Journal of Ayurveda and Integrated Medical Sciences

Introduction

The 21st century is characterized by elevated levels of stress and anxiety, contributing to a decline in overall health prioritization. This modern lifestyle has fostered a surge in medical and mental health disorders, with hypertension emerging as a particularly critical concern. As a chronic condition with a strong association with cardiovascular diseases, hypertension poses a significant public health challenge. While classical Ayurvedic texts do not explicitly address hypertension, its symptomatology aligns with the Vata-related disorder, Raktgata Vata.

Hypertension, a silent killer, is a global health concern with increasing prevalence. Conventional medicine offers various therapeutic approaches, but the quest for effective management and prevention persists. Ayurveda, an ancient Indian system of medicine, offers a holistic perspective on health and disease.

Nadi Pariksha, a cornerstone of Ayurvedic diagnosis, involves assessing the patient's pulse to understand the physiological state. The traditional texts Sharangdhar Samhita, Yoga Ratnakara, Basavarajeevam and Bhavprakasha have discussed the details of Nadi Pariksha in succinct set of Shlokas. As per Ayurveda balanced Tridoshas represent the sound health and vitiated Doshas lead to diseases. According to Yoga Ratnakara all the diseases can be diagnosed from Nadi and it was compared with strings of Veena playing all the Ragas which signifies the importance of Nadi Pariksha. Dosha predominance is described in detail in the texts and is felt from specific locations on the radial artery. Accordingly, Vata Dosha is felt at the root of the thumb and is felt with the index finger; Pitta Dosha is felt next, and is felt with the middle finger; Kapha Dosha is felt with the ring finger.

In this modern era there are several references available for the disease hypertension with worldwide acceptance but in Ayurveda experts have suggested different names to demonstrate the phenomenon like पितावृत वात, स्क्तावृत वात, सिरागत वात व्यानवृष्धि, रक्तचाप, रक्तवृध्धि, धमनिप्रतिचय.^[1]

विकारनामाकुशलो न जिह्नीयात् कदाचन ।

न हि सर्वविकाराणां नामतोऽस्ति ध्रुवा स्थितिः || (Charaka Samhita, Sutrasthana 18/44)

It involves palpating the radial artery with the three fingers, assessing various parameters to understand the patient’s physiological state.

This review aims to explore historical perspective, theoretical underpinnings, and contemporary research on Nadi Pariksha. Origins of Nadi Pariksha can be traced back to ancient India, with detailed descriptions found in classical Ayurvedic texts like Sharangdhar Samhita, Yoga Ratnakara, Basavarajeevam and Bhavprakasha.

These texts emphasize the importance of Nadi Pariksha in diagnosing diseases, determining prognosis, and guiding treatment. Ayurveda posits that the body is composed of three fundamental doshas - Vata, Pitta, and Kapha.

Nadi Pariksha is believed to reflect the balance or imbalance of these Doshas. The characteristics of the pulse, such as its strength, rhythm, depth, and temperature, are correlated with the predominant dosha and the nature of the disease.

Methodology of Nadi Pariksha

Synonym of Nadi

Nadi, Dhamani, Dharani, Dhara, Tantuki, Snayu, Jeevangyana, Hansi.^[2]

Tridoshas and Nadi

Three fingers placed in position over Nadi indicate the condition of the Tridosha and their movement like Manda, Madhyama and Tikshana. The index finger denotes Vata, the middle finger denotes Pitta and the ring finger denotes Kapha.^[3]

Nadi Pariksha deals knowledge about involvement of Doshas and prognosis of disease. The parameters assessed include: Gati, Vega, Sthira, Dosha Pradhanata. The three main division made for the movement of the pulse, which resembles with the movements of various animals or birds, make the study easier and understandable.

Site of Nadi Pariksha

• The physician should conduct the pulse examination on the patient's right hand using their own right hand.
• The pulse felt at the wrist region indicates the patient's life status. The physician should be able to diagnose diseases and assess the patient's health by observing the pulse's nature.

Raktagata Vata Ayurvedic review

The disease hypertension is abnormality of Rakta Dhatu popularly known as Shonita Dushti because Lakshanas are similar to that of hypertension are - Shiroruk, Klama, Anidra, Bhrama, Buddhi Sammoha, Kampa which akin to the manifestation of hypertension. Mada, Murcha, Sanyasa equally true in relation to malignant hypertension.^[6]

The disease Raktagata Vata is one of the Nanatmaja Vata Vyadhi^[7] (specific diseases caused by individual Doshas) i.e., Raktagata Vata (HTN) disease occurs due to vitiation of Vata Dosha specially. The Nidana (Causative factor) described by Charak in the context of Vata Vyadhi vitiates only the Vata Dosha and not, the other factors involved in disease like Dushya, Srotas(channels) etc.^[8] In Raktagata Vata, the vitiated Vata interacts with Rakta Dhatu and Raktavaha Srotas (circulatory system), leading to the development of the disease. Notably, the abnormal state of Rakta and Raktavaha Srotas is a consequence of the imbalanced Vata, rather than being caused by independent factors.^[9]

According to Ayurveda the Nidana (causative factor) of Raktagata Vata (HTN) as described in the context of Vatavyadhi (disease caused by Vata) by Acharya Charak, are^[10]

Aharaja Nidana (Dietary Factors)

• Ruksha and Sheeta Aahara: Dry and cold foods are termed as Ruksha and Sheeta, respectively. These can aggravate Vata Dosha.
• Alpa and Laghu Aahara: Insufficient or light food is described as Alpa and Laghu. These can weaken the body (Dhatu Kshaya) and subsequently lead to Vata
• Ama: This term itself signifies undigested food or toxic residue. It is a crucial factor in vitiating all three doshas, including Vata. Ama obstructs channels (Srotas) and interferes with normal physiological processes.

Viharaj Nidan (life style disorder)

• Vyayama: Excessive physical exertion, improper exercise
• Atiprajagaran: Insomnia, excessive wakefulness
• Divasvapa: Daytime sleep
• Langhana: Fasting, improper diet

Pitta's role in metabolism and transformation is crucial, and its imbalance can lead to oxidative stress and inflammation.

• Kapha Dosha: Essential for maintaining cardiovascular health, Kapha vitiation can contribute to hypertension by affecting the smooth functioning of the heart and blood vessels.
• Ama: The accumulation of toxins due to impaired digestion (Agnimandya) further aggravates the condition. Ama obstructs channels, leading to edema, fatigue, and reduced appetite.

An imbalance in Samana Vata and Pachaka Pitta results in poor digestion (Agnimandya), leading to the formation of Ama. This, in turn, hampers the transformation of food into essential tissues, causing the accumulation of excess Meda (fat) and its deposition in blood vessels. Sadhaka Pitta, located in the heart, governs mental functions. Its imbalance can affect the mind-body connection, influencing blood pressure regulation. Based on the observed symptoms and the understanding of Doshic functions, hypertension appears to be a Vata-predominant disorder with significant contributions from Pitta and Kapha imbalances. Raktagat Vata is a complex Ayurvedic concept with potential implications for understanding and managing cardiovascular disorders. While modern medicine has made significant advancements, the Ayurvedic perspective offers complementary insights into pathophysiology and management of these conditions. Further research is essential to bridge gap between Ayurveda and modern medicine and to explore potential benefits of integrating Ayurvedic approaches into mainstream healthcare.

Raktagata Vata modern review

Hypertension: Hypertension, often termed the "silent killer," is a chronic medical condition characterized by persistently elevated blood pressure. Blood pressure is the force exerted by the blood against the walls of your arteries as it circulates. When it's consistently too high, it puts extra strain on your heart and blood vessels.

Causes of Hypertension

While the exact cause is often unknown in many cases (primary hypertension), several factors contribute to its development:

Pathological conditions

Pathological conditions when bradycardia occurs are- Hypothermia, Hypothyroidism, Heart attack, Congenital heart disease, Degenerative process of aging, Obstructive jaundice, Increased intracranial pressure and Drugs which include bradycardia are-B-blockers, Ca-Channel blockers, Digitalis and other antiarrhythmic drugs, etc.

Pulse rate and blood pressure are intricately linked through their impact on cardiac output and peripheral vascular resistance. Relationship between pulse rate and blood pressure is complex and influenced by various physiological factors. While an increased heart rate generally leads to an increase in systolic blood pressure, overall effect on blood pressure depends on interplay of cardiac output, peripheral vascular resistance & another factors.^[11]

Discussion and Conclusion

While modern medicine offers a comprehensive understanding of hypertension, Ayurveda, with its emphasis on holistic health, provides a unique perspective through Nadi Pariksha.

Correlation Between Nadi Pariksha and Hypertension

• Vata Dominance: Ayurvedic texts correlate hypertension with an imbalance of Vata dosha, particularly Raktagat Vata. Nadi Pariksha can identify this imbalance through specific pulse characteristics, such as a rapid, irregular, and feeble pulse.
• Pitta Involvement: Hypertension is associated with an aggravated Pitta Dosha as well. This can manifest in a sharp, forceful, and hot pulse.
• Vital Organ Assessment: Nadi Pariksha can assess condition of vital organs like heart, kidneys, and brain, which are often affected by hypertension.
• Early Detection: Some practitioners believe that Nadi Pariksha can detect early signs of hypertension before it manifests in clinical symptoms.

While modern medicine offers effective management strategies for hypertension, Nadi Pariksha provides a complementary perspective. By understanding pulse characteristics associated with hypertension, practitioners can identify potential risk factors & develop personalized treatment plans.