Angela Hicks, John Hicks and Peter Mole Churchill Livingstone, 2004 Hardback, 404 pages, £35
(Reviewed by Alan Hext, EJOM Vol. 4 No. 6)
This major work by the joint Principals and Dean of the College of Integrated Chinese Medicine is destined to become a landmark textbook for acupuncture students and practitioners. It contains much to stimulate those using the Elements in their practice, whilst also being informative to the sceptical and those bemused by this approach’s continuing attraction. They may be persuaded by the recommendations on the back cover from Giovanni Maciocia, Peter Deadman, Ted Kaptchuk and Lonny Jarrett, who give due recognition to the book’s genuine wealth and breadth.
The book is systematically structured in the Churchill Livingstone publication’s house style, providing a richness of information which is both clear and accessible. Following the introduction, each Element is presented with its resonant correspondences, illustrated by their Chinese characters and accompanying explanation. The Element’s associated organ-officials are described and then elaborated with a chapter identifying their patterns of behaviour, frequent life issues and their responses to these. The key methods and process of diagnosis are described. The focus is on accessing the roots of a person’s condition, addressing them as a whole and understanding symptoms in this wider context.
There are the expected chapters on blocks to treatment with their recommended treatment procedures. Each meridian is covered by a selection and practical explanation of over 220 acupuncture points. The chapter on needle technique is enlivened with a description of how much the development of the skills being described requires the cultivation of the practitioner’s awareness, which is an underlying theme of the book.
The chapter on the inner development of the practitioner reflects the realities that this way of working is more than merely the technical application of theory. The authors detail the human qualities requiring conscious development that make this approach both challenging and rewarding, a path that might be called a true practice.
What are especially valuable for the practitioner are the sections looking at the process of diagnosis, treatment planning and evaluating patient responses. The selection of patient cases with treatments brings the reality of clinical practice alive. The final section introduces ways the authors integrate a Five Element Constitutional approach with TCM, illustrating this with case analysis and a protocol for treatment.
The book follows the recent publication of Lonny Jarret’s Clinical Practice of Chinese Medicine and Nora Franglan’s Handbook of Five Element Acupuncture which draw upon the pioneering teachings and writings of the late JR Worsley. Five Element Constitutional Acupuncture firmly roots this approach in ancient traditions whilst continuing the work of proving its contemporary therapeutic relevance. It frequently references classical texts, especially honouring the illuminating work of the late Claude Larre and of Elisabeth Rochat de la Vallee, published by Monkey Press.
The extensive teaching and clinical experience of the authors is seen in the wisdom contained in chapters on the practicalities and traps of diagnosis and common confusions between different clinical manifestation of Elements. In this book we are rewarded with the fruit of their experience in training acupuncturists, particularly the teamwork of their College in Reading over the last 11 years.
As this publication is intended as an authoritative text, a review necessitates careful scrutiny. In the chapter on Water resonances the Chinese character they select for the colour is qien, (mistakenly naming it kan). The character more commonly used in the Nei Jing where the key presentation of the Elements occurs in Su Wen 4 and 5 is hei, (Wieger 40 D), the sooty darkness which their text describes on page 154.
When listing the ‘secondary resonances’ of the Elements, the authors use the term residue to describe for example the nails in relation to Wood. They are referring to the way the qi of an Element expresses itself in us, what is classically its flourishing aspect, its ‘blossom’ (hua). The term residue, with its implication of something left over, misses the meaning of the way an Element physically manifests the power of its qi in bodily form.
It was surprising to find in the chapter on Fire, the Element’s residue being given as hair, (page 86). They cite a reference in Wiseman’s Glossary of Chinese medical terms (page 76), where hair on the head is stated as the surplus of blood. However, in Wiseman’s larger Dictionary (page 251) he clarifies this, stating the hair (of the head) as the surplus of the blood related to Liver blood, (rather than blood in relation to Fire). The more usual Elemental association for head hair, is contained in another Wiseman Dictionary entry, where the power of the ‘Kidneys (as Water) manifests as the bloom of the hair of the head.’
The treatment style detailed in this book came to be brandnamed ‘Five Element’ in the last two decades of the twentieth century. The work of JR Worsley might be more fully entitled Five Element and Twelve Officials. His brilliance was to bring the Elements alive through their direct relationship with the natural world. The Officials can be accessed as embodiments of the Element which a practitioner can relate to as living characters in a patient. This book appropriately quotes and acknowledges Chapter 8 of the Su Wen of the Nei Jing where this awareness of the Officials as a team under the leadership of the Heart is introduced.
The authors opt for the title Pericardium for the official in relation to the heart following the current Chinese choice. This reflects a more recent emphasis on the anatomical compared with energetic functions of the original descriptions. In their book the authors discuss the various names, but fail to mention a key title Xin Zhu, (literally Heart Master), which can help comprehend its role of the Heart mastering the circulation of blood and joyful spirits. In the Nan Jing 25 it is described, along with its couple, the triple heater, as a name without a form. In the published lecture on the Su Wen 8 even Father Larre asked for a minute’s silence to commemorate the death of the term Xin Bao Luo as the official’s title.
The book reinterprets the acronym CF as constitutional factor rather than causative factor, or my preference core factor. Constitutional may imply that what is being described is genetically inherited, (another thing for patients to blame on their parents!). The choice does however skilfully bypass the potential misunderstandings of the term causative and the dangers of categorisation in the guise of real diagnosis. Valuable insights into a patient’s core imbalances can turn a holistic vision into a perverse simplistic reductionism. Strangely, such a critical diagnostic practice has rarely been publicly questioned, e.g. Jan Resnick’s article in Pacific Journal of Oriental Medicine when he took over editorship.
When taking a case record of a patient, the authors use the term golden key in relation to ‘unusual behaviour’. I have always understood it as the way that the Elements and Officials can innocently express themselves, revealing direct truth about the roots of their imbalance.
This is the first major work on the subject by an international publisher. They have priced it at a very reasonable £35 for its information rich 400 pages. It deserves a wide readership. In the current context of the ‘academisation’ of the transmission of acupuncture and bureaucratic regulation of our profession this book gives this tradition accessibility, credibility and authority. It draws on wisdom and practice originating in the Orient which has now become established in the West. There is a certain rightness that this book is printed in China. The circle is complete.
Alan Hext Alan Hext taught with the book’s authors in the 1980’s at the College of Traditional Chinese Acupuncture. He currently teaches at the School of Five Element Acupuncture in London and is also a practitioner and teacher of Zero Balancing bodywork. Alan has recently moved to practise in South East Dorset in the UK.