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
Does Chinese Medicine cure disease?
I’m writing an article for a class about using Chinese medicine to deal with common colds and flus. This is one of my passions (I know, weird) and something I feel the general public doesn’t really know about. In the past three years, I’ve suffered two external invasions, one more flu like and one more cold like. During the first two days of both, I went to the clinic. They both resolved the next day, with copious herb intake in the Shang Han Lun style. I’m a believer, you might say. Simply because of my personal experience? No, because of the countless people I’ve seen have similar experiences in clinic.
Everywhere I read about “finding a cure for the common cold” indicates that such a thing has not yet been achieved. The party line goes like this, “While there is no cure for the common cold, there are things you might be able to do to reduce its duration and severity.” Well… yeah. My question is this - how is that not a cure?
The dictionary definitions for cure are many, but the most relevant for our purposes recurrent themes:
A cure is a process
A cure does not indicate that the disease never occurs (that’s more like eradication)
A cure involves treatment
When people talk about “a cure for cancer” I don’t think they mean that cancer would never happen. While a vaccine for cancer (or the common cold) would be nice, usually that doesn’t seem to be what people are discussing. What we want is a way to avoid prolonged suffering and/or death at the hand of the disease process in question. We want, in essence, to reduce the illnesses duration and severity to minimal levels. We want to get better fast and suffer few lasting negative effects from our experience.
I think one other essential piece of the idea of curation involves the ability for the cure in question to be always and everywhere applicable. We wouldn’t call something a cure that sometimes worked and sometimes didn’t. That may be the info behind the claim that no “cure” for the common cold has been found. That being said, under the care of a competent Chinese medical practitioner, I do believe that rectification of cold and flu symptoms can be reliably achieved. If under such circumstances a person still suffers from their symptoms or, perhaps, even worsens (developing phlegm deep in the lungs, for example) this is likely due to some misunderstanding on the part of the practitioner about the pre-existing state of the patient’s body constitution. This is the case, I think, with any medical therapy and any disease. Consider any disorder we consider to be “cured” in modern medical practice. If a person displays with that illness and the therapy is inappropriately applied or some pre-existing condition of the patient renders the therapy ineffective, we don’t cast shadows on the ability of that therapy to be curative for that disease.
For Chinese Medicine, curing a disease simply involves a restoration of the body’s natural balance. Yin and Yang come into appropriate relationship with one another and all the seasons of the body come in their course with a typical expression. The body responds easily to normal daily stresses and no symptoms of blockage (pain, pathological products) exist. Chinese medical therapies, when applied consistently and competently, rectify the state of health for many conditions for many people. Wouldn’t you say?
What is your understanding of “cure”? What would it take for you to consider the common cold to be “cured”? I’ll be interested to read your thoughts in the comments.
Eric
Tags: chinese-herbs, cold, common cold, cure, cure for the common cold, disease, external invasion, flu, healthRelated posts
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