Exploring Nadi Pareeksha (Pulse Diagnosis) and Panchakarma (Five Putative Procedure) in OPD Practice
KSR Prasad Professor, Panchakarma
http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Purpose and Learning Objectivities
• The purpose of this Lecture is to introduce the OPD level Panchakarma and offering Nadi diagnosis skills – At the end of the lecture a minimum understanding of Nadi, Dosha finding through Nadi and proposal of Specific Panchakarma for the patient is possible – At the end of lecture utility and practicability of Panchakarma at OPD levels is understood – At the end of lecture exploring the utilization of the opportunities around practicing area is known
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Introduction
• AYUSH role in National Health maintenance is around 12% and out of Ayurveda is 60% • Ayurveda is rich in common formulations that can be prepared and used any where with minimal skills • If the skills like –Diagnosis through Nadi and OPD lllevel PhkPanchakarma PdProcedures are adopted the AY‐GAD is alternative to AY‐GOD
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Introduction
• Whether Ayurveda practitioner is able to avail and utilize the resources surrounded? – The answer is mostly “NO” • We have rich vegetation and Herbs around us • Ayurveda suggest many single and combination of herbal products that are “GOOD” for the common problems • LlLocal collecti on and dist rib uti on among the group can bring “GOLDEN DAYS” to Ayurveda
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Panchakarma
• Panchakarma is a procedural part of AdAyurvedathiherapeutics establish ed for the Dosha elimination from the Body either from oral or rectal route (GI system) • In due course the Panchakarma extended to get rid of the Physical and Psychological DhDosha accumultdlated by enviitlronmental or Dietetic misbehaviors also
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Panchakarma
• Five karma are told as “Shodhana” / (Eliminative) “Langhana” in nature based on “Bahudosha Nirharana” • But only two karma are fully capable – (Poorna Shodhana) – “Vamana” (Upper GI cleanser) – “Virechana” (lower GI cleanser) • The other three karma are partial for elimi nati on as they are even used for Brimhana and others
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Panchakarma
• Karma are attributed to Dosha – – Vata – Vasti (Basti) – Pitta – Virechana – Kapha – Vamana • The selection of patient for the karma are commonly based on Disease but not on the basis of Dosha – Which is wrong –it should be at the dosha sanchaya • We observe “Fitness” of patient always • But many times the expected results are not observed as the “Karma” is not suitable for the situation
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Panchakarma at OPD
• A big question and debatable at Ayurveda community is – Panchakarma at OPD level and Instant and duration reduction in Panchakarma – the reasons to adopt OPD level or Sadya PhkPanchakarma are ‐ • Time schedules of the Patients are stingy • Sustenance capacities of patients are reduced • Herbs are less potent to yield long duration effects
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice How much PPhkanchakarma can be done @OPD • There is more feasibility and possibility to develop and practice instant time reduced portable OPD level Panchakarma • A small variants have to be introduced or altered for the present day in traditional practices of Panchakarma
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Sadya‐Snehapana • Propose: to get soften ing and liquef acti on of Shakhashrita Dosha • SltiSolution: SdSadya‐ShSnehapana tldtold by ShtSushruta to make unction instant • RiRecipe: Ghri ta (dose according to the weihight and Dosha) + Saindhava Lavana (10gm for 24 ml of Ghee) ++ advised to add Honey 10gm for each 24ml of Ghee and QS milk • Time of Application: Morning on empty stomach • Assumption of Effect: Fingers Greasing at anal wash & oily stools or floating oil at lavator y pan in 6 to 24 hours Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Sadya‐Swedana
• Propose: to move the liquefied Dosha to Koshta (GIT) • Solution: Sadya‐Swedana with altered methods like long duration Hot water bath or steaming • Recipe: For sweating we can use common herbs of easily available like – Shigru (Drumstick), Nirgundi, or any churna according to disease etc instead of only Dashamoola etc. • Time of Application: Preferable after external Abhyanaga (il(oil applicati on – not massage) • Assumption of Effect: Forehead sweating
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Sadya‐Vamana
• Propose: to remove the Kapha Dosha from Koshta (GIT) through oral orifice • Solution: Many Vamaka yoga are available • Recipe: Madanaphala pippali in 3‐6gm dose offer smooth evacuation after drinking full stomach milk followed by Saindhava Jala – Conform there is no cardiac problem through ECG and enquire GIT problems – If no previous Abhyanatara snehana is undertaken you may add 24ml of Ghrita to the Milk • Time of Application: Preferable on empty stomach at Kaphakala (6‐10 AM) • Assumption of Effect: Bile vomiting, Bitter tongue,
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice Sadya‐Viihrechana • Propose: to remove the Pitta Dosha from Koshta (GIT) through Anal orifice • Solution: Many Virechana yoga are available • Recipe: Trivrut Avaleha 30gm + Ghrita 60ml + Saindhava 10gm + Honey 90ml followed by hot water sippings – Conform there is no IBS, Hemorrhoids, etc. – NO need of any previous snehapana as Ghrita is added to yygoga • Time of Application: Preferable at 6 AM or best when the patient is hungry and in pitta kala (10 AM to 2 PM) • Assumption of Effect: hot water evacuation – This program makes more secretion of HCl from stomach and Pancreatic Juice and Bile – So the total emptiness of the Gall bladder, Pancreatic Juice, cleansing of HCl production cells, shift of fluids from Internal to External compartment along with fluid regulation takes place
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Sadyo‐Vasti
• Vasti or Basti means only Niruha or Asthapana Vasti • Ekanginka Niruha Vasti – a term continuously only Niruha is given • Vasti is a broad range treatment with many combinations and permutations • It is not Just Enema – it is far highest sophisticated technical route of medicine administration with density, temperature, pressure, intestinal dilatation, fluid shift, and many more components ildinvolved • Best Time to give is Vata Kala –4 ‐6 AM or 2‐6 PM
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Sadyo‐Nasya
• As Nasya is a common program and Pratimarsha Nasya is in practice there is no need of any other alternative for the Nasya karma • Any time it can be given
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Uttara Vasti
• Uttaravasti for the female do require instrumentation and sterile room with aseptic and antiseptic precautions • A new OPD method sterile disposable clamp method is derived for Male Uttaravasti • Easy, economical, infection free, effective • See for ppt on www.slideshare.net//ytechnoayurveda
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice Nadi Diagnosis Introduction
• Nadi Pareeksha (Pulse diagnosis) is a fantasy of the AdiAyurvedic Physi ci an • We lost the precision of information and thtechnol ogy in the time • Still with the information available through the doctrines of Ayurveda we are able to relocate and retrieve wisdom of Nadi Vijnana
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Nadi (Pulse)
• Nadi Pareesksha is one among the eight meeodsoethods of examining gp a pati ent • We examine a patient for the understanding of – – Rogi Prakriti (Patient Body Constitution) – Vyadhi Prakriti (Disease Constitution) – Dosha Prakriti (Humoral Constitution)
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
History of Nadi (Pulse)
• Brihatrayee gives kldfknowledge of – – Spandana – Praspandana – Aspandana, – but not focus diagnostic or prognostic Nadi
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Laghutrayee • SHARANGADHARA (13th A.D) – First time mentioned 15 types of Nadi that include – physiological, Psychological and pathological states of body correlated with those of the birds, reptiles and amphibians. 24 notable nadi are described for Nadi pareeksha – “DtDootana di” (Messenger pul)lse) – popular in AdhAndhra • BHAVAPRAKASHA 15th century AD – – Gender based Nadi – Three finger usage for thridosha • YOGARATNAKARA (16th century AD.) – included different Sites and methods of pulse examination and prognosti/diic / diagnosti c meth hdods Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice Check ‐ History of Nadi (Pulse) • BjBasavarajeeyam (17th century AD. ) • Ashtastanas for Nadi and Diseases coming under it are mentioned. The primary are three ‐ 1) Wrist –Hasta(radial artery) 2) Neck – Kantha (carotid artery) 3) Nose –Nasa(facial artery branch) The other areas where Nadi is witnessed are ‐ – Ankle ‐ Paada (posterior tibial artery) – Penis (pudendal artery) – Elbow (brachi al art)tery) – Ear (superficial temporal artery) – Eye (supra orbital)
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice History of Nadi (Pulse) • Vaidyachinthamani • Mentioned Ajeerna Nadi along with Dosha nadi. • RavanaThantra • Ravana in his treatise Nadi Pareeksha included Nadi after taking certain diets along with prognosis, physiological, Psychological and pathological conditions and diseases
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Selection
• Thus the “Selection of Panchakarma” through “NdiNadi PkhParrekshana” • We need sound knowledge of – – What is Nadi Pareekshana – How it is classified – What is the procedure of initiation – How to interpret the knowledge
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
What is pulse (Nadi) wave?
– An objective criterion for diagnostic or Progn osti c con diti on s thr ough th e wa ves of blood transported in the vessels – The wave dynamics depends upon the stroke volume and contents along with the obstructions caused in the path way – It offers even much more information also
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Classification The clifitilassification of NdiNadi PkhParreksha bdbased on utility can be – – Predictive Nadi diagnosis –for Prakruti assessment – proportionate – Diagnostic Nadi diagnosis – disease understanding – by different static principles of movements described in the text – DiDynamic NdiNadi diagnosi s – used for understanding disease & ppgrescribing medicine or procedure
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Classification There are lllevels of NdiNadi predicti on also • 1st level –Interpretation of Dosha at Gross • 2nd level –Interpretation of Dosha at Sublevel • 3rd level –Interpretation of Dosha for Panchakarma • 4th level – Interpretation of Dhatu /Organ involvement • 5th lllevel – ItInterpret ttiation of UdhtUpadhatu /Organ involvement • 6th level – Interpretation of Mind • 7th level ‐ Interpretation of Constitution
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Predictive Nadi diagnosis • This is superficial in nature • Interpreted with Rate, Rhythm, Blood vessel consistency, etc. • Commonly used for “Dosha” involvement colloquially in Disease iidnterpreted wiihth movement of aniilmals
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Predictive Nadi diagnosis
• Index finger –Vata– movement resembles snake • Middle finger – Pitta ‐ movement resembles Frog • Ring finger – Kapha ‐ movement resembles Swan
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Predictive Nadi diagnosis
• Other examples are – • Index finger – Vata – movement resembles Earth Worm • Middle finger –Pitta‐ movement resembles Crow • Ring finger – Kapha ‐ movement resembles Pigeon
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Predictive Nadi diagnosis
VATA PULSE PITTA PULSE KAPHA PULSE
CHARACTERISTICS Fast , feeble , cold , Prominent , strong , Deep , slow , broad light , thin , high amplitude , , thick , cool , disappears on hot , forceful , lifts regular pressure up the palpating finger LOCATION Best felt under the Best felt under the Best felt under the index finger middle finger ring finger
GATI Moves like a cobra Moves like a frog Moves like a swimming swan
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Diagnostic Nadi diagnosis • The diagnostic Nadi is based upon the various examples given from text to know a disease or condition • They are based on Gati – momentum • Different examples are given here with resembling momentum of the itinsects or anilimals
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Diagnostic Nadi diagnosis • Krumi gathi – parasites , worms • Pippilika gathi – terminal illness • Mayura gathi – arterial hypertension • Kukkuta gathi – diabetes , albuminuria • Ushtra gathi – aortic stenosis • Gaja gathi – elephantiasis, lymphatic obstruction • Girija gathi – heart bloc k • Vishama gathi – pulsus alterans , atrial fibrillation • Damaru gathi – ftlfatal illness , renal filfailure , shkhock • Padma gathi – perfect health , enlightenment
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
KSR Prasad’s Dynamic Nadi Diagnosis
• This is inventory method of me with various experiences encountered • In this a blind method is observed to assess the condition and inter relation of the Dosha – quantification – Organ ‐ sub dosha – system – dhatu – etc. • Subjected for validation
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
BBiasic wave of accel erati on pul se wave
• In a blood vessel the flow in a a rhythm hitting the two walls with
c a velocity e • Dosha “tara‐ tama Anupalabdi” is made with the intensity of the hit to the finger d • Pravruddha (a) heena (e) and b madhyama (c) are observed
a,b,c,d,e wave of five component • This could be even in % • Time Duration between two hits at the finger gives duration of specific dosha movement from its Sthaana (b) (dosha place) to reach Dooshya (c)(disease place)
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Panchakarma reflection
• As the Urdhwa and Adho Doshahara method are fllfollowed in PhkPanchakarma . . . – Urdhwa Dosha Nirharana (Vamana) • Kapha (Bahu dosha) – Hrullasa • Pitta (Alpadosha) – Amlodgara – Adho Dosha Nirharana (Virechana) • Pitta – (Bahu dosha) – Guda Daaha • Vata – (Alpa Dosha ‐ Anulomana) – Vayu Sanchara
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Procedure of PDND • Sit comfortable (both patient and doctor) • First place your right hand on the radial artery (Jeeva sakshini) • Select right hand for male and left hand for female – Record your readings • Take patients both hands in to your hands placed three fingers on the Jeeva Sakshini – Record your readings
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Interpretation of PDND • Each finger is divided in Dosha‐Finger Dosha Gati to two halves Kapha Adho Kapha Dosha Z • The half toward the Ring Urdhwa Kapha Dosha C patients hand represents Adho Pitta Dosha the Urdhwa Dosha and Pitta Y the other part towards Middle Urdhwa Pitta Dosha B the shoulder represents Vata Adho Vata Dosha X the Adho dosha Index Urdhwa Vata Dosha • When pulse is found A more than 60% of intensity at former it is subjected for Vamana and for later it is Virec hana Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Kapha Urdhwa (Bodhaka, tarpaka) PittaUrdhwa (Sadhaka, Alochaka) Vata Urdhwa (Prana, Udana) Kledaka Vata Adho (Samana, Apana) Sleshaka AlAvalamb bkaka Pitta Adho (PhkPachaka, RjkRanjaka) Bodhaka Kapha Adho (Kledaka, Avalambaka) Tarpaka Alochaka Dosha‐Finger Dosha Gati Bhrajaka Sadhaka Kapha Adho Kapha Dosha Ranjaka Ring Urdhwa Kapha Dosha Pachaka Adho Pitta Dosha Apana Pitta Vyana Middle Urdhwa Pitta Dosha Samana Vata Adho Vata Dosha Udana Prana Index Urdhwa Vata Dosha
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Dosha‐Finger Dosha Gati Interpretation Kapha Adho Kapha Dosha Z
Ring Urdhwa Kapha Dosha C • Vamana Pitta Adho Pitta Dosha Y A + C = Ajeerna, Middle UdhUrdhwa Pitta DhDosha B Swasa Vata Adho Vata Dosha A + B = Ajeerna, X Index Urdhwa Vata Dosha Pandu A • Contra indicated A + S = Hrudroga • Virechana X + B = Ajeerna, Stanantra samagata Grahani X + B = Ajeerna, Grahani B +
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice Take Home Message • You can search your surroundings for the Herbs available and make Ekamoolika or combinations for the benefit of patients with available Amayika Prayoga • Every patient should be scanned for the Dosha dusti thhhrough Nadi Pareekhksha • Apply as much as possible OPD Panchakarma, so patients gets faith in Ayurveda
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice
Thank you
He can do Miracle – Even you can do Miracle
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/ Nadipareeksha & Panchakarma in OPD Practice Any questions?
• Dr KSR Prasad, Professor, Panchakarma • Chief Editor, Journal of Indian System of Medicine • Vice –Dean (PG), MGACHRC, Wardha (MS) • technoayurveda@gmail. com • Cell Phone: 9503227966
Dr. K. Shiva Rama Prasad, at http://www.technoayurveda.com/