Pulse Diagnosis: How do we read the heart beat? (by Noah Volz C.A.S)

Introduction

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.

VATA

PITTA

KAPHA

Characteristics

Fast, feeble, cold, light, thin, disappears on pressure

Prominent, strong, high amplitude, hot, forceful, lifts palpating finger

deep, slow, broad, wavy, thick, cool or warm, regular

Location

Index

Middle

Ring

Gati

Sarpa (Cobra)

Manduka (Frog)

Hamsa (Swimming Swan)

Vega (Rate)

80-95

70-80

50-60

Tala (Rhythm)

Irregular

Regular

Regular

Bala (Force)

Low +

High +++

Moderate ++

Akruti (Tension and Volume)

Low

High

Moderate

Tapamana (Temperature)

Cold

Hot

Warm to cool

Kathinya ( vessel wall)

Rough, hard

Elastic, flexible

Soft thickening

(Lad, 14)

Anyone can recognize that there are differences between their pulse and that of others. What these differences mean is what Ayurveda has refined over its 5000 year existence. The Pulse can be read like a book, and the categories and qualities mentioned above are the alphabet that we will use to learn from this book. Understanding movement, rate, and rhythm of the pulse can be a tool for understanding the body. The beauty of this is that the symptoms of disease manifest in the pulse long before they do in the body. An example of this is when a chemical imbalance occurs in the blood before their aggregate affects produce symptoms in the body. The characteristics and the movement of the pulse are symptoms of the functioning of the body.

Interpreting the meaning behind what is felt in the pulse has been done by many generations of masters. It is their knowledge, expressed through the refined methodology of their technique that will guide us through the great river of the pulse, following the current looking for the continuity and conflict between methods. We will explore the ways of ancient wisdom and compare the differences and similarities between these time- tested-methods of pulse diagnosis.

When the Doshas are found in the pulse, how can they be seen in the body? Are the different methods consistent in assessing the link between the pulse and the body? Ayurvedic knowledge shows the myriad of ways that the Doshas are responsible for imbalances. One can feel the Doshas in the pulse and thereby also determine the imbalance. Are pulse methods consistent in determining Doshic aggravation in the body? Each method will be looked at and then assessed in combination with the other methods to illuminate what the pulse shows on its own, and what each method uniquely brings to the pulse. Let's take a journey with Dr. John Douilliard, Dr. Vasant Lad, and Dr. Smita Naram to find the ways in which the pulse can teach us about our way back to optimal health.

Dr. John Douilliard

John Douilliard begins with identifying V,P,K in the movement, rate, rhythm, strength, and quality of the pulse. Douilliard says that the dominant qualities of the Doshas should be felt in their respective fingers. The index finger is for Vata, the middle finger is for Pitta, and the ring finger is for Kapha . The pulse will feel like a snake (V), frog (P), and swan (K) under these fingers when the pulse is in balance. When feeling the pulse, distinguish what Doshas are in which finger. As mentioned before, the Doshas should be found more in one finger than in the others. The Doshas will permeate more than its dominant finger and spread to other fingers as well. Or the Doshas could leave its finger completely when we are imbalanced. If you feel a Vata pulse in the Pitta finger than an imbalance may be present. In the beginning, focus is placed on differentiating between the V,P, and K pulse.

As each finger has unique characteristics that are most prevalent under that finger, each finger has different levels of intensity or amplitude. The amplitude is the strength with which the pulse moves into the finger. As each Dosha has unique characteristics the amplitude is relative to itself and not to the other fingers. For example a vibrant Kapha pulse will never jump into the finger with the same amplitude as a strong Pitta pulse. Because the quality of the Pitta pulse is to jump and the quality of the Kapha pulse is to glide. The relative intensity is given a number; 3 being the highest and one being the lowest. When taking the pulse, the relative strength thumping into a finger is given a number. This information is valuable for establishing ones Nature. As each person has their own unique body type built by genetic information, they also have their own unique nature. The Doshas combine to make a unique psycho-physical being. This is called Prakriti or Nature. This combination of all three Doshas is their natural state of balance at birth. By ascertaining the amplitude we can know the person's Prakriti . If for example you feel a Vata 3, Pitta 2, and Kapha 1 then the body type for this person would be 50% Vata , 30 % Pitta and 20% Kapha . The body type is that persons balanced state or Prakriti . This is the balance point where that individual is the most optimally healthy.

When taking the pulse the fingers can lie on the surface or press deeper to find different levels of the pulse. The change in the pressure on the vein, changes the meaning of the pulse. There are three levels of the pulse in this method. The first level is the superficial level, the way the pulse feels at the surface level of the wrist. The last level is the deepest level. Move from the superficial level to the deep pulse by pressing deeper into the underarm and noticing the quality of the pulse. It is described by Douilliard as throwing your buoy into the lake. The buoy sinks to the bottom, like the fingers moving to the bottom of the pulse. Once the bottom has been touched, you come up a little until you can feel the pulse again. Then move towards the uppermost surface of the lake and feel the difference in quality at the superficial level. In Douilliard's method the deep layer of the pulse is the layer of the soul. It is the deepest layer and the root of our being. By misusing our intellect Pragna Parad we move away from the essence of our being, which is infinite. The deep layer of the pulse is this ground on which truth and wisdom grow. The superficial pulse is the material form, or our body. The pulse that links the two becomes important in this method later on. It is the junction point pulse and the bridge between the two. It is here that the imbalance that is causing disease in the body can be felt. The Gap pulse as it is called is very important in this method.

The pulse is influenced by our external environment. By taking the pulse at different times of the day and in different seasons V,P,K can be found. The seasons where each Dosha is provoked are: Vata in the fall and early winter, Pitta in the summer, and Kapha in late winter and early spring. See below

Provoked

Accumulating

Alleviated

Feb.1-June 1

Kapha

Pitta

Vata

June 1- Oct 1

Pitta

Vata

Kapha

Oct 1- Feb 1

Vata

Kapha

Pitta

The Doshas also relate to the times of the day. Vata is the most prominent from 3 until sunset (7), Pitta rules the hours from 11- 3, and Kapha is in charge from sunrise/sunset until 11. See the chart below

Provoked

Accumulating

Alleviated

7am-11am / 7pm-11pm

Kapha

Vata

Pitta

11am-3pm / 11pm-3am

Pitta

Kapha

Vata

3pm-7pm / 3am-7am

Vata

Pitta

Kapha

Another technique used to familiarize oneself with how the pulse changes and what the presence of the Doshas feels like in the pulse is to take the pulse at meal time. As Fire is used to digest food, Pitta peaks as you are eating your meal and for approximately 15 minutes after the meal. Kapha takes over as the food is assimilated and the steady qualities of earth and water are needed. When Vata returns to the pulse approximately 4 hours later, the food has been completely assimilated and it is time for another meal.

The pulse can also be used in a therapeutic way. When one takes their own pulse the fingers give feedback to the entire system of where there is a site of weakness or imbalance. Even when the intellect cannot seize the wisdom of the pulse our body and mind adapt to remedy the vitiation felt in the pulse. Douilliard has many testimonials that account for his understanding of the pulse as a therapeutic technique.

Determining a balanced and imbalanced pulse is the key link to using pulse diagnosis. Using all the previous methods to familiarize ourselves with the qualities of the pulse and levels of the pulse, we can begin to use this information to determine whether the pulse is balanced or imbalanced. We begin by becoming familiar with the deep pulse as we move from the deep pulse to the superficial pulse. If the overall quality is consistent from the deep to the superficial and there are no spikes at any level then the pulse is considered balanced. The deep and superficial levels have different qualities themselves, so the practitioner must know the qualities of each level to know if the pulse is balanced all the way through. The pulse is taken for a 2-3 day period to establish if the pulse is truly consistent and to rule out any variations that may be based on seasons, meal times, or other external factors. The same is true for imbalance. If a definite spike or variation in the overall character of the pulse can be determined over a 2-3 day period of time than treatment will be based on that variation.

Once we know if the pulse is balanced or not we can begin to use our sensitivity to find where in the body there is weakness or Doshic aggravation. In this method each finger tip is broken down into five parts, four distinct quadrants (1-4) and the entire length of the finger tip (5). These relate to different Subdoshas . A Subdosha is the subdivision of the three Doshas. Each Subdosha has locations and functions that are related to the predominant qualities of the Doshas within the body.

1 2 3 4 1 2 3 4 1 2 3 4

The figures above are the finger tips and the numbers correspond to the quadrants of each Subdosha . Douilliard sets out in his Pulse course from LifeSpa the Subdoshas and their relationship to the parts of the fingers. The four parts of the finger tip, with the 5 th being the entire circumference of the finger tip, are broken down below into their different Subdoshic functions. Number 1 is always closest to the radial styloid of the pulse recipients hand and 4 is closest to their heart.

VATA

V-1 Prana Mental, Respiratory, Neurological

V-2 Udana Ears, Nose, Throat, Neck, and Speech

V-3 Samana Digestion, improper formation of tissues, anorexia, diarrhea

-4 Apana Excretion, Constipation, Menstrual, Sexual

V-5 Vyana Circulatory, Systemic disease

PITTA

P-1 Pachaka Digestion, jaundice, acid stomach, jaundice

P-2 Ranjaka Blood disorders, liver

P-3 Sadhaka Decisiveness, Memory, Intelligence, Spiritual inclination, Emotions

P-4 Alochaka Vision, Eyes

P-5 Brajaka Skin disease

KAPHA

K-1 Kledaka Digestion, mucous, the root of all other Kapha's

K-2 Avalambaka Back, Heart, Lungs

K-3 Bodhaka Taste, Smell

K-4 Tarpaka Senses, Cough, Nasal Congestion, Cerebral spinal fluid, headache

K-5 Shleshaka Joint pain, congestion

(Douilliard, 29-30)

These are the main points of Douilliard's technique. His methodology is very experiential and he believes that the experience of the pulse must come first. The technique builds on the previous lessons and ends with the specificity of determining where in the body an imbalance is based on its Subdoshic correspondence in the finger tip and the characteristic amplitude and quality.

Dr. Vasant Lad

Levels of the Pulse

There are seven levels of the pulse that are discerned in Dr. Lad's lineage.

  1. The deepest level of the pulse is the Prakriti .
  2. Then up from there Manas Prakriti (2 nd ),
  3. Dhatus (3 rd ),
  4. Ojas/Tejas/Prana (4 th ),
  5. Subdoshas (5 th ),
  6. Manas Vikriti (6 th ),
  7. Vikriti (7 th ).

In each level many sensations can be experienced and eventually understood by the advanced practitioner. We must remember that feeling initially takes place in the mind and then in the fingers. It is our mind's eye that truly reads the pulse and not the fingers alone. At each level of the pulse there is a minor variation in the spike of the pulse. As one continually moves from deep to superficial pulses they begin to differentiate between the many levels of the pulse. (Lad, 36)

1 st and 7 th Level Organ Pulses

The organ pulses can be felt in both the Prakriti and Vikriti levels. The first level corresponding to Prakriti is associated with the superficial organs. The seventh level corresponds to Vikriti ans is associated with the denser organs deeper within the abdomen. Organ pulses are taken on both the right and left hand of the recipient. The table below links the finger, Dosha , level, and organs together.

Right Side

Dosha

Vata

Pitta

Kapha

Finger

Index

Middle

Ring

Superficial

Colon

Gallbladder

Pericardium

Deep

Lung

Liver

Circulation

Left Side

Dosha

Vata

Pitta

Kapha

Finger

Index

Middle

Ring

Superficial

Small Intestine

Stomach

Bladder

Deep

Heart

Spleen

Kidney

(Lad, 47)

3 rd Level Subdoshas

The third level down are the Subdoshic pulses, unlike Douilliard, Lad separates the tip of the pulse feeling finger tips into 5 segments. On Vata finger beginning from the most distal point from the heart the Vayus or winds go in order from Prana, Udana, Vyana, Samana, Apana . On the Pitta finger from thumb to heart is Pachaka, Ranjaka, Bhrajaka, Alochaka, Sadhaka. On the Kapha finger moving towards the heart is Kledaka, Avalambaka, Sleshaka, Bodhaka, Tarpaka . See the table below. Like Douilliard, spikes on one of these places on the finger indicate an imbalance in that Subdosha . The Subdoshas actions and functions are always the same. (Lad, 85)

4 th Level Subtle energies

Ojas , Tejas , and Prana are the subtle energetic parts of Kapha , Pitta , and Vata respectively. Ojas can be felt in the ring finger, which is attuned to Kapha . Tejas is felt in the middle finger and Prana in the index finger. Prana , Tejas , and Ojas relate to the body in many ways even though they are the subtle counterparts of the Doshas . In the endocrine system, Prana is related to equilibrium and adaptability to different situations. Prana is found in the pituitary and pineal gland. Tejas is responsible for the digestion and metabolism of the thyroid gland and pancreas. Ojas deals with reproduction, the most unrefined of endocrine secretions, since the endocrine fluid is created from the reproductive fluid. Ojas also governs energy reserves and is found in the testes, ovaries, and adrenals.

The subtle energies influence the physical body. Prana , Tejas , and Ojas are the primary energizing principles of the body as expressed by the immune system. The immune system is a collaboration of all the systems for maintaining health and neutralizing disease. The pulse as expressed through the chemical and physical actions of the blood is mirrored in the subtle energies. Prana is the underlying movement that defines where the immune response will be most prevalent. Tejas is the active, fiery element that mobilizes the tools of the immune system. Ojas is the innate capacity of the system, its tool box and energy supply for coming back into balance. On the fourth level of the pulse these qualities can be determined.

Lad mentions that the detection of these differences is subjective. Listen to the amplitude of the highest point of the pulse's crest, its spike, in each finger. Give the strength of the spike a number. Three is a strong sharp lunge into the finger and one is a feeble prick. This numbering system and identifying method is the same as Douilliard's body type differentiation. But instead of looking for variation as Douillard's method does, Lad's method believes all three subtle energies should be equal and at the three strength level if they are optimally healthy. (Lad, 108)

5 th Level Dhatus (Tissues)

At the fifth level of the pulse we can assess the strength and quality of the tissues. The seven tissues are Rasa (Plasma and Fluid), Rakta (Blood), Mamsa (Muscle), Medas (Fat), Asthi (Bone), Majja , (Marrow) and Shukra/Artava (Reproductive Tissue male and female). Healthy Dhatus will not spike, it is when the Dhatus have been invaded by excess Doshas or are weak that a spike will be felt. The quality of the spike is very important. If it is sharp and intense then there is Pitta in that tissue. If it is dull and solid then Kapha and if it is feeble and thread-like then Vata is present.

The male and female reproductive tissues are found at the center point of the finger tip on every finger when a spike is detected. Because the reproductive tissue is felt on all three center parts of the fingers it is not only the quality of the spike, but whether the finger is V,P, or K that determines the imbalance. When a spike is felt on the ring finger in the proximal position (close to the heart) the Rasa is compromised, on the distal position Rakta. On the middle finger proximal is Mamsa and distal is Meda . On the index finger proximal relates to Asthi and distal to Majja . (Lad, 94)

Second and Sixth Level Manas Prakriti (Flow of Consciousness)

The second and sixth levels of the pulse are finely tuned to the mind. It is here that we discover our mental imbalance or balance and identify the deeper flow of consciousness as defined by chakras. It is here in the mind that objective reality is converted into subjective reality through our senses and perceptions. These levels are the bridge between body and mind, objective and subjective. As the majority of this technique is subtle and quite different than the previous techniques the aspects that relate most directly to the other levels of the pulse will only be described. These levels of the pulse take a sensitive awareness and cannot adequately be described in a technical way.

Again the tips of the fingers are divided into thirds. In this level VPK can be felt in all three fingers. The third of the finger closest to the heart relates to K, the third in the center to P and the third towards the thumb to V. Vata felt on the distal edge of each finger, Pitta in the middle and Kapha proximal to the midline of the recipient. Each of these Doshas is influenced by a Guna (quality of the mind) this is how the characteristics of the Dosha will manifest in the mind. In the second level of the pulse the qualities of the mind are Sattva , Rajas , and Tamas . Sattva is the underlying energy of peace and truth. Sattva has an inward and upward movement bringing us towards our true nature. It is the true state of consciousness: light, stable, harmonic, and virtuous. Rajas are the qualities of passion, turbulence, activity, distraction, assertion, motivation, and movement. Its action is outward, egoistic, self-seeking, and self-motivated. Tamas is cloudy, dull, sticky, cold, and stagnant. It is the inertia of downward motion causing decay, degeneration, and death. The second level pulse is connected moment to moment to our minds eye. (Lad, 135)

The sixth level of the pulse relates to the seven Chakras . The seven Chakras are the energy centers of the subtle body. There are many of them, but the pulse identifies the seven that lie along the spine. They show how the life force directs and guides the physical body through the nervous system. The crown center Chakra can be felt as a spike at the center part of all the pulse taking fingers if it is blocked. On the ring finger the root Chakra is felt in the distal position (close to the thumb, far from the heart) and the navel Chakra is felt on a proximal position. On the middle finger a spike on the edge closest to the thumb is the will Chakra and towards the heart is the heart Chakra . The Index finger can feel the throat Chakra on its distal edge and the third eye Chakra on its proximal edge. Manas Prakriti does not change unless the Chakras are open and one becomes enlightened. A spike indicates an imbalance or blockage in these subtle energy centers. (Lad, 132) The chakras in the table below are related to the elements and organs for further clarification of their physical manifestation.

CHAKRA

ELEMENTS

SENSE ORGANS

ACTION ORGANS

Muladhara Root

Earth

Nose-Smell

Anus

Svadhithana Navel

Water

Tongue-Taste

Reproductive organ

Manipura Will

Fire

Eyes-Sight

Feet

Anahata Heart

Air

Skin-Touch

Hands

Vishuddha Throat

Ether

Ears-Sound

Mouth

Ajna Third eye

Mind

Mind

Mind

Sahasrara Crown

Spirit

Virtual Nervous Sys

VNS

Dr. Smita Naram

Vikriti Dosha/ Prakriti Dosha

Prakriti is the nature of an individual. It is established by the percentage of each dosha that makes up their unique constitution. The Prakriti is felt in the same fingers as the other two methods: the index (V), middle (P), and ring finger (K). The difference is that Vata is felt on the superficial level, Pitta is felt on the middle level of the middle finger, and Kapha is felt in the deep level of the ring finger. If the pulse is going into some other level than this site that means that there is an imbalance. This imbalance is called Vikriti . Vikriti is when the D oshas are not in balance within the body and symptoms of disease can become apparent. (Naram, slide1)

Agni and Ama

Agni and Ama are the most important factors that cause disease. Both can be felt in the pulse. Agni is the fire of transformation. Agni is not only in the digestive system as the fire of digestion, Jathara Agni . There is an Agni at each level of the tissues, Dhatus . Agni can be high, Tikshna : low, Manda ; and variable, Vishanagni . If the agni at any of these levels is not functioning properly then Ama can form. Ama is undigested food mass that turns toxic and can obstruct the channels of the body. If any of the Agni's become deranged then Ama can form in the tissues. The three Agni abnormalities can be felt in the pulse. (Naram)

Vata pushing Ama and Doshas

As Vata rules movement it can push Ama deeper into the tissues as well. When Ama is in the digestive system it can be removed easily. When Vata pushes it deeper into the tissues more preparation of the body must be done to return the Ama to the digestive system for easy elimination. When Ama or Doshas are present in excess, blockages can occur. This obstruction of natural flow ( Vata ) can be felt in the pulse. Vata can also degenerate the tissues because of its drying nature. This creates a deficiency and weakens the amplitude of the pulse. (Naram, s6)

Dhatus (tissues) and Ojas (most refined tissue)

The tissues were mentioned earlier. Their individual strengths are determined by the tissue Agni's . If the Agni is strong and stable the tissues that are created will be of high quality. If Vata is felt in a certain place in the pulse the tissues are considered deficient. Ama in the pulse can also produce low quality tissue. The tissues themselves and their quality and quantity can be felt in the pulse. Ojas , which is the vital essence of all the tissues, can be felt in the pulse as well. If Ojas and the Dhatus have little strength or have the characteristics of Vata, then the body will show weakness and symptoms may arise.

Comparison and Contrast

There are many methods used to read the pulse. Each technique has its own way of determining what the characteristics of the pulse mean. All methods determine the Doshic involvement through the parameters of movement, amplitude, width, rhythm, and overall characteristics. The interpretation is based on what each method is looking for.

Douilliard looks in the pulse for movement and contrast. Like a hunter in the woods the color of a snow white rabbit moving across the green forest floor will catch attention. Douillard begins by familiarizing us with the qualities of the pulse and their meaning, and then uses that information to interpret the most prevalent characteristics of the pulse.

Dr. Lad embraces the complexity of the pulse and sees the entire body from its most subtle layers to its grossest manifestation in the pulse. The knowledge of a refined practitioner who has taken many pulses is paramount to distinguishing between the many levels of the pulse. The intuition and clarity of the pulse-taker allows for precise interpretation after intense discipline in the art of pulse reading.

Dr. Smita Naram looks into the pulse for signs of deficiency and excess that ultimately started in the digestive system and amidst the chemical and enzymatic reactions that create each individual tissue. In her technique, the pulse will tell us the health of the body's transformative power ( Agni ), movement of substances through the body (Vata), and where an excess is occurring ( Ama ).

Pulse diagnosis is a competent method when performed by each of these practitioners, but with so many variations and differences between methods, how can it be useful for everyone? There are similarities between the methods, and these are found in the foundations of the pulse. By looking at the similarities and differences between these three methods we recognize a wide range of interpretations. Still each method relies of recognizing the qualities of Vata , Pitta , and Kapha within the pulse. In every method the Doshas are found within the blood beating through the veins. Each Dosha has its own characteristic quality, movement, rhythm, strength, and width. All methods use this information to draw conclusions. The conclusions are different based on the unique methodology of each method. The table below compares the different levels and places where the tissues are felt, where and how imbalances are read in the pulse, qualities of the subtle energies, etc. In each level and for each part of the body the Doshas are understood by their individual characteristics manifesting in the flow of blood through the pulse. How they are understood appears to be subjective because of the variations in methodology.

Category

Dr. John Douilliard

Dr. Smita Naram

Dr. Vasant Lad

Levels

3

3

7

Dhatus

Not mentioned

Felt

Felt

Ojas

In Gap pulse

As essence of all Dhatus

4 th level K finger

Subdosha

Quadrants

Not mentioned

Quintets

Prakriti

Deep level

Not mentioned

Deep level

Vikriti

Superficial level

On many levels

Superficial level

Manas

Deep level

Not mentioned

2 nd and 6 th level

Fingertips

Felt in different places

Spikes at different places

Therapeutic

Yes

Yes

Agni

Meals felt in pulse

Dhatu agnis

Dhatu agnis

Pulse felt

Radial artery

8 places on body

8 places

Practice

Self first

On others

Self first

What conclusions can be drawn about the importance and efficacy of the methodology of the pulse based on this information? As we have seen from the beginning. All methods are looking for the presence of the Doshas in the pulse. This is in line with the ancient texts of Ayurveda. As we move further into the understanding of the pulse we find that the way the Doshas manifest in the body is interpreted differently by different lineages. Each method has proven its worth and ability to properly assess the imbalances of an individual. The aspects of the pulse although they have their similarities are not consistent enough to be objective. Pulse techniques rely on the basics until they develop sensitivity to the more subtle aspects of the pulse through practice, intuition, and study. The most consistent aspect of the pulse is feeling Vata in the index finger, Pitta in the middle finger, and Kapha in the ring finger. In each method the practitioner is looking for characteristics of the pulse that are either forceful or weak. The variations that are sought are not always the same in each method, but it is the looking for variation that allows the pulse to be effective. Once establishing what balance feels like in an individuals pulse, then imbalance can be differentiated. This differentiation varies between the methods, but in each method there is a clear movement away from what is considered by that method to be balance. The difficulty lies in the subjective nature of the methods to determine what Dosha and imbalance is actually occurring based on the qualities of the pulse.

This assessment can only shed light on the truth that the pulse varies and can be read with practice and commitment. How the pulse is read varies widely between the methods. Every pulse has a distinguishable rate, characteristic, movement, rhythm, and amplitude. The unique ways the Doshas speak within the pulse are understood differently in each method. This understanding is the link between the pulse and Doshic manifestation in the body. The alphabet is the same for each method, but the words that are formed are as different as French, English, and German.

References

Douilliard, John, Dr. John Douilliard's Ayurvedic Pulse Reading Course, 1998 Dr John Douilliard

Lad, Vasant, Secrets of the Pulse: The ancient art of Ayurvedic Pulse Diagnosis, 1996 The Ayurvedic Press

Naram, Smita, Ayushakti Slide Presentation , 2000 Ayushakti

Naram, Smita, email correspondence with Noah Volz 2005