NADI PAREEKSHA (PULSE DIAGNOSIS ) IN AYURVEDA GREAT TOOL FOR PHYSICIANS

INTRODUCTION
No physical

sign - more basic or important than the arterial pulse . The most fundamental sign of life . Even today under emergency clinical conditions the modern physician frequently records the pulse .

NEED OF PULSE EXAMINATION

the pulse examination become an outdated procedure of only historical importance ?

WHAT IS PULSE READING ?

(...)

Sucessful pulse reading involves touching, feeling, observing and experiencing the rate, rhythm, and volume of the pulse. Also its movement, amplitude, temperature, force, and consistency in the body.

ASHTASTHANA PAREEKSHA

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Nadi (pulse) Mutra(urine) Mala(stools) Jihwa(tongue)

Sabda(voice) Sparsa (touch) Drik(sight) Akriti(facial expression)

WHY ?
It is sign of life Illustrates all types of disease progression . Helps to detect -Ongoing physiological changes Imbalances in human body , Inhance digestion , Verify levels of Aama in pulse ,Imbalance in Agni.

LITERATURE REVIEW IN AYURVEDA

of Nadis Upanishada in which Prashnaupanishada mentioned Seventy two crore Nadis Similarly in Kathoupnishada that from heart hundred Nadis are originated. Charaka in the Indryiasthana - cessation of pulsation of ever pulsating Manya (carotid artery) ,is the indicative of death. In Sushrut Samhita Sharirsthana Nadis are called as Sarvadoshavaha .

, 4th chapter of second section describes normal pulse rate of the body which is Trishadvaram (thirty). But the first time it was Sharangadhara who introduced the Nadi Pareeksha as a another branch in Ayurveda. Acharyas Bhavaprakasha(15th century AD.) Yogaratnakara (16th century AD.) Vasavarajeeyam (17th century AD.) Kanada and Ravana.
Harit-samhita

REVIEW OF LITERATURE
Egyptian pulse lore Greek pulse lore

knowledge of the pulse is limited only to know the condition of heart, but there is no information available about procedure of pulse examination signs of pulse with reference to diagnosis and prognosis.

pulse according to their length , breadth, depth . Pulse has been described only in qualitative form there is no where reference to its counting.

Chinese pulse lore

Arabic pulse lore

Their entire superstructure of practice is built upon the theory of pulse. Pulse is based on Yang Yin and Superficial Deep principle. They also observed pulse variations under the influence of seasons, age, sex of the patient

based on principles of Greek medicine

TANTRIK PULSE LORE

belonging to the school of Shaiva Agama Tantrism developed medicine including pulse lore From review of Tantrik literature - some are of opinion of theoretical knowledge of Indian pulse lore has been derived from pre-existing pulse lore of Tantrik literature of India

SYNONYMS FOR NADI

Nadipariksha Kala first three hours of morning

PULSE EXAMINATION - METHOD

should be in state of mental stability and peace of soul and mind. Should examine by his right hand the pulse lying one finger in breadth below from the root of the thumb. The elbow(Kurpar) of the patient should be slightly flexed to the left The wrist slightly bent to the left with the fingers distended and dispersed. In female pulse of left hand and left leg

In male pulse of right hand and right leg should be examined. The physician should press the artery lightly with his three fingers for three times by giving and releasing the pressure alternately over it

Finger

Dosa

Tarjani (index finger) Vata

Madhya ma(midd le finger) Pitta

Aanamik a(ring finger) Kapha

ANIMAL MOVEMENTS CORRELATION

Vatika Pulse
Snake movement Rate of the pulse should be fast

Leech movement
Volume - Smallest Character - Curvillinear

Paittika Pulse
Character bounding in nature Rate relatively slower than Vatika

Kaphaja Pulse
Amplitude intermediate between Vatika & Paittika pulse

Kaphaja Pulse
Rate would be slowest.

Sannipattika Pulse
Rate would be rapid.

Vatika

Jaloka-Sarpa gati (snake-leech like movement) Kulinga-Kaka-Manduka (sparowcrow-frog like movement) Hansa Paravat gati (swan-pigeon like movement) Kadachitmandagamana kadachitvegavahini (alternately slow and fast) Lava Titir-Varti(lark-quailpatridge like movement) Slips from its normal postion Aatikshina (slow) & sheeta(cold)

Paittika

Kaphaja

When any two Doshas are in combination

When all three Doshas are involved

Death

DVIDOSHAJA PRAKOPA
Dosa prakopa Fingers

Vata-pitta prakopa

Below index and middle finger

Vata-kapha prakopa

Below index and ring finger

Pitta- kapha prakopa

Middle and ring finger

When all three Dosa involved

Pulse is felt under all three fingers

NADIPAREEKSHA NISHEDHAKALA (CONTRAINDICATION)

hungry or thirsty states, just from the sun , tired due to exercise , during sleep & just after awakening, patient has anointed with oil, when patient has taken his meals, after intercourse

8 NADIS

FOR EXAMINATION Nasamulagata nadiindicate life, death, eye disorders, headache, ear disorders thorat Akshinadi Karnamula nadi Jihvanadi Medhranadi

Karangaushtamula nadi - indigestion, Aamdosha and vitiated Vata,Pitta , Kapha Padagulpha nadi Kathanadi- Aagantuka jwara, Bhaya, shoka , krodha

SHARANGADHARA SAMHITA
the first authoritative physician implanted

knowledge of pulse examination in third chapter a)physiological b) mental c)pathological , states of the body

Types of pulse in different condition Healthy pulse(Swasthawastha) Good hunger and appetite(Deeptagni) Lust(Kama) & anger(Krodha) Anxiety(Chinta) & fear(Bhaya) Poor apetite(Mandagni) & cachexia(Kshina dhatu) Intoxification (amadosha)

Characterstic of pulse Sthira (steady) and Balawati (strong) Laghwi (light to touch) Chapal & Vegawati (tremulous & fast) Vegavaha(rapid) Kshina (feeble) Mandatara (slow) Gurvi (heavy)

BHAVAPRAKASHA SAMHITA
6th subdivision of

the first part. According to Jolly this samhita flourished in 16th century A.D. relation between the specification of fingers and Doshas sides for pulse examination pulse inphysiological , indication of three mental , fingers pathologiacal states unfavourable conditions when it is not examined ,

YOGARATNAKARA
According to P.K. Gode its period lies between 1650 A. D. & 1725 A. D. According to Jolly, not later than 1746. In the opinion of Singh its period is 1676. First chapter of the book describes pulse examination addition of pulse indicating bad prognosis, quantitative form of the pulse instruction to physician to wash his hand after examining patient

NADIVIJANANA BY KANAD
(a)

general consideration of origin of Nadi and its examination (b)pulse characteristics after different foodstuffs
Different foods Mansa (meat) Pulse characterstic Lagudakriti (like rod steady)

Banana , molasses cake prepared from pulses etc .dry foods & meat

Nishakram vatapittatirupen (resembles pulse of Vata Pitta but maintain no order)

Parched grain , flattened rice Kushmanda (gourd) Mulak (radish) Shaka- Kanda (green leaves & stem roots Molasses , cakes , milk

Sthira & Mandatatra (steady &slow) Manda (slow) Resembles the movement pulse filled with blood Sthira & Manda(steady & slow)

DIFFERENT RASA & EFFECT ON PULSE

Salt

Sarala & Druta (straight & rapid)

PULSE IN PHYSIOLOGICAL STATE Types of pulse Pulse characteristics

Healthy pulse Good hunger

Sthira(steady) Laghvi Vegawati (light & fast) Chapala (tremulous) Hot like flame Snigdha (smooth) Hot Fast Less prominent than day

PULSE IN MENTAL STATE

Types of pulse

Pulse characteristics

Kama- Krodha (lust & anger) Chinta Bhaya (anxiety & fear)

Vegawati (fast)
Kshina (feeble)

PULSE AS A PRODROMAL SYMPTOMS

Types of pulse Anga-graha (slight pain in the body when fever is to occur ) If fever is about to increase Sannipata jwara

Pulse characteristics Manthara & Plava (slow & jumping) Jumping forcibly Miscellaneous movement

PATHOLOGICAL CONDITIONS Types of pulse Pulse characterstics Fever Very hot and fast Indigestion (aajirna) Kathina & Jada (heavy & tight) Toxication (aamadosha ) Heavy Grahani (malabsorption) In leg moves like Hansa(swan) but in hand like Manduka(frog) Prameha (diabetic condition) Granthirupa (beaded) Bhagandara (fistula in ano) Hot & curvilinear Pulse in poison Jumping

 f)pulse of

bad prognosis at the time of death, death in one day upto death within one month (g)good prognostic pulse ( h)characterstic of pulse appearing apparntly of bad prognosis but really not so.

RAVANKRUTA NADIPARIKSHA
The whole work is attributed to pulse written in the same form as the work of Kanada with some additional work like

Pulse in pregnancy

Gurvi Vatavaha(heavy & Vatika pulse Paitikka in nature

Puise in infants

(Arsha)Piles

Grahani Swasa (asthma) Shleshma Kasa Rajyakshama (tuberculosis) Pandu (anaemia) Kushta (leprosy)

Manda kvacidavakrakvachidaruju(slow sometimes curvilinear and straight Mrutasarpopama (like dead snake) Tivragati (fast) Sthira Manda (steady & slow) Naga gati (slow) Fast sometimes visible sometimes not Kathina & sthira (hard & steady)

EXPLANATION OF MODERN TERMS

for tachycardia Druta, Twarita, Tivra, Shighra, Vaykul, Vikala . Similarly for bradycardia Manda , Manthara Rhythm to explain regular rhythm - Sarala (not crooked) Samya (regular) for irregular pulse Trutita, Vakra, Kautilya Volume for high volume Atyuchchaka

 Sukshma

(fine, thin), Atisukshma(very thin), Shithil (weak feeble) signify that pulse is of low tension and low volume. Pushtihina can be coined as a single word for low tension Force Vegavati, Vegadhara, Balwati, Prabal, Uttanabhedin these words also tell about high tension of the pulse Condition of arterial wall Karkasha , Kahara , Kathina for hardening of wall Temperature of skin over pulse Koshna , Soshma and Shita

RESEARCH SCOPE
In recent

times researchers worked on Ayurvedic Nadi through modern parameters like Sphygmography , Pulse meter etc. A beginning has been made by researchers like Dr. Sarva Deva Upadhyaya & Dr.Eknath Ghosh who published series of articles in Journal of Ayurveda of Calcutta it is necessary to plan and conduct research on Nadi pariksha so that an acceptable model may be constructed for universal application.

CONCLUSION
The art and

science of examination of pulse was well developed in ancient India. Fortunately some of the ancient Ayurvedic literature is still available to us . A humble attempt is made here to present most of the literature in systemic manner An attempt has been made to corelate terminology of pulse examination in Ayurveda with modern science

 Systematic and

comprehensive training of Nadi pariksha in Ayurveda colleges can be ray of hope. Finally, Experience alone can make one perfect.

THANK YOU

THANK YOU

Pulse , like a lamp , throws light on all the physiological and pathological states encountered in man.