NOVEMBER 24, 2013
WHEN STEVE JOBS lost his battle with cancer two years ago this month, one of the most widely discussed aspects of his life had very little to do with his life itself. Rather, many internet commenters were instead drawn to Jobs’s death — a death that numerous medical practitioners claimed could have been easily avoided. When Jobs was first diagnosed with a rare form of pancreatic cancer in 2003, he decided to forego standard biomedical intervention in favor of a homeopathic regimen that consisted of acupuncture and dietary supplements. Jobs’s early decision to opt out of chemotherapy and surgery, it has been suggested, ultimately proved fatal.
The hoopla surrounding the death of Jobs draws attention to a particular trend in contemporary American medical practice. Regardless of the fact that little scientific evidence exists to support the efficacy of homeopathic medicine, Jobs has not been alone in his choice to pursue alternative healing practices. Over the past decade, Americans have increasingly attempted to bypass or supplement conventional biomedical treatments with homeopathy and alternative medicine. Viewing Western medicine as overly invasive, unnatural, or simply incomprehensible, a surprisingly large contingent of patients — the National Institute of Health puts the number at close to 20 percent of American adults — have pursued some form of complementary or homeopathic approach to healing.
Traditional Chinese medicine, often referred to simply as TCM, is one of the most popular forms of alternative medicine in use today. Consisting of such practices as acupuncture, acupressure, qi gong, and tai chi, TCM appears to many American consumers as more holistic, humanistic, and philosophically palatable than much of Western biomedicine. Perhaps one of the most appealing elements of TCM is the fact that it is touted as an extremely ancient practice. (Again, the National Institute of Health claims that TCM “dates back more than 5,000 years.”) Since the practices that comprise TCM are hyped as being part of a longstanding tradition of unchanging praxis, many Western consumers assume that TCM is somehow linked to an originary truth: one that understands the relationship between mind, body, and environment better than practitioners of Western biomedicine ever could.
In their recent edited volume, Chinese Medicine and Healing: An Illustrated History, Linda Barnes and TJ Hinrichs — a professor of medicine and a professor of history, respectively — aim to set the record straight. Rather than thinking of TCM as a single, unchanging body that can be traced back along a clear ideological lineage, Barnes and Hinrich demonstrate that Chinese medical practice is better thought of as a plural tradition: one that, like Western biomedicine, developed over time and in response to changing sociopolitical conditions. Indeed, the very acronym “TCM” was only introduced in the second half of the 20th century, when the Chinese Communist Party sought to standardize and “scientize” what could otherwise be considered a hodgepodge of local medical practices. Prior to the 1950s, Chinese medicine had no single doctrinal form, and was performed by a range of practitioners: from shamans and herbal medicine “adepts” to midwives and classically literate physicians.
Each chapter in Chinese Medicine and Healing examines a different dynastic regime. Covering over 3,000 years of medical history, the volume demonstrates how successive schools of medical thought adopted new practices, accommodated old ones, and diverged from their own ideological and institutional roots in response to new sociopolitical contexts. Beginning with a chapter on shamanism and oracle bone divination in the Shang dynasty (~1500-1046 BC), the book traces the rise of religious medicine after the fall of the Han dynasty (221 BC-206 AD), when millenarian groups arose in response to crumbling political structures. In the Tang dynasty (618-906 AD), the spread of Hinduism and Buddhism influenced the development of medical ethics and the rise of philanthropic healing institutions. During the Song (960-1279), Ming (1368-1644), and Qing (1644-1911) dynasties, the state oscillated between initiating centralized medical training and allowing medical practice to be pursued independently, leading to a multiplicity of competing medical philosophies. Finally, the book examines the complex relationship between Chinese medicine and the West. The intrusion of Western medical missionaries in the 19th and 20th centuries led Chinese state authorities to alternately condemn Chinese medicine or advocate its preservation as a treasure-house of national tradition. Meanwhile, a variety of Chinese healing methods simultaneously spread across the globe to Europe, Africa, and the United States, taking root as something ancient and exotic.
While the sheer breadth of information contained within the volume might appear daunting, the book itself is actually quite approachable. The authors assume little foreknowledge of Chinese history on the part of the reader, and do a nice job of integrating general contextual information with specific examples of medical practice (often offset from the main text in gray boxes). The use of visual imagery, including maps, anatomic charts, and photographs of practitioners in action, further reinforces the multiplicity of ways in which Chinese medicine has been deployed in a range of settings and geographic contexts. By culling from a wide variety of primary and secondary sources and recruiting over 50 scholars to contribute to the volume, Barnes and Hinrich are able to create a book that is thorough and comprehensive, yet not intimidating.
This is not to say, however, that Chinese Medicine and Healing is able to cover all ground. Readers looking to gain a better sense of the specific content of Chinese medicine will be disappointed, as Hinrichs and Barnes both seem more interested in changing institutional structures than in the application of Chinese medicine itself. Furthermore, the large number of contributors to the volume is both the book’s strength and its greatest weakness. One of the most bothersome aspects of Chinese Medicine and Healing is its tendency toward redundancy and inconsistency. Although this is to be expected to a certain extent from an edited volume, small problems like inconsistencies in spelling (“moxibustion” vs. “moxabustion”) become grating for the picky reader. Perhaps more problematic are the conceptual discrepancies that are often juxtaposed on consecutive pages. Due to the fact that different scholars — with different viewpoints — were recruited to produce individual case studies within each chapter, their divergent analyses are sometimes left hanging without a neat resolution.
All of this is secondary to the major contributions of the volume, however. Chinese Medicine and Healing can serve as a reference for students, scholars, and anyone looking to understand the historical roots of contemporary Chinese medical practices. Readers might be surprised to discover that acupuncture — today thought of as a benchmark of TCM — only became central to Chinese medicine in the mid-20th century. Prior to this time, acupuncture was more typically practiced as a type of minor surgery by street tradesmen than as a specialized form of healing by the literate elite. While such revelations might not have changed Jobs’s or anyone else’s opinion on the decision to pursue or forgo alternative medicine, they can certainly enlighten readers as to the disparity between myth and historical fact in the development of Chinese medical practice.