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
Questions for the ancients
I’m part of the student government association at NCNM in Portland, OR and I am currently working on creating a scholarship for Classical Chinese Medicine students at our institution. The SGA funded the scholarship and now I’m just working on logistics. Part of the scholarship application will involve students answering a question - with the best answer (as judged by a panel of students) getting the nod for the award. Anyway, as I was brainstorming potential questions I became lost in thought at my potential answer to one. I thought I would pose it to you, my readers.
If you could ask three questions of any ancient scholar of Chinese medicine, who would it be, why, and what would your three questions be?
For me, it would definitely be Zhang Zhong Jing. I know that in ten years time I will have much more insightful questions, but right now my questions would be:
1. To what extent did you base your work on the Neijing and Tang Ye Jing?
2. What’s up with Wu Zhu Yu Tang? I mean, seriously.
3. Are there any diseases you feel can’t be treated by what you present in the Shang Han Lun and Jin Gui? If so, what are they and why can’t they be treated by the formulas and procedures set out in those books?
As a bonus, I would ask him if he has an intact copy of the Tang Ye Jing and, if so, if I can have it. :D
Post your questions in the comments.
Eric
Tags: ancient scholars, books, chinese-herbs, Classical Texts (general), classical-chinese-medicine, formulas, Learning, ncnm, Portland, scholar, scholarship application, shang-han-lun, student government association, tang-ye-jing, Zhang Zhong JingRelated posts
5 Computer based tools no Chinese medicine student should be without
While I’ve been working on my January Year of Sagely Living goal, I’ve really had to increase my efficiency in a number of respects. I’m doing a fairly good job keeping to my basic commitment, but I’ve had to spend an unusual amount of time finding the holes in my various systems. It’s an interesting by-product of the whole thing, that while the focus of this month is scholarship, it has changed me in ways that will ultimately be beneficial for more than just my study of Chinese medicine. I think, in a way, that’s the point of the whole Year of Sagely Living. To show that the principles of Chinese medicine, when instantiated in daily life, have benefits far beyond what would initially seem likely.
I thought I’d just mention some of the tools that have come out on top as I’ve refined my system. I’ve mentioned a couple of these before, but it might be nice to have them all in one place. All of these tools are worth the time it takes to learn them.
1. Rootdown.us and TCM Assistant : When it comes to quickly accessing basic Chinese medicine information, no sites are easier to use and easier to trust than these. Rootdown includes the “community editing” features that make sites like Wikipedia so popular. TCM Assistant has the edge of something a bit neglected, but has a wider database of formulas, so I turn to it when I can’t find something on Rootdown. There are other Chinese medicine websites, but they are mostly badly designed and/or too infrequently updated to be of any real use.
2. Google Book search and Google Blog search : With these two tools, you can find pretty obscure information that you wouldn’t otherwise be able to find. The book search does full text searching of a number of books, with some having many pages available online. Even if you can’t read all of the information you desire, you have at least a better idea of where to look for the info you’re after. Blog search is an easy way to look across the blogosphere quickly and efficiently to see what “real people” are saying about a given topic.
3. PubMed, Blue Poppy’s article search, your school library’s databases : I like to cover all my bases. In finding information on Chinese medicine, you have a lot of resources at your disposal. Your books, lecture notes, professors and peers, nature herself, patients, the websites I listed above… it’s incredible, really. Here are three more tools to help round out your personal Chinese medicine info warehouse.
PubMed is a huge clearinghouse for information in nearly all of the major journals of all kinds of medicine, including Chinese medicine. Some of the journals even have full text available for free. If you’re looking for any published research studies on Chinese medicine topics, this is probably the first place to start. Blue Poppy recently opened their article database for free use - an event I enthusiastically blogged about a while ago. It’s a great resource of first-rate information on a variety of Chinese medicine topics. Finally, don’t neglect the databases your library provides as well as - of course - the library itself! I’m always shocked to find how few folks actually use their libraries as they are intended to be used - freely!
4. Omnifocus or kGTD w/Omnioutliner : To use these tools effectively, you need to have read David Allen’s Getting Things Done
These electronic tools are elegant and powerful ways to implement the core processes of GTD, but they would probably also be useful for anyone trying to get a better handle on the projects they are working on. Total, it has probably taken me about 48 hours to fully understand and implement GTD and Omnifocus. 48 hours well spent. I’ve probably saved that much time and frustration since getting to full implementation. Now that it’s set up, it only requires about two hours a week to keep in perfect working condition. I rarely forget an appointment or deadline, I’m often prepared well in advance of exams and I find myself with plenty of time and energy to work on “side projects” like this website.
5. Bookburro, a Firefox extension : Now, obviously, this requires that you’re using Firefox. I can’t imagine a single reason NOT to use Firefox. Please, just go get it. You can import all of your bookmarks from IE or whatever other web browser you’re using. It won’t hurt, really. Then go look at all the awesome add-ons you can hook on to expand Firefox’s functionality. I only use a few, but my beloved is Book Burro. In short, this extension helps you to find the book you want at the cheapest price possible. With just a few clicks, you can configure it to search all of the book selling websites, PLUS all the public and big college libraries in your area. It will give you a list of all the book websites and their best price for the book, as well any relatively nearby libraries that carry the book and their distance from your location. I’ve saved around $500 over my Chinese medicine school career because of this little program. It’s incredible, seriously.
Taken together, these five tools probably compose only 40% of my on-computer time, but probably account for 75% of the eventual results! I hope you will find similar successes using them.
Eric
Tags: Blogging, books, getting things done, habits, internet, productivity, students, study, Technology, websites, Year of Sagely LivingRelated 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, versluys
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