Acupuncture Medicine: Its Historical and Clinical Background (review)

This is an idiosyncratic book: neither history nor clinical guide, it is, rather, one researcher's summary of East Asian philosophical concepts as applied to health and the human body. Yoshiaki Omura's educational background is in modern science and medicine, with a long-standing professional interest in East Asian medicine and its history. In 1972 he performed acupuncture analgesia for surgery in the United States, the first known such event outside China. Omura presents this book as a work of cultural brokerage, one that attempts to make the indigenous ideas underlying acupuncture comprehensible to Western readers. In doing so, he takes pains to compare East Asian concepts with similar ones from Western traditions. For example, in the chapter on diagnosis, iridology in the West—the use of the appearance of the iris of the eye to diagnose—is compared to similar concepts described in Chinese medical handbooks. The use of physiognomy and palmistry, East and West, is also compared and contrasted. What is not discussed is the fact that all these techniques are marginal to medicine everywhere.

Students of Chinese medicine and culture will find the second chapter, "Anatomical and Pathophysiological Concepts of Oriental Medicine," useful for its description of classical theories underlying the use of acupuncture. In particular, the summary of the meridians, or channels, of qi flow, and the accompanying translations of the acupoint names, will be useful for students without knowledge of Chinese or Japanese: the meanings of the point names often bear considerable relation to their clinical usefulness, information that is lost when students merely learn "LI4," or "large intestine point 4," for example. That said, the link between meaning and use is rarely made explicit, and the clinical indications given here sometimes fail to mention the most obvious—for example, that the point LI4, or hegu, is most often used today in pain management.

The author repeatedly refers to modern medical research to shed light on why particular oriental medical ideas, though "primitive," may have empirical usefulness. As he notes, the book was originally intended to describe only those aspects of East Asian medicine that have been either vindicated by modern research or "statistically proven for centuries to be very effective in treating patients" (p. 259). In the course of writing, however, he reconsidered, deciding that the results of even modern medical research were better understood against the background of classical concepts of yin, yang, the Five Elements (or Five Phases, or Five Agents), and the flow of qi (ki in Japanese). The resulting presentation is successful in treating Western and Eastern ideas symmetrically: both cultures appear equally superstitious and inventive in producing unlikely correlations between outward signs and bodily health.

As someone trained in Chinese medicine and its history, I found the descriptions of techniques found only in Japanese traditional medicine, such as diagnosis by abdominal palpation, to be interesting. Physicians of modern medicine may find the summaries of research into aspects of oriental medicine helpful if they are considering using (or referring patients for) acupuncture. On the other hand, Omura cites relatively little of the huge research literature on acupuncture; the book has no bibliography; and the rendering of Chinese names and terms is inconsistent and often does not correlate with any known romanization system. The author reproduces several diagrams from eighteenth-century Japanese texts without mentioning their origins in older Chinese medical classics.

The book ends where Omura's career in this field began, with acupuncture analgesia—in a conclusion that can only be described as confusing, with too much information summarized in a handful of poorly organized pages. In attempting a synthesis of East and West, traditional and modern, the author has produced a book with many useful and interesting nuggets of information, but with no obvious constituency of readers. A pity.