Essential Subtleties on the Silver Sea: The Yin-hai jing-wei: A Chinese Classic on Ophthalmology (review)

Bulletin of the History of Medicine 75.1 (2001) 123-125

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Book Reviews

Essential Subtleties on the Silver Sea: The Yin-hai jing-wei: A Chinese Classic on Ophthalmology.

Jürgen Kovacs and Paul U. Unschuld, trans. and annotators. Essential Subtleties on the Silver Sea: The Yin-hai jing-wei: A Chinese Classic on Ophthalmology. The Chinese Medical Classics. Comparative Studies of Health Systems and Medical Care. Berkeley and Los Angeles: University of California Press, 1998. xii + 503 pp. Ill. $65.00; £46.00.

With Essential Subtleties on the Silver Sea Drs. Jürgen Kovacs and Paul Unschuld provide a new translation of a Chinese medical text not only for historians of medicine but also for practitioners of Chinese medicine and biomedicine. Paul Unschuld has published two previous books in this genre: the first, Nanching: The Classic of Difficult Issues (1986), presented an important second-century consensus on eighty-one problems in the medical canons of antiquity, which Unschuld translated along with Chinese and Japanese commentaries on the same text from the third to twentieth centuries; the second, Forgotten Traditions of Ancient Chinese Medicine: The liu lun of 1757 (1990), is an eighteenth-century collection of essays on various medical topics from history to practice by one elite physician. In contrast to these two more broadly cast texts (the first theoretically and the second topically), Kovacs and Unschuld have here translated a sixteenth-century text on one medical specialty, ophthalmology.

What, then, does "silver sea" mean in the title? "Silver sea" was used metaphorically for eyes in an eleventh-century poem that refers to how light reflecting off freshly fallen snow "dazzles the eyes [lit., silver sea] with sparkles" (p. 123). Although recent scholars have attributed this text to the famous seventh-century physician Sun Simiao (581-682?), the authors concur with eighteenth-century scholars during the Qing dynasty (1644-1911) that it was most likely compiled from different sources during the fourteenth or fifteenth century (pp. 53-54). It thus represents the state of ophthalmology during the mid-Ming dynasty (1368-1644) more accurately than it does any earlier period. To better understand what preceded this text, the authors have written a substantial history of ophthalmology--from the earliest depictions of eyes on pottery jars of the eighteenth and seventeenth centuries B.C.E., and characters on oracle bones of the thirteenth and twelfth centuries B.C.E., to textual references to eye morphology, afflictions, and treatments in the most important medical texts from the Han dynasty (221 B.C.E.-220 C.E) to the Song-Jin-Yuan dynasties (920-1368). This prolegomenon takes up a quarter of Essential Subtleties and concludes with an overview of the content of the main text, from the anatomy of the eye and classification of eye diseases to pharmaceutical and surgical treatments for eye problems.

The remaining three-fourths of the book are devoted to the translation of the text itself, divided into four sections: editorials and prefaces, introductory material, the nosographies, and miscellaneous topics. The reader will find few leaves left unturned. Ophthalmologists will see a sophisticated practice founded on a basic anatomical knowledge of the eye and a pathological morphology of its illnesses. Unschuld and Kovacs use this text, in fact, as an example to counter conceptions that premodern Chinese physicians employed a purely functional perspective when examining the human body before medical missionaries introduced Western medicine's predominantly anatomical and morphological one (p. 65). They suggest that clinicians from both Chinese and biomedical traditions should read this translation for possible pharmaceutical and surgical interventions they could use today. They will be frustrated, however, with the occasional Chinese or Indian term and title left untranslated (see, for example, pp. 82-83). Historians of medicine, on the other hand, will be interested in an alternative history of ophthalmology with a comparable but different history in the Western world. Explicit comparisons of the role of eye medicine in the development of surgery, medical specialties, and even the...