Essential Subtleties on the Silver Sea

Jurgen Kovacs, Paul U Unschuld

University of California Press, £46, pp 515

ISBN0520080580

Rating:

This is the first English translation of a classic 15th century text on Chinese ophthalmology. Its very title warns us that we are stepping from the solid shores of the exact sciences into speculative waters, into a parallel world sustained by a sequence of analogues and origins, fantasies and metaphors, where all our comfortable realities become shifting and insubstantial. We are left with a galaxy of theories and attributions, which are hard to digest.

In the beginning of recorded time, for those who sought to interpret the world about them, there was little to choose between the learned systems that were emerging in southern Asia, from China, through India, and on to the Aegean, generally in the form of mixed compilations from the different schools, to which labels soon became attached with the names of Susruta, Hippocrates, the Yellow Emperor, and so on.

But while research in the West became increasingly analytical, with an interest in anatomy and biomedicine gradually taking over, in China the great learned medical traditions were simply codified; their interest rested with bodily functions, centred on the circulation and transformation of ubiquitous humoral fluids which passed through 12 mysterious and ever shifting channels. Physiological and therapeutic properties were explained in terms of perceptual qualities, often in contrasting pairs (hot-cold, light-dark, etc), which sought to integrate man with the spatiotemporal universe. Thus an immense number of specialised writings and formularies have survived: over 10 000 in China, supplemented by endless borrowings from Buddhist literature elsewhere.

The text provides detailed descriptions of the aetiology, symptomatology, and treatment of every eye disease known to 15th century Chinese practitioners, including the couching of cataracts, probably introduced from India, but the surgical details are confusing (and possibly kept secret). There is a formidable list of drugs—animal, vegetable, and mineral—and an impressive bibliography. It was particularly interesting (and gratifying) to find hardly any mention of acupuncture. There was also a surprising absence of references to sex. The “evil eye,” common in the West, is also rarely encountered in China, although the women of the harem, who freely painted their eyebrows, were accused of practising “evil magic.” Copious oracle bones (usually bovine scapulae) and turtle shells were unearthed from the earliest (Shang) periods, with inscriptions referring to eye inflammations (as well as simply recording ancestry).

The book is beautifully produced, with copious diagrams and illustrations, and is clearly a work of impressive scholarship, a pleasure to handle for those fortunate enough to appreciate its subtleties.