Pulse Diagnosis in Early Chinese Medicine: The Telling Touch by Elisabeth Hsu (review)

Abstract

Reviewed by: Pulse Diagnosis in Early Chinese Medicine: The Telling Touch by Elisabeth Hsu Michael Nylan Elisabeth Hsu . Pulse Diagnosis in Early Chinese Medicine: The Telling Touch. Cambridge: Cambridge University Press, 2010. xv + 404 pp. Ill. $120.00 (978-0-521-51662-4). This book is a welcome if odd contribution to the expanding field of Chinese medicine. Elizabeth Hsu is a reader in social anthropology at Oxford, and her previous publications include the well-received books titled The Transmission of Chinese Medicine (1999) and Innovation in Chinese Medicine (2001). Hsu's translation of Sima Qian's Shiji "biography" of Chunyu Yi appears in volume 9 of William Nienhauser's The Grand Scribe's Records (2011). By her own telling, Hsu has been working since 1987 on this text, which is mainly a medical casebook detailing twenty-five case histories and eight dialogues on medical rationale and transmission. This protracted history may account for some of the book's oddities, since the field of early China studies has made great strides recently, not all of which are reflected in this volume. (Few items in the bibliography postdate 2002 anyway.) Still, a contribution to the field of pulse diagnosis, especially one comparing the contents of excavated manuscripts with this well-known Shiji chapter, is bound to excite considerable interest. My chief concern is that the book does not (cannot possibly?) deliver on its initial promise to provide a study free of anachronisms and ethnocentricity. The book's undeniable strengths include these: Hsu does a memorable job of separating Chunyu Yi the historical actor from Chunyu Yi the exemplary healer portrayed in Sima Qian's chapter, proving the formulaic nature of the these case histories in three parts, the (1) disorder's name, (2) disorder's cause, and (3) diagnostic quality indicating the disorder. Hsu should be applauded, too, for insisting that Chunyu Yi's treatments are not "primitive magic" (in the style of Frazer), nor "occult thought" (contra Harper), nor "natural philosophy" (despite legions of scholars) (pp. 7, 17), since all the foregoing characterizations presuppose the superiority of modern Western modes of thinking supposedly premised on rationality and reason. Hsu posits three overlapping ways to view the body: (1) the rather static "bodily architecture" of muscles and skeleton; (2) what Hsu calls "the body ecologic," which presumes seasonal change and humoral transformations; and (3) her "sentimental body," whose two main sentiments of grief/joy and anger are generated in the heart and liver respectively, which organ systems then produce the feelings we moderns tend to dub "psychological." Sense perception, especially touch (with visual perception cast as contact/impact in early China),1 plays a key role not only in guiding the body's workings but also in making it readable to technical experts and diagnosticians.2 Equally useful, [End Page 115] if perhaps somewhat overdrawn, is Hsu's observation that Chinese technicians are more interested in synchronicity and cycles than in mechanical causation. ("Knowing how" meanwhile trumps "knowing that.") Crucially, Hsu realizes that qi in Sima Qian's account does not always refer to something that permeates the entire universe; often it operates more locally. At the same time, there are undeniable weaknesses in this book. First, there is a paucity of references to modern Chinese and Japanese secondary literature on classical-era medical treatises, aside from the original reports of excavated finds. Second, having noted—quite correctly—that Chunyu Yi's biography is not really a medical treatise, Hsu quickly proceeds to treat it as such when fashioning her analysis. Far too often she resorts to external evidence from the Huangdi neijing medical compendium for determining the right way to read her text of centuries earlier, when reference to closer analogues, for example, other Shiji chapters, early legal casebooks, and the vast literature devoted to the technical arts, might have shed greater light on the preoccupations threading through in Chunyu Yi's "biography." Third, Hsu is more positivist than the extant sources allow; as we have but one-one thousandth of what once existed, by some estimates, one is inclined to query such definite statements as "the inner aspect of the 'sentimental body' comprised only two feelings, joy/grief and...