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

Is the examination of pulse any significance ?

Will the pulse examination become an outdated procedure of only historical importance ?

यथा वीणागता तन्त्री सवाान ्रागान ्प्रभाषते । तथा हस्तगता नाडी सवाान ्रोगान ्प्रकाशते ॥ (योगरत्नाकर)

WHAT IS PULSE READING ?

दशानस्पशानप्रश्नै: परीक्षते च रोगगणम ्। (अ.ह्र.स.ू१)

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

रोगाक्रान्त्तशरीरस्य स्थानान्त्यष्टौ ननरीक्षयेत ्। नाडी मूर ंमलं जिहवां शब्दं स्पश ंदगॄाकॄनत: ||

• 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

Atharavaveda contains description of Nadi’s

Upanishada – in which Prashnaupanishada mentioned Seventy two crore Nadi’s

Similarly in Kathoupnishada that from heart hundred Nadi’s are originated.

Charaka in the Indryiasthana - cessation of pulsation of ever pulsating Manya (carotid artery) ,is the indicative of death.

In Sushrut Samhita Sharirsthana Nadi’s are called as Sarvadoshavaha .

Harit-samhita , 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.

REVIEW OF LITERATURE

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.

Egyptian pulse lore Greek 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

Chinese pulse lore Arabic pulse lore

TANTRIK PULSE LORE

Siddha’s 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

Nadi , snayu , hansi , hinsra ,

Dhamani , dharani , dhara,

Tantuki , jivitajnya , jivanajnyana,

Vasa , sira

Nadipariksha Kala

first three hours of morning

PULSE EXAMINATION - METHOD

Physician 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 Tarjani

(index

finger)

Madhya

ma(midd

le finger)

Aanamik

a(ring

finger)

Dosa Vata Pitta 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)

Paittika Kulinga-Kaka-Manduka (sparow-crow-frog like movement)

Kaphaja Hansa –Paravat gati (swan-pigeon like movement)

When any two Doshas are in combination

Kadachitmandagamana –

kadachitvegavahini

(alternately slow and fast)

When all three Doshas are involved Lava –Titir-Varti(lark-quail-patridge like movement)

Death Slips from its normal postion

Aatikshina (slow) & sheeta(cold)

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)

just after bath,

in 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 NADI’S FOR EXAMINATION

Karangaushtamula nadi - indigestion, Aamdosha and vitiated Vata,Pitta , Kapha

Padagulpha nadi

Kathanadi- Aagantuka jwara, Bhaya, shoka , krodha

Nasamulagata nadi- indicate life, death, eye disorders, headache, ear disorders thorat

Akshinadi

Karnamula nadi

Jihvanadi

Medhranadi

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

Characterstic of pulse

Healthy

pulse(Swasthawastha)

Sthira (steady) and Balawati

(strong)

Good hunger and

appetite(Deeptagni)

Laghwi (light to touch)

Chapal & Vegawati

(tremulous & fast)

Lust(Kama) &

anger(Krodha)

Vegavaha(rapid)

Anxiety(Chinta) &

fear(Bhaya)

Kshina (feeble)

Poor apetite(Mandagni) &

cachexia(Kshina dhatu)

Mandatara (slow)

Intoxification (amadosha) Gurvi (heavy)

BHAVAPRAKASHA SAMHITA

6th subdivision of the first part.

According to Jolly this samhita flourished in 16th century A.D.

specification of sides for pulse examination

indication of three fingers

unfavourable conditions when it

is not examined ,

relation between the fingers and Doshas

pulse in- physiological , mental , pathologiacal states

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 Pulse characterstic

Mansa (meat) 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 Sthira & Mandatatra (steady

&slow)

Kushmanda (gourd) Mulak

(radish)

Manda (slow)

Shaka- Kanda (green leaves &

stem roots

Resembles the movement pulse

filled with blood

Molasses , cakes , milk Sthira & Manda(steady &

slow)

DIFFERENT RASA & EFFECT ON PULSE

Sweet taste Resembles the movement of

peacock

Bitter taste Moves like earthworm

Acid taste Slightly hot & jumping

Pungent Like movement of sparrow

Astringent Kathina & Mlana (hard)

Salt Sarala & Druta (straight &

rapid)

PULSE IN PHYSIOLOGICAL STATE

Types of pulse Pulse characteristics

Healthy pulse Sthira(steady)

Good hunger Laghvi –Vegawati (light &

fast)

Appetite Chapala (tremulous)

After sexual enjoyment Hot like flame

Morning Snigdha (smooth)

Afternoon Hot

Evening Fast

Night Less prominent than day

PULSE IN MENTAL STATE

Types of pulse Pulse characteristics

Kama- Krodha (lust &

anger)

Vegawati (fast)

Chinta – Bhaya

(anxiety & fear)

Kshina (feeble)

PULSE AS A PRODROMAL SYMPTOMS

Types of pulse Pulse characteristics

Anga-graha (slight pain

in the body when fever

is to occur )

Manthara & Plava

(slow & jumping)

If fever is about to

increase

Jumping forcibly

Sannipata jwara 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

Puise in infants Paitikka in nature

(Arsha)Piles Manda –kvacidavakra-

kvachidaruju(slow sometimes

curvilinear and straight

Grahani Mrutasarpopama (like dead

snake)

Swasa (asthma) Tivragati (fast)

Shleshma Kasa Sthira – Manda (steady &

slow)

Rajyakshama (tuberculosis) Naga gati (slow)

Pandu (anaemia) Fast sometimes visible

sometimes not

Kushta (leprosy) Kathina & sthira (hard &

steady)

EXPLANATION OF MODERN TERMS

Rate –

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

रुग्णस्य मगु्धस्य ववमोहहतस्य दीप: पदाथााननव िीवनाडी । प्रदशायेद्दोषिननस्वरुप ंव्यस्तं समस्तं यगुलीकॄतं च ॥

THANK YOU

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