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Book Review: With the publication of Zang Fu Syndromes: Differential Diagnosis we see another example of the recent maturing process in our textbooks. Authors John McDonald and Joel Penner have written a lengthy text on this important aspect of differential diagnosis in Chinese medicine. The first chapters give lists of each organ and their major syndromes, along with the most common combined syndromes. Each syndrome is discussed under the headings; etiology, clinical manifestations, complications, associated Western conditions, differential diagnosis, and treatment. These listings provide students with a good foundation on how to recognize each syndrome, their common points of origin, how to distinguish them from others that are similar, what are the common directions through which they develop, and what are some common Western medical diagnoses given for the syndrome. The treatment section includes lists of the common acupuncture points and their indications. Also included are the common herbal formula prescribed for each syndrome. The later part of the book includes several very indexes that contribute significantly to the book’s usefulness as a textbook and clinical reference tool. For example, the herbal formulas listed earlier under each syndrome are further explained. Details are given of doses and functions of each individual herb, and how they act in combination, as well as the overall actions of the formula and the syndromes for which the formula may be useful. Useful indexes of the pin yin and English names of the formulas are included. Each individual herb is indexed in the same way, and all the formulas in which it is included, are listed. An index of all the points in the text, their functions and the pages they are listed on follows. The pulse and tongue qualities, and all the syndromes in which they occur, are also indexed. There is also a comprehensive symptom index, showing all the syndrome’s any given symptom may occur in. These indexes provide a valuable research and study feature. As with many of our texts, the lists of the syndrome’s could be strengthened by including how the particular symptoms have come to represent each syndrome. For example, under heart qi xu, we have palpitations, but no explanation of how this is representative of heart. Symptoms worse on exertion or when tired are more specific to qi xu than heart xu and occur under all the qi xu listings. Palpitations locate this syndrome in the heart and the fact that they are worse on exertion tell us what is wrong with the heart. For students new to the ideas and language some further explanation of points like this may be helpful. More detailed analysis of syndromes that are similar in presentation, but are of different natures, requiring different treatments would encourage more problem solving skills in students. Examples would include, clarifying the differences between yang deficiency and cold, heat and yin deficiency with yang rising. By elaborating on the criteria for choosing the points listed, the authors would help students and practitioners learn to think about strategies for point selection, rather than just learning lists. While these suggestions might add considerably to the overall length of the book, it would also add to its value as a classroom textbook. Perhaps with a different layout the book’s overall size and its cost may be reduced. Having said what I hope is taken as encouragement to continue to develop the book, I use Zang Fu Syndromes as a classroom text at Pacific College. Students appreciate it and find it very useful. I have known John McDonald as a friend and colleague for many years, and admire greatly his many contributions to our field. The book is a very useful textbook for students learning how to make a differential diagnosis and for practitioners to use as a clinic reference.
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