As I was helping to interpret for the Q&A sessions at the workshop this morning, I had time to carefully go over the powerpoint presentations before the workshop. Of the four presentations, the one that really caught my attention was delivered by Jing Xianghong of the Chinese Academy of Chinese Medical Science.
She took us from laboratory research - experimentation with epilepsy rat models - to a clinical study on patients suffering from severe epilepsy, and during the Q&A session mentioned that her hospital is currently using their new technique as an alternative to invasive VNS device implantation.
The starting point was an explanation of how vagus nerve stimulation (VNS) is able to reduce the frequency or severity of epileptic seizures through direct electrical stimulation of the vagus nerve. She then explained that, like most other cranial nerves, there are no surface areas of the torso that are innervated by the vagus nerve. However, there is an auricular branch of the vagus nerve (the ABVN), which can be stimulated through the skin in the external auditory canal (and, apparently, the auricular concha - the area of the ear associated with the internal organs in the 'inverted fetus' microcosm image).
From this, Prof. Jing presented their epilepsy rat model showing that electrical stimulation of this area of the ear was effective in controlling epileptic discharge. With this evidence, they went ahead with a 50 subject clinical pilot study where the patients, all of whom suffered from refractory (i.e. not controlled by medication) seizures, had the area of the ear innervated by the vagus nerve stimulated using a small electronic device. This stimulation was done twice a day for 30 minutes each time, and was able to bring about a significant clinical effect in controlling their seizures. (it was more complicated than that, but I don't want to go into that here...)
Next was a larger study with 144 patients that also showed a significant effect.
One of the audience members asked if she had done a direct comparison between this auricular stimulation and conventional VNS, and Prof. Jing responded that they had not compared these two directly, but that in her hospital in Beijing they now use this device in an experimental fashion for every patient who has been referred for VNS device implantation, and that many patients were able to become seizure-free just by doing this external stimulation twice a day, and were thus able to avoid an expensive and potentially risky operation.
A great example of translational (ie from 'bench' to 'bed') research!
Tomorrow morning the pre-conference workshops for the 2013 SAR conference here in Ann Arbor will begin! I've been waiting for this conference for a while and am excited to see it finally roll around.
In order to reflect on the talks and share interesting developments, I've decided to post summaries and comments as frequently as I can during the next four days. There are two workshops tomorrow morning, and I will be at #2 "Challenges of Acupuncture Clinical Research in China." I certainly found doing acupuncture research in China challenging (though perhaps for different reasons than the workshop panelists ;P ), so I'm looking forward to hearing some new perspectives on it.
Even though acupuncture research is a fairly obscure field, there are several 'household names' giving talks in the next couple days, some of which are also personal heroes of mine. I just hope I can keep up with everything without getting burnt out!
Minor epiphany this morning while playing Taiji: "Walking backward along a circular trail" is a much better description of life than "Marching forward", "The forward march of progress" etc.
My Taiji practice consists of repeating one move while slowly moving along a trail in the woods, and the easterly wind and snow was so strong this morning that I decided to start off walking backwards along the trail to keep the snow out of my face. Watching my footprints extend out in front of me put me in mind of history, while looking to the left and right to get my bearings, and occasionally walking off the trail or stumbling over roots and stumps, made me think of how we can only guess at the future by comparing our present point in history with what we know of the 'circular trail'.
There are many observable and reliable cycles: the rising and falling of the sun, the waxing and waning of the moon, the changes of the seasons...we don't really know what will happen next, but by becoming familiar with these circular trails, and knowing our present position in it, we are able to accurately predict and prepare for what will happen next.
There are many other cycles that are perhaps less directly observable and more contentious, such as 'the rise and fall of civilizations', the natural fluctuation of the economy, etc.
The trail analogy could be extended by talking about the trail representing the range of variables that represent our comfort zone or healthy zone, as in temperature, diet, labor and sleep, etc. As I looked back on my footprints I could see where I had not been able to predict the turnings of the trail and walked into a bush (ouch!). We can look to the past to inform us of our limits, and the consequences of going outside them. At the same time we can take steps to ensure that the trail is even more comfortable, by taking care of the trail as we walk along it (removing fallen branches, trimming the bushes on either side, even putting down flagstones...).
It would seem that many insights could be gained by walking backwards along a circular trail every day!
It occurred to me last week, while I was trying to understand the blurb for Prof. Nappi's talk, that a lot of work in academics revolves around identifying concepts from different cultures and comparing them to each other and to our own.
Bodies, for example.
The first step, of course, is to identify the concept - to conceptualize it. What is a body, in this culture? What are the ideas that revolve around and are wrapped up together with the body? Once you are able to tease out the various strands of thought and form a complete and distinct conceptual image, then it becomes possible to compare that image with those from other cultures, or from different periods in time from a single culture.
I'm currently reading through Liu Lihong's Sikao Zhongyi (《思考中医》，刘力红著), a large part of which involves conceptualizing the 'year' from the perspective of yin and yang. I've realized that my 'year', far from being painted in seasons, is wrapped about the image of a calendar that starts with January and ends with December, with the school year and summer break dividing these months into black and white.
As I work my way through the book, I can feel something tugging at this year-image, bulging and warping its proportions. So this is how it feels to move between concepts! My 'year' will be quite a bit different after I've finished this book!
I'm quite disappointed that work will prevent me from attending Dr. Carla Nappi's lecture tomorrow afternoon (see PDF for details), especially as it might have been my only chance at finding out what the word 'Oktosi' means. :)
Dr. Nappi is a prolific scholar whose interviews with current authors in the field of East Asian Studies have introduced me to a number of valuable books exploring various aspects of East Asian medicine and history. According to the flyer, this lecture will be about:
Situating the history of medicine within a broader context of empire in Chinese early modernity transforms the way we understand science and medicine in relation to a historical notion of “China.” Paying special attention to the ways that translation shaped how bodies and their norms were understood in the Qing (1644-1912), this talk will consider the ways that a medical body emerged from Manchu, Tibetan, Mongolian, Chinese, and other language practices.
I have to confess that there are too many unfamiliar concepts in this abstract for me to make any sense of it; starting with the idea of a 'medical body'. I've seen this usage before, but never had a firm idea of what exactly is being referred to. Thinking as I write, it seems that it is used to refer to what a certain culture accepts to be facts regarding the physical body, as informed by that culture's medical professionals. For example, the findings of anatomical studies have played an essential role in the development of modern biomedicine's 'medical body'. In ancient China the 'medical body' was informed primarily by texts such as the Nei Jing, large portions of which cover medical topics.
Now what is confusing me is 'language practices'. The Manchu, Tibetan, Mongolian, and Han peoples were four of the major cultures that made up Qing dynasty China. Each culture had its own language, certainly, but what is being referred to by saying "a Manchu language practice", for example? How much influence could the practices (?) of a certain language have on the development of a 'medical body'? And by referring to 'empire' is Dr. Nappi saying that Qing dynasty China was an empire, rather than a nation? Is the reference to 'Chinese Medicine' in the title talking about the gathering together of disparate traditions into the single field called 'Chinese medicine' in response to the arrival of 'Western medicine' (and culture) in the late Qing? And what the heck does 'oktosi' mean??!!
So many questions...if anybody who attends the lecture or who is familiar with these concepts can enlighten me here, please comment away! :)
Warning: an attempt at humor follows!
I have on my desk two different translations of the seminal text in the field of developmental psychology; “Viridia Ova atque Perna” by Dr. Suess.
As befitting such a work, the first of the translations takes a straightforward approach to the task of translating Dr. Seuss' prose into modern Chinese. "I am Sam" becomes "我是山姆", "I do not like that Sam-I-am!" is translated word for word as "我不喜欢那个“山姆是我”!", etc. Sentences like "Would you? Could you? In a car?", where the exact activity in question is left unsaid, are translated explicitly as "那你愿不愿意，要不要在车里吃?", avoiding any possible misunderstanding. Additionally, Dr. Suess' usage of the terms ‘would, could, may, like’ etcetera are translated faithfully and consistently.
The translator does, unfortunately, take liberties with certain phrases: “Say! In the dark”,for example, is translated as “嘿！摸黑吃呢？”, 摸黑 being a common and course phrase indicating the performance of some activity, probably in the countryside, in the dark. I would preferred a more literal translation; “在黑暗中吃”，for example.
All in all it is quite a satisfactory source－based translation, and I do express my appreciation to the publisher for their quite appropriate choice of 16 point English text with 8 point Chinese text.
This leads me to the second book. I am nearly at a loss of words when it comes to expressing my opinion about the decision to translate ‘Sam’ as the Chinese character 凡 (fan). There is a perfectly acceptable and established Chinese equivalent of the name, 山姆 (shanmu), and just because ‘fan’ rhymes with ‘Sam’, and it allows for aesthetically pleasing lines like 凡是俺／凡是俺／我不喜欢／凡是俺 is no excuse to do away with convention and strike out on one’s own!
Let us look at the line “I would not, could not in a tree./Not in a car! You let me be.”The previous translator, of whom I am so fond, translated it word by word, line by line, adding in missing details not found in the source text: “我不愿意，也不要在树上吃。／不要在车上吃！你别缠着我啦！”. Perhaps not so pleasing in the mouth, or to the ear, but such accuracy! Such faithfulness to the text! It is only with great pain that I can bring myself to enter the version belonging to the latter translator: “我不想在大树上，／更不想要在车上，／拜托你别烦。”. Ok, it is quite nice how the first two lines have seven characters apiece, reminding one of the traditional Chinese 7-character poetry form. And the way each line ends with similar –ang/-ang/-an finals does reflect Dr. Seuss’ own usage of rhyme. But the source! The source! Oh does mine heart weep.
The final straw, the one that broke this camel’s back: my six-year-old daughter, fluent in Chinese, prefers the latter version as well!
ps: In case it was not obvious, I much prefer the second translation, by 郝广才 Hao Guangcai, and published by Yuan-Liou Publishing, Taipei
I have found it extremely difficult to write even a simple blog post about Professor Michele Thompson’s talk on Vietnamese medicine.
If, as Yi-Li Wu said in her introductory remarks, the greatest questions in the study of Asian Medicine are 1) What is Asia; and 2) What is medicine, then how is one supposed to write coherently about the historical interactions between Vietnamese and Chinese medicine?
The modern geographical and cultural boundaries of Vietnam and China are quite clear, but when looking at the historical period in question (the first millennium CE), the boundaries in question are those that existed between the Viet peoples in the south (modern southern China and northern Vietnam) and the Han peoples in the north (modern central China). This is why, in an effort to make this post more intelligible, I’ve avoid using the words ‘Vietnamese’ and ‘Chinese’ entirely, and instead refer only to the Viet and the Han peoples.
And let’s not even get into the question of what is medicine…
There is another issue here, which is that the primary window through which modern historians look at this period is textual, and there was only one written language in this area: that of the Han people. Even the Viet people used Han characters to record their history. In a situation like this any textual researcher must be willing to ‘read between the lines’ and understand not only the writers’ situation, but also that of the people the writers were interacting with and writing about.
I’m simplifying a lot here, but according to my understanding Professor Thompson used three approaches to challenge the conventional assumptions that “Southern medicine came from the North”, or “Viet medicine came from the Han“. The first approach was to examine the textual evidence involving the usage of herbs that only grew in the South. The second was to ‘read between the lines’ of the accounts of northern Han officials sent south to control densely populated Viet areas. The third was to simply look for solid evidence that Han medicine did, as is commonly held, move from north to south, with local southern cultures (the Viet in particular) doing nothing more than supplying herbs for trade to the north.
1) Drawing on the work of Donald Harper, Professor Thompson examined the texts found at Mawangdui, a tomb dating from 168 B.C.E located in modern Changsha, Hunan province (in the south of China) - specifically the document given the name of《五十二病方》(‘Prescriptions for Fifty-two Diseases'). The prescriptions or recipes contained in the document make extensive use of herbs the natural growth range of which was Southern. This includes herbs such as cinnamon, black pepper and hemp. Even though some of these herbs were considered ‘precious’ and commanded high prices in trade between the Viet and the Han, they appeared in many of the prescriptions in the Mawangdui text, indicating to Prof Thompson that the people who developed those prescriptions regarded these herbs as commonplace. Cinnamon, for example, occurs in 13 of the 283 prescriptions, and is the single most called-for ingredient in all the prescriptions. This provides some evidence that, in contrast to the prevailing view that the Han in the north imported these medicinals and developed their usage, these prescriptions or recipes were actually developed in the southern regions.
2) During the period of direct Han rule (43 to 939 C.E.), the areas what is now Northern Vietnam and Southern China had a relatively high population density and plentiful food supply. In Han records of this time by officials sent to control the area, the area was described as ‘venomous, poisonous, pestilential’, and populated with practitioners of witchcraft who could summon disease-causing mists. However, the very fact that the Han attributed falling ill to the work of local enemies practicing witchcraft suggests to Thompson that the locals were not getting ill, at least not from the same diseases that were plaguing the Northern officials; this can be extended to imply that the Southerners had enough knowledge of hygiene and medicine to allow residents of high population density areas to live in relative health. This again is not evidence that Viet medicine had an influence on Han medicine, but it counteracts the prevailing view (perhaps based in part on a superficial reading of the same accounts) that the southern areas were backward when it comes to hygiene and medicine.
3) There is simply a lack of solid evidence that Northern medicine was formally introduced to the region. The prevailing view is that Han medicine was introduced during the period of direct Han rule (43 to 939 C.E.), but the earliest textual evidence dates to the 1400’s, when a Viet medical text showing clear influence of Han medical theory was written.
What I gained from this talk was the understanding that 1) there is little evidence to support the prevailing view of the interactions between Viet and Han medicine, and 2) there is a fair bit of evidence suggesting that the Viet did more than just supply medicinals to Han traders; rather they developed the use of these local medicinals and applied them in ways that later became associated with Han medicine.
I encourage anyone interested in learning more to get a copy of Southern Medicine for Southern People: Vietnamese Medicine in the Making, edited by Laurence Monnais, C. Michele Thompson and Ayo Wahlberg.
*Map credit: Author: Thomas A. Lessman. Source URL: http://www.worldhistorymaps.info/maps.html
For various reasons I've limited myself to one text, mentioned in the last blog post, so this may not be representative of mainstream Chinese views. However, as it is a nationally produced textbook used in all TCM Universities in mainland China, it shouldn't be too far off either.
There is only one paragraph specifically about Chinese-Vietnamese medical communication, in the subsection 'Medical communication between China and other Asian and African countries'. Let me start with that:
According to Da’nan huidian, [a mid-18th century compilation of state regulations in the region now known as Vietnam], the Chinese medical texts Yixue rumen and Jingyue quanshu had entered Vietnam in the Ming and Qing period. The Vietnamese 'medical sage' Lê Hữu Trác (1720-1791), credited with a certain amount of originality and insight, combined local [medical] knowledge with Chinese medical theory in writing the 66 volume text Haishang yizong xinling quanzhi. He discovered and/or fleshed out the functions of 305 different southern medicinals, as well as collecting more than 2850 formulas as used by physicians and in folk traditions, and in doing so founded a complete system of Vietnamese medical theory, methods, formulas, and medicinals. The importation into China of locally produced precious medicinals, including xijiao (Rhinocerotis Cornu), tanxiang (Santali Albi Lignum), longnao (Borneolum), sumu (Sappan Lignum), etc, helped to enrich Chinese medical knowledge.
So basically what we have here is:
Unfortunately I think this is all I'll have time to look at before the talk, but I'm looking forward to what Prof Thompson adds to this!
From the announcement for C. Michele Thompson's talk this Friday (Nov. 9th):
Abstract: This talk will present the history of the exchange of medical products and knowledge between China and Vietnam. It will challenge the conventional assumption that Vietnamese medicine is Chinese in origin and will note that much of Chinese medicine is actually Vietnamese.
This should be interesting! In preparation I will be going through my textbook《中国医学史》* to get the mainstream Chinese perspective on Chinese-Vietnamese medical interactions throughout history, and will post a summary in the next few days.
For more information about the talk, please click this link to view the PDF: Historic Interactions between Chinese and Vietnamese Medicine
Yesterday I attended a talk by Dr. Pierce Salguero of Penn. State University, part of a series of talks on Chinese medicine organized by Yi-Li Wu and Miranda Brown at the University of Michigan.
Professor Salguero started his talk by showing a map of Eurasia, and introduced the term ‘Indo-European Humoral Medicine’, which he uses to describe the common elements between ancient Indian, Greek, and Roman (and to some extent Persian) medical traditions, all of which recognized the four elements of earth, fire, water, and wind, as well as humors such as bile, phlegm, and blood. These ancient cultures were in close communication with each other and shared medical theories.
An independent and distinct style of medicine was developing on the other side of Eurasia: Classical Chinese medicine, as exemplified by the 2nd century C.E. text 《黃帝內經》(Yellow Emperor's Internal Classic). This was the medicine of “qi, yin-yang, and the five phases”, a conceptual framework quite distinct from that of ‘humoral medicine’.
These two distinct medicines were isolated from each other until the ‘waking up’ of the silk roads (including both land and sea routes), and by the 3rd century C.E. there was widespread communication via these routes.
Professor Salguero’s research focuses on the exchange of medical information and practices that were transferred across the silk road networks in the first millennium C.E. He has observed a close relationship between Buddhism and the medical information (goods, items) that was traded throughout this region; with Buddhism acting either as the vehicle for this information, or the inspiration for the transfer of this information.
The medical exchanges included medicinal herbs, texts, rituals and deities, and even living individuals who traveled great distances along the silk road and were recorded as having great healing powers in texts of that time. It was during this ‘medieval’ period that the Chinese medicine pharmacopeia exploded – from 365 herbs in the original material medica 《神農本草經》(The Divine Husbander's Herbal Foundation Canon) to thousands of herbs by the Tang dynasty (618-906 C.E.).
Much of Professor Salguero’s research has focused on textual exchange during this period – the translation of Sanskrit texts into Chinese. Some of these texts were clearly efforts to integrate foreign knowledge into the pre-existing local understanding of the body, by using qi, yin-yang, and the five phases to make the foreign concepts more understandable to a local audience. There are also examples of popular accounts of Buddhist healers rewritten to match the style of similar stories in Chinese literature. However, other texts clearly try to ‘foreignize’ the material by drawing a distinction between local concepts and the foreign concepts that the author is trying to introduce.
Still other texts include both foreignizing and domesticating elements: for example a two-part conversation between a Buddhist and an interlocutor in which a request for information about a particular concept is answered with very foreign sounding explanation, followed by another request for clarification that is responded to in a way that is more familiar.
Professor Salguero gave the following example for the translation of the term dhāranī, which is a type of incantation used in Buddhist rituals: The term might be introduced using the Chinese characters 陀羅尼, which is simply a phonetic equivalent (“tuoluoni” in modern pinyin) that sounds similar to the Sanskrit term and doesn’t actually mean anything in Chinese. The first request for an explanation might be met by with the Chinese term 總持, which literally means ‘comprehensively grasp’. This is a type of translation known as a calque, which is a literal translation of the root(s) of the original term. Although this term does mean something in Chinese, it is unlikely that the reader would understand how this term is used; the interlocutor asks for clarification, and lastly the term is explained using the Chinese character 咒, or 神咒. This would be very familiar, as it is a term that had been used for centuries even before Buddhism was introduced to China to refer to magic spells or magic incantations as used by Daoists or others. At this point the interlocutor (and the reader) would have a fairly complete understanding of the original Buddhist concept.
There were several other topics covered in this talk, as well as many others brought up during the Q&A period at the end, but in order to keep this post to a reasonable length I will leave those for later posts!