Innovation in Chinese Medicine (Needham Research Institute Studies) Paperback – 17 Feb 2011

For the average practitioner of Chinese medicine, this book is likely to be an extraordinary eye opener. After reading it from cover to cover, with its wealth of detail on particular stages of the development of Chinese medicine, I can see clearly now that what is taught in most acupuncture schools in the West is only a small part of the whole. When taught Chinese medicine, we are usually given the impression that it has a very stable tradition, yet this book explores some of the extraordinary debates and controversies that have been instrumental in shaping modern Chinese medicine. It gives us an insight into "medicine in the making" as well as opening the door to the breadth and depth of the field.Oxford Don Elisabeth Hsu, whose earlier book "The Transmission of Chinese Medicine" was a fascinating account of her studies in Yunnan, edited this book. The third in a series published by the Needham Research Institute in Cambridge, she has helped sustain a high level of scholarship throughout. The book is structured into five parts, each with a theme and two chapters. Each chapter is an in-depth exploration of an aspect of change or innovation within Chinese medicine.In the first chapter acupuncturist and historian Vivienne Lo gives us an insight into the medical writings that came from the Mawangdui tomb of the second century BC. From the silk ad bamboo manuscripts, excavated in the 1970's, there was a strong emphasis on what she calls a "nurturing life" tradition. This includes discussion of the sexual arts, and how proper sexual conduct can augment and strengthen the qi. Vivienne argues that this self-help tradition was influential in shaping doctrine in the early days of traditional Chinese medicine. In the second chapter, Elisabeth Hsu explores 25 medical case histories written around 90 BC by Chunyu Yi. These cases all show an understanding of illness as having a strong emotional context, as well as a process of medical reasoning that takes into account the environment, the seasons and the climate.In the third chapter Donald Harper provides, from excavated documents, manuscript evidence of astrologers and diviners in the fourth century BC with their highly elaborate framework for predicting the course of illness and the transition to the cosmological foundations of traditional Chinese medicine. The next chapter by Catherine Despeux delves into the esoteric world of the five circulatory phases and the six seasonal influences as a source of innovation in medicine under the Song (960-1279).The next two chapters are oriented more towards Chinese herbs and dietetics. Ute Engelhardt explores dietetics in Tang China. She identifies the key role of Sun Ci Miao (581-682) in developing a better understanding of food as medicine, such that for the first time dietary therapy is seen as clearly separate from herbal medicine. She also discusses the affinity of this approach with the "nurturing life" tradition discussed above. In the next chapter Frédéric Obringer discusses another Song innovation, the development of new arsenical compounds and their therapeutic benefits. However such toxic drugs are not without their dangers, and he goes on to discuss their fall from favour for a variety of reasons.Li Shizen's sixteenth century classified materia medica (Bencao gangmu) is the subject of the next chapter. Georges Métailé examines this monumental text and the new way it categorised medicinal herbs, minerals and other therapeutic agents. Following this tour de force, Marta Hanson explores the nineteenth century development of the "warm factor disorders" wenbing medical theory. This evolved in the south of China as a local approach in response to epidemics and the different geography and climate of the south.In the next chapter Chris Cullen explores the emergence during the Ming dynasty of a new style of writing up medical cases. He calls these "case statements" and describes how they were primarily used by physicians to establish their credentials in what was becoming an increasingly competitive marketplace. Bridie Andrews follows this with the further development of such records into what she calls "case histories" in the 1920s and 1930s. This new format closely followed the style set by the biomedical model. Contrary to what one might assume, Bridie suggests that this new standardisation was actually an attempt by physicians to assert the value of traditional Chinese medicine.The final two chapters deal with Chinese medicine in the People's Republic. Kim Taylor explores a short-lived medical doctrine that evolved in the period 1945 to 1949. It was based on an imaginative restructuring of the channels to mirror the organisation of the Communists' army, an innovation that came and went without lasting impact. Acupuncturist and anthropologist Volker Scheid then provides a unique insight into the way Western and Chinese medicine are integrated in two different practices in Beijing. He shows how western medical considerations have become part of the Chinese medical rationale for diagnosis and treatment, without a loss of the integrity of Chinese medicine itself.To conclude, this is a weighty tome. It carries such depth in the specific areas that are explored. It leaves me with the daunting thought, how much else don't I know. I should add that this book does have its dense moments. In places it is not an easy read. However if one takes the time, I think this book could add considerably to our respect for our medical tradition. The time for over-simplifying Chinese medicine for the West should now be over. Instead we have a bigger challenge, to explore and understand the complexity of the roots of our medical past. This book will help guide us on this path.