International Conference on Computing, Communication and Automation (ICCCA2015)

Role of Pulse Diagnosis:A Review

Ramandeep Kaur Nidhi Garg
Assistant Professor, UIET, PU
Research Scholar, UIET, PU Chandigarh, India
Chandigarh, India nidhi_garg@pu.ac.in, nidhi461@gmail.com
ramandeepkr163@gmail.com

Manu Chopra Dr. Hardeep S Ryait

Research Scholar, UIET, PU HOD & AP, BBSBEC
Chandigarh, India Fatehgarh Sahib (PB), India
manuchopra45@gmail.com hardeepsryait@gmail.com

Abstract— Pulse diagnosis is very important method for Fig. 1. Prominant Theories of Ayurveda
predicting the health status or disorder in a patient in Indian TABLE 1 Characteristic of Vata, Pitta and Kapha
Traditional Medicine. This paper presents the literature review
on research & findings of researchers on different techniques & Vata Pitta Kapha
approaches of pulse diagnosis. Prakriti and Vikruti can be Location Index Finger Middle Finger Ring Finger
discovered through pulse diagnosis. Knowledge of prakriti and
Amplitude Low + High +++ Moderate ++
vikruti can help a person in maintaining good health. Recently,
more work is focused on proving the theories related to prakriti Frequency 80-95 70-80 50-60
present in ayurveda. Modern scientific approaches are going on
Regularity Irregular Regular Regular
to resolve the problem of standardization and quantification. The
aim of this review is to provide readers with a complete picture of Temperature Cold Hot Warm to Cold
current progress in this area.
Tension and Low High Moderate
Volume
Vessel Wall Rough hard Elastic flexible Soft thickening
Keywords—Ayurveda; Pulse diagnosis; Sensors; Feature
extraction; Prakriti; Vikruti
All three doshas (V, P and K) exhibits different
characteristics as mentioned in the TABLE 1.
I. INTRODUCTION
Traditionally, Ayurveda practitioners use their finger tips
Ayurveda is one of the ancient and well established natural to feel the pulse sensations on the wrist. They used three
health care system in the world with tridosha and prakriti fingers i.e. index finger, middle finger and ring finger to
being the principal concepts. Ayurveda is mainly based on measure the vata, pitta and kapha respectively. Examination of
three prominent theories (shown in Fig.1.) i.e. Panch wrist pulse (Pulse Diagnosis) is one of the ways of examining
Mahabhuta theory (Five Element), Tri-dosha theory (Three the body in Ayurveda.
Body Humors), and Sapta-dhatu theory (Seven Body Tissues).
A lot of training and experience is required to master the
Tri-dosha theory involves three fundamental doshas called art of pulse diagnosis. Pulse diagnosis subject to fluctuation
vata, pitta and kapha. The five elements (i.e. Air, Fire, Water, and sudden changes. As it is skill based, the results vary from
Earth and Ether) combine in pairs to form three dynamic one physician to another. Moreover, the factors like diet,
forces called doshas. Vata is the combination of Air & Ether, emotions, season, etc. also result in sudden changes. So, there
Pitta is the combination of Fire & Water, and Kapha is the is a need to invent a tool that can replace the physician’s job
combination of Water & Earth. Health of an individual is all and produce results upto a satisfactory level.
about maintaining balance between these doshas. Every
person contain all 3 doshas but their proportion varies from 1 The radial pulse can be sensed at seven different levels.
individual to another and usually 1 or 2 doshas predominate. Vikruti is read at first level (superficial level) and Prakriti is
read at seventh level (deepest level).
Ayurveda Theories Prakriti and Vikruti are the combination of Vata, Pitta and
Kapha. The term Vikruti means our present state and Prakriti
means, “the first creation” or “nature”. Prakriti of a child is
Panch Mahabhuta Tri-dosha Sapta-Dhatu decided at the time of conception and remains unchanged
Theory Theory Theory throughout the entire lifespan. According to Ayurveda
literature, our present status i.e. vikruti should be identical to

ISBN:978-1-4799-8890-7/15/$31.00 ©2015 IEEE 152

 International Conference on Computing, Communication and Automation (ICCCA2015)
our fixed prakriti. If both are identical, it means person is in
balanced state or no disease state, otherwise suffering from
some disease.
The body is in imbalance state if the proportion of doshas
within the body is beyond desirable limits. Every individual
have unique body constitution (i.e. prakriti and each person is
diagnosed as per his body constitution. So, prakriti is one of
the basic parameter in defining the way of treatment for an
individual.
In recent years, scientists are showing keen interest in proving
theories of Ayurveda scientifically. Many researchers has been
working in the field of designing sensors, developing
algorithms for feature extraction & verifying the theories of
Ayurveda. A lot of concepts and theories of Ayurveda are still
under question. Till date, a large number of gaps are present
in the study of Ayurveda, which has to be filled out. This
paper majorly would highlight the progress in listed fields.
The rest of the paper is organized as follows: - Under the
previous work section we discuss about pulse diagnosis using
different sensors, various features and feature extraction
methods, classification of diseases based on pulse diagnostic
systems and recent research related to prakriti and lastly
conclusion.
II. PREVIOUS WORK
Pulse diagnosis using different sensors
Sensing the radial pulse is first and one of the most
important step in pulse diagnosis. For sensing radial signals
we need a device which can convert one form of signal into
desirable form with amplification. Different Authors
[2][4][5][8][9][14][16][19][21][22][27][28] used different
types of sensors in pulse diagnosing, although their purpose
was same i.e. gathering information from the radial artery.
In 2007, Aniruddha Joshi et al. [2] adopted a methodology
based on pressure sensing i.e. milli volt output medium
pressure sensor with data acquisition card (NI USB-6210) at
the rate of 500 Hz to attain pulse signals with 16-bit accuracy.
Some researchers [4][9][14], lead their research work by using
USB-based doppler ultrasonic blood analyzer module. It holds
only one probe. The pulse signal taken only from pitta position
and recorded as Doppler spectograms or Doppler pulse
waveforms. Piezoelectric sensors was used by Abhinav et al.
[5][8] to sense the pressure applied at the radial pulse with a
BioPac150TM (data acquisition system) at the rate of 1000
samples per second for assessing autonomic nervous system
(ANS) non-invasively. A simple and inexpensive optical
sensor was used by N. Deepa and A. Balaji Ganesh in 2012.
Pulse signals were obtained by Photoplethysmographic (PPG)
sensor along with NI DAQ card at a sampling rate of 200 KHz
[19]. In 2014, Sanjana K. Mathew & C. Jamuna [27] used
piezoelectric sensors with a pulse oximeter setup to find the
mean factor of tridosha. Sensors mentioned above were not
able to provide characteristics like pulse length & pulse width
accurately. These characteristics can be easily detected using
array sensors. Author Yu-Feng Chung et al. explored a
153
concept of array sensors. The tactile capacitive array pressure
sensors have 12 sensing points at single sensing position.
Pulse signals were obtained after sampling at 100 Hz by
analog to digital acquisition card (D 600, PPS, USA). Array
sensor had one more plus point over other sensors that it could
obtain the optimal location on the wrist during pulse sensing
in a very short time period [16][21][22][28].
Till now a large number of different type of sensors like
piezoelectric, optical, ultrasonic, capacitive array pressure
sensor were used by researchers which showed varying
efficiencies. Modifications are still required in order to
achieve more accurate results. The most important point need
to be considered is the feasibility of the sensors for
quantification.
A. Various features and feature extraction methos
With the growing research in the field of pulse diagnosis, a
number of feature extraction methods have been invented. In a
standard radial pulse waveform, time domain features like
percussion wave (P), dicrotic wave (D), tidal wave (T) and
valley (V) should be present with a definite amplitude and
time duration. These features will vary with a type of disorder
present in a person. In 2007, Aniruddha joshi et al. [2]
mentioned, changes in V, P, K due to the variation in age and
pressure applied on three wrist positions. Waveforms obtained
by the experimental setup were superior enough to apply
machine learning algorithms.
Wavelet decomposition techniques were used for feature
extraction in 2009 by Abhinav et al. [8]. Both time domain
and frequency domain features were extracted to assess the
Autonomic Nervous System (ANS). Mean, SDNN , RMSDD,
SDNN/RMSSD, NN50 were the time domain parameters and
VLF, LF, HF were the frequency domain parameters. It was
concluded that sometimes interval between consecutive beats
are of more importance than HR(heart rate) itself for HRV
(heart rate variability).
In 2011, Chung-Shing Hu et al. [16] conducted an
experiment using array sensors to extract features with
temporal and spatial properties through surface fitting.
Features extracted through 3-D pulse mapping were pulse
length, pulse width, peak, frequency, ascending slope and
descending slope. Paired samples t-test and two-way ANOVA
test were carried out to check the repeatability and
practicability of the pulse signals [16][21]. In 2013, Yu-Feng
Chung et al. [21] extracted the same features (i.e. Pulse
length, pulse width, peak, frequency, ascending slope and
descending slope) to represent the difference between
Simultaneously Palpation (SP) & Pressing with One Finger
(PWOF). The process using two different analytical methods
i.e. Discrete Mode (DM) & Surface Fitting Mode (SFM)) were
carried out to observe which one was better. Results revealed
that both (SP and PWOF) were highly correlated but SP was
recommended over PWOF as it delivered more information
based on array sensors. Peak value, power, ascending slope &
descending slope were the four features extracted by Yu-Went
Chu et al. [28] through surface fitting by 3-D pulse mapping.
It was noticed, 2-way ANOVA test revealed the interaction
comparison of extracted features at 9 different locations (i.e. 3
 International Conference on Computing, Communication and Automation (ICCCA2015)
positions * 3 depths). Results discovered the significance of
all the four parameters at all the 9 locations and paired
comparison also comes out to be significant except at the pair
of 2nd & 3rd level with respect to peak value and power. Only
spatial feature extraction was carried out by Cheng-Ying
Chung et al. [22] to detect features peak, width, length &
curvature through polynomial surface fitting with 3-D pulse
mapping. This study was conducted for the purpose of pulse
diagnosis and classification. The parameters A2/A1, τ2/τ1,
σ2/σ1, τ1/L, τ2/L, σ1/L and σ2/L were calculated by Yinchuan
et al.[9]. In this study, authors used the fitting process to fit a
2-term Gaussian function over the single period of obtained
pulse signal to estimate the parameters of Gaussian function.
The overall single period of wrist pulse signal resembled with
the shape of Gaussian function. For classification purposes,
firstly feature selection was carried out by excluding tightly
correlated feature pairs and then selecting the pairs with high
statistical difference only. A similar study was conducted by
Ganging Lu et al. [29], instead of 2-term Gaussian model
researchers included 3-term Gaussian model that results in 3%
increase in accuracy.
Classification of diseases based on pulse diagnostic systems
Ayurveda related 15 sub-doshas under 3 doshas with
different organs of the body [15]. The trained practioners can
identify over 350 different type of diseases based on the
dominant dosha[19]. Numerous studies have been conducted
by researchers to target a large number of diseases.
Kuanquan Wanget et al. [4] considered time-frequency
analysis based on Hilbert Huang Transform for discriminating
healthy people from patients of Gastritis, Cholecystitis and
Nephritis. 91.43% of accuracy was acquired for discriminating
Healthy Vs Gastritis, 91.43% for discriminating Healthy Vs
Cholecystitis and 89.65% for discriminating Healthy Vs
Nephritis.
In 2009, Pancreatitis and duodenal bulb ulcer (DBU) were
targeted by Yinghui Chenet et al. using 2-term gaussian model
[9] and achieved classification efficiency upto 94.5% (Healthy
Vs Pancreatitis), 85.9% (Healthy Vs DBU), 90.9 %
(Pancreatitis Vs DBU) and 85.1% (Healthy Vs Pancreatitis Vs
DBU). 3-term Gaussian model was adopted by Guangming Lu
et al. [29] that distinguished Healthy person from patients of
Angicardiopathy, Nephrosis and Gastropathy. Comparitively
3-term Gaussian model provided results with approximately
3% more accuracy as compared to 2-term Gaussian model.
The increase in classification accuracy from 2-term to 3-term
using SVM classifier was 80.61% to 81.22% for Healthy Vs
Angicardiopathy, 72.03% to 73.49% for Healthy Vs
Nephrosis, 73.34% to 78.69% for Healthy Vs Gastropathy and
69.01% to 72.83% for Nephrosis Vs Gastropathy.
In 2010, Xiaorui Jiang et al. tried six different classifiers
(FLD, QFLD, PERC, KOZI, KNN and SVM) for classifying
patients of two digestive diseases i.e. Gastritis and
Cholecystitis. Patients of both diseases were successfully
distinguished from healthy people using L2-soft margin SVM
classifier. For recognizing Healthy Vs Gastritis, SVM
classifier gave upto 100 % accuracy on both the hands and
93.10% accuracy on left hand in recognizing Healthy Vs
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Cholecystitis. 95.24% of accuracy was achieved on left hand
in recognizing Gastritis Vs Cholecystitis using four out of six
classifiers [14]. Overall, the performance of SVM classifier
was the best. Transformation of time domain to network
domain lead to extraction of complex network features. Peng
Wang et al. proposed a method of combining sample entropy
features with complex network features to get higher accuracy
in diagnosing Diabetes and Liver disease. Performance level
achieved was 88.3% for recognizing Diabetes and 81% for
recognizing liver Disease [30]. Further researches are going on
to classify more diseases with more efficiency.
Recent research related to prakriti
Prakriti is one of the most prominent research area under
the field of ayurveda. Researchers are trying to build the core
concept of prakriti with respect to genotype, metabolism,
BMI, blood group, chronic diseases. Prakriti constitution is all
about the study of individual differences. Ayurveda have
defined a total of seven different prakriti constitutions (i.e.
vata, pitta, kapha, vata-pitta, vata-kapha, pitta-kapha and vata-
pitta-kapha). The way in which a human body respond to the
development of any kind of disease directly depends upon the
prakriti of the individual.
Recent researches are going on to correlate prakriti with
genotypes and this concept is termed as “Ayugenomics”.
Experiments have been conducted to find out the relation
between prakriti and genotypes[7], prakriti and blood group
[23][25], prakriti and BMI [25], prakriti and geographical
climatic region [25], etc. Studies have been conducted to relate
different metabolic activities to various prakriti constitutions
[24].
Advanced knowledge of prakriti can lead to a concept of
personalized prevention. This concept of prevention could
further be applied to newborns. Determining prakriti of a child
can guide in establishing the most healthy and suitable
lifestyle to lead a disease free and productive life[24].
For verifying all the above concepts firstly, we need to find
out prakriti accurately. One way of finding the prakriti of a
person is through the questionnaire. Numbers of
questionnaires are available online. But the problem is with
the outcome of all the questionnaires. They do not match all
the time and it is varying from questionnaire to questionnaire.
In the paper [17][18] the authors found the differences in the
results of 5 questionnaires and later tried to standardize it
using Principal Component Analysis (PCA).
More work need to be done for the standardization of
questionnaire based on prakriti.
III. CONCLUSION
In this paper, we have discussed work done related to pulse
diagnosis. Generally, sensors were used to capture the radial
signals. The selection of sensor for this task is crucial. The
feasibility of the sensors for quantification is must. To detect
diseases, various features were extracted from the signal. For
extracting features various techniques were used. Although,
the motive was same but different accuracy levels achieved by
 International Conference on Computing, Communication and Automation (ICCCA2015)
different methods for different diseases. Major consideration
in designing a system is to come with a simple, low cost and
reliable device with the capability of quantification. Growing
research on prakriti has revealed some of the important facts
like its relation with genotypes, blood group, metabolism,
chronic diseases, BMI, newborn genetic screening and
personalized prevention. The system with the prakriti
identification would be helpful in near future for the
prevention and cure of health in Traditional Indian Medicine.
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