A Comprehensive Guide to the Nadi Pariksha in Ayurveda

Location of the dosha in Nadi Pareeksha (pulse examination)

In the examination of the pulse, each dosha is felt or palpated at the fingers of the examiner. Vata dosha is felt at the Tarjini (index finger), Pitta dosha is felt at the Madhyama (middle finger) and the Kapha dosha is palpated at the Anamika (ring finger).

Sites of Nadi Pareeksha (pulse examination) in the body

• Wrist (radial artery)
• Elbow (brachial artery)
• Arm (brachial artery)
• Axilla (axillary artery)
• Neck (carotid artery)
• Near the nose (branch of the facial artery)
• In front of the ear (superficial temporal artery)
• Above the eye (supra-orbital artery)
• Lips (labial branch of facial artery)
• Tongue (lingual artery)
• Ankle (posterior tibial artery)
• Dorsum of the foot (dorsalispedis artery)
• Penis (branch of internal pudendal artery)
• Perineum (branch of internal pudendal artery)
• Apex beat.

Procedure of Nadi Pareeksha

• The ideal time for Nadi Pareeksha (pulse examination) is in the early morning hours.
• The patient and the examiner should have passed urine, flatus, and bowels, and taken baths.
• The patient should be made to sit in a chair or lie down on the examination table in a comfortable position.
• The examination of the pulse usually is done at the radial artery located in the wrist area.
• For males, the examination is done in the right hand, and for females in the left hand.
• The examiner should gently hold the hand of the patient at the elbow joint and place the right-hand fingers on the patient’s wrist to palpate or feel the pulse.
• The fingers of the examiner’s hand are placed in such a way that the index finger, middle finger, and ring finger are near each other on the wrist region.
• The examination is carried out by gently palpating, pressing, tapping, and rolling the artery under the fingers.
• Identify the pulsation of each dosha while examining; Vata dosha is felt at the index finger and the pulse is feeble, Pitta dosha pulse is moderate and is felt at the middle finger and the fast-beating pulse felt at the ring finger is Kapha dosha.
• Examination of the pulse is done to know the healthy state, individual dosha, combination of dosha, and the pathological conditions.

Methodology of Nadi Pariksha

Nadi Pariksha is conducted by a trained Ayurvedic practitioner who employs a specialized technique to assess the pulse. Unlike conventional pulse-taking methods, which primarily focus on the rate and rhythm of the pulse, Nadi Pariksha involves a comprehensive analysis of various pulse characteristics. These include:

1. Strength (Bala): The forcefulness or vigor of the pulse.
2. Speed (Gati): The rate at which the pulse travels through the arteries.
3. Rhythm (Anupravesh): The regularity or irregularity of the pulse beats.
4. Width (Sthana): The width or breadth of the pulse.
5. Depth (Sankocha): The depth to which the pulse is felt upon palpation.
6. Consistency (Prakriti): The uniformity of the pulse throughout the examination.

Through a combination of palpation techniques and intuitive assessment, the Ayurvedic practitioner discerns subtle variations in these pulse characteristics, which provide valuable insights into the individual’s physical and psychological state.

Significance in Diagnosis and Treatment

Nadi Pariksha serves as a diagnostic tool for identifying imbalances in the doshas and their associated subtypes within the body. By analyzing the pulse patterns, the practitioner can ascertain the underlying causes of disease or discomfort, even before symptoms manifest. This preemptive approach allows for early intervention and personalized treatment strategies tailored to the individual’s unique constitution.

Furthermore, Nadi Pariksha extends beyond mere diagnosis and plays a pivotal role in monitoring the progress of treatment. As the individual undergoes therapeutic interventions such as herbal remedies, dietary modifications, and lifestyle changes, the pulse characteristics gradually shift, reflecting the restoration of balance and harmony within the body.

Contra-indications for Nadi Pareeksha

Certain conditions of the patient are contra-indicated for pulse examination and they are as follows:

• Immediately after the bath
• When the patient is feeling hungry
• When the patient is feeling thirsty
• When the patient is at sleep
• Immediately after waking up from the sleep
• Immediately after taking the food
• After the Snehana karma (both internal and external).

Characteristics of a pulse in a healthy person

The pulse of a healthy person is steady and forceful. It beats like Hamsagamana (the movements of a swan) and Gajagamini (the walking of an elephant).

Nadi Gati (movement of the pulse) and their relationship with Dosha

• Vata dosha: Jalauka and Sarpagati – The pulse moves like a leech or snake.
• Pitta dosha: Kulinga-kaka-Manduka gati – The movement of the pulse is like a sparrow, crow, or frog.
• Kapha dosha: Hamsa and Paravata gati – The movement is like a swan or pigeon.
• Vata-Pitta dosha: Muhur sarpa gati and Muhur beka gati – The pulse sometimes moves like a snake and sometimes like a frog.
• Vata-Kapha dosha: Sarpa – hamsa gati – The pulse sometimes moves like a snake and sometimes like a swan.
• Pitta-Kapha dosha: Hari-hamsa gati – The pulse sometimes moves like a monkey and sometimes like a swan.
• Sannipataja or Tridoshaja: Lava-tittira-vart gamanam – The pulse movements are like a bustard quail, grey partridge, or button quail.

Relationship of Dosha with the colour and touch of Nadi (pulse)

The pulse appears differently colored and the touch of the pulse is different in three dosha.

• Vata dosha – The appearance of the pulse is Neela Varna (blue colour) and is feels sometimes warm and sometimes cold.
• Pitta dosha – The colour is Peeta (yellow) and a warm pulse is felt.
• Kapha dosha – The colour that appears is Shweta Varna (white) and is felt cold to the touch.

Relationship of the age with the Nadi (pulse)

• Baby that has just given birth – The pulse rate is 56 pala and that is approximately 140 pulses/min.
• Infant – The pulse rate is 44 pala which is approximately 120 pulses /min.
• Adolescent – The pulse rate is 36 pala and that is approximately 90 pulse/min.
• Adult – The pulse rate is 29 pala and that approximates 72 pulse/min.
• Old age – The pulse rate is 28 pala and that is approximately 70 pulse/min.
• Very old age – The pulse rate is 31 pala and that approximates 78 pulse/min.

Relationship of the time in a day with the nature of Nadi (pulse)

• Morning – Snigdha (untuous)
• Afternoon – ushna (warm)
• Evening –Teekshna (rapid)
• Night – Manda (slow)

Dosha predominance and its effect on the pulse in a day

• Morning – Kapha dosha
• Afternoon – Pitta dosha
• Evening –Vata dosha
• Midnight – Pitta dosha

Relationship of the Rutu (season) with the Nadi (pulse)

Different pulsations are felt in different rutu (seasons) and those resemble the movement of different animals/birds, etc.

• Shishira rutu (winter season) – The movement of the pulse is like a leech or elephant.
• Vasanta rutu (spring season) – The movement of the pulse is like a swan or peacock.
• Greeshma rutu (summer season) – The movement of the pulse is like a swan or snake.
• Varsha rutu (rainy season) – The movement of the pulse is like a rabbit or fish.
• Sharad rutu (autumn season) – The movement of the pulse is like a swan.
• Hemant rutu (pre-winter season) – The movement of the pulse is like a leech, crow, or frog.

Nadi (pulse) in different stages of Jwara (fever)

In the different stages of fever, pulse rate is different.

• Vataja Jwara – Vakra (curvilinear), Chapala (unstable), and cold on touch.
• Pittaja Jwara – Pulse is rapid and for a long duration.
• Kaphaja Jwara – It is slow, stable, and cold in touch.
• Vata-Pittaja Jwara – a bit Vakra (curvilinear) and a bit Chapala (unstable)
• Vata-Kaphaja Jwara – Manda (slow)
• Pitta-Kaphaja Jwara – It is Sthira (stable) and Sheeta (cold) on touch.

Nadi (pulse) in different physical conditions

• Jwara – In fever, the pulse is Ushna (warm) and Vegavat (rapid).
• Mandagni – In decreased digestion, the pulse is slow and feeble.
• Ama – the pulse is Gurvi (heavy).
• Asrikpurna – when the blood vessels are the full volume of blood flow, the pulse is Ushna (warm).
• Ksheena Dhatu – In the malnourished Dhatu, the pulse is slow and feeble.
• Kshudhita – In the state of hunger, the pulse is Chapala (unstable).
• Trishna – in a state of thirst, the pulse is Sthira (stable).
• Deeptagni – when the digestion power is very high, the pulse is Laghu (light) and Vegavat (rapid).
• Asadhya Vyadhi – in diseases where they are uncurable, the pulse is Kampate (vibration).

Nadi (pulse) in different mental conditions

• Kama – The pulse in the state of sexual desire or lust is Vegavat (rapid)
• Krodha – The pulse in the state of anger is Vegavat (rapid)
• Bhaya – The pulse in the state of fear is Ksheena (weak)
• Chinta – The pulse in the state of worry is Ksheena (weak).

Nadi at different sites and their relevance with the diseases

The different sites of pulse indicate different conditions in a human being and the diseases.

• Pulse at ear – Karna roga (disease of the ear), Chakshu roga (disease of the eye), Padaroga (disease of the foot), Prameha (diabetes mellitus).
• Pulse at the nose – indicates Kama (lust), jeevana and marana (indicate both life and death), Anila roga (diseases of Vata dosha), Kantha roga (diseases of the neck), Shiro and Shravana ruja (pain in the head and ear).
• Pulse at the neck – Bhaya (fear), Shoka (grief), Kopa (anger), Aayasa (physical exertion), Trishna (thirst), Maithuna (sexual intercourse), Aagantuka jwara (fever of Aagantuka type).
• Pulse at the foot – Raktapitta (bleeding disorder), Ajeerna (indigestion). If the pulse of the foot attains its normal position, it indicates Laghavam (feeling of lightness in the body), Swasthya (healthy state), Jwara vimochana (recovery from fever), Jivita (life).

Arishta Lakshana (fatal signs) of Nadi (pulse) for prognosis of disease

Based on the pulse examination, its nature, the site where it is felt, etc. factors the prognosis of the disease can be evaluated.

• The Nadi is sthira (stable) and rapid like Vidyut (electrical force) – The patient may die on 2^nd day.
• The Nadi is sheeghra (very fast), sheeta (cold) and the patient is passing Mala (stools) – patient will die within 2 days.
• The pulse is sometimes tivra (fast) and sometimes manda (slow) along with perspiration – patient may die within 7 days.
• There is no facial pulse, the body has become cold and there is klama (exhaustion) – patient may die within 3 days.
• The Nadi is teevra (rapid) with daha (burning sensation) and sheetata (cold) in the body and there is Shwaskashtata (difficulty in breathing) – patient will die within 15 days.
• Sometimes it is rapid and sometimes it is slow – indicates that the patient is about to die.
• Vakragati (curvilinear) pace of the pulse indicates immediate death.
• The pulse moving like a snake, it is warm and is rapid – indicates that the patient may die.
• Chanchala (unstable) and ativega (very rapid) – indicates patient may die in one Yama kala (approximately 3 hours).
• Pulse felt two fingers proximal to the normal site – indicates death within one and a half hour.
• Pulse felt two and a half fingers proximal to the normal site, fast and cold – indicates death within 3 hours.
• Pulse felt three fingers proximal to the wrist joint – death after 3 hours.
• Pulse is not felt at the normal site and the middle finger gets the impulse like a thread – death within four and a half hours.
• Pulse is hardly felt by any of the three fingers – death within 6 hours.
• Pulse is felt by only middle finger, thread-like, tortuous – death within 15 hours.
• Pulse felt is very weak – death after 15 hours.
• Pulse felt one and one-fourth finger proximal to the normal site and is very weak – death within 18 hours.
• Pulse felt two fingers proximal to the normal site and tortuous – death within 21 hours.
• Pulse felt one finger proximal to the normal site, difficult to find, slow, felt by index finger resembling Damaru – death within 24 hours.
• Pulse felt one finger proximal to the normal site and is cold – death within 27 hours.
• Pulse felt a quarter finger proximal to the normal site, slightly warm – death within 33 hours.
• Pulse felt a quarter finger proximal to the normal site, becomes slowly cold, sometimes felt and sometimes not – death within 36 hours.
• Pulse felt half a finger proximal to the normal site, cold – death within 39 hours.
• Pulse felt half a finger proximal to the normal site – death within 45 hours.
• Pulse felt a quarter finger proximal to the normal site, fast, irregular, stops suddenly and then reappears but is not felt – death within 48 hours.
• Pulse felt half a finger proximal to the normal site, slow, thready, not felt by the index finger, is cold when felt by the middle finger, and very weak when felt by ring finger – death within 3 days.
• Pulse is very weak, hot, and fast when felt by index finger – death within 4 days.
• Pulse gradually becomes weak and slow – death within 5 days.
•  Pulse is very weak, resembles a snake or earthworm – death within one month.

Asadhya Nadi (incurable condition)

The characteristics of the pulse that indicate the asadhyata (incurable) disease or condition of the patient are given below:

• The condition is said to be Asadhya (incurable) if the pulse initially attains Pittaja gati, and then Vataja gati and, finally Kaphaja gati because of which it sometimes becomes fast and sometimes slow, moves like Chakra (wheel).
• The pulse gets displaced from its place and becomes very slow indicating a poor prognosis and the patient will die.
• The feeble and cold pulse is a definite indication of the patient’s death.

Assessment of different factors on different levels of Nadi

Radial artery assessment has different levels to evaluate different conditions as per the classics. There are seven levels that are examined.

Radial artery is pressed to the deepest level on either side of the left/right to stop the pulse and then release the pressure to resume the beating of the pulse. The seventh level is the Prakrut Avastha of Tridosha. At the sixth level is the Manasa Prakruti, fifth level is the assessment of Dhatu, at fourth level Ojas, Tejas, Prana are assessed, sub-types of dosha are examined at the third level, Manasa Vikruti and Dosha Vikruti are assessed at second and first levels respectively.

Conclusion

Nadi Pareeksha is the examination method and is explained in Ashta Sthana Pareeksha. It is elaboratively explained in Ayurveda. The procedure of Nadi Pareeksha, its contra-indications are also given the importance such that there would be proper examination carried out by the examiner. The location of each dosha, the prakrut and vikrut avastha of dosha can be known through Nadi Pareeksha. The predominant dosha in different parts of the day, Nadi gati in different seasons, age groups, different states of fever, fatal conditions, prognosis of the disease can be known through Nadi Pareeksha.

Reference

1. CLINICAL IMPORTANCE OF NADI PARIKSHA (PULSE EXAMINATION): AN AYURVEDIC DIAGNOSTIC METHOD, World Journal of Pharmaceutical and Medical Research, 2020, Volume 6, Issue 5, page. 150-154.
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