The Evidence-Based Primary Care Handbook

Shigehisa Kuriyama has written a brilliant study of how ancient Greek (and Greco-Roman) and Chinese medicine represented the body. Concerned with the visual and literal vocabularies of medicine and the map that they draw of the body, Kuriyama provides detailed studies of how these systems work and of how they differentiate themselves from one another. Thus, the chapter on “the origins of the muscular body” asks why ancient Greek medicine initially did not “see” the muscles, but learned eventually to do so, while ancient Chinese medicine never truly discovered the muscular system. Shigehisa Kuriyama claims that Greek medicine “learned to see” over time; building on anatomical dissection, while Chinese medicine relied on a powerful philosophy of the body that precluded anatomy. Reality testing, however, is sufficient only if there is a philosophy, which demands the accretion and change of knowledge. This is present in Greek medicine, at least until it becomes canonized in the early middle ages. Indeed, one of the most striking things about Shigehisa Kuriyama’s book is that it gives one a strong claim to understand what happens to flexible versus rigid systems of representation in different historical contexts. Thus, the representation and transmission of Greek medicine through Arabic and Hebrew sources into Latin Europe creates a canon of medical truths that exist until Vesalius. Indeed, the power of such models, as has been well noted, is such that even Vesalius, who takes Aristotle’s model of the body to task, is unable to see such anatomical features as the Fallopian tubes because of his mirror-like response to Aristotle. Only his student, Fallopius, is able to make the break. On the other hand, Chinese traditional medicine in Japan (and later in post–Republican China) amalgamates itself into Western medicine. Traditional medicine is banished as part of the Westernization of the Meiji revival, and its reappearance only after the beginning of the 20th century is in very different form. The very nature of the models used in traditional medicine shift. Thus, by the 1950s acupuncture comes to be used as anesthesia during surgical procedures. Given the refusal to open the body in traditional systems of Chinese medicine, such a use would have been literally “unthinkable” before the introduction of Western models of medical thinking.