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Nadi Pariksha - Ayurvedic Pulse Examination

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Nadi Pariksha - Ayurvedic Pulse Examination

  1. 1. Nadi Pariksha -Ayurvedic Pulse Examination Prof. Y. K. Sharma Dean cum Principal Rajiv Gandhi Govt Post Graduate Ayurvedic College and Hospital Paprola - Himachal Pradesh
  2. 2. Examining the pulse  Arterial pulses can be examined at various sites around the body. Systematic examination normally involves palpating Radial, Brachial, Carotid, Femoral and other distal pulses.
  3. 3. Assessment of the Pulse  Palpate the artery wall with the tips of the index and middle fingers.  Do not press too hard for fear of obliterating the pulse.  Establish whether the wall feels soft and pliable or hard and sclerotic.  Identify the qualities or characteristics of the pulse by asking:  What is the pulse rate?  What is the pulse rhythm?  What is the character of the pulse?
  4. 4. Pulse rate: newborn (0–3 months old) infants (3 – 6 months) infants (6 – 12 months) children (1 – 10 years) children over 10 years & adults, including seniors well-trained adult athletes 100-150 90–120 80-120 70–130 60–100 40–60
  5. 5. Pulse Diagnosis
  6. 6. Synonyms of Pulse in Ayurvedic Literature:  Snayu,  Nadi,  Hamsi,  Dhamani,  Dharani,  Dhara,  Tantuki,  Jeevana Jnana.
  7. 7. History of Nadi Pariksha  Ayurvedic Medicine has been using the pulse as a form of diagnosis since it was created 2500 years ago.  In the seventeenth century, Yoga Ratnakara Samhita mentions the “Nadi Pariksha” technique
  8. 8. Eight fold or Ashtavidha pariksha: 1. Nadi – Pulse 2. Mutra – Urine 3. Mala – Feces 4. Jihva – Tongue 5. Shabda – The various body sounds (such as crackling in case of arthritis), voice hoarseness etc. 6. Sparsha – examination by touch. – to know body temperature, local raise of temperature etc. 7. Druk – external appearance of the person, examination by eyes. 8. Akruti – shape and built of the person. In a patient, eight places should be examined.
  9. 9. Why Nadi Pariksha:  The root cause for all diseases is imbalance of Tridosha (Vata, Pitta and Kapha) .  Doctor should examine the pulse in the initial consultation to know about the extent of Dosha imbalance.  Like the strings of musical instruments generates all Ragas or musical notes , similarly the pulse of the hand highlights nature of Dosha vitiation
  10. 10. Site of Nadi Pareeksha – Pulse Diagnosis:  For the purpose of knowing the disease, the doctor with his right hand should examine the pulse of the right hand of the patient at the base of thumb i.e. over the flexure aspect of distal end of radius bone .  In a comfortably sitting patient before him , the doctor should feel pulse with his finger tips.
  11. 11. The Hand to Examine Pulse:  In female, probably the left hand gives accurate pulse reading and in men, the right hand. Hence, pulse of left hand should be examined for women and right hand for men.
  12. 12. Method of Starting Pulse Reading:  The arm of the patient should be extended, hand of the patient should be slightly bent at the elbow joint, the fingers should remain straight. The patient should not feel any pain or discomfort.  The pulse examination should be done at the root of the fingers, in the wrist part, in the first three hours (Prahara) of the morning.  The pulse should be examined three times, by feeling the pulse and giving gap in between.  The doctor should use his three fingers to know about the status of Vata, Pitta and Kapha respectively.
  13. 13. Gatis of Pulse  Mandagati – Slow movement of pulse  Madhya gati – Moderate movement of pulse .  Teekshna gati – Sharp, swift movement of pulse.
  14. 14. Doshaj Pulse:  In Vata- vitiation : Pulse moves like movement of Snake i.e. Low volume/fast.  In Kapha imbalance ; Like gait of a Swan i.e. High in Volume and low in rate.  In Pitta imbalance – Frog like pulse i.e. Rate and volume both are high.  In case of Sannipata – imbalance of all the Doshas together, then like woodpecker (Kashtakutta), the pulse will felt swiftly sometimes with frequent gaps. Variable volume and rate or irregular.
  15. 15. Kaphaj Nadi
  16. 16. Pattaj Nadi
  17. 17. Vattaj Nadi
  18. 18. Sannipataj Nadi
  19. 19. Inappropriate Time for Pulse Examination:  When the patient has just taken bath, taken food, have just undergone snehana (oil massage or fat intake), having thirst and hunger or is asleep.  Patient having fear, anger, etc are also not fit for Pulse Examination.
  20. 20. Pulse reading indicating incurable disease –  The pulse which beats for 30 times speedily and then subsides abruptly, and that pulse which runs with lot of interruption.  The pulse which is weak, mild, feeble, stops in between, very minute, which is sometimes felt feebly in shoulder and sometimes at wrist, such a Nadi indicates an incurable disease.  When the Nadi is like Damaru (musical instrument of Lord Shiva), sometimes observable, sometimes not, it indicates incurable disease.  The pulse which is too high, too frequent and fast, suggests death in future.  The Nadi which is stable but suddenly sparks up like a lightening, suggests incurable disease.  The feeble and cold Nadi suggests death is certain within a day or two. Asadhya Nadi –
  21. 21. Sudden Change in Dosha Status and Nadi:  If the feature of the Nadi changes from Vata to Pitta or Pitta to Kapha, etc . Such a Nadi reading indicates incurable disease.  The Nadi which is swift, felt only near to the distal one third of wrist, often feels cold, associated with sweating, suggests death within a week.
  22. 22. Incurability of Disease Status and Nadi:  Person with cold body, who suffers from dyspnoea, breathes forcefully with mouth, with swift Nadi dies within 15 days.  In the pulse place, if the distal part does not read any pulse, middle part is cold and proximal part is feeble, the person dies within 3 days.  Gambheera nadi or High volume pulse feels hot, indicates fever.  Due to Kama (sexual desire) and anger, the pulse rate increases.  Due to worries and fear, low digestion strength and depleted body tissues (Ksheena Dhatu), it decreases.  When blood (Rakta Dhatu) is dominant and when Ama is there (altered digestion and metabolism), then it will be slugish and high volume  When the person is Hungry , Nadi will be feeble and fast.
  23. 23. Science of Pulse Examination:  Think of the pulse like a cardiograph: a computer readout graphically recording the physical or functional aspect of the heart. Like the graph being sketched across the screen of the computer the pulse has its own rate, crest, wave, amplitude, and cessation.  These individual characteristics define the overall movement, quality, and rhythm of the pulse. In these broader categories the Doshas of Vata , Pitta , and Kapha can be distinguished based on the smaller movements sketched graphically by a cardiograph. In pulse diagnosis our fingers become the receptors that transfer the information of the heart beat graphically into a more concrete image.
  24. 24. VATA PITTA KAPHA Characteristics Fast, feeble, cold, light, thin, disappears on pressure Prominent, strong, high amplitude, hot, forceful, lifts palpating finger deep, slow, broad, wavy, thick, cool or warm, regular Location Index Middle Ring Gati Sarpa (Cobra) Manduka (Frog) Hamsa (Swimming Swan) Vega (Rate) 80-95 70-80 50-60 Tala (Rhythm) Irregular Regular Regular Bala (Force) Low + High +++ Moderate ++ Akruti (Tension and Volume) Low High Moderate Tapamana (Temperature) Cold Hot Warm to cool Kathinya ( vessel wall) Rough, hard Elastic, flexible Soft thickening (Lad, 14)
  25. 25. Conclusion  Pulse examination is one of the component of Dosha evaluation in Ayurveda under Ashtavidha Pariksha.  It evaluates the normal and abnormal state of Doshas.  While there is no referencse to diagnosis of Disease in Ayurveda purely on basis of Nadi Pariksha.  Later books like Kanad samhita and Ravan Samhita have concluded that specific diseases can be diagnosed purely by Pulse Examination.
  26. 26. THANK YOU

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