Preface

It is now 27 years since I started writing the first edition of the 'Foundations of Chinese Medicine': this proved to be very popular with students and it has been adopted as a textbook by many acupuncture colleges all over the world. The present edition is a revision of the second edition published in 2005.

As its name implies, this book is intended to give the foundations of the principles of Chinese medicine: it is therefore only the beginning in the journey of learning this ancient art. There are of course, very many different traditions of Chinese medicine and especially, acupuncture: I hope that this book can provide a 'foundation' from which a practitioner can build and branch out in different directions.

My main sources (indicated in the bibliography) for this book are modern Chinese textbooks and some ancient ones and in particular the Yellow Emperor's Classic of Internal Medicine (Simple Questions Su Wen and Spiritual Axis Ling Shu) and the Classic of Difficulties (Nan Jing). I have tried to present the theory of Chinese medicine from Chinese books but I have also occasionally presented my own experience gleaned from nearly 40 years of practice. Whenever I present my own experience, I precede this with the statement 'in my experience' or 'in my opinion'.

It is worth mentioning the main changes made in the second edition:

1. An expanded discussion of the functions of the Pericardium

2. An expanded discussion of the functions and nature of the Triple Burner

3. An expanded discussion of external pathogenic factors both as causes of disease and as patterns

4. An expanded section on Diagnosis

5. A new section on pathology (chapters 27, 28 and 29)

6. A complete revision of the clinical manifestations of the patterns of the Internal Organs with a clearer distinction between Yin deficiency and Empty Heat for each organ and the addition of herbal prescriptions for each pattern

7. An expanded discussion of the Identification of Patterns according to the 6 Stages, 4 Levels and 3 Burners.

8. A greatly expanded discussion of the nature, functions and clinical application of the 8 Extraordinary Vessels

9. The discussion of categories of point not previously discussed, e.g. points of the 4 Seas, Window of Heaven points, 12 Heavenly Star points, Sun Si Miao's Ghost points, points of the Eye System and 5 Command points

10. A complete revision of the functions of the points with a new heading of 'Clinical manifestations' and the addition of some points not previously discussed

11. An expanded discussion of the principles of combination of acupuncture points.

The present revision made the following changes or additions to the 2005 edition:

1. Over 200 new figures throughout the book

2. New self-assessment tests to help students in their studies

3. Case histories with self-assessment tests

4. New diagrams illustrating the precursors and developments of the Internal Organs patterns.

5. New guidelines with figures as to how to learn the patterns of the Internal Organs in a logical, simple way, avoiding mere memorization

6. More clinical notes throughout the text

7. More acupuncture point combinations with analysis of points actions

8. More case histories

9. Location of acupuncture points mentioned

The reader will notice that I do not use the term 'Traditional Chinese Medicine' (TCM) in my books as I personally do not agree with this term. It is a term that came to be used purely by chance when Westerners started attending courses at Chinese colleges, all of which are called 'College of Traditional Chinese Medicine'. In China, Chinese Medicine is simply called 'Zhong Yi' (which means 'Chinese medicine') to distinguish it from Western medicine (Xi Yi).

When the Chinese colleges started running courses for foreigners they coined the term 'Traditional Chinese medicine'. The Chinese colleges did not use the word 'traditional' with the same meaning as most acupuncturist would give it in the West. Unfortunately, the word 'traditional' is often used in the West by followers of particular styles of acupuncture, each claiming to be more 'traditional' or 'classical' than another.

Especially in the context of Chinese medicine, the word 'traditional' can mean anything depending on which tradition one refers to. Is a tradition from the Han dynasty more 'traditional' than one from the Song dynasty because it is older? More importantly, is an innovation introduced post 1949 to be discarded because it is 'marxist-leninist' or 'maoist'?

As the Chinese colleges were called 'College of Traditional Chinese Medicine' and taught courses in 'traditional Chinese medicine', the term TCM began to be used to identify Chinese medicine and acupuncture 'as it is practised and taught in modern China'.

For me, the main problems with the term 'TCM' are two. Firstly, this term implies that Chinese medicine 'as it is practised and taught in modern China' is rigidly monolithic and uniform and not allowing any diversity. This is simply not the case.

There are as many styles of acupuncture in China as there are provinces, counties and colleges. While a certain 'systematization' is encouraged, diversity is not suppressed. One only needs to walk into a bookshop in China and check the Chinese medicine section: there are always many texts called 'Collection of Experiences of Modern Chinese medicine doctors' (apart from the collections of experiences of ancient doctors). It is wrong to make a judgment on the state of Chinese medicine in modern China purely on the basis of the few textbooks translated into English and on the basis of the curriculum of the courses run for foreigners. That diversity is not suppressed is also evidenced by the reverence demonstrated towards old doctors 'lao zhong yi'") and the appreciation of their particular styles and theories.

Secondly, the term 'TCM' is difficult to define as a particular style of acupuncture in the West. There is certainly no uniformity of 'TCM' acupuncture among Western practitioners. For example, if TCM is defined as 'Chinese medicine and acupuncture as they are taught and practised in modern China', then I personally do not practise 'TCM' and neither do any of the colleagues I know.

There is an on-going debate as to how much the modern Chinese (post 1949) have changed, excessively 'systematized' or even corrupted Chinese medicine and acupuncture. This is a very wide issue that could actually be the subject of a book in itself. Of course the modern Communist Chinese regime has influenced Chinese medicine, in the same way as any previous dynasty also influenced Chinese medicine. Undoubtedly, there has been a 'systematization' of Chinese medicine which, in my opinion, was dictated more by the need to train vast numbers of doctors of Chinese medicine in the dramatic public health situation of 1950 than by the desire to consciously impose a Marxist orthodoxy onto Chinese medicine. Moreover, some of the 'systematization' actually started before 1949.i

The new Communist government was faced with the huge task of delivering healthcare to a population weakened by innumerable infectious diseases, malnutrition, 25 years of civil war and famines: the new Government made the conscious decision to rely on Chinese medicine and raise it to a new level. They had little choice but to do that. Indeed, they did that not through a conviction in the value of Chinese medicine but out of sheer necessity as many millions of peasants relied only on Chinese medicine for their health.

Another important factor that drove such 'systematization' was the necessity to make Chinese medicine appear more 'scientific' so that it would be more readily accepted by the Western-trained Chinese doctors of Western medicine. We should realize that there was a fierce struggle going on in the Chinese Ministry of Public Health in the 1950s between the promoters of Chinese medicine and the 'modernizers'. Again, such need to make Chinese medicine appear more 'scientific' started before 1949. Indeed, it was in the 1930s and at the hand of the Nationalist government (of Chang Kai Shek) that they tried to suppress Chinese medicine entirely.

The systematization that occurred in modern China, therefore, was more the result of a necessity to set up solid colleges with a common syllabus that could train thousands of doctors of Chinese medicine in a rational manner, rather than of a conscious Marxist agenda bent on suppressing divergent views. Any group of persons which decides to set up a college needs to draw up a syllabus that necessarily represents a 'systematization' of a subject and one that necessarily includes certain subjects and excludes others.

That the modern...