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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