Three Radial Artery Pulse Sensor Design for Siddha Based Disease

Diagnosis
S. Mahesh1, M.Manivannan1, T.Anandan2
1
Indian Institute of Technology Madras, Chennai-36
2
Central Research Institute for Siddha, Chennai-16

ABSTRACT

The roots of diagnostic techniques in Indian medical systems lie in the three radial pulses. In this paper we present
design and analysis of a pulse sensor using PVDF material for acquiring the three pulses from the radial artery. Sensitivity
analysis of the design is also presented. The sensors are firmly held at each of the three radial points and by varying the
pressure on the sensor head the recordings were done on 10 healthy subjects who had no history of cardiovascular disease.
The shapes of the pulses were analyzed using amplitude and frequency analysis and accordingly classified the subjects as
vata, pitta and kapha type. Further we can also find that the pulses are varying over time from morning, afternoon, to evening.
Establishing that the three pulses provide information about the psychic characteristics is difficult and it requires long term
comprehensive, comparative research in to both modern medicine and Indian medicine. As the pulse diagnosis assumes an
enormous significance in several alternative medical systems and the present work is a preliminary investigation to study the
basis.

INTRODUCTION the wrist artery have a different feel to each finger). It is the
presence and location of these vibratory qualities (with
Developing a universal tool for diagnosing almost all
such names as the snake pulse, the frog pulse, or the swan
kinds of diseases is an ambitious task for every biomedical
pulse) that alert the physician to the nature of the imbalance
engineering researcher. According to Siddha which is
that is responsible for the patient's condition.
considered as one of the world’s oldest medical systems
In this paper we present our high sensitive sensor
and local to south India Pulse diagnosis is such a tool. It
design for acquiring the three pulses from the radial artery
was developed and practiced widely not only in India, but
along with a method of validating the sensor with a
also in other parts of the world like China, Egypt, and
standard procedure of diagnosing.
Greece. There has been a mention in the papyrus of ancient
Egyptian medicine about the pulse diagnosis.
Where physicians in the West use the pulse to Pulse Diagnosis
determine heart rate, their Siddha counterparts feel the
The three principal pulses are felt in the wrist
patterns of vibration that represent the metabolic processes
region along the radial artery [1]. The place for feeling the
going on in the body at a specific time. They locate three
pulse is on the lateral aspect of the right forearm, 2cm up
different pulses in single radial artery on each wrist,
from the wrist. The index, middle, and ring fingers are used
corresponding to each of the three doshas. The index finger
to feel the three pulses in their respective order as shown in
senses the vata pulse; the middle finger, the pitta pulse; and
figure 1. Pressure of varying levels is applied with each
the ring finger, the kapha pulse. The adept practitioner can
finger on the artery in order. Application of pressure is
also locate other pulses that are combinations of the main
repeated as many times as needed for diagnosing the
three as well as subdivisions of those pulses. Altogether,
disease. Based on the dominant pulse among the three and
the skilled pulse-taker can detect as many as 32 different
the direction in which the pulse motion is felt, a trained
pulse qualities. What the rhythm and vibrating movement
practitioner identifies over 350 different disease conditions.
of these distinct pulses tell the examiner is the condition of
The study of the relationship between these pulse patterns
other systems beyond those related to the cardiovascular
is the key to identification of the ailment [2]. Healthy
system. The experienced physician can read, through the
human subjects have the three pulse amplitudes in the ratio
pulses, the strength and vitality of each internal organ, and
of 4:2:1 respectively. However, this ratio is believed to
even is reputed to be able to diagnose diseases like asthma
follow seasonal variations and changes with parameters
and diabetes. Pulse diagnosis is explained scientifically by
such as time of the day, temperature and humidity of the
its proponents as each dosha having different tactile
vibratory qualities in the radial artery (or, the vibrations in
skin. The right arm of male subjects and left arm of female measurement system, where a low pressure cuff was
subjects is used to read the pulse. wrapped around the wrist and then the pressure modulation
in the cuff caused by the pressure pulse was measured with
strain gauges. Gagnadre et al., [7] describe the use of fiber
optic sensors to detect heart rate. A multimode optical fiber
was placed between two aluminum plates. The force
generated by the pressure pulse caused variation in the
modal distribution in the fiber and the pulse is detected
using a photodetector.

The pulse type classification by varying contact pressure, a

quantitative method has been introduced by Young-Zoon et
al., (2000). Kazuo Kodama et al.,(1992) had taken the
pulses of 123 adults volunteers and manual pulse diagnosis
according to ayurvedic principles were carried out, then
Figure 1: The process of Pulse Diagnosis they concluded that vata increases with the lowering of
As shown in table 1, the three pulses could be differentiated total peripheral vascular resistance, proximal vascular
using eight parameters namely location, rate, rhythm, force, resistance, pitta increase with the decrease of total
gait, tension and volume, temperature, and vessel wall. peripheral vascular resistance, increase of vascular
Table 1: Characteristics of Pulses compliance and kapha increase correlate with the lowering
of pulse rate and increase of total peripheral vascular
resistance. These results were compared with biochemical
and physiological diagnosis of the modern medicine
thereafter and showed that the ayurvedic findings by
manual method correlated well with the diagnosis of
western medicine.

Piezoelectric Based Sensors

Our sensor is designed using a piezoelectric

polymer known as PVDF (polyvinylidene fluoride). PVDF
is a highly non-reactive and pure thermoplastic
fluoropolymer. Polyvinylidene fluoride is a long chain
semicrystalline polymer of the repeat unil (CH2-CF2). The
monomer, vinylidene fluoride, CH2=CF2, has a large
dipole moment, about 7.56 x 10-30 Cm. The monomer
units polymerize in an orderly fashion to produce greater
than 90 percent had-to-tail configuration; i.e. – CH2 – CF2
– CH2 – CF2 - . Thus, the polymer exhibits an unusually
high net dipole moment.

Related Works: The properties of PVDF, including

piezoelectricity, are highly influenced by the degree and
Almost seventy years ago infrared optical sensors have type of crystalline structure. Therefore it is important to
been used as in photo-plethysmography (PPG) for consider piezo film as a dynamic material that develops an
cardiovascular pulse detection to measure the optical power electrical charge proportional to the change in mechanical
variation which is due to absorption or scattering when the stress, in our case pulse pressure. It does not operate in a
amount of blood in the measurement volume varies [3]. static condition because of the rapid decay of the induced
However, IR sensors donot measure the pressure directly. charge. The time constant is determined by the film's
Recently piezoelectric sensors have been used for dielectric constant and internal resistance, as well as by the
measuring pulse pressure directly where the mechanical impedance of connected circuits. Among many constant
stimulus generated by the pressure pulse in converted to an characterising the material, we considered the coupling
electrical signal for further signal processing. Sorvoja et.al. constant K, piezoelectric Strain Constant d, piezoelectric
and Ruha et al., [4,5] describe utilization of new pressure Stress Constant g, and Piezoelectric Hydrostatic Constant
sensitive materials like electromechanical film (EFMi) and dh.
polyvinylidene fluoride (PVDF) in sensors for pulse
detection in the radial artery. Dupuis et.al. [6] describe use
of a strain gauge differential pressure sensor in a Design of PVDF based Pulse Sensor
 The length of the PVDF required for our sensor
was decided based on the following:

 the diameter of radial artery and the sheath above it.

The radial artery diameter varies from 2mm-4mm
and including sheath it will come up to 3mm-5mm.

 the length should be more or twice the (diameter + Figure 3 a) Model of our sensor for sensitivity analysis
sheath) and hence it is (5x2) mm that is 10mm. b) Half of the above model to simplify our analysis

 the length should be less than the distance between Tensile Stress σt = P Sinθ / b x tp
the two tendons (that is the Abductor pollicis longus
and Extensores pollicis longus) between which the The relation between the stress and the resultant electric
artery passes. This varies from person to person field generated on the polymer can be written as
from 10mm to 20mm and hence the length was
restricted to 14mm. Є = – (σt x g31) – (σb x g32) + β D’

The breadth of the PVDF was designed based on where g31 and g32 are PVDF material constants. The electric
the placement of sensor since the sensor is placed at three displacement D’ is independent of the coordinate direction
points on the wrist where we acquire the three pulses are at x3 and so are the strains. This is justified by the thinness of
a distance of 7mm center to center the breadth should be the PVDF film. Hence the voltage across the electrode can
restricted to 5mm. be obtained by a simple integration of the electric field
equation
The handle for holding the PVDF material was
made using Plexiglas in a simply supported beam Є = e / tp
arrangement as shown in Figure 2.
where e is the voltage across the electrode and tp is the film
thickness. Therefore

e / tp = – (σt x g31) – (σb x g32) + β D’

Rearranging the above equation we get

D’ = e / β tp + (σt x g31)/ β + (σb x g32) / β

Figure 2: Design of our Pulse sensor
D’ In the above equation can also be written in terms of
Sensitivity analysis for the sensor: electric charge q as dq / dA , generated in the electrodes
substituting for D’ and integrated over the surface area of
The sensor is modeled as a simply supported beam the polymer which gives the total charge
as shown in figure 3a for the purpose of sensitivity
analysis. Here P is the load applied on the PVDF at the q = ( e / β tp + (σt x g31)/ β + (σb x g32) / β ) x A
center, which is the pressure (either the systolic or the
diastolic pressure) acting over the area of the artery. To where A= area of the film which is electroded = l/2 x b
simply the analysis, we considered only the half of the
PVDF as shown in figure 3b. To get the voltage across the polymer open circuit
conditions are established by setting the charge equal to
zero and solving for open- circuit voltage that is generated
by the bending of the PVDF

e / tp = – (σt x g31)x A – (σb x g32) x A

e= – (P Sinθ/a) g31 x tp x A – (P Sinθ/a)(1+ν)g32 x tp x A

where a= b x tp Hence

e= – (P Sinθ/b) { g31 + (1+ν) x g32 } x A

Since g32 is very small the equation can be written as

e= – (P Sinθ / b) x g31 x A

Therefore sensitivity is given as

M0 = e /P = (Sinθ / b) x g31 x A

Considering that θ does not exceed 45 degrees, sensitivity

is 2.1 x 10-3.

Our Pulse Measuring System

We have designed a signal conditioning unit to

improve the quality of the signals such as signal scaling,
amplification, linearization, filtering, and common-mode
rejection, generated by the PVDF sensor before they are
converted in to digital signals by the data acquisition card
interfacing the computer. The signal conditioning unit
consists of charge amplifier, voltage amplifier, and a low
pass filter.

Methodology:
The sensor system required for picking up the radial pulses Figure 5: Vata, Pitta, and Kapha Pulses as recorded by
from the wrist was initially tested with signals from the our sensor
function generator and found to be showing the same shape
of pulse as any other pulse system such as The signal was acquired at 250Hz and the three pulses were
Photoplethysmography (PPG). PVDF sensor are attached recorded one after other from all the pulse points and then
analysis was done.

We followed the following procedure for recording and

data acquisition:

1. The subjects were made to elax for 10 min before

taking the readings.

2. The subjects were asked to sit on a chair comfortably

and stretch his left arm forward approximately at the
heart level for placing the sensor.

Figure 4: Basic block diagram of the pulse sensor 3. The PVDF sensor was first placed over the radial
system artery where we recorded the vata pulse, that is the
sensor was placed below the radial styloid as shown
in the figure. The radial styloid is the protruding wrist
to the wrist at three different places as identified by siddha bone on the thumb side of the hand of the pulse
experts and the vata, pitta, and kapha pulses are recorded as recipient.
shown in the figure 5. The sensors are firmly held at each
point using a tape. By varying the pressure on the sensor 4. Then the second pulse and the third pulse were
head at that point recordings were done on 10 healthy recorded by placing the sensors at the second and the
subjects in the age group of around 20-30 years with a third pulse points respectively which are next to the
mean age of around 25 years, who had no history of first pulse point. All the three pulses were recorded at
cardiovascular disease. The recording was done three times the same smapling frequency 250 Hz.
a day for each subject to see the variation of three pulses
during morning, afternoon and evening. All the subjects 5. The recording was done three times a day for each
were asked to fill up a questionnaire regarding their daily subject at the same ambient room temperature during
routine activities and lifestyles which will indicate their recording 22-24oC.
body type and combination of doshas as per the siddha
concept.
RESULTS AND DISCUSSION
Vata pulse Pitta pulse Kapha
The shapes of the pulses were varying across subjects and amplitude in amplitude in pulse
there was also variation in amplitude and frequency among (volts) (volts) amplitude
the three pulses within subjects. According to the siddha in (volts)
theory and principles the three pulses vary in amplitude in Morning 10 7 5
the ratios of 1:2:4 for kapha, pitta, and vata respectively Afternoon 9.5 4.2 5.5
and the frequencies must be 80-95 beats/min for vata pulse, Evening 8 4 3.8
70-80 beats/min for pitta pulse and 50-60 beats/min for
kapha pulse. According to the amplitude and the frequency
of the three pulses we classified the subjects as vata, pitta 12

and kapha type if either the amplitude or frequency 10

deviates from that of the prescribed for normal subjects. 8 vata pulse
6 pitta pulse
The frequency analysis of a subject’s pulses are shown in 4 kapha pulse
figure 6. It could be inferred from the data that the vata 2
pulse rate is less than the normal range that is 80-90 0
beats/min where as the pitta and the kapha pulse is with in 1 2 3
the normal range. This indicates that the person may have
less vata constituents. Further we can also find that the Figure 7: The variation of the pulse amplitude for the
pulses are varying over time that is during morning, three pulses during morning, afternoon and evening of
afternoon and evening even though there is variation in the a typical subject
pulse rate of the three pulses we can see that pitta pulse is
always maintaining higher rate than the other two pulses. The scores of the subject in the standard Ayurvedic
questionnaire is vata-62, pitta- 70, and kapha-67. This also
From the amplitude data as shown in figure 7 of the same indicates that the person is having less vata and more pitta
subject, it could be inferred that the ratio of vata, pitta, and constituents. The amplitude and frequency analysis was
kapha pulses are in the ratios 1: 0.6: 0.4 respectively. This done for all the 10 subjects and is shown in table 2.
indicates that that the person is having more pitta and kapha
constituents.
DISCUSSION

Vata pulse in Pitta pulse in Kapha Comparing the information regarding the ayurvedic body
(beats/min) (beats/min) pulse in type of the subjects obtained with the help of the
(beats/min) questionnaire and the result with our analysis, it is
Morning 60 67 63 interesting to note that body type classification done by
Afternoon 72 78 60 both methods coincides. If this is not a coincidence, then
Evening 62 70 60 raises an important question that how can the pulse
waveform, which represent specific properties of
Figure 6: The variation of the pulse rate for the three circulatory system, reveal fundamental information about
pulses during morning, afternoon and evening of a subjects personality characteristics, including the psychical
typical subject and physical?
Establishing that the three pulse provides
information about the personality characteristics is difficult
100 and it requires long term comprehensive, comparative
research in to both modern medicine and Indian medicine.
80
The present work is only a preliminary work in
vata puls e that direction.
60
pitta puls e Pulse diagnosis assumes an enormous significance
40
kapha puls e in several alternative medical systems such as siddha
20 medicine, chinese medicine etc., and the present work is a
0 preliminary investigation to study the basis for the
1 2 3 fundamental importance given to the pulse diagnosis in
alternative medical systems.
 This work can be extended to an algorithm that
estimates the relative levels of the three doshas from the
three pulses and to predict the diseases. Three pulses can be
analysed for different pathological cases such as diabetes,
heart disease, respiratory problem and others.

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Banarsidass 2005.
3. Herztman, "Photoelectric Plethysmography of the
fingers and toes in man", [Proceedings of the
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Table 2: Comparison of constitution determination 4. Sorvoja H. et.al. Licentiate Thesis, University of
from three experiments a) frequency analysis b) Oulu (1998--in Finnish).
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6. Dupuis & Eugene, in "IEEE Transaction on
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We have designed and implemented a system for (2000)
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system could be used as an important diagnostic tool for 1993 (1998)
various clinical applications. We collected the three pulse 8. Kazuo Kodama, Hitoshi Ishiyama and Hiroshi
data from the radial artery from 10 subjects at different Kasaha,” Visualisation and quantitative analysis of
time that is during morning, afternoon and evening. the pulse diagnosis in Ayurveda”, Tokyo Denki
Information regarding the Siddha or Ayurveda body University, 1992.
type of the subjects is obtained with the help of the 9. Young-Zoon Yoon, Myeong-Hwa Lee and
questionnaires and compared the result with our analysis. It Kwang-Sub Soh, “Pulse type classification by
is interesting to note that body type classification done by varying contact pressure”, IEEE Engineering in
both methods coincides. If this is not a coincidence, then Medicine and Biology(2000)106-110.
this raises an important question that how the pulse 10. Shantanu Sur and S. K. Ghatak “An Inexpensive
waveform, which represents specific properties of Arterial Pressure Wave Sensor and its application
circulatory system, can reveal fundamental information in different physiological condition “ School of
about subjects personality characteristics? This question is Medical Sc & Technology, Dept of Physics and
not obviously easy to test as it requires long term Meteorology, Indian Institute of Technology,
comprehensive, comparative research in to both modern Kharagpur
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only a preliminary work in this direction and towards Fellow, ASCE “Relationship between Wrist-pulse
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There are several questions which are unanswered at this Hong Kong.
juncture. Existence of the three pulses itself is a mystery; 12. Katsuhiko Kohara, Yasuharu Tabara, Akira
from a single radial artery, how three different pulses with Oshiumi, Yoshinori Miyawaki, Tatsuya
different characteristics as explained in the table1 could Kobayashi, and Tetsuro Miki “Radial
exist. The above question requires research in subtle Augmentation Index: A Useful and Easily
anatomy and fluid dynamics. In the present work the pulses Obtainable Parameter for Vascular Aging” From
were not acquired simultaneously. A cuff could be used to the Department of Geriatric Medicine , and
fix all the three sensors on the wrist and can be used for Department of Medical Genetics , Ehime
getting the pulses simultaneously which can give reliable University School of Medicine, Ehime, Japan; and
results. Omron Healthcare Company, Ltd.,2005.