- Essential Subtleties on the Silver Sea: The Yin-hai jing-wei: A Chinese Classic on Ophthalmology
Western scholarship on the history of medicine in Asia has, until recently, focused on a few available sources in translation or on recent Chinese editions, and has drawn broad generalizations from these sources. Fortunately, more critical translations of older texts are becoming available for study, and this book is a fine example of this new scholarship. The older, overstated histories will soon be supplemented with more detailed, nuanced, and scholarly reappraisals of this important aspect of Chinese culture. This translation of Yin-hai jing-wei makes available to English-reading scholars the text of a standard work on conditions of the eye. This book provides a close look at both the conceptual and practical basis of medical practice as it relates to the eye in traditional China. In addition, the translators have provided a substantial commentary on the context of this work that is valuable in itself.
The Yin-hai jing-wei (Essential subtleties on the silver sea) was compiled sometime between the Song and Ming periods; the earliest edition known is from the late fifteenth century. Sixteenth-century editions are still extent, and two Japanese editions from the seventeenth century are known. Interestingly, these early editions contained illustrations, albeit rather simple, of eye anatomy. The Chinese text is presented with the annotated translation interposed between each topical division of the text. More competent observers than the present reviewer have attested to the philological aspects of the translation.
To the medical historian, this translation offers clear evidence that older views of Chinese medicine, often presented in surveys of traditional Chinese medicine, are superficial at best, and more often simply wrong. This treatise shows clear evidence of medical specialization, balanced emphasis on surgical and pharmacological approaches, and the syncretic influences of Indian medicine on Chinese thought and practice. In the introductory essay, the authors present a chronological account of earlier Chinese writings about the eye and its afflictions, and indicate the role of the eye in the medicine of systematic correspondences. They further elaborate on Unschuld's interest in the tension between the functional and ontological approach to illness within the context of traditional Chinese medicine.
A strong theme in this book relates to the position of anatomy in Chinese medicine. The conventional account is that anatomy in any Western sense of the term was of little or no interest to the Chinese until at least the early nineteenth [End Page 1] century. This text suggests otherwise. The role of anatomy, albeit ambiguous, in Chinese ophthalmology is emphasized while its limited effects on the conception of disease and its treatment are also noted. For example, Kovacs and Unschuld suggest that the language used to describe the relationship of the eye to its traditional inner correlate, the liver, via "conduits" is evidence for the Chinese belief in actual, physical hollow tubes carrying material stuff, not simply a metaphysical concept of action at a distance.
Another theme in the introductory commentary is the important distinction between "disease as a theoretical construct and as a perceivable affliction." This distinction is critical to keep in mind in cross-cultural comparisons as well as in the interpretation of historical material distant in time from our current context. For example, the authors resort to the neologism "pathocondition" to warn the reader away from the pitfall of confounding the manifestation or evidence of an illness (zheng) with its cause (in a Western sense as well as in terms of the theories of systematic correspondence). The translation is remarkably free of Western diagnoses and modern categories of disease. Even the footnotes and the index are restrained in this whiggish practice. There is an index of prescriptions from the Yin-hai jing-wei given in both Chinese and English, as well as an appendix containing an alphabetic list (in pinyin) of the drugs mentioned in...