The testing of classical pulse concepts in Chinese medicine: Left- and right-hand pulse strength discrepancy between males and females and its clinical implications

Objectives and design: The use of the radial pulse as a diagnostic tool is an important part of the Chinese medicine (CM) clinical evaluation. 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. Method: Using a standardized pulse taking procedure and concrete operational definitions, two pulse assessors with a demonstrated high level of inter-rater agreement each assessed the overall left and right pulse strength and rated their findings on a standardized pulse form. Results: The overall percentage of inter-rater agreement for manual assessment of dominant hand was 86% (based on a cohort of 65 subjects). 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 the observed frequencies for an assessor's rating of dominant hand in males were significantly different to those expected according to CM theory. Conclusions: The CM assumption of gender-related pulse-strength differences in left and right hand pulses was not supported within this study.