Nepali Times
Life Times
The erratic pulse


By carefully taking the pulse, ghata (riverside) vaidyas (physicians) in Nepal determine the time when a seriously ill patient may die. With the advent of modern medicine there are fewer vaidyas now. But in past, many relied on them to predict the hour of death of their loved ones so that religious rituals along the riverside could be auspiciously carried out.

There are many stories of these riverside physicians making arbitrary, life and death calls at the Aryaghat in Pashupatinath. After taking the pulse of a dying man, if the ghata vaidyas determine that death is imminent, the patient is put on a tilted slab of stone (bhramanal) next to the water. Relatives then put a handful of the holy (albeit contaminated) Aryaghat water into the mouth of the dying to facilitate salvation. Unfortunately sometimes people who are not quite dead yet, choke and aspirate water into their lungs.

But taking the pulse and making an important diagnosis is very common not only in Ayurvedic but also in Greek, Tibetan, Chinese, and Islamic medicine. In these traditional medicines, problems in the intestines, liver, gall bladder, kidneys, lungs and brain are determined through careful assessment of the radial pulse. Even psychological health is determined by the pulse. Avicenna, the famous Islamic physician of the tenth century used the pulse as a lie detector to figure out that a sultan's sick wife was actually pining for her lover and that nothing else was wrong with her. This is akin to the scene in countless Hindi movies where the doctor after studiously taking the pulse of a beautiful, unmarried woman and performing no other examination announces gravely to the parents, "Apki beti ma banne wali hai" (your daughter is pregnant).

In modern medicine, doctors use the pulse to determine the seriousness of an illness as just one of the important means of assessing the patient. Light reflexes in the eyes, response to any kind of stimuli (especially pain), breathing, blood pressure are some other determinants besides pulse which are included in the assessment. But figuring out the exact time of death is still scientifically very important. For example harvesting the organs for donation from people who have given consent needs to be done immediately after death to optimise the chances for the organ to work in another patient. Perhaps with some fine tuning, the roles of ghata vaidyas could be expanded for organ harvesting when Nepal is ready for this.