Pulse Diagnosis Ayurveda
Ayurvedic Medicine has been using the pulse as a form of diagnosis since it was created 5000 years ago. Those who are familiar with modern Ayurvedic medicine think of the scenario where an Indian doctor takes your pulse and looks at your tongue and then can tell you what you've eaten for dinner the night before. Although many intuitive doctors have this capability this paper is more concerned with the methodology of the pulse. What are these doctors looking for? How do they interpret their findings? What can the pulse offer us as health care practitioners? What can be identified as fact by being repeatable with adequate practice? This will become more clear to us as we begin to understand what the pulse is and what it has to teach us. To do this we will look at the methodology and lineages of Dr. John Douilliard, Dr. Vasant Lad, and Dr. Smita Naram. Then we will compare and contrast these doctors' methods and ideas. The goal of this analysis is not to determine the efficacy of the pulse as a diagnosis method, but to understand the methodology of the pulse more clearly as a diagnostic tool. In Ayurvedic medicine the pulse is used in conjunction with Darshana (pure observation and inspection), and Prashna (questioning). It is all three of these that must be employed to reach a complete diagnosis. Pulse diagnosis is best understood through the teachings of those who have been practicing and teaching it the longest. We will begin the journey of understanding the pulse through the three most revered methods in the West. An assessment of their similarities and differences will follow. Concluding with the relevance pulse diagnosis has to emerging practitioners here in the west. Let us begin by holding the threads that weave Ayurveda and the pulse together. The overall method of taking the pulse begins with the placement of the fingers. The index finger is placed below the radial styloid. The radial styloid is the protruding wrist bone on the thumb side of the hand of the pulse recipient. The middle finger and ring finger are placed next to the index finger. The pulse taking fingers are adjusted along the underside of the arm to find where the pulse is the strongest. The pulse is the beating of blood through the arteries as it moves outward from the heart. The blood carries nutrients to each cell in the body, just as thought is transferred through chemical reactions in the cells simultaneously, intelligence is found in the blood in the information it carries to each cell. In Ayurveda this information carried by the blood is made of the 5 elements: earth, water, fire, air and ether. These are the scientific building blocks of Ayurveda. The 5 elements are used to explain in simple terms what science has determined through complex experiments. These elements combine in three distinct ways in the physical form. These are the Doshas , psycho-physiological functional principles of the body. The three Doshas are Vata which combines the elements of air and ether. Pitta is fire and an aspect of water. Kapha is water and earth. We can find the Doshas in the qualities and textures that can be felt in the pulse. The Doshas have concrete qualities that are made when their respective elements are combined. Doshas being combinations of elements are not only found in the body, but also in the environment. As we look at the natural world we can see the dominance of air and ether in the dry barren plains of the high mountain desert of central Arizona . Vata is seen in the rough and rugged change of season characterized by Fall in the northern hemisphere. Pitta is characterized by summer heat, hard work, and intensity. Kapha is embodies the spring moisture of the Northwestern states of Washington and Oregon . This is when the qualities of earth and water are the most noticeable. Like the environment, Doshas can be supportive or destructive to our total well being. Doshas and their qualities are also found in the pulse. Think of the pulse like a cardiograph: a computer readout graphically recording the physical or functional aspect of the heart. Like the graph being sketched across the screen of the computer the pulse has its own rate, crest, wave, amplitude, and cessation. These individual characteristics define the overall movement, quality, and rhythm of the pulse. In these broader categories the Doshas of Vata , Pitta , and Kapha can be distinguished based on the smaller movements sketched graphically by a cardiograph. In pulse diagnosis our fingers become the receptors that transfer the information of the heart beat graphically into a more concrete image. The Gati (movement) is best defined by the natural world. A snake as it swiftly slithers out of danger or attentively rests on a warm rock when felt characterizes Vata. The elements that make up Vata are air and ether and they are swift and light as they slither through the fingers. A frog on land bounds powerfully, a frog in water pumps its legs and arms in strong fluid motions. The elements of fire and an aspect of water characterize Pitta bounding into the fingers, strong and forceful, but without the sharp quality of the snakes bite. A swimming swan methodically bobs its head as it gracefully moves across the water. The elements of earth and water in Kapha glide into the fingers. The Gati is considered the most important part of the pulse as it makes up the crest and wave of our computerized image or the movement of an animal. Vata has the quality of a snake. Pitta is a frog. Kapha is a swimming swan. In Western diagnostics it is only the rate of the pulse that is taken. The rate is dependant on the dominance of the Doshas in Ayurveda. Vata is 80-90 beats per minute. Pitta is 70-80 bpm. Kapha is 60-70 bpm. The rhythm of the pulse can be irregular or regular. An irregular pulse has no distinguishable pattern. Its intensity and rhythm fluctuates wildly. Vata is irregular. A regular pulse in consistent, it pumps in the same rhythm and amplitude. Its crest and wave are even. Pitta is regularly irregular, meaning that if it skips a beat it always skips that beat, and thus the pattern repeats itself. The amplitude of the pulse is the force or strength with which the beat moves into the fingers. Pitta's intensity is high, Kapha's consistency is moderate, and Vata's variability is low. Overall the characteristics of each dosha are: Vata is feeble and light as it slithers into the fingers. Pitta bounds into the fingers strongly and clearly. Kapha slides into the fingers slow and cloudlike. These are elaborated on in the graph below.