nadi pareeksha (pulse diagnosis) - an authentic scientific approach
TRANSCRIPT
NADI PAREEKSHA (PULSE DIAGNOSIS) - AN
AUTHENTIC SCIENTIFIC APPROACH
Foremost means of Pareeksha
First Avayava Pareeksha in Ayurveda.
Subjective and objective approach to disease diagnosis
Any ailment in body brings about a change in constitution of Vata, Pitta, Kapha transmits through Nadi sensed by fingers of an examiner varying pressure
Non invasive computer aided device which will eliminate all the human errors performed manually by the practitioners, should be developed
Introduction
• तस्मात् शास्त्रार्थ वि�ग्याने प्रवु्रतौ कम दशने भि�षक् चतुष्टे युक्त प्राणाभि�सार उच्यते
• एकं शास्त्रं अधीयतो न वि�द्यात् शास्त्र विनश्चयम् तस्मात् बहुश्रुतं शास्त्रं वि�ग्यानीयात् चिचविकत्सक
• प्रयोग ज्नान वि�ग्यनम् चिसधिधचिसध सुखप्रद जीवि�तभि�सरस्ते स्यु: �ैद्यत्�ं त्ेषु अ�स्थि6तत्�ं
Mythological Origin
Shiva → Brahma → Indra → Kanaada
Nadi vijnana exits from the time of origin of Ayurveda
In bruhathrayee – explained based on tridosha siddhanta
ACCORDING TO BRIHATHRAYEE
Caraka Indriyasthana
•Spandana – Aspandana•Swasa - Hraswa - Spandana - Aspanda •Spandana - Stambha
Caraka Shaareera
Sthana•Aspandana - Nagodara
Sushrutha Sutrasthana
•Garbhakshaya - Garbha Aspandana•Muda Garbha Nidana - Aspandana
ACCORDING TO LAGHUTHRAYEE
SHARANGADHARA SAMHITHA
First time in the history of Ayurveda
Fifteen types Pulse in certain physiological
states of the body. Pulse in certain mental states.
Pulse in certain pathological states of body. According to three Doshas involved the
movements of the pulse are correlated with those of the
birds, reptiles and amphibians.
BHAVAPRAKASHASpecification of sides - male
and femaleIndication of three fingers
unfavorable conditions Relation between fingers and different positions of
Doshas. Pulse in physiological
conditions of the body. Pulse in mental states.
pulse in pathological states.
YOGARATNAKARA Indication
Sites and method of pulse examination.
Pulse in physiological and mental states
Pulse in pathological conditions
Pulse indicating bad prognosis
Miscellaneous description related to
pulse
OTHER IMPORTANT REFERANCES
VaidyachinthamaniMethod of Nadi Pareeksha is
mentioned, explanation regarding Vata Nadi ,Pitta
Nadi , Kapha Nadi , Dwandwaja Nadi , Ajeerna
Nadi. He had also mentioned regarding Samshaya Nadi.
RavanaThantraRavana in his treatise Nadi
Pareeksha included following points (a) general description (b) pulse after taking certain
diets (c) pulse in certain physiological conditions (d)
pulse in certain mental states (e) pulse in general
pathological conditions and diseases (f) pulse in prognosis.
Site of Origin and Sankhya Sthula and sookshma nadi – 3.5 crore in number
All are connected to nabhi kantha
Forms urdhwa , adha and thiryak branches and sub branches
1000 sthula nadis – which transfers panchendriya gunas from one place to other
700 sookshma chidra nadi – circulates the annarasa for shareera pushti
24 are clear nadi situvated at nabhi
Among them only is yogya nadi for pareeksha
ART OF LEARNING
ACCORDING TO OTHERSKANAADA – morning time after
evacuvation of malas by both physician and patient before nadi pareeksha.According to condition nadi can be
looked at anytime.BASAVARAJEEYAM – nadi palpated over the kurpara sandhi madhya of
right hand with three anguli.Angushtamoolas pashchima bhaga
madhya nadi gathi is noted.In women kurpara sandhi kurma
urdhwa mukha an in men kurpara sandhi kurma adho mukha.
BHAVAPRAKASHA- males right hand and females left hand is examined.
Angushtamoola nadi is touched with the three fingers.
Bhishak will be knowing the sukha and dukha by examining the nadi of a
person.
Experts opinion Concentration of mind is the most important thing in nadi
pareeksha Physician should understand even the minute tactile tactile
perception even in the middle of distractions (proper sparshanendriya jnana)
Practice of manthras daily in early morning hours. Example : chanting of gayathri mantra and look for the beats of his own nadi
The practice of mantras and pranayama daily to get peaceful mind Should understand first which part of the finger gets the beat and
the flow of the beat , path of its movement Note the normal flow of nadi of ones own just after waking up ,
after bath , after having breakfast etc….
Tarjani •Index finger •vataMadhyama •Middle finger
•pitta
Anamika
Basic information obtained from Nadi Pareeksha
VATA PITTA KAPHA
GATHI (movement) Sarpa Manduka Hamsa
VEGA (rate) 80 - 95 70 - 80 50 - 60
TALA (rhythm) Irregular Regular Regular
BALA (force) Low (+) High (+++) Moderate (++)
AKRUTHI (tension and volume)
Low High Moderate
TAPAMANA (temperature)
Cold Hot Warm to cold
KATHINYA (consistency of vessel wall)
Rough , hard Elastic , flexible Soft , thick
Three Basic Gathis of Nadi
VATA PULSE PITTA PULSE KAPHA PULSE
CHARACTERISTICS Fast , feeble , cold , light , thin , disappears on pressure
Prominent , strong , high amplitude , hot , forceful , lifts up the palpating finger
Deep , slow , broad , thick , cool , regular
LOCATION Best felt under the index finger
Best felt under the middle finger
Best felt under the ring finger
GATI Moves like a cobra Moves like a frog Moves like a swimming swan
Examples of gati and their conditions• Krumi gathi – parasites , worms• Pippilika gathi – terminal illness• Mayura gathi – arterial hypertension• Kukkuta gathi – diabetes , albuminuria• Ushtra gathi – aortic stenosis• Gaja gathi – elephantitis , lymphatic obstruction• Girija gathi – heart block• Vishama gathi – pulsus alterans , atrial fibrillation• Damaru gathi – fatal illness , renal failure , shock• Padma gathi – perfect health , enlightnment
Vega ( Rate )• Rate – number of beats per minute• To get an accurate resting pulse – take in early morning in a restful
condition• Physiologically – vega is high (80 – 90 beats/min) in vata , moderate (70 –
80 beats/min) in pitta and low (50 – 60 beats/min) in kapha• Relation with height – tall people have slower heart rates and short
people have faster heart rates (pulse rate inversely proportional to height)
• Relation with age – children have higher heart rates and older people rate is slow
• Relation with metabolism – slower the pulse rate slower the metabolism• Relation with agni – when agni is strong pulse is fast , light and hot and
agni is slow pulse is slow , heavy and cool• Pathology
Tala ( Rhythm )• Rhythm – defined as the time interval between two
consecutive or successive uplifts• In a healthy person – the time interval is regular ,
uninterrupted and rhythmic• Balanced tala reflects – symchronization function of prana
vayu , vyana vayu , avalambaka kapha , and sadhaka pitta• If regularly irregular – both kapha and vata are in imbalanced
state• If irregularly irregular – both vata and pitta are in imbalanced
state• Pathology
Bala ( Force )• Force – pressure of the pulse• Bala – the amount of force pressing on the blood vessel is being
exerted back onto the fingers• Force / pulse pressure (PP) = difference between systolic and
diastolic pressure• If systolic b.p is 120 and diastolic b.p is 70 then PP is 50 which is
normal• If PP is 170 which is high – heart is working under great stress and
if PP is 10 – person doesn’t receive oxygen to brain• If bala is high (+++) – force is full and bounding is high , deep
pressure of finger necessary in order to stop the pulsation• If bala moderate (++) – moderate pressure• If bala low (+) – superficial pressure causes the pulse to disappear
Akruthi ( Volume and Tension )• Volume – uplift to the palpating finger , amplitude• It is not necessary to depress the radial artery , just feel the uplift while the
fingers rest lightly on the artery• In order to feel the volume try to press the artery gently and feel the throb
pushing against the fingers • If throbbing is very prominent in middle finger , the volume is good (+++) ,
pitta.If throbbing is felt under ring finger , it is moderate volume (++) , kapha. If throbbing is barely felt under index finger , volume is low (+) , vata
• Don’t press too hard• Amplitude is high volume is high• The volume corresponds to systolic bp• High volume – pitta type of pulse , if good amount of water intake , high systolic
bp• Low volume – dehydration , congestive heart failure , anemia
• Tension – is felt by pressing the ring finger to stop the pulsation of the radial artery and then feeling the tension under the middle and index fingers
• Tension is the pressure between the two uplifts , diastolic pressure.
• It is the constant pressure of blood in the artery• Water hammer / collapsing pulse
Tapamana ( Temperature )
• There is relation between gati of the pulse , the wave of the pulse , the temperature of the pulse and the agni or metabolic fire of the person
• If pulse is cold , fast and light – vata is high , agni is low ,vishama agni
• If pulse is hot , sharp and light to touch – pitta high , agni high , tikshna agni
Kathinya ( Consistency of the Vessel Wall )
• The consistency of vessel wall , felt by rolling the artery between the palpating finger and the radial bone
• Palpating reveals – vessel wall is thick or thin , elastic or inelastic , rigid , hard or rough
• If vata – rough and hard vessel – vessels becomes narrow
• If pitta – elastic and fragile , bruise easily• If kapha – broad and thick
NADI IN MENTAL STATUSMENTAL STATUS NADI
Kaama Fast
Krodha Fast
Chintha Feeble
Bhaya Feeble
NADI ACCORDING TO DIET• Madhura rasa - vakra , mayura gathi• Amla rasa - ushna , plava gathi• Katu rasa - kulinga pakshi gathi• Tikta rasa - kechuva ?• Kashaya rasa - kathina• Taila - pushti• Ksheera - sthimitha• Guda , guda vikara - pushti , vata pitta prakopa• Mamsa - lagutakruthi ?• Phala varga - • Kushmanda , mulaka - manda
According to biological clock
• Praatha kaala - snigdha ,manda gathi• Madhyanna kaala – ushna , vega gathi• Saayam kaala – vata nadi• Rathri kaala – uthejarahitha nadi
NADI IN PREGNANCY
• Nadi shifts towards lateral side (thumb side , radial border) or medial side (little finger side , ulnar border)
• It can be felt both right and left sides• If nadi shifts laterally – male foetus• If nadi shifts medially – female foetus• Can be felt within fifteen to thirty days after
conception• She should give her complete attention while taking
nadi
Jwara Ajeerna
Athisara
Grahani
Prameha
Gulma
Raktapitta
Rajayakshma
Arsha
Muthraghata
Pandu
Amaja vikara
Malajeerna
Vrana
Visha
Shalya
Urdhwajathrugata roga
Pulse Conditions with Unfavorable Prognosis
The following pulse conditions are indicative of bad prognosis• Rapidity of the pulse• Hardness (this indicates that the pulse is felt between the beats)• Extreme slowness of the pulse • High tension pulse• Extreme smallness• Extreme arrhythmia• Displacement of the pulse from its normal site• Imperceptibility of the pulse• Irregularly irregular pulse• A pulse which is only felt under the index finger at vata spike , is
very feeble and moves like an ant
Nadi in Arishta
Vibrating and pulsating like that of lightening. More rapid and sometimes very thin runs extremely weak /
fast / cold Not felt in hand but in leg and mouth remains open Creates Dehashaithya along with Swasa and Daha – die
within 15 days Teevra and Manda sometimes with Sweda – die within 7 days. Mukha Nadi sensation disappears, Shaithya and Klama in body
– die within 3 days Not felt at proximal end, cold in middle, appears tired at
terminal – die within 3 days. Feeble and felt like cloth wave and cold - die within one yama
CONTRAINDICATIONS 1. Sadyosnatha2. Sadyabhukta3. Kshudhitha4. Trushitha5. Atapa , dhooma , dhoopa sevitha6. Vyavaya shrantha deha7. Bhuktha8. Nidritha9. Upavasina10. Vyayama shrantha deha11. Bhoothavesha12. Rodana13. Madyapana14. Mathibhrama15. Gandhara bhikshana16. Pavanabhyasa sadhaka17. Sneha avagaahina18. Kukkuta , shasha , manduka , sarpa mamsadi bhakshaka19. Apasmara20. Shrantha deha21. Tailabhyanga
CONCEPTS UNABLE TO EXPLAIN
Seven levels of pulse
• 1st level – vikruthi• 2nd level – manas vikruthi• 3rd level – subdoshas• 4th level – ojas , tejas , prana• 5th level – dhatus• 6th level – manas prakruthi• 7th level - prakruthi
WHY NADI VIJNANA – A SUBMERGED AREA
• In olden days through various zoological ways Acharyas interpreted the Nadi
• Achieved by feel or experience which was unexplainable.
• Needs very special skill, advanced knowledge and sharp perception of even minute character which is achievable after decades of study and practice.
• For diagnosing we come to the curriculum without any special acquaintance of such skills as our Acharyas have
• Minimum amount of time
SPHYGMOGAPH
SPHYGMOGRAPH• three identical piezo film based sensors to
capture the waveform• by applying varying pressure• collected are filtered, amplified and• read by the software application • which plots the graphs accordingly.• read by the software application • DVSOFT software
Percussion wave (P) Tidal wave (T)
Dicrotic wave (D)
Percussion (P) wave • raises fairly rapidly
without any interruption on itRounded peak.
• The percussion wave first raises due to rapidly transmitted shock of left ventricular contraction and then fells towards the end of systole.
Tidal (T) wave• Sometimes after a
slight depression from the peak there may be another systolic wave near the peak between Percussion wave and Dicrotic wave
Dicrotic (D) wave• The descenting limb
of the pulse less steep due to a more gradual fall in pressure corresponding to the elastic recoil of the arterial walls
CONCLUSION
• Simile • Blind person climbing the mountain • Person moving through darkness. • Nadi Vijnana should be known to all Vaidhyas
which is decreasing now a days• Future researches can be done concentrating
on the diagnosis of disease using an improved version
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