestyle), and emotional healing. The periods returned. She was overjoyed. “Doctor, you should start a YouTube channel.”
Maybe I should. Title: “Ayurveda: Slower Than Reels, Deeper Than Algorithms.”
One of my toughest consultations was with a father of a child with epilepsy. He asked me if I could cure his son. I said, “Let’s improve his immunity, digestion, and sleep. We’ll track changes. I won’t promise miracles. But I’ll promise effort.”
Later, the father told me something I will never forget: “Doctor, I needed someone who would not lie to me, but also not give up on us.”
In essence, that is the prognosis in Ayurveda. It’s about hope with boundaries. It’s about trust, not just between patient and doctor, but also between the patient and their body.
Over the years, I’ve learned to read the subtle signs—a spark in the eyes, a sigh that says they’re ready to try, or the way they ask questions—not for shortcuts but for understanding. Those are the patients whose prognosis is better than any textbook says.
If you’re a patient, know this: Healing is not Amazon Prime delivery. Be honest about what you eat, how you sleep, and how many ‘rare’ drinks you take. Trust the process—especially the slow, steaming, oil-dripping, herb-scented one. Follow up. Ayurveda is not a one-powder miracle. It’s a journey.
If you’re a young doctor, learn to say “I don’t know” with compassion. Use prognosis as a dialogue, not a declaration. A good prognosis can inspire, but a wrong one can destroy trust.
My professor, Dr. T.D. Kshirasagar once told me something that still echoes in my mind. “An Ayurvedic doctor doesn’t just treat disease. He treats chinta (worry), ahankara (ego), pramada (carelessness), and avidya (ignorance).”
Prognosis, then, is not about the disease. It’s about the person. The path. And the possibility of change.
What if we treated life like health, noticed early signs, made minor changes, and lived with care?
