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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the pulse examination become an outdated procedure of only historical importance ?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: परीक्षेत 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 मरं मलं जिहवां शब्दं स्पशं दगाकनत: || ू ॄ ॄ

• • • •

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 .

, 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
 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

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)
 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 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
Sweet taste Bitter taste Acid taste Pungent Astringent Resembles the movement of peacock Moves like earthworm Slightly hot & jumping Like movement of sparrow Kathina & Mlana (hard)

Salt

Sarala & Druta (straight & rapid)

PULSE IN PHYSIOLOGICAL STATE Types of pulse Pulse characteristics

Healthy pulse Good hunger
Appetite After sexual enjoyment Morning Afternoon Evening Night

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
 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 मग्धस्य ववमोहहतस्य दीप: पदाथााननव िीवनाडी । ु प्रदशायेद्दोषिननस्वरुपं व्यस्तं समस्तं यगलीकतं च ॥ ु ॄ

THANK YOU

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