I’ve always loved reading, but ever since university, very little of that has been fiction. I joined a book club through a friend a few years ago, but hadn’t been for a long time. I was going to join the next one, just for the chance to meet up again with these wonderful women even though I hadn’t read the book.
But then my friend told me this book is about Traditional Chinese Medicine. Even though book club was supposed to be two days later, I decided to plow through to finish it. So glad I did! Note: If you’re in my book club, we moved the date for this convo to next week, so maybe you don’t want to read this blog just yet. Or maybe you do. 🙂
Lady Tan’s Circle of Women is a fictional story based on a real woman named Tan Yunxian, a female doctor of TCM in the mid 1400s to 1500s. She had a book published when she was 50, based on her cases, particularly of women’s health issues, but also of common health issues of the time. What an amazing woman!
Lisa See, the author, was inspired to write this book because she came across Dr. Tan’s (she was called Lady Tan, but I’m going to give her the title she earned) book of case studies and she wondered about her life. While the story is largely fiction, Lisa did her research on the time and place, and she also had some written words from Dr. Tan about her mother and grandmother.
I loved reading how Dr. Tan trained under her grandparents, especially her grandmother, who’s also depicted as a force of nature. Lisa makes sure to include some of the case studies from Dr. Tan and the principles of TCM, as well has how challenging it was for the women of that time. Most TCM doctors were men. Men weren’t allowed to touch, question, or even see their female patients. That meant they’d have to have a go-between relay the questions and answers. Can you imagine trying to explain your personal and complicated health issues to your brother, father, or husband and hoping they would deliver the message effectively to the doctor?
In the book, Dr. Tan’s grandfather said women are 10 times harder to treat than men because of women’s emotions. Yes, the terms hysteria comes from the Greek word hystera which means uterus. Women have long been undertreated, poorly treated, or even injured (e.g., lobotomies) because of this idea, not just in China. The grandmother dismisses her husband’s opinion because she knows what questions to ask, how to interpret the answers, and she can actually talk to and see these women in person!
In Traditional Chinese Medicine, we don’t separate the physical, mental, and emotional. They are deeply interwoven, so addressing one addresses the others. And, it’s not just for women–it’s for all genders and ages. The good news for men is that, hey, you’re allowed to feel the feels too!
Women weren’t supposed to be educated. Confucius said that an educated woman is a worthless woman. Additionally, a woman’s perspective on her own health was often discounted by her male doctors (some things haven’t changed or haven’t changed enough).
As for the TCM part in this book, Lisa explains the “Four Examinations”: visual observation (looking), auscultation and olfaction (listening and smelling), palpation (touching, including pulse taking), and inquiry (asking). We still use this in TCM today. Does the person look flushed, pale, frail, robust, irritated, sullen, swollen, limping, and so on. Is their cough dry or phlegmy? Their voice loud or barely audible, raspy or clear? While scented soaps, lotions, creams, essential oils, and perfumes can alter our ability to smell our patients–not to mention how awkward it would be to lean in and sniff someone–we can sometimes use our sense of smell to identify issues. One of my patients relayed a story about how she saved her father’s life by noticing he smelled off after a major abdominal surgery. Turns out he had a significant infection! Does the person’s skin feel dry, moist, warm, cold? When we push into the skin, does it leave a dent that takes time to rebound? Do the muscles feel knotted, wiry, soft, firm? Is the pulse fast, slow, forceful, weak, deep, superficial, slippery, wiry, hollow, etc.? And, of course, there are all the questions we ask, even ones that don’t seem relevant to you.
The cases mentioned in Lisa’s book include ones that have been around for over 2000 years and are still some of our most common formulas of today! Si Jun Zi Tang, Si Wu Tang, Bu Zhong Yi Qi Tang, and Er Chen Tang are just some of them. Moxibustion is mentioned often, as well as TCM food cures and lifestyle recommendations. Some of the details for treatments in this book are fictional, or perhaps they were used at one time but are more folk and superstition than TCM medicine. But Western medicine history also has many of these kind of dubious therapies. The thing is, what actually worked hundreds and thousands of years ago still works today! So, the therapies that were effective have endured and evolved.
We’ve come a long way (still have room for improvement!), and I’m grateful to be able to practice this amazing medicine. Pretty soon, however, I’m going to need to write a blog about what we, as healthcare professionals and public who wants to continue to receive our safe and effective treatments will need to do soon to maintain that. There are proposed changes by the provincial government to our TCM regulations that, as currently worded, will negatively impact and weaken how we can deliver care.
I was inspired by this book. If a woman with all odds against her could practice TCM and deliver care to people rich and poor, even writing and publishing a book that holds up with useful information hundreds of years later, then it’s worth fighting for what you’re passionate about.