The testing of classical pulse concepts in Chinese medicine: left right hand pulse strength discrepancy between gender and its clinical implications

The use of the radial pulse as a diagnostic tool is an important part of the Chinese medicine (CM) clinical evaluation. In spite of its long history of use, there is little systematic information available to support the many claims about the relationship between the pulse concepts contained in the classical Chinese texts and their manifestation in contemporary clinical practice. This study reports the findings of an investigation into inter-arm pulse strength differences in subjects and the relationship to traditional pulse claims relating to gender. The pulses were assessed by two pulse assessors with a demonstrated high level of inter-rater agreement using a reliable means of measuring and recording pulse characteristics. This was achieved by reporting on the physical sensations that are detected under the fingertips that had been determined as relating to the concept of gender related left/right force/strength differences in the relevant available literature Using a standardised pulse taking procedure and concrete operational definitions two pulse assessors each assessed the overall left and right pulse strength and rated their findings on a standardised pulse form. The overall percentage inter-rater agreement for manual assessment of dominant hand was 86% (based on a cohort of 66 subjects). A further breakdown of the findings indicated inter-rater agreement for 81% of male subject pulses and 89% of female subject pulses. In relation to the three possible choices regarding dominant side (right, neither, left) the right hand side was most commonly selected as relatively strongest of the two regardless of gender (60% of males and 71% of females). Analysis of the data using Chi square (II) found that the observed frequencies for an assessor's rating of dominant hand in males were significantly different to that as expected according to CM theory. Accordingly, the CM assumption of gender related differences in left and right hand pulses was not supported within this study.