Ayurvedic diagnostics is multimodal. It consists of oral questioning in the anamnesis interview and a physical examination. All the results are then analysed in order to gain a holistic understanding of the origin and development of the symptoms and all the factors involved.
In my article series „Examination methods in Ayurveda“, I introduce you to the 8 most important Ayurvedic procedures: Pulse, tongue, urine, stool, hearing, feeling, eyes and face. Part 1 is dedicated to the fascinating pulse diagnosis.
Nadi Pariksha - the ayurvedic pulse palpation
Few examination procedures are as fascinating and extraordinary as feeling the pulse. To do this, the Ayurvedic doctor gently places the three fingertips of the index, middle and ring fingers on the surface of the skin above the wrist - the index finger lies in a hollow, the other two fingers relaxed next to it. Fully concentrated, almost meditative, he perceives subtle qualities and empathises with his patient.
Mentioned in writing for the first time Nadi Pariksha in the 13th century in the Sharangadhara Samhita and later in the 17th century in the Yogaratnakara as part of an eightfold investigation methodology, the Ashtavidha Pariksha. In addition to pulse palpation, the eight procedures include the examination of urine, faeces, tongue, sounds (voice, heart, abdomen, joints), skin, eyes and overall appearance.
Nadi means both pulse and nerve in Sanskrit and describes the fine energy channels through which Prana, the life force, flows. The pulse therefore traditionally reflects the state of prana and nerve energy.
Sharangadhara wrote: „The radial pulse symbolises the presence of life. The physician should be able to recognise health and illness through the activities of the pulse“.
The ancient Ayurvedic scriptures lack concrete descriptions of how to perform a pulse examination. This is why different regional styles have developed in the countries of origin, India and Sri Lanka. So don't be irritated if an Ayurvedic doctor examines and interprets your pulse differently than you may have been used to.
The pulse is very sensitive and rapidly changeable - factors such as hunger and thirst, lack of sleep or emotions have a direct influence on its quality. The patient should not have consumed alcohol or caffeine drinks on the day of the examination and should be examined in a relaxed atmosphere. Pulses are felt on both wrists in succession, with the left side being the most important for women and the right side for men.
Pulses primarily indicate subtle, current, short-term conditions and sensitivities and can be used as an important diagnostic criterion for the course of treatment. Some Ayurvedic schools also interpret constitutional qualities from the pulse.
The true quality and informative value of the pulse examination is achieved in relation to the medical history and all other examination procedures. You should therefore be healthily sceptical if a therapist bases your treatment plan solely on his pulse diagnosis. The more capable a diagnostician is, the more comprehensive the examination will be.
Basics of interpretation
Traditionally, the movement of a pulse was compared with animal images. If Vata is elevated, the movement of the pulse resembles that of snakes (Sarpagati). If Pitta is elevated, the movement resembles that of frogs (Mandukagati). High Kapha resembles the movement of swans (Hamsagati).
One of my Indian teachers, Prof. R.H. Singh from Benares Hindu University in Varanasi, has further systematised the Ayurvedic pulse examination. He differentiates between four basic criteria and relates these to the three dosha Vata, Pitta and Kapha.
The four parameters are
- PULSRATE | The speed of the pulse rate
- PULSRHYTHM | The regularity of the pulse rate
- PULSAMPLITUDE | The vertical deflection of the pulse
- PULSVOLUME | The horizontal width of the pulse wave
A through Vata Dosha pulse is fast, irregular, the amplitude varies, the volume is small and the pulse is thin.
A through Pitta Dosha influenced pulse is medium-fast, relatively regular, of high amplitude and medium volume.
A through Kapha Dosha influenced pulse is slow, absolutely regular, of low amplitude and high, broad volume.
Topography in the Ayurvedic pulse examination
In Ayurveda, we feel the pulse of female patients primarily on the left wrist and the pulse of male patients on the right wrist with three fingers at three depths - this results in a 9-point grid in which each position has its diagnostic significance.
The index finger feels the position close to the wrist (distal), the middle finger the centre and the ring finger the position close to the torso (proximal). These three palpation points are assigned to Vata, Pitta and Kapha. Deep pulses are Kapha dominant, more superficial pulses are Vata and Pitta dominant.
Guna - Properties of the pulse
In Ayurveda, 20 properties are described in 10 pairs of opposites, which can also be used for diagnostic purposes. For example, a pulse can be hot or cold, light or heavy, sluggish or penetrating, dry or moist, hard or soft, static or mobile, clear or dull, subtle or coarse, thin or thick, rough or smooth.
Each individual property correlates with functional or structural parameters of the body and mind. The sum of all properties results in a pulse pattern with ayurvedically valuable information about the patient's condition.
„You only start to differentiate and compare from 1000 pulses“, said my first Ayurveda teacher Dr Arora in Rishikesh in northern India in 1994.
Our pulse speaks the language of our inner self - whether and to what extent this can be decoded and understood depends on the individual skills and experience of the therapist.
With best wishes for your health,
Ralph Steuernagel
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