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Reviews Illustrated Chinese Moxibustion Techniques and Methods Professor Chang Xiaorong, Professor Hong Jing and Professor YI Shouxiang Publishers: Singing Dragon Press, London Paperback, pp.350 ISBN: 978-1-84819-087-0 Price (RRP): £29.99 blended with the cultural idiosyncrasies and artefacts of the translation process that we have come to know and love. The first 20 pages covers basic moxa theory well; its effects in traditional terms, general indications and application in bu fa and xie fa (strengthening and draining), warming, moving and so on. Discussed too are numerous issues such as contraindications, selection of suitable points, dealing with sores. All this is expressed using the Chinese medicine explanatory model as well as connecting, to some degree, to the realities of biomedicine. For instance: ‘The heat of moxibustion can warm, supplement and support yang qi and treat vacuity qi desertion. From the perspective of modern western medicine it can regulate the body’s stress levels and raise tolerance, regulating various glandular functions and maintaining the organisms physiological functionality.’ Here we see another dimension of the concept ‘very Chinese’. The biomedical notions alluded to seem rather vague and, to the critical, raise more questions than they answer. You have got to admit that it is hard to be much more vague than ‘regulating various glandular functions’. These days it is possible to be more specific and detailed about the effects of moxibustion on physiological function; on the specific alterations in immune responses it can elicit, its effects on nitric oxide, blood flow, and so on. It seems a shame that such a detailed textbook should be so coy about the literature on actual physiological effects. First I should reveal a personal bias – I love moxibustion! If forced to choose between needles or moxa I might well go for the smoky option. Needles are nice but moxa is marvellous, it just does so many things so well. Following this we have 30 pages of basic data on the traditional points with illustrations and basic indications tabulated – again ‘quite Chinese’, for instance the heavy emphasis on ‘atrophy and paralysis of the legs’. Most leg points are given this attribution but it is not too clear what actual conditions are referred to; stroke? multiple sclerosis? traumatic nerve injury? spinal stenosis? old age? This section is useful if you are a novice but less compelling for experienced readers. We have seen the publication of quite a few moxa texts in recent times, each one taking a distinctive approach and each one very distinct from the next. This book is quite different in style and content from two other leading contenders; Moxibustion – the power of mugwort fire by Lorraine Wilcox and The Moon Over Mastushima by Merlin Young. Wilcox’s book takes as its reference point the historical literature on moxa and so gives a strong sense of treatment from the perspective of the historical tradition. Young’s book is more like a collection of fascinating and chatty miscellaneous essays on all aspects of moxa – a style and content quite different to the text under review here, which is a bit more normal. I like the chapter on moxa for yang sheng – health cultivation with its numerous subsections such as ‘foster and supplement original qi and protect against disease’ and ‘perseverance is golden’ and ‘fortify brain, boost intelligence’. The key points and methods used in yang sheng treatment are covered extensively and, again, the pronouncements are couched in the classic Chinese style. On Bl 43 we are informed that: ‘moxa of this point can perfuse and free yang qi, kill worms and calm panting … A common folk custom is for children to moxa this point at 17 or 18 years of age … to raise their ability to resist tuberculosis and common cold.’ Illustrated Chinese Moxibustion – Techniques and Methods is ‘very Chinese’ – personal shorthand for a mix of positive attributes These days, part of our new-found maturity as a profession entails applying a little more criticality to the representation of what 48 The European Journal of Oriental Medicine Reviews acumoxa can and cannot do (and equally to what modern biomedicine can and cannot do). It is hard for me to adjudge the effect of moxa on this point on killing worms but I do feel that nowadays our textbooks should themselves include a touch more criticality. Next we get some very good information on moxa itself; its different forms, the manufacturing processes used, the use of other combustible substances such as juncus grass pith, which is referred to as juncibustion. This is where you take the pith out of the Chinese grass deng xin cao, dip it in oil and then apply burning end to acupoints. There is excellent information on non-heat moxa methods – the use of irritant substances on the skin such as mustard seeds and garlic that are quite commonly used in China. The subsequent chapter, on special moxa methods, is excellent too and describes many ways of using moxa stick including one of my personal favourites – pressing moxa. This involves momentarily pressing a moxa stick into tissues using cloth or paper partitioning. I know from experience, first as a patient and then in my practice, that this produces a deeply penetrating sustained warmth that often provides rapid results. Other partitioning methods include the use of fuzi (aconite) cake, garlic, ginger and moxa of the eyes using walnut shells – another wonderful, if slightly bizarre, method to experience for yourself first. terminology. Overall, as a student text or for one wishing to develop high-level clinical moxa skills I warmly recommend this book. For those fascinated by scholarship of classic texts get Wilcox’s book and for endlessly engaging bedtime reading seek out Merlin Young’s eclectic text and so help fund his Moxafrica project. Charlie Buck has enjoyed three decades in the world of Chinese medicine and was one of the very first to practise Chinese herbal medicine in the UK. As an author and educator he has made significant contributions to the development of Chinese medicine in the UK and Europe. Rooted equally in both classical Chinese medical scholarship and in science, Charlie’s teaching has been described as lucid, engaging and insightful. He is currently chair of the British Acupuncture Council. ejom The rest of the book is a reference formulary that discusses well over 100 conditions, point selection and the most appropriate moxa techniques for each condition. Some of the conditions the authors cover here I have not seen discussed elsewhere in relation to moxa treatment such as psoriasis and chronic fatigue syndrome. As an example, a section on excessive armpit sweating says: ‘… shave the armpit, and then mix starch into a paste with an appropriate amount of water, applying it to the underarm. A needle-like black point will appear on the surface of the starch paste; this is the area of a large sweat gland. Put a small moxa cone on the black point and perform direct moxa, 3-5 cones each time 2-3 times per week.’ This is neat and, as with many of the numerous other interesting clinical tips to be found here, is obviously born out of practical experience. All in all, this book succeeds in delivering a comprehensive and enlightening Chinese-style presentation on the practice of moxibustion. ‘Very Chinese’ is fine by me and is largely the language-culture issue that we accept or even enjoy. The weak point is the lack of anchoring of the material in efficacy and mechanism research and in meaningful biomedical The European Journal of Oriental Medicine 49 Reviews The Double Aspect of the Heart Elisabeth Rochat De La Vallée Translated from the French by Madelaine Moulder Publishers: Monkey Press, 2012 Paperback: pp.80 ISBN 978-1-872-468-129 Price: £7.50 The Double Aspect of the Heart is one in a series of titles offered by Monkey Press, including a translation and commentary on chapter 8 of the Ling Shu; it joins the existing works on The Heart, The Heart Master and The Triple Heater. These are nicely framed and attractive volumes, reasonably priced. The Double Aspect of the Heart is a small pocketsized book; it consists of an introduction by Alan Hext, four main chapters and a bibliography. This is not an authored text, but a transcription of a lecture in the French language. The Double Aspect of the Heart has relatively few footnotes, and uses Chinese characters and Mandarin pronunciation after technical terms rendered into English. For example, Mr Hext speaks of the zang fu, without an explanation but the text supplies the Chinese characters and the Mandarin pronunciation e.g. the formless (wu xing 無形). Mr Hext tells us that the text is based upon the classic, the Ling Shu, and ‘complements the teaching of the five elements/phases’ and that it ‘reveals the relationship between the heart, the heart master and the sovereign fire (jun huo), and the ministerial fire (xiang huo).’ There are no illustrations, charts or graphs. I imagine the intended readership of The Double Aspect of the Heart to be attendees of De La Vallée’s lectures (held at University of Westminster through Peter Firebrace’s Orientation) or devotees of this tradition. Hence the text lacks explanatory information which new readers require; there is simply not enough introductory information or enough background. There is too much Daoism for the practical acupuncturist, not enough ‘meat’ 50 The European Journal of Oriental Medicine to satisfy a Daoist seeker of truth (Mr Hext speaks of ‘the dao and the de, the ways of manifesting virtue’), while charts of points and pathways would be needed for the non-practitioner or the neophyte. This book does not attract the novice to this lineage, or speak to the unconverted. The practice of acupuncture within the clinical setting requires us to perform the roles of clinician, historian and anthropologist. My criticisms here are with the presentation of the text, rather than the commentaries by De La Vallée. From the standpoint of a historian, the introduction is misinformed: there is no extant, original copy of any of the classics referred to; these and all medical books were rewritten and reconfigured by government in the Song period (960–1279 AD). The new Song government required structure and textual information to conform to its agenda. The allusions to ‘one ruler, and obedient ministers’ suit that agenda precisely. These political ideals intended to bring order to the world by replacing the previous aristocratic order. Texts which could not be made to conform to Song policy had their wooden plates burned, and ceased to exist. Hence being a ‘classic’ is no reason in itself for a text to have merit, especially when what exists is a replacement text under the name of the original. A text must prove itself to be relevant to each generation of users by being relevant in place and time. Repeated references to ‘the classics’ coupled with a bibliographical reference as brief as the Ling Shu tend to imply reference to an unambiguous, solid authority. Thus keeping to the illusion of textual authority, the bibliography simply lists documents, and would be more correctly described as suggestions for further reading than as a tool for exploring and further understanding the comments from De La Vallée. It is not made clear who De La Vallée is, nor the sources and origins of her commentaries. As a practitioner, and one who has not studied acupuncture or herbal medicine in Europe, but in Tokyo and in Beijing, this text is difficult to place clinically. Mr Hext describes the dao and the de, the ways of manifesting virtue. Daoism, and mysticism do not sit well with the attention to substance in the Japanese interpretations of medicine. In some traditions, illnesses described as resulting from problems with the flow of qi are to be treated as ‘internal’ problems. Does that apply to this text? Rather than the virtue of being based on a classic, it is the practitioner aspects common to medical anthropology which commend this book and indeed I recommend it as essential reading for acupuncturists, shiatsu practitioners, reflexologists, kinesiologists, those interested in macrobiotics and all Western practitioners who wish to understand all medical traditions related to the ideas of pathways, meridians, channels, qi, five element theories, etc. Attending such lectures on medical classics and Reviews listening to commentaries from elder statesmen of acupuncture or medical history is an established and a treasured way of study. For how else is the novice student to reflect on why treatments come to produce successes or failures, or to move beyond the mechanical point prescriptions of the classroom? Without interpretative readings, we will find the students of Chinese medicine supplement their lack of reflective understanding with bits from other disciplines, homeopathy, or the transient truths of ‘science’. These commentaries give a framework and vocabulary useful for describing to European patients how Chinese medicine might be working for them. The commentaries provide a language and framework for debates such as the role of a revival of the sensory aspects of the four diagnostic procedures. For a practitioner to note appropriate that ‘in case of fullness there is pressure in the diaphragm, in the case of emptiness, one can no longer speak’, from chapter 10 of the Ling Shu, requires the development of a keen skill set in listening, touching, and the sensory aspects that come from patient/practitioner contact. Following the advice from the conclusion on page 66: ‘through the heart the human being takes responsibility in life’, I would like to see Monkey Press take responsibility for these works by producing a heart-led introduction that places the teaching inside some known category; to clarify its translated sources and to offer a proper bibliography. It would also be helpful to provide a commentary/context to De La Vallée’s commentary. In summary, the kind of commentary De La Vallée presents is essential for those who wish to understand Chinese medicine in the English language, and there are many keen to do so. The potential is immense. Gretchen De Soriano is an acupuncturist and medical anthropologist (Oxford University 2010). She was awarded Wellcome Trust funding to investigate medical illustration in early Japanese texts. She studied acupuncture and the Japanese herbal tradition, kampo, for eight years in Tokyo, and a year in Beijing. Her translation of the text, Kampo I Gaku,漢方医学 was published in 2010; from 2012 she is leading a team developing an app to reference kampo terminology. ejom The European Journal of Oriental Medicine 51