Professor Donald Harper
Kegan Paul: London (The Sir Henry Wellcome Asian Series), 1998
Hardback. 549 pages. £55 $93.50

(Reviewed by Vivienne Lo, EJOM Vol. 3 No. 1)

In a world in which we constantly re-interpret tradition to suit our own contemporary fetishes, hang pretty crystals on the pine beams and cite bad translations of the Nei jing to justify newfangled theories of 'traditional Chinese medicine' does history really matter? Isn't immediate clinical efficacy a higher ideal? People often ask me, "does the study of history have anything to do with your practice?" And that is a hard question to answer. Yet in the same breath I hear claims of the 'thousands of years of clinical practice' that are at the foundation of our work and professional competence. If those claims of 'thousands of years' have any validity it must then be our professional responsibility to invest some time and effort into understanding who those practitioners were and what it was that they were doing during all those hours of practice.

The problem is that most histories of Chinese medicine are either anachronistic or so dry and crusty that modern practitioners have no patience for them. Surely a new history of early Chinese medicine, and an academic one at that, is simply just another idiosyncratic interpretation of the distant theories of remote peoples and their even more elusive practice. Can it have any bearing on our work? The beauty of Professor Donald Harper's Early Chinese Medical Literature is that it is both a rigorous account of a narrow and pivotal time in the development of early Chinese medical theory and practice, as well as an easy read. Being focused on a medical literature full of the familiar physiology of qi, jing and shen but, unfamiliarly, couched in texts that are not only concerned with the treatment of illness but also with sexual practice, callisthenic exercises, drug treatments, as well as an exotic array of magical recipes, spells and incantations makes Harper's book essential entertainment.

Archaeologists excavating tomb 3 (closed in 168 BC) at the Mawangdui burial mound in Changsha, Hunan, in 1973, discovered the richest cache of ancient manuscripts ever unearthed in China. Seven of the manuscripts are concerned with different approaches to the cure of illness and/or the enhancement of life. Altogether they provide us with a unique window into the medical world of late Warring States and early imperial times. Harper's translation of the entire medical corpus is the first ever into any language. Unlike received texts, such as the Huang di nei jing, they have not been tampered with by generations of editors keen to re-arrange and re-order according to the prejudices of their own time. Harper's translations are based upon the photographic reproductions of the manuscripts and the transcripts published in Beijing in 1985. He has painstakingly corrected the original transcription. Together with a wide-ranging introduction, the extensively annotated translation represents the finest of sinological scholarship available in the west today. At the same time Harper's style is straightforward enough to be accessible to those with no sinological training.

Harper is well qualified to present these texts; his 1982 PhD thesis introduced and translated the Wu shi er bing fang (52 Recipes), the longest of the manuscripts. Included in the recipes are pharmacological, surgical, exorcistic and magical methods of treating illness. Since then Harper has published on other aspects of the Mawangdui medical literature, in particular the sexual and breath cultivation practices. He is currently writing on aspects of divination and prognostication in the Huang di nei jing. Hidden in these texts we will find the roots of many of the concepts that we know in TCM today. From lyrical ways of describing the anatomy of the body to techniques of physical alchemy (working on the body's qi and jing) and incantations to exorcise illnesses caused by the ghosts of our ancestors, it's all in the Mawangdui medical manuscripts.

There are few other scholars working on the Mawangdui medical texts in the west. Annotated texts with extensive commentaries of some parts exist in Chinese and Japanese, most notably by Ma Jixing and Yamada Keiji, but this will come as no consolation to most EJOM readers. What should most distinguish Early Chinese Medical Literature for the members of the Chinese medical profession is its comprehensive introduction to the world of medical people, ideas and practice as it was developing through the few centuries before and after the establishment of the first empire (221BC). In this short period of rapid political, social, intellectual and technical change the environment was ripe for fostering the theories and practices at the foundation of acupuncture, moxibustion and Chinese pharmacology. Of particular interest to acupuncturists are the earliest extant texts to describe the mai which are direct antecedents of those treatises that describe the jingmai in the Huang di nei jing.

There are many reasons to celebrate the long-awaited publication of this book. Having taught a course in the history of Chinese medicine to first year acupuncture students at last I have something new to add to the reading list. This must be the first substantial contribution to the field since Unschuld's Medicine in China volumes published way back in the mid eighties. Medicine in China was ambitious in its breadth and scope. Harper's strength, in contrast, is in his attention to fine detail, but his book is anything but a dry history and has something in it for everyone. For me his great contribution to Chinese medical history has been to broaden the field by demonstrating that the late Warring States and early imperial medical tradition was much richer and more varied than we might imagine on the evidence of the received medical canons alone. The eclectic tastes of the original owner of the Mawangdui medical manuscripts reminds us of how much more we can get out of our medicine if we pay careful attention to lifestyle, both ours and our patients. It reminds us to value diversity in practice, rather than totally embracing the ever-increasing specialisation that is symptomatic of our times. In summary, Early Chinese Medical Literature is essential reading for anyone with a serious interest in traditional Chinese medicine.

Vivienne Lo
Vivienne Lo qualified as an acupuncturist about 20 years ago and is a founder member of the Traditional Acupuncture Centre at Waterloo in London where she currently practises. She graduated from London and Cambridge in Chinese and taught the Chinese Medical History module at the University of Westminster for 2 years. She is a Wellcome Fellow at London University, working on the interpretation of early Chinese medical literature.