The use of the radial pulse as a diagnostic tool is an integral part of the Traditional Chinese Medicine (TCM) patient evaluation. In spite of its long history of use, there is little systematic information available to support the many claims about the relationship between pulse qualities and physiological condition contained in the ancient Chinese texts and echoed in modern pulse terminology. This study reports the development of a reliable means of measuring and recording pulse characteristics. This was achieved by reporting on the physical sensations that are detected under the fingertips when the radial pulse is palpated, rather than attempting to translate these into the complex and typically ambiguously defined TCM pulse qualities. The study involved development of a standardised pulse taking procedure and development of concrete operational definitions for each of the characteristics of the pulse being measured. The inter-rater reliability of the pulse taking procedure and operational definitions was assessed by determining agreement levels between two independent pulse assessors for each characteristic. Inter-rater agreement averaged 80% between the two assessors in both the initial data collection (66 subjects) and in a replication collection (30 subjects) completed two months later. Demonstrating reliability of the procedure represents an essential first step for examining the validity of TCM pulse diagnosis assumptions.
This study was undertaken to determine whether healthy adults exhibited characteristic pulse profiles. Pulse characteristics measured for 83 women and 65 men included presence at the Traditional Chinese Medicine (TCM) locations ( Cun, Guan, Chi); and depth (superficial, middle, deep), overall pulse force, relative pulse force, pulse width and pulse rhythm. Most subjects had similar values for many of the characteristics investigated including relative pulse force at the three traditional palpation locations ( Cun, Guan and Chi), pulse width and pulse rhythm. There were some significant gender differences. The pulse was present beyond Chi in 90% of males compared with 56% of females. Female pulses tended to be less forceful compared with males. However, with the exception of overall force, there was little support for TCM assumptions of gender differences in pulse such as in left/right balance. There was some support for the use of the TCM palpation locations Cun, Guan and Chi to discriminate between pulses since there was significant differences in manifestations of some pulse characteristics among these locations.
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