Book review: Clinical Handbook of Internal Medicine (Vol 1)

Maclean clinical handbook of internal medicineI have been using the first two volumes of Maclean’s Clinical Handbook of Internal Medicine for a couple of years, now.  I find them to be the most useful basic TCM pathology texts available and want to share, briefly, my reasons.

General Information

This text is part of a series that, apparently, will include more volumes in the future.  The first volume, pictured at left, covers the Lung, Kidney, Liver and Heart organ systems.  The second volume, with blue lettering but a similar cover, looks solely at the Spleen and Stomach.  I’ll focus on the first volume for this review, but the majority of what I say applies to both of them.

The authors, in their introduction, explain that their aim was to develop a workable clinical manual of Traditional Chinese Medicine (TCM) that “at least [begins] to take our cultural and social differences into account.”  They seem to feel that because Chinese medicine was created and developed in a particular social and geographic location, it will be significantly different when practiced in other locations with differing social and natural environments.  The book, then, is a clinical manual intended to make the basic information of TCM more accessible and relevant to Western readers.

The book is created primarily with herbalists in mind, thus the formula suggestions are extensive while the acupuncture suggestions are more sparse.  The book is organized by organ system and then by basic TCM symptom picture – for instance the Lung section starts with external diseases (cold and warm) then moves into coughing, wheezing, etc…  The Chinese names for the symptom pictures are provided, along with characters.  This is helpful since people learn them using different English translations depending on where they study and I found it much easier to simply work with the Chinese.  They provide Chinese for herbs, formulas, patents and acupuncture points – though the points have only pinyin, no characters.  The general organization of the book is intuitive and the overall quality of the text is reasonable for the price.

Looking Deeper

Let’s investigate a single section.  Consider Gan Mao – the “common cold” or external invasion.  The book begins with a concise and readable description of the disease in general, providing some historical background and discussion of the severity of the illnesses in question.  This moves on to a page on etiology and a fine mindmap of the most common causes.  Following this is the section on specific causative factors and their treatment.  Fortunately, they begin the discussion in this chapter with Wind Cold.  Shang Han Lun fans will be snickering, now.  ;)  But, not for long – as the first prescription suggested is Jing Fang Bai Du San.  Thus begins my basic problem with the text – which is predictable given my trepidation about non-classical formulas.

That being said, the layout of the various treatment options (with confounding symptoms, etc) is clear and descriptive enough without being confusing.  Several formula suggestions are followed by standard acupuncture protocols (LI4, GB20, BL12, BL13, GV14) and modifications based on presenting symptoms.  The section is completed by other advise to the physician such as, “Acupuncture treatment can be applied 2-3 times in severe cases,” and a list of biomedical (Western) conditions that might fit this picture.  In general, all of the sections flow in this way.  Some have more extensive descriptions or finer distinctions between symptom patterns, but the basic flow is similar.

My assessment

Positive:  I have looked at quite a few books trying to find one that would helpfully and concisely explain syndrome differentiation from a TCM perspective – in good English.  I found it in these texts.  It could be helpful as a clinical manual, I suppose, but I found it more helpful in my TCM studies as a way to understand the way that your average TCM doctor treats any particular condition.  Its breadth, completeness and pleasing layout, as well as inclusion of Chinese characters and pinyin puts it heads above anything else I’ve found.  It’s also fantastic as a way to quickly see the basic TCM treatment protocol for a given disease with points AND formulas included.

Negative:  The authors seem allergic to Classical formulas.  Gui Zhi Tang and Ma Huang Tang are not even mentioned in the Wind-cold section.  Um…?  I suppose this has to do with the oft repeated refrain that “Westerners are too deficient for such strong formulas.”  I must be a strange Westerner, indeed.  My daughter, too.  Oh, and the rest of my family.  Oh, and a big chunk of the patients I’ve seen treated in clinic.  Ok, ok – sorry.  My point is this – I think it’s a dramatic oversight to leave out Classical formulas.  I understand if you want to include others, perhaps put a caveat on the “too strong” formulas – but… honestly?

There are some holes in the texts – I understand future volumes may address this.  For instance – no women’s diseases as far as I can see.  Also, the organization according to “diseases” (gan mao, yi jing, etc…) sometimes made it difficult to find a formula or point protocol for some simple set of symptoms that doesn’t necessarily fit into one of those categories.  That’s not so much a problem of the book, but a problem of that system of categorization.  All things being equal, I think this is a relatively minor problem.

Should you buy it?

If you’re interested in having a basic, clear manual for understanding TCM syndrome differentiation and the way that a large majority of TCM physicians treat patients – these books are indispensible.  I sold all of my other TCM texts – all my Maciocia included.  There is enough theory in here to do the job, and in combination with all the treatment advice it’s just a fantastic resource.

Click here to buy the Clinical Handbook of Internal Medicine Volume 1 from Amazon.com

 



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About Eric Grey

Hi - I'm the founder of Deepest Health. When I'm not writing here, you can find me reaching out to the Chinese Medicine community across the web and in my own backyard. I currently teach Chinese herbs at my alma mater, the National College of Natural Medicine. Additionally, I'm the founder of Watershed Community Wellness, a thriving local clinic in Southeast Portland in Oregon. No matter where I'm working, you'll find my focus on the Classical approach to Chinese medicine laced throughout everything I do.

View all posts by Eric Grey - Website: http://deepesthealth.com