Foreword to the First Edition
East Asian medicine must always negotiate a peculiar tension between revered point of departure and thousands of years of experience. If the ancients are overvalued, the clinical application could be interpreted as a decline. If the accumulated experience is praised too highly, the original sources can seem to have been a bit too flawed. Each practitioner must also embody this tension; to what extent does one follow strictly the established authority and to what extent do unique cultural and personal exigencies supersede ‘standard’ perspectives? Successfully navigating this polarity has been a key component of the vitality of the entire East Asian medical tradition and a hallmark of a sensitive and masterly practitioner.
Excellence in the tradition of East Asian medicine has always been defined by the ability to be simultaneously immersed in the past while also responding meaningfully and practically to the present. To be a great teacher for any generation of the tradition requires the rare ability to summarize contemporary experience and then integrate these insights into the perennial dialogue of the archaic. Time and timelessness. New insights and revered knowledge. Change and reverence. Movement and stillness. These two poles must balance upon a single fulcrum, becoming a unified body of knowledge in an unbroken transmission. An almost impossible goal, this enterprise is also an absolutely necessary task for every generation. The history of East Asian medicine is a remarkable chain of transmission and modulation from one generation, dynasty, and even country, to the next.
Our generation seems especially significant in this transmission and transformation of East Asian medicine. We are participants in a huge leap: health expectations, disease burdens, linguistic barriers and complex cultural obstacles must be bridged. The ancient traditions must not only co-habit and interact with modern biomedicine and a host of other complementary therapies, but also graft themselves upon a very different civilization. Clarity, sensitivity, knowledge and wisdom must all be brought to bear lest the authenticity of age-old theory and techniques weaken into shallow semblance. Under what circumstances should modern clinical experience suggest modification in ancient approaches? How would such alteration fit comfortably into the tradition? How can such an adjustment become the very link to preserving the continuity with the past? These are serious questions needing thoughtful responses.
Giovanni Maciocia is a respected guide in this transitional period of East Asian medicine to the Western arena. His accomplishments as a teacher and writer have made him a major force in this successful movement from one world to another. The Foundations of Chinese Medicine, The Practice of Chinese Medicine and Tongue Diagnosis in Chinese Medicine are all outstanding contributions of scholarship and clinical acumen, and this present volume, Obstetrics and Gynecology in Chinese Medicine, adds significantly to his accomplishments. Indeed, one begins to see the outlines of a Maciocia transmission or tradition existing within our very own generation.
This volume is simultaneously an encounter with the classics of Chinese medicine, this morning’s patient and the insights of a seasoned practitioner. It is a wonderful example of balancing old and new in order to fulfil the mandate of ‘accurate’ transmission. The contemporary clinical insights in Obstetrics and Gynecology in Chinese Medicine are deep, while its references to classical sources are precise and relevant. Classical citations are balanced with contemporary case histories to provoke understanding and clinical guidance while eschewing mere pedantry. Giovanni Maciocia is wonderful in exhuming details of the archaic knowledge that has been neglected in Asia itself. This is apparent throughout the text and two important examples are his discussions of the Extraordinary Vessels and of post-natal melancholy. Giovanni Maciocia is comfortable acknowledging the divergence of his clinical experience with that of his mentors in China. This textbook is unafraid to present the details of patterns of disharmony that are relatively infrequent in China, and therefore not mentioned in typical books or lectures, but which actually appear frequently in Western societies. The text extensively addresses a simultaneous deficiency of Kidney-Yin and Kidney-Yang in women which is rarely mentioned in Chinese sources. Giovanni Maciocia is also unafraid to quote contradictory authoritative sources. The ancients were physicians, not a ‘health cult’ with all the answers, and their multiple voices in this text help to give them depth and allow our modern voice to embrace diversity.
Obstetrics and Gynecology in Chinese Medicine is a paradigmatic work. It is tempered with reverence and innovation, meticulous archival attention and detailed modern clinical insight. When future generations look back at this work and other books by Giovanni Maciocia, they will find not only knowledge and wisdom but also reasons for inspiration and awe. As a community of practitioners, we are fortunate to benefit from the efforts of giants such as Giovanni Maciocia. Because of his efforts and also our entire community’s dedication, our ‘generation’ will probably succeed in its critical destiny and responsibility for bringing East Asian medicine to the centre of a new cosmopolitan healthcare agenda.