Book review: Clinical Handbook of Internal Medicine (Vol 1)
I have been using the first two volumes of Maclean’s Clinical Handbook of Internal Medicine for a couple of years, now. I find them to be the most useful basic TCM pathology texts available and want to share, briefly, my reasons.
General Information
This text is part of a series that, apparently, will include more volumes in the future. The first volume, pictured at left, covers the Lung, Kidney, Liver and Heart organ systems. The second volume, with blue lettering but a similar cover, looks solely at the Spleen and Stomach. I’ll focus on the first volume for this review, but the majority of what I say applies to both of them.
The authors, in their introduction, explain that their aim was to develop a workable clinical manual of Traditional Chinese Medicine (TCM) that “at least [begins] to take our cultural and social differences into account.” They seem to feel that because Chinese medicine was created and developed in a particular social and geographic location, it will be significantly different when practiced in other locations with differing social and natural environments. The book, then, is a clinical manual intended to make the basic information of TCM more accessible and relevant to Western readers.
The book is created primarily with herbalists in mind, thus the formula suggestions are extensive while the acupuncture suggestions are more sparse. The book is organized by organ system and then by basic TCM symptom picture - for instance the Lung section starts with external diseases (cold and warm) then moves into coughing, wheezing, etc… The Chinese names for the symptom pictures are provided, along with characters. This is helpful since people learn them using different English translations depending on where they study and I found it much easier to simply work with the Chinese. They provide Chinese for herbs, formulas, patents and acupuncture points - though the points have only pinyin, no characters. The general organization of the book is intuitive and the overall quality of the text is reasonable for the price.
Looking Deeper
Let’s investigate a single section. Consider Gan Mao - the “common cold” or external invasion. The book begins with a concise and readable description of the disease in general, providing some historical background and discussion of the severity of the illnesses in question. This moves on to a page on etiology and a fine mindmap of the most common causes. Following this is the section on specific causative factors and their treatment. Fortunately, they begin the discussion in this chapter with Wind Cold. Shang Han Lun fans will be snickering, now. ;) But, not for long - as the first prescription suggested is Jing Fang Bai Du San. Thus begins my basic problem with the text - which is predictable given my trepidation about non-classical formulas.
That being said, the layout of the various treatment options (with confounding symptoms, etc) is clear and descriptive enough without being confusing. Several formula suggestions are followed by standard acupuncture protocols (LI4, GB20, BL12, BL13, GV14) and modifications based on presenting symptoms. The section is completed by other advise to the physician such as, “Acupuncture treatment can be applied 2-3 times in severe cases,” and a list of biomedical (Western) conditions that might fit this picture. In general, all of the sections flow in this way. Some have more extensive descriptions or finer distinctions between symptom patterns, but the basic flow is similar.
My assessment
Positive: I have looked at quite a few books trying to find one that would helpfully and concisely explain syndrome differentiation from a TCM perspective - in good English. I found it in these texts. It could be helpful as a clinical manual, I suppose, but I found it more helpful in my TCM studies as a way to understand the way that your average TCM doctor treats any particular condition. Its breadth, completeness and pleasing layout, as well as inclusion of Chinese characters and pinyin puts it heads above anything else I’ve found. It’s also fantastic as a way to quickly see the basic TCM treatment protocol for a given disease with points AND formulas included.
Negative: The authors seem allergic to Classical formulas. Gui Zhi Tang and Ma Huang Tang are not even mentioned in the Wind-cold section. Um…? I suppose this has to do with the oft repeated refrain that “Westerners are too deficient for such strong formulas.” I must be a strange Westerner, indeed. My daughter, too. Oh, and the rest of my family. Oh, and a big chunk of the patients I’ve seen treated in clinic. Ok, ok - sorry. My point is this - I think it’s a dramatic oversight to leave out Classical formulas. I understand if you want to include others, perhaps put a caveat on the “too strong” formulas - but… honestly?
There are some holes in the texts - I understand future volumes may address this. For instance - no women’s diseases as far as I can see. Also, the organization according to “diseases” (gan mao, yi jing, etc…) sometimes made it difficult to find a formula or point protocol for some simple set of symptoms that doesn’t necessarily fit into one of those categories. That’s not so much a problem of the book, but a problem of that system of categorization. All things being equal, I think this is a relatively minor problem.
Should you buy it?
If you’re interested in having a basic, clear manual for understanding TCM syndrome differentiation and the way that a large majority of TCM physicians treat patients - these books are indispensible. I sold all of my other TCM texts - all my Maciocia included. There is enough theory in here to do the job, and in combination with all the treatment advice it’s just a fantastic resource.
Click here to buy the Clinical Handbook of Internal Medicine Volume 1 from Amazon.com
Thanks for reading,
Eric
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Tags: book-review, books, ccm, external invasion, formulas, internal medicine, tcmRelated posts
5 Chinese Medicine texts you shouldn’t live without [Video]
I’ve been figuring out how to take Deepest Health to the next level. It seems important to start diversifying media. Text is great, but the power of the Internet doesn’t stop there. I’m going to begin experimenting with audio and video content to see how best to integrate them into Deepest Health. I’m planning a Podcast series, tentatively on Fridays, that will probably be me rambling about some of what I learned in the given week. I will also be adding interviews with professionals and students when I am able to get them. I will also do Video when possible, particularly when that medium will add something special to the given content.
In the video below, I’m mostly just getting used to the medium. I tried to provide some value for you folks, though, by talking about the five books that are practically glued to me right now. :) You’ll notice product links in the video, I hope they’re not too annoying. I’m also unsure whether RSS/Email subscription readers will be able to see the video - you may have to come to the site to see it. I encourage you to do so! Please give me feedback about this new format. Don’t worry, text will continue. Depending on the situation, I may offer transcripts to folks who request them because they aren’t capable of using the audio or video content. Contact me for more details.
Note: Brief reviews of the following texts are included in this video:
2. Arnaud Versluys’ and Heiner Fruehauf’s formulas text
(Link for the above text points to the NCNM bookstore - you may have to contact them by phone or email to order the book.)
3. Bensky’s Formulas and Strategies
4. Mitchell/Wiseman’s Shang Han Lun translation
5. Deadman’s Manual of Acupuncture
(Links for the last three texts are within the video itself.)
Enjoy!
Tags: Acupuncture, Blogging, book-review, books, chinese-herbs, formulas, videoRelated posts
Don’t call it a comeback
Wow, sorry folks. I didn’t consciously stop blogging which tells you that I must be pretty busy. :) This term has been a lot more intense than I expected it to be - mostly because I’m so engaged in everything that I’m learning that I don’t even WANT to do anything but study (aside from stuff with my family). However, I have plenty to share and over the weekend I’m going to be doing my best to write a few articles. I’ll give you a quick preview as well as open up a discussion about different approaches to herbal medicine.
What’s coming up on Deepest Health?
1. Report on the Student Caucus at the AAAOM Conference in Portland. // I’ll just go over what I took away from all the student networking that went on at the conference and my hopes for a stronger, broader professional Chinese medicine community in the United States and beyond.
2. Review of the Acupuncture Desk Reference, a good looking little book put together by David J. Kuoch. // It’s a good attempt at a basic reference book helpful for students and new practitioners. I’ll share what I love and what I think could be improved.
3. Review of the beautiful “Living Meridian” charts available from the folks at The Fifth Element. // I’ll discuss my experiences using the charts in keeping up with my points study and some recommendations for getting the most out of this useful study tool.
4. Review of Blue Poppy Press’ release of a new translation of Yi Lin Gai Cuo, a fascinating work in relatively modern Chinese medicine. // I’ll consider how this book might be useful to students and how it has expanded my understanding of both the history and content of our profession.
5. Discussion about the future of health care in North America and what place I see for Chinese medicine in the overall fabric of medical practice.
6. Many discussions that have come from this term of school including: balancing competing teacher perspectives, the importance of humility in learning and practicing medicine, developing peer relationships in a busy world and comparison of electronic and low-tech methods of study and organization.
I hope you’ll stick around.
A broad question about Chinese herbal medicine practice
I have been learning quite a bit about Chinese formula science these last weeks. This information combined with what I had already integrated through study and watching patients in the clinic has led me to a few conclusions. The first, and most important, is that the “broad spectrum” approach represented by many more contemporary formulas (for instance, RenShen Bai Du San 入參敗毒散 ) is fundamentally bankrupt. It wasn’t until my teacher Arnaud Versluys suggested to us the similarity between the approach of this class of formulas to the use of broad spectrum antibiotics that I really understood how important this principle is for the integrity of our medicine.
Where Zhang Zhong Jing’s formulas were extremely tight in structure, extremely focused and strong in action, “broad spectrum” formulas can hardly be said to have a structure and seem to want to be everything to everybody. They are the John Kerry of the herbal medicine world (sorry John). They seem to characterize a way of looking at medicine that says, “Hey, we don’t REALLY know what’s going on at all, so let’s just cover all of our bases and see what happens.” The fact is that most people do improve, over the short term, with these formulas. Their root pathology, however, may simply sink beneath the surface only to eat away at vital substances and/or resurface at some later time with renewed ferocity. Why not improve our diagnostic skills, improve our understanding of the science behind our medicine and be confident enough in our diagnoses that we can prescribe strong, focused and time-tested formulas?
I don’t know enough to say that all non-Han dynasty formulas are worthless, baseless or are going to harm people in the long run. In fact, I’m sure that’s not the case. But why (and here’s my question to you) not learn very well the principles behind truly Classical formulas, pay careful attention to their clinical effects and proceed in that direction? I would love to hear your thoughts in the comments.
Eric
Tags: Acupuncture, Blogging, book-review, books, Character, chinese-herb, formula-science, formulas, herbs, professional-development, versluysRelated posts
Book Review: Bob Flaws, Statements of Fact in Traditional Chinese Medicine
I am pleased to review Bob Flaws‘ latest book, an updated and revised version of his Statements of Fact in Traditional Chinese Medicine
This book is, essentially, a highly organized collection of statements culled from various texts of Chinese medicine thematically represented with English, Chinese and pinyin included. It contains statements about a number of essential topics, from basic theory to individual Zang-Fu organs to pathological processes to treatment principles. So, for instance, in the section on physiology we find a subsection about the Zang and Fu organs. Within that section, under the subheading Lung, we find 49 Chinese statements and their translation from a variety of source texts. There are statements about the Lung’s function in the body, the things that easily harm it, some of its pathological states as well as some more symbolic information pertaining to it. Additionally, Flaws provides a brief yet rich interpretation of each statement and its relevance.
Statements of Fact is intended to be a companion to beginning theory classes in Chinese medicine. In the preface of the book, Flaws discusses the challenges faced by Western students of Chinese Medicine. I have to agree with him on his basic assessment of the situation. We are not commonly asked to memorize pieces of texts or the many poems that Chinese speaking students do. We tend not to have basic theoretical information imprinted on our minds and so when we are in clinic or in conversation with a Chinese-trained practitioner, we may be at a disadvantage. Having the basics of theory at hand make it easier to understand inferences, make connections between treatments and their patterns and generally make us more effective students and practitioners. In the introduction, Flaws states:
“Therefore, I recommend that students study this book along with whatever basic theory text their school has chosen. Then, along with understanding the theory contained in that text, they should try to memorize as many of the corresponding statements of fact as possible. That way, one will have remembered the words and the understood their meaning.”
Further, in many schools of CM doctors make many statements in lecture and clinic that have their roots in the voluminous Chinese medicine literature. Only rarely do they have time to verbally source every statement! The ability for an English speaking student to quickly and easily locate that statement as part of the literature is invaluable. Yet this is also where the book finds its primary weakness. While an extensive bibliography is provided, Flaws was unable to follow each statement with a listing of its source text. He explains in the book that this was impractical. Those statements that did not come directly from a Classical text came mostly from Chinese language compendiums of classical statements and knowledge. He explains that the Chinese sources he utilized did not always list their original source for each statement. However, I feel that it would have been wonderful if he could have at least told us which Chinese source each statement came from, regardless of whether that was likely to have referenced the original source. Additionally, for those statements that he was able to trace back to their original source he could easily have listed them. This would have increased the book’s value immeasurably. However, this omission does not significantly alter my overall positive rating.
Overall, the book is a fine effort. As I’ve already mentioned, the organization is first rate and the inclusion of characters, English and pinyin is most appreciated. All of these elements are improvements over the previous edition. Flaws’ explanations of each statement or group of statements is very nice for beginners, but it will be important for students to be careful of taking these as absolute truth. They are Flaws’ interpretation, and while he is a very experienced practitioner and worthy of great respect, he of course interprets these statements through his own point of view. Using his interpretation as a guide will help new students to get a grasp of the basic idea and they can do further investigation to come to a fuller understanding for themselves.
The book is a great value for the price and I believe it will make a good addition to your Chinese medicine library. You can visit Blue Poppy Press’ website for more information and to purchase yourself a copy. You can also simply click on the picture of the book at the beginning of this article. When you do and have had a chance to use it for a while, please do come and let us know how you enjoyed it.
Eric
Tags: blue-poppy-press, bob-flaws, book-review, books, Character, Classical Texts (general), textual-analysis, Theory, translationsRelated posts
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