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JCM's review of the "Gold Mirrors and Tongue Reflections"



My book “Gold Mirrors and Tongue Reflections” has been reviewed in the latest issue of the Journal of Chinese Medicine: 

This is a translation of two important historical sources on tongue diagnosis. The first is the Ao Shi Shanghan Jin Jing Lu (Scholar Ao's Golden Mirror Records in Cold Damage), which originated in the Yuan dynasty (1260-1368) and became more detailed as subsequent editions were authored during the Ming dynasty. The second is the Shanghan She Jian (Tongue Reflections in Cold Damage), which was published near the start of the Qing dynasty. Living and working in Beijing for the last ten years has allowed Ioannis Solos to collaborate with some leading Chinese medical experts on this subject. Commencing with a concise history of tongue observation in early Chinese medicine, we come to realise that the method was quite perfunctory until the Song-Jin-Yuan era (960-1368 CE), with references to the tongue being more often concerned with pathology of the tongue itself than as a more general diagnostic indicator of physiological function. In a readable style Solos discusses the origins and history of his two main sources and the various subsequent editions.

The translation of the Ao Shi Shanghan Jin Jing Lu is eminently readable, and includes reproductions of the Chinese source text and its illustrations together with modern diagrams. Summary pages translated from the original discuss the theory and ideas behind the key elements of tongue diagnosis - the purple tongue, red tongue, yellow tongue fur, and so on. Each tongue presentation is described and interpreted, and suitable prescriptions are suggested. Although both of the source texts are primarily concerned with shanghan (cold damage) illnesses, the later publication date of the Shanghan She Jian (1668) means that it also includes some wenbing (warm disease) ideas, which are evident in one of its key concepts, the membrane source (gaohuang), and the use of the formula Da Yuan Yin (Reach the Source Drink). The slightly wider scope of this book can also be gauged from the fact that some non-shanghan formulas are mentioned, including Sheng Mai San (Generate the Pulse Powder), Bu Zhong Yi Qi Tang (Tonify the Middle to Augment the Qi Decoction) and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia). Like the text by Ao Shi, the main focus in this text is on matching changes in the tongue to shanghan patterns, formulas and modifications.

As you might expect from their titles, the great majority of the formulas suggested in the two source texts are those from the Shanghan Lun (On Cold Damage), which means that the discussion focuses on using the tongue as a guide to the treatment of shanghan fevers rather than as a diagnostic tool in general medicine. We are repeatedly told that the patient might be saved from death using this method, or, more grimly, 'Most patients who have this pattern will die'. Fortunately, few of the patients we see in our clinics today are facing death due to catastrophic pandemic illness, and so the focus of this text on tongue changes during such illnesses might be seen to diminish its appeal.

Ioannis Solos's text is a reminder of the need for contextualisation when studying ancient medical writings - the fact that times and conditions change and that great care is needed to interpret what we read. For instance, a common historical cause of lower limb oedema was beriberi, but it could be mistaken to use treatments intended for this 'leg qi' problem in patients today with oedema from other causes. The patients these Ming and Qing dynasty authors were treating were very different to those we might see in our clinics. In the early 1640's repeated and devastating epidemics killed massive numbers of people – more than it was possible to bury and so people rotted in their deathbeds. In 1643 it was recorded that in many towns the only sound to be heard was the buzzing of flies. Pestilential disease was a regular part of life right back to the Shang Dynasty, and texts such as those translated by Solos largely reflect what was learned by those faced with diagnosing and treating these conditions.
So is Solos's book a useful addition to your library? If you are a student or are in the early stages of your career, the answer is probably no. If you solely practice acupuncture this text is also probably not useful - I did not notice a single mention of acupuncture in this book. However, If you have chosen shanghan as your core clinical methodology, or if you aspire to full mastery of Chinese medicine, then you probably should buy a copy.

Charles Buck


The original review can also be found here:
http://www.jcm.co.uk/book-shop/product/catalog/product/view/12011/gold-mirrors-and-tongue-reflections/

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