Chinese Medicine, Professor Paul U. Unschuld’s newest book, is an important and timely contribution to the field of Chinese medicine. Professor Unschuld, director of the Institute for the History of Medicine at the University of Munich, is one of the world’s leading authorities on the history of Chinese medicine. This book is a “must read” for everyone practicing or studying Chinese medicine. At 122 pages, Chinese Medicine is by far Professor Unschuld’s shortest, most affordable, and easiest reading book. Also, at a time when our profession is debating exactly what qualifications should be required for the practice of acupuncture and Chinese medicine, Professor Unschuld’s succinct overview of the history of Chinese medical theories and practices as recorded in the medical literature of the day provide important food for thought.

Written in seven chapters, the first half of the book details the appearance of the fundamental theories of Chinese medicine that began to replace older notions of disease being caused by gods, demons and (apparently irritated) ancestors. Professor Unschuld cites a tomb sealed in 167 BC in which medical texts were found detailing both magical and demonological materials together with sophisticated pharmacological prescriptions and descriptions of the significance of blood vessels. By the next century, according to Unschuld, The Yellow Emperor’s Classic appears and details a medicine oriented toward natural laws - not demons.

After detailing the appearance of the theories of “systematic correspondences,” i.e. yin-yang and five phase doctrine as well as the later appearance of the theories of medical applications of the ten stems and twelve branches and the six qi, Professor Unschuld seeks to prove a point by inserting a chapter on eye diseases.

Eye diseases had been described on oracle bone inscriptions from as early as 1000 BC, before the emphasis on classifying everything in terms of systematic correspondences. As the system of correspondences (especially five phase) gains prominence, most, but not all, eye diseases are described under correspondence theory. Some eye problems are said to be caused by reading with insufficient light and others described by their infectious nature without any attempt to describe these conditions or their treatments under theories of correspondence. Professor Unschuld uses this example and others to show that there existed a contrast between theory and practice.

A most interesting part of the book is the revelation that, unlike acupuncture whose practice from the earliest records was founded on the theories of systematic correspondences, pharmaceutical therapy in China flourished without such theory. According to Unschuld, while the quality of edible substances had been determined by their flavor and temperature since the earliest records, it was not until the 12th century A.D. that authors began to theorize about the effects these qualities had in the organism and even then, not without significant disagreement.

The last two chapters describe the transition of Chinese medical practices into the “modern” era including an excellent account of Westerners’ exposure to Chinese medicine from the Portuguese Jesuits in the 16th century to Soulie de Morant, whose writings on Chinese medicine during the first half of the 20th century were the first to describe qi as “energy” and use the term “meridian” for acupuncture channels.

The primary point of this work is brought to a head in the final pages when Professor Unschuld states that it is “impossible for Chinese medicine to be brought to the West in its entirety or in some purely original Chinese form.” He then rhetorically asks in what form it should be brought. Should it be the version that the political climate in the Peoples’ Republic of China has today chosen from the “heterogeneous heritage” as useful? The various practices free of political influences that rely on “personal interpretation of traditional opinion and techniques”? The many “pragmatic approaches relatively free of theory”? He answers his own questions by stating that there is no reasonable way to judge one or another nor is it possible to standardize the “theoretical basis, diagnosis or even the theory of Chinese medicine.”

The weak link in this book is when Professor Unschuld ventures out of his field of expertise (history) and tries his hand at philosophy. Unschuld theorizes that Chinese medicine’s popularity in the West has more to do with factors such as the energy crisis and that it addresses the “existential needs of a sector of the population at the end of the 20th century” than with clinical results. This failing aside, Chinese Medicine teaches many important lessons about popular history vs. literal history.

As a closing commentary I would like to add that while I personally believe that folk history should be considered in order to get the best view of the tradition of Chinese medicine (in fact I am writing a book on this subject), we should not gloss over the good work of scholarly historians like Professor Unschuld because their historic facts burst the bubble of our popularly held notions about the “tradition” of TCM. As we focus on what should be required training for the practice of Chinese medicine in this country, we should be leery of opinions that emphasize the need to keep Chinese medicine “whole” or in its “traditional form.” Whatever we decide about Chinese medical training is up to us. We cannot sidestep these difficult questions by deferring to the past and saying, “This is the way it has always been done” or “This is the way it was meant to be.” The better we understand the history of Chinese medicine, the better we can do our part in molding our future.

Dr. Paul Unschuld will be presenting a lecture and workshop on The Origins of Chinese Medicine at Pacific Symposium 2001. For more information, refer to the center section of this issue of Oriental Medicine.