Ancient Science of Life, Vol. IV, No.3 January 1985, Page 148-152

THE CONCEPTION OF NADI ITS EXAMINATION

S.K.RAMACHANDRA RAO

305, I block, Jayanagar, Bangalore 560011, India.

Received: October 2, 1984 Accepted: November 15, 1984

ABSTRACT: The examination of Nadi (pulse) in diagnosis of diseases in the Indian system of medicine is minutely discussed here. Also the author throws some light on the emergence and its importance of this science in Ayurveda.

Meaning tubular stalk or flute (from nada, seem to have been other texts by authors like hollow reed which grows in the rainy Agneya, Yajnavalka, Dattatreya and season(, the word nadi, is as old as the Vedic Gautama dealing with this doctrine, for literature (e.g. RV 10, 135, 7; AV, 6, 138,4) Krpala-misra’s Nadi-prabobhana cites from used in the human body. It is often used them; Kanada’s Nadi-vijnana mentions synonymously with dhamani (RV 2, 11,8; Gautameya and Vasishtha. AV 1, 17 3 and 4), sira (or hira, although a distinction is sometimes made, as e.g. AV However, the present meaning of pulse, 7,35,2 hundred dhamanis and a thousand amenable to examination and helpful in hiras’) and snava (‘tendons’, AV 9,8,11 and diagnosis and prognosis, is absent from the 12;12,5,69). The diminutive form nadika, is Vedic an early religious literature. The also used (e.g. AV 5, 18, 8). concept of nadi – pariksha (pulse examination) is likewise absent from the In the Vedic context, the nadi means classical texts of Indian medicine (CS, SS, conduits in the sense of spermatic ducts and KS, BS, AS, AHr, MN), although there are cordons (AV, 6,138, 4). One of the references in CS (indriya-sthana, 3, ‘satatam Upanishads (Katha, 6, 16 speaks of a spanda-sthana, 28, 32), AHr, (Sarira-sthana, hundred and one nadis of heart, and another 5, “hrasvam cha yat prasirsihi vyaviddham (Prasna,) 3,6) of the hundred nadis of the the spandatau bhrsam”) which suggest that these heart with their thousand branches. This authors were acquainted with the doctrine of idea developed in due course into an nadi. Its first occurrence appears to be in elaborate doctrine of nadi organization in the SaS (purva-khanda, 3, 1-11), about the human body (nadichaka). There are thirteenth century. It is also mentioned in references to this in several puranas, (e.g. BP, (1, 7, 11-22), BYT, YR, Dhanvantari’s Padma, Brahma-vaivarta, Kalia), Sarva-roga-nidanha, and Gada-samjivini. Upanishads (Prasnopanishad, There are about 50 works dealing Kshurikopanishad, etc.) and tantras exclusively with this topic (e.g) kanada’s (Kundalini-tantra, Rudra-yamala etc). There Nadivijnana, Ravana’s nadi-vijnana,

Page 148-152 sankara-sena’s Nadi-jnana-tantra, Nadi- Even as the strings of a lute articulate all the darpana, Nadi-nidana and Nadi-parikstha. melody- moulds, the nadi of the hands can In the course of time, pulse examination reveal all the diseases (ibid). became very popular not only as a variety of examination by touch (sparsa-pariksta) but YATHA VINAGATA TANTRI SARVAN as a valuable aid for discovering the errant RAGAN PRABHASATE TATHA condition of dosas. HASTAGATA NADI SARVAN ROGAN PRAKASATE. Pulse examination was regarded as an indispensable aid for the physician to There are said to be three crores and a half- ascertain the nature and severity of diseases. crore of nadis, grass and subtle, in the “Like the study of scriptures without human body, all rooted in the region of the understanding, like food without salt, like a umbilicus and spreading upward, downward, woman who has been widowed, the and across. Among them 72,000 are gross, physician would be without a knowledge of and carry the properties of the five sense- pulse-examination” (ND, 3,3): functions. The subtle ones (called sira, in SS, Sarira, 7,3) are 700 in number, and they BODHAHINAM YATHA SASTRAM carry uninterruptedly the ‘food-juice’ (anna- BHOJANAM LAVANAM VINA rasa). Prompted by the skin even as the PATIHINA YATHA NARI TATHA mrdanga (a percussion instrument) is. Not NADIM VINA BHISAK. all of them, however, are visible; only 24 are, and among them one alone (which “The physician who attempts to practice extends to hands and feet) can be examined without a knowledge of pulse examination (c f SKD Todala-tantra, 8). It is directly would not be prosperous, would not do the related to the heart and therefore the right thing, and could not obtain celebrity” condition of the entire body is reflected in it. (NP, 2,41): In man, this nadi is to the light, and in NADIJNANAM VINA YO CIKIT SAM women to the left. Its condition is KURUTE BHISAK SA NAIVA LABHATE perceptible on the wrist of the right hand of LAKSMIM NA CA DHARMAM NAVAI men, and of the left hand of women. It is YASAH. also perceptible in the foot; but in practice the wrist is to be preferred. Pulse examination was given primacy among diagnostic aids in all diseases : the The pulse for examination is to be found in pulse, tongue, eyes, urine and blood were the wrist immediately below the thumb. sought to be examined in that order (ND, This pulse (nadi, dhamani) is described as 3,3): the witness of the life-process in the body (jivasakshini), and as the evidence of ADAU SARVESU ROGESU NADI happiness or misery within the body. When JIHVAGRANETRAKAM the physician presses against this pulse with MUTRARTAVAM PARIKSETA PASCAT his three fingers of the right hand (the ROGAM CIKITSAYET. forefinger, the middle finger and the right-

Page 148-152 finger), he can feel by the first finger, movement in the pulse is sometimes slow, movement that is diagonal in the part of the sometimes fast, when all three doses are pulse that resembles a barley-deed. This troubled (samnipata), movement in the pulse portion of the nadi indicates the condition of is extremely erratic, sometimes very slow, vata. He can feel by the second finger the sometimes very fast, resembling the flight of movement that is diagonal in the part of the a quail (lavaka) or a partridge (tittiri). The pulse that resembles a barley-seed. This physician will understand by pulse- portion of the nadi indicates the condition of examination whether the disease is hard to vata. He can feel by the second finger the cure (krcchrasadhya) or impossible to cure movement that is quick and constant but in (asadhya). The dose that strays from its one point. This portion of the pulse that position on the pulse (sthana-vicyuta), the resembles a barley-seed. This portion of pulse that stops every now and then, the the pulse indicates the condition of pitta pulse that is extremely sluggish, and the (fire’ in the body). He can feel by his third pulse that is cold to touch indicate finger movement that is oblique (horizontal) approaching death (Nadiprakasa, SKD). but slow and almost non-existent. This indicates the condition of kapha. The The examination of the pulse was introduced physician must press the pulse three times into Greek medicine was early as 320 B.C. with his three fingers and release it, before by Pnaxagoras of Cos. Herophilus is said to he begins to feel exactly the condition of the have evolved a system of counting the pulse three doshas. During examination, however, by a water-clock. Pneumatists evolved an he must first discernpitta (with his middle elaborate pulse lore. And it entered the field finger), then vata (with his fore-ginger) and of Arabic medicine, and thence into the finally kapha (with his ring-finger) (GOML, Yunani system. Chinese medicine had an Madras, vol 23, NO. 13086). ancient literature concerning pulse- examination. It cannot be ascertained with The three doshas are perceived in the pulse any degree of certainty when or how pulse- as transverse movement (vata like the examination was introduced into Indian movement of wind), unsteady (pitta, like the medicine. It its popularity during the middle flames of the fire), and steady(kapha, like ages and in the recent past is beyond doubt. the settling water). When vata is It is likely that the ‘Nadichakra’ doctrine of aggravated, the pulse at the point the Yoga-Tantra complex provided the appropriate to this dosha, is perceived like back-drop for the nadi-pariksha’ method. the moving serpent or crawling leech. When pitta is aggravates, movement in the pulse Examination of the pulse (nadi, principally appears like the flight of a crow or sparrow, the radial artery) is included in the eight-fold or like the hopping of a frog. When kapha is examination (ashta-sthana pariksa) which aggravated, movement in the pulse is similar gained currency during the middle ages, to the measured strutting of a peacock or the however it is different from the pulse floating of a swan on water. When two examination in European medical practice, dosas are together aggravated, the where the pulse (usually the radial artery

Page 148-152 running superficially at the wrist, and rarely ‘Even as the strings of a lute illumines all also the carotid artery behind the knee and the melody modes, the radial artery the posterior tribial artery at the ankle) is felt (hastagata nadi) shows up all the diseases (in for rate, rhythm, volume and character, and the body)” (Nadi-darpana). To become given an idea about the condition of the proficient in pulse examination, incessant circulatory system especially the condition practice is important; but more important is of the heart. “pulse in this practice is little the trance-like concentration (Samadhi) more than the change of pressure within the which the physician is capable of while artery that occurs with each heart-beat. The examining the patient, for it is only by such pulse indicates its rate or rhythm, the size concentration he can enter, with the aid of and condition of the arterial wall or the the lamp of wisdom (jnana-buddhi volume of blood that flows trough the artery, pradipena’), into the very inside of the or the force with which the blood flows. But patient ( ‘visati aturasya antar atmanam’) pulse in Indian medical practice is the (CS, vimana 5,12). The expertise is “witness of the living processes” (jiva- obtained by the grace of a competent saksini), and its examination helps the teacher. physician ascertain not only the totality of all the vital functions of the patient’s body The examination as it was standardized in (including mind) at the time of examination India involved the ascertainment of the size but also its trends in future”. or volume of the pulse (determined by the condition of kapha), frequency or rapidity of The assumption is that the nadi pulsates the pulse (indicated by the condition of characteristically differently under the pitta), and the rhythm or regularity of the influence one, two or all three of the doshas pulse (determined by the condition of vata). (vata pitta and kapha). The ascertainment of The purpose is to know the prevalence of a these differences is of great value in particular dosa or a combination of two or diagnosis as well as prognosis. “The sum all three dosas. The articulations of the total of whole impression that the physician pulse under the influence of such prevalence acquires, through the degrees of abnormality are likened to the creeping movement of a that exists in the vitiation of vata, pitta and leech or a snake (in vata prevalence), to the kapha helps the physician to estimate the leaping movement of a frog, crow or a prognosis... “The investigation is used sparrow (in pitta prevalence), to the leaping chiefly to ascertain the deranged soda or movement of a frog, crow or a sparrow (in dosas to the extent to which they are pitta prevalence), and to the steady respectively deranged, and also to forebode movement of a swan, a peacock, of a pigeon any complications of impending death”. (in kapha prevalence) (SaS, 1, 3,1). The movements may be characteristically When the pulse is examined, it involves the isolated (when dosas vitiated are severally physical examination of the artery; but it is responsible for the diseases) or may occur in not merely a mechanical counting of the combinations of two (like vata-pitta, vata- pulse rate. It is an art as well as a science.

Page 148-152 kapha and pitta-kapha) or of all three the hand of the patient slightly and holds it samnipata). lightly; and then places gently the three fingers of his right hand; the forefinger is When the pulse articulates now emulating places nearest the thumb, ad the other two the movement of the snake, and then that of fingers next to it in order. the frog, the indication in that both vata and pitta have been vitiated. When, however, The best time for pulse-examination is said the articulations of the pulse resemble the to be early in the morning. The articulations movements of a snake as well as a peacock of the pulse characteristically differ during then vata and kapha are vitiated. If the pulse the course of the day, for in the early hours is felt as jumping like a frog alternately with of the morning kapha prevails around noon the gait of peacock, then pitta and kapha are time pitta, and in the evening vata; and in vitiated. When all three dosas are vitiated the early parts of night kapha, around (the condition known as samnipata), this is midnight pitta, and last part of the night indicated by the alternative slowness of the vata. Seasons also play an important role in pulse (manda), intermittence (sithila), altering the pulse-examination. The pulse crookedness (vyakula) and fickleness articulations also vary in accordance with (chanchala). The pulsation appears, the patient’s bodily condition (hunger, thirst, disappears and reappears frequently. At sleep, exertion, food in the body and stage of times it is very subtle and hard to be digestion, posture etc), mental state perceived, it varies time and again. The (excitement, anger, sorrow, joy, etc) and pulsation in this condition is likened to the environmental conditions (exposure to sun, unpredictable flutter, flight and immobility heat, cold breeze, strong smells etc). of a partridge (tittiri) or a quail (lavaka) (saS, 1,3,3), or to the movements of a rodent Pulse examination is not indicated in certain caught in a heap of fire-wood (Lolimbaraja). conditions of the physician inebriation, suppression of natural urges and extreme The examination of the pulse is done for the distraction; or if the physician is greedy or length of time the pulse takes to beat thrity sexually excited (NP, 2, 41): times, or longer, if required. Usually it is repeated twice (viz., three counts in all). PITAMADYA CANCALATMA But in between the counts, the physician MALAMUTRADI VEGAYUK withdraws completely his hand from the NADIJNANASAMARTHAH patient’s wrist. SYALLOBHAKRANTASCA KAMUKAH. Both the patient and the physician must be comfortably seated while the pulse is being Pulse examination is a difficult art, and examined, and must be free from worry, presupposes not only long, and assiduous fear, stress, and bodily urges. The patient’s practice but insight into the normal human hand must be free, not too far nor too near constitution as well as pathogenesis. the physician, slightly flexed at the forearm. The physician with his left hand massages

Page 148-152 Scriptural study alone would not be an talk irrelevantly etc). Amidst the welter sufficient; guidance of an expert teacher is of confusing symptoms, the pulse can indispensable. Likewise constant practice is provide an accurate picture of the diseased of paramount importance; and one must condition of the body ‘like objects being indeed be lucky to become adept in it: illumined by a lamp’. It tells the physician the condition of the body ‘like objects PARIKSANIYA SATATAM beings being illumined by a lamp’. It tells NADINAM GATAYAH PRIHAK the physician the condition of the three NA CADHYAYANA MATRENA doshas (vata, pitta and kapha), severally NADIJNANAM BHAVEDIHA. (vyasta), in pairs (dvandva or yugalikrta) NA SASTRA VIJNA NADAPI and collectively (samasta, or samnipata). It NA BAHUSRTAKARANAM also suggests to him the ease or difficulty NADIJNANE MANUSYANAM with which treatment could be effected, or ABHYASAKARANAM PARAM whether the disease is altogether incurable SADURUPADESACCA (‘sadhyasadhya – viveka’) DEVATANAM PRASADATAH NADI PARICAYAH SAMYAK Abbreviations Used PRAYAH PUNYENA JAYATE (ND, 3,3) AHr : Ashtanga – hrdaya The physician who is wise and disciplined in AS : Ashtanga – Samgraha personal life, must examine the pulse only AV : Atharva – veda when he is in a state of perfect composure BP : Bhava – prakasa (‘ekacittah prasantatma’) for otherwise, the BS : Bhela –samhita pulse will not reveal the details: ByT : Brhad – yoga- tarangini CS : Charaka – samhita NADIGATIMIMAMJNATUM GOML : Govt. Oriental Manuscripts Library YOGABHYASAVADEKATAH KS : Kasyapa – samhita SAKYATE NANYATHA VAIDYA U MN : Madhava – nidana PAYA1H KOTISAIRAPI. ND : Nadi – prakasa SaS : Sarngadhara – Samhita Its especial value consists in helping SKD : Sabda – kalpa – druma diagnose the disease of patients who cannot SS : Susruta – samhita communicate (dumb folk, patients with YR : Yoga – ratnakara paralysed speech, patients who have lost consciousness, patients who are ‘possessed’

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