(i) Nadi pariksa (Pulse examination)
Pulse examination is one of the most important methods to know about the patient and the nature of the disease because healthiness or unhealthiness affect the heart rate and its palpitations, which simultaneously affects the arterial pulsation. A suitable time for pulse examination is with an empty stomach in the morning, as the pulse rate becomes erratic and inconstant after eating, massage and physical exertion. Therefore, immediately after these activities, the correct diagnosis of disease by means of pulse examination is difficult. In the same way, the accurate pulse rate cannot be checked if the patient is hungry or thirsty. The pulse is examined at the radial artery approximately half an inch below the thumb of the hand. The pulse is examined in the right hand of a male and left hand of a female. At times, for the clarity of the pulse, the radial arteries of both hands of males and females are examined. Patients should keep the arm straight and flexible and loosen the hand for pulse examination. The fingers and thumb should also be kept straight and spread. A physician should carry out pulse examination with the right hand. The pulse is felt with the first three fingers, the index, middle and ring fingers. It is important in pulse examination to keep all three fingers on the radial artery. The index finger is kept on the root of the thumb. Mild and equal pressure is given with the finger tips to feel the throbbing of the pulse and finger pressure is increased and decreased slightly, again and again, to know the accurate and definite pulse rate and also to sense the varying movements of the pulse. In this way, the nature of disease is determined on the basis of pressure felt on a particular fingertip. The pressure felt on the index finger denotes the pulse of Vata, middle finger denotes the pulse of Pitta, and pressure felt on the ring finger indicates the pulse of Kapha dosa.
However, to know the proper nature of a disease, a physician should be acquainted with the type of movement of the pulse. If the movement of the pulse is like that of a snake (wave-like motion), it denotes the predominance of Vata dosa. If movement resembles a frog (active and exciting pulse with jumping movement), it represents Pitta dosa. If the pulse moves like a pigeon (strong and floating), it denotes the prominency of Kapha dosa.
Also Read: Different Methods of Disease Examination
If the pulse throbs 30 times at the normal rate, it means the disease is curable and the patient will survive, but if obstruction occurs in between, it means that if immediate treatment is not provided, the patient may die soon. In fever, the pulse felt is hot and its movement is also fast. In the same way, pulse movement is fast in case of lust and anger, and slow in anxiety and fear. The feel of the pulse is very mild in dyspepsia (weak digestive fire) and during loss of tissue elements. In the same way, the pulse felt is light but rapid in persons with strong digestive power and is heavy in case of ama (if the food is undigested).
By means of pulse examinations, a physician gains insight about three dosas and can ascertain the status of seven dhatus, thirteen agnis, ojas and srotas. Not only physiological disorders but the knowledge of tridosa gathered by means of pulse examination also helps to diagnose the psychological condition of the patient. Though the pulse mainly denotes tridosa status, the complete body physiology is reflected in tridosa, because tridosa is the basic principle of existence of the body.
- Incurable pulse according to Ayurveda
A skilled physician through pulse examination is able to determine whether the disease is curable or incurable and whether the patient will survive or not. A pulse with many different movements slow, weak, unstable, obstructive and mild is known as sannipatika (suffering from vitiation of all three dosas). It is incurable and causes death.
When the movements of the pulse resembles with Pitta, Vata and Kapha types, respectively and then revolves like a fast moving wheel, with high frequency and volume rhythm and then suddenly falls down from its normal speed and gets slows. This also denotes that the disease is incurable. A pulse which is feeble with high pulse rate and cold also denotes that the disease is incurable and life is at an end.
- Health indicative pulse or curative pulse
The patient with a pulse throbbing like that of a swan and with a cheerful face, denotes that the patient is healthy. In this way, precise explanation of pulse movement is elaborated in Ayurveda. On this basis, a skilled physician can easily determine the causes of disease, diagnosis of disease, curability, incurability, birth and mortality of the patient, and can prescribe a suitable treatment at a right time.
Identification of pulse
Vata: Index finger placement denotes the pulse of Vata. The pulse feels like the movement of a snake, quick and slithery. The pulse is fast, narrow, feeble, cool and irregular.
Pitta: Middle finger placement denotes the pulse of Pitta. The pulse feels like the movement of a frog, active and jumpy. The pulse is excited, prominent, jumping, hot, moderate and regular.
Kapha: Ring finger placement denotes the pulse of Kapha. The pulse feels like the movement of a floating pigeon or a swan or a peacock. The pulse is slow, strong, steady, soft, broad, regular and warm.
(ii) Mutra pariksa (Urine examination)
For urine examination in Ayurveda, the first sample of urine is collected at an ambrosial hour (Bhrama muhurta) or after rising from the bed. Urine is collected in a clean glass or transparent vessel. Avoid the first stream of urine. Thereafter the mouth of the vessel is closed and the urine is examined at the time of sunrise.
On the basis of the color of urine, one can determine the nature of the patient and the disease. If the urine is pale yellow in colour, it means patient is Vata dominated. If the urine is white in color and with foam, it means Kapha dosa predominates. Yellow or orangish-red color in the urine is an indication of Pitta dosa. In the same way, if urine is dusky and lukewarm, it is an indication of Pitta and Vata vitiation. If urine is white in color with effervescence, it means Vata and Kapha dosas predominates. If urine is red in color with haziness like clouds, it is an indication of Kapha and Pitta aggravation. In chronic fever, urine is red like blood and yellow in color. If urine is transparent and black, it means patient suffers from sannipatika roga (provocation of all three dosas). Urine examination is also based on the theory of tridosa, in a similar manner to pulse examination.