🤰 Is it a boy or a girl? The pulse and sex...

published 6 MONTHS AGO | 8 MINS READ

An interesting question came up this week: How do you use the pulse to determine the sex of a fetus during pregnancy?

I feel like this is an area where a lot of people will have vague answers along the lines of, "This is what my teacher said..." or "My experience has been..."

But here we're going to take a look at what the classics have to say about the pulse and pregnancy...

The Pulse and Pregnancy

You probably learned in school that a slippery pulse (滑脉 huá mài - slippery, rolling) can indicate pregnancy.

*A slippery pulse refers to how smoothly the blood is flowing. It is the opposite of a choppy pulse.*

This is a fact that is covered in the Bin Hu Mai Xue by Li Shi-Zhen. This is a short book that is written in verse, probably meant to be memorized by students learning the pulse.

In Chapter 8 he writes:

Cubit pulse slippery and uninhibited, Pregnant. Can be Joyful. Slippery, racing, and also scattered, Fetus must be three months. However, if racing and not scattered, It must be five months.

And in his section about the slippery pulse, he writes:

In a woman's pulse, (whose menses is regular) and time is (otherwise) stable, (she) has a fetus. This means that, if you feel a slippery pulse in a woman whose period is normally regular but is now overdue, she may be pregnant. However, this also assumes that the patient did not previously have a slippery pulse, and that she does not have any other condition that would cause a slippery pulse.

Please do not go around telling people that they're pregnant just because you feel a slippery pulse.

(A teacher did this in front of a class once when I was in school and made the girl cry...)

Ball of Phlegm?

Now, I've heard many people claim that the reason the pulse feels slippery during pregnancy is because the fetus is basically a ball of phlegm, and phlegm makes the pulse slippery.

As far as I can tell, this is false. In all the books I've researched (both classics and modern textbooks), I have never seen this statement corroborated. So I consider it rumor. It's true that phlegm can cause the pulse to become slippery, but that does not mean that all slippery pulses involve phlegm.

Instead, most books will say that the pulse becomes slippery because there is an abundance of qi and blood going to the lower jiao to nourish the fetus. In certain stages of pregnancy, it is also normal for the pulse to become rapid, reflecting the yang nature of the growing fetus.

Determining Sex with the Pulse

The Bin Hu Mai Xue also gives us a few ways to predict the sex of a fetus. Again in Chapter 8, he writes:

Left racing is a boy,

Right racing is a girl.

A female, the abdomen is like a winnowing basket.

A male, the abdomen is like a cauldron.

So if the pulse is racing on the left, that means it's a boy; if the pulse is racing on the right, that means it's a girl.

But let's look into this a little deeper...

Left vs. Right

This is something that people often get confused about. Some people will say, "Right is female, because girls are always right (and boys get left behind)."

But most people remember being taught that right = yang and left = yin. So which one is it?

Well, it's kind of both.

If you go back to fundamentals and your first semester about yin and yang, you will see that the first statement is correct: right is yin and left is yang.

(One way to think of this is: in China, maps were drawn with south at the top. So if the sage is facing south, that means that east is on your left and west is on your right. East is the direction of the rising sun (yang); west is the direction of the setting sun (yin). So left is yang and right is yin.)

However, there are also statements from the Nan Jing saying that the left kidney houses true essence and the right kidney houses the Ming Men fire. So the left kidney is yin, and the right kidney is yang. That's why Restore the Right Drink is a yang tonic.

But in this case, we're using the first interpretation.

A Racing Pulse

Li Shi-Zhen also says to look for a racing pulse on one side.

And the racing pulse (急脉 jí mài) denotes rate -- it is a very rapid pulse.

The rapid pulse is categorized as yang.

Six arrivals, one respiration.

Seven is racing, eight is extreme.

So a racing pulse comes at seven beats per breath, or 120+ bpm.

However, this seems strange to me: how can the pulse be faster on one side than the other?

I mean, the rate of the pulse is determined by the beating of the heart. And you only have one heart. So theoretically the pulse should have the same rate on each side.

So I don't know how to interpret this. I've never felt a pulse that was more rapid on one side versus the other. So I think most modern practitioners use a quality other that rate to determine sex.

Winnowing Basket vs. Cauldron

Li Shi-Zhen also says that the abdomen will appear differently depending on the sex of the fetus. If it's a girl, the abdomen will look like a winnowing basket; if it's a boy, the abdomen will resemble a cauldron.

*A winnowing basket is more flat, while a cauldron is more round (I think).*

I would guess this is related to the idea that if the belly is low, that means you're carrying a boy; but if your belly is high that means you're carrying a girl. But most modern doctors consider this a myth, or an "old wives' tale."

Pregnancy in the Mai Jing

If we go back even further in history, the Mai Jing (Pulse Classic) has even more methods for determining the sex of a fetus. Some of them are quite interesting...

The first method is similar to what is written in the Bin Hu Mai Xue:

When a woman is in the fourth month of pregnancy, the method of determining the sex (of the fetus) is that a racing pulse on the the left hand tells a male, while a racing pulse on the right tells a female. If the pulses are racing on both hands, this tells that two babies will be born.

Other methods talk about floating vs. deep:

Another method is that a deep and replete pulse on the left hand shows a male, while a floating and large pulse the right hand shows a female. If the pulse is deep and replete replete on both the left and right hands, as a rule, male twins will be born. If the pulse is floating and large on both the left and right hands, as a rule, female twins will be born.

Another method looks specifically at the Chi position (rear position). This makes sense because the Chi position usually reflects conditions of the lower body, which is where the fetus resides:

Another method is that, if the pulse is large in the chi on the left hand alone, a male is indicated. If the pulse is large in the chi on the right hand alone, a female is indicated. If the pulse is large on both the left and right hands, twins will be born. This large pulse is similar to a replete pulse.

When I talk to modern practitioners, this seems to be the method that most of them use.

After that, things get a little more interesting...

Another method is to instruct a the pregnant woman to walk southward and then call her. If she turns left, a male (fetus) is suggested. If she turns right, a female is suggested.

But if you're not sure which way is south, you can always just interrupt her on the way to the bathroom...

Another method is to call her suddenly while she is seen walking to the latrine. If she turns left, a male is suggested. If she turns right, a female is suggested.

And finally, you can also examine the husband:

Another method is that, if, during pregnancy, the husband of the woman develops a tubercle on his left breast, a male (fetus) is suggested. If he develops a tubercle on his right breast, a female is suggested.

What's the best method?

So which method should you use? Probably not the latrine one...

I believe that most modern practitioners adhere to the left=male and right=female paradigm, but rather than looking for a racing pulse they look for which side is more large and forceful.

Some will consider the pulse as a whole (all three positions), while some will look specifically at the chi position.

Some say they can tell as early as 8 weeks, while some say it's more accurate to wait until into the second trimester. Some say you have to be careful because it can switch easily. And some say that you really need to know the patient's pulse before pregnancy in order to compare.

But overall, I would say that this is something that is just for fun. I know that some people say that they have a very good track record with predicting sex, but personally I'm skeptical. If the patient really wants to know, they can get an ultrasound.

What do you think?