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Prakruti and Vikruti
Balance and Imbalance
Levels Seven and One
Vata, pitta and kapha move in the blood through the rasa and rakta dhatus and it is an interesting fact that the doshas are best felt under specific fingers. We feel the qualities of vata best under the index finger, because the nerve receptors in that finger best perceive those qualities embraced by vata--light, subtle, mobile, dry, rough. The same is true for feeling pitta and kapha under the middle and ring fingers, owing to their respective qualities. Vata is always the distal finger (the finger farthest from the heart) wherever the pulse is palpated, whether it is the wrist, ankle, groin or elsewhere.
I like thinking about all the animals of the pulse being in their homes. When a happy and cheerful cobra is felt under the index finger, a mellow and easy-going frog is felt under the middle finger, and a peacefully swimming swan is under the ring finger, that person is a happy and healthy human being. However, in cases of imbalance, a different animal may be felt under each finger. For instance, a frog may be felt under the index finger, where one should feel a cobra. We can say that the frog is chasing the cobra, which means pitta is blocking vata. Perhaps under the middle finger one feels a cobra instead of a frog. In that situation, visualize the cobra chasing the frog, which means vata is pushing pitta. These are only two observations of many that can be made.
Even though the gross manifestations of the three doshas are perceived generally under the index, middle and ring fingers, their subtle qualities are felt under specific areas of each fingertip: at the distal, middle and proximalcurvatures.
The most subtle dosha is vata, which is light, mobile, subtle and expansive. With very little pressure, the blood flow can be blocked. Even if vata is partially blocked by the finger, its subtlety will not create a spike at the proximal curvature of each palpating finger. It will easily go through to find space to expand and create a spike at the distal curvature of the fingers, as shown in the picture.
Like vata, pitta is also light, but it is liquid, oily and substantial in nature, whereas vata is dry and empty. Because of its light and liquid qualities, a pitta spike will be felt at the middle curvature of each of the three fingers.
Kapha is heavy, oily, static and slow, so it stops at the site on the finger closest to the heart and creates a spike at the proximal curvature of each finger.
In summary, vata is faster and moves ahead to the distal curvature, pitta is next and moves to a central position next to vata, while kapha is slow and stops at the proximal curvature. The curvature of the finger is a sensitive instrument, placed directly on the pulse to feel the throb. The art of pulse reading is very subtle and Ayurveda teaches us to be aware of the nature of the body, mind and consciousness of the individual and of the quality of the spikes felt separately under each finger.
The Seven Levels of the Pulse
It is convenient to divide the reading of the radial pulse into seven levels. According to the Ayurvedic system of medicine, there are seven dhatus. If we take a cross-section of any extremity, from the superficial layer to the inner core, the seven dhatus are present. For instance, the superficial layer is rasa , the capillary layer is rakta , and so forth. Likewise, in the pulse, the superficial level can be called the first level, and if we go to the deepest level, after which the pulse is obliterated, we feel the seventh level. In between the superficial and deep pulse there are another five levels, to make seven in total. As we press down on the radial artery, we can feel the spikes of the pulse change as we move deeper or shallower from one level to another.
These seven levels are not explained in the Ayurvedic texts. There are various systems and methods of reading the pulse and every vaidya has his or her unique technique that has been developed from clinical practice. I respect all those methods. Whatever I say in this book comes from my guru's teaching. Ayurveda has a guru-disciple tradition and I learned about these seven levels from my guru. In modern medicine, the pulse only relates to the cardiovascular system, whereas in Ayurveda, the pulse has a wide range of perception. These seven levels can elaborate in great detail about the prakruti-vikruti paradigm, the state of each subtype of the doshas, the status of prana, tejas and ojas , and the condition of the seven bodily tissues. An illustration of all seven levels of the pulse is shown at "The Seven Levels of the Pulse on Page 140. We will now examine each of these levels separately, beginning with the seventh.
The Prakruti Pulse
At this point, we will bring our attention to prakruti and vikruti and how to read them on the seventh and first levels respectively of the radial pulse. To avoid confusion, be aware that the locations of prakruti and vikruti are referred to in several ways--levels seven and one, deep and superficial levels, the levels of balance and imbalance. Prakruti is one's basic constitution, established at the time of conception, and is read at the seventh or deepest level. Vikruti is our present state and is read on the first or superficial level of the pulse. Ayurveda says that in some individuals, the prakruti may be V3P3K3, which means that all doshas are present equally. However, few people are born with this ideal prakruti, called sama prakruti . Most people have some combination or variation of the ideal, such as V2P1K3 or V1P2K3. These numbers indicate the relative ratios of the doshas present in that individual. There is almost always at least one dosha that we can describe as having a level of "3". If there is no "3" in the reading, it indicates the person was born with a depleted dosha, called dosha kshaya . Kshaya means diminished, deteriorated or deficient.
When the superficial pulse corresponds to the deep pulse, that person is healthy and balanced. Our present status and our prakruti should be identical. For example, if a person's prakruti at the deep (seventh) level shows V2P3K1 and the superficial reading at the first level is the same, that person is balanced. Every individual's balanced state will vary according to his or her constitution.
Some say that the right hand pulse of a man and the left hand pulse of a woman will give the most accurate readings. Others say that both the pulses should be felt, but that it is okay to first master one side. Either way, feel the throb of life under the fingers. Try to evaluate the relative presence of vata, pitta and kapha. If you feel both arms and the pulses on the right and left sides of the body are just about equal, it indicates that the male and female energies are balanced and vyana vayu is moving the doshas equally on both sides. In some individuals, vyana vayu pushes a dosha more on one side and that pulse will be more prominent than the other. The pulse may also become feeble on one side, due to previous surgery on the forearm or from a lymph node pressing the main blood vessel.
If pitta is strong in a person's pulse, a spike at the pitta position will be felt under all three fingers, which we describe as pitta3. Likewise, if vata or kapha is strong, a spike at their positions will be felt under all three fingers, which we describe as vata3 or kapha3. However if, say, pitta is strong (pitta3) but vata is feeble, only one vata spike at the distal position will be noted, which is vata1. If kapha is relatively strong in that person's pulse, it will create a spike at the proximal position on two fingers. This information shows that person's prakruti is vata1 pitta3 kapha2, which is abbreviated as V1P3K2.
There are a number of situations that may lead to an inaccurate reading of the pulse. Sometimes the three fingers are not positioned at the same level. If, say, the ring finger and middle finger press deeply but the index finger is less deep, the reading will not be accurate. In addition, if the index finger is held directly on the radial tubercle, it may not feel any throb. Firstly, individual perception must be ruled out as the cause of an inaccurate reading. Sometimes the appearance of a person can be deceiving. Though the person may look like a healthy, chubby kapha type, the thick subcutaneous fat may cover the true sensation of the pulse. If someone is prematurely born, that person may have a prakruti reading of V1P1K1. Other factors, such as umbilical strangulation, may also affect the reading. However, these things are not prakruti. They are called vikruti encroaching prakruti and, in these patients, it is difficult to read the real prakruti. In a situation such as this, asking the patient questions will be helpful.
Meditate upon each finger and feel where the spikes are located. We have to be still and observe closely. Pulse reading needs persistent, prolonged practice and it is practice that makes one perfect. This is a technique, but unless it is digested and understood, insight will never come. Insight is a product of repeated practice and through this, the art of pulse reading will develop.
At this point, select someone to practice on. Take their right or left arm and press the radial artery deeply enough to cut off the pulsation. Release slightly, just to the point where the pulsation returns. This is the seventh and deepest level, the level of prakruti. Now feel for the throbs of vata, pitta and kapha. Count the number of throbs at the vata site, at the distal curvature of the index, middle and ring fingers. Then feel for the number of pitta throbs in the middle of each of these three fingers. Next, count the number of throbs at the kapha site at the proximal curvature.