BOOK REVIEW: The Expressiveness of the Body, Shigehisa Kuriyama

Shigehisa Kuriyama has written a book with wide arms.   At the beginning of his preface, he summarizes his driving interest in writing this book:  “A…riddle lies at the heart of the history of medicine.”  At the end he elaborates: “The body is unfathomable and breeds astonishingly diverse perspectives precisely because it is a basic and intimate reality.”  Thus, he launches into a painstakingly scholarly, yet creatively woven comparison of two distinct views of the body and of medicine.

The book is divided into three ways of perceiving and understanding the body:  touch, seeing, and being. This approach acknowledges at the outset that medicine was founded on a multifaceted perception of the body based and the bodily senses. Within each of the three main sections are two chapters:  one looks primarily at the Greek view and the other focuses mainly on the Chinese view. Yet within each chapter, the author moves back and forth between these two histories of medicine, giving us a complex story that never completely settles one way or another.  Each view emerges out of a cultural context.  Each view captures an essential truth about the body.  And each view misses or ignores information that the other pays close attention to.

The opening chapter, “Grasping the Language of Life”, acknowledges that the body speaks a language, and that we can use our hands to decipher it. Kuriyama examines in detail the Greek and Chinese views of the palpation of pulse.  In both traditions, the pulse is a window into the state of the body, but the views diverge from there. For the West, there is one pulse.  For the East, there are 12 different ‘pulses’ (6 on each wrist), reflecting the state of all the internal organs.

The second chapter, “The Expressiveness of Words”, illuminates the relationship between language and the body by showing how our language defines our preconceptions:  we tend to see what we name. The Greeks discussed in depth what the words ‘full’ and ‘empty’ meant.  They used words that would be accurate labels for what they assumed were objectively observed events.  The Chinese focused on the way the pulses were perceived – the placement of the fingers and the amount of pressure one used to read the pulse – and then used descriptive language, such as ‘like clouds rolling in the sky’ or ‘like scallion leaves rolled lightly between the fingers’.

In the section “Styles of Seeing”, we are offered examples of Greek and Chinese artwork clearly showing two very different views of the human body.  Greek painting of the body illuminates the muscles in a way that we rarely see in real life, even in great athletes.  Muscularity was interwoven with the Greek sense of identity.  The emphasis on dissection and on anatomy itself is peculiar to the Greeks. Kuriyama carefully dissects the question of “why anatomy?” in a fascinating unraveling of culture, language, and knowledge. We in the Western world take anatomy for granted.  We assume that our knowledge of the body is based on observable, objective fact, and thus anatomy is an unassailable and reliable knowledge.  The roots of Western identity are interwoven with our particular view of what knowing is, which we believe is achieved through external, objective observation.  Once something is known in this way then our knowledge is concrete.

In “The Expressiveness of Colors” Kuriyama describes the Chinese view, which seems to ignore anatomy (in the Western sense) and focuses on texture and color.  Chinese anatomists were also most interested in those bodily aspects that could be measured in numbers corresponding to the greater cosmos, driven by “the ethos of the unified state.”  The Greek anatomists ignored these measurements.  The Chinese doctors were also less interested in structure and more concerned with how things evolve over time.  Also, muscles do not even make an appearance in Chinese medical diagrams.  Instead we see soft and full bodies with clearly marked channels of Qi flow.

In “Styles of Being”, Kuriyama looks at the deeper Western view of the blood as essence, and the broader Chinese view of the body as influenced by winds (seasons, weather, environment.)   The author weaves between the two views thoroughly, asking questions about their similarities and dissimilarities, and sparing us from any hammering home of an academic conclusion.  We are left instead with an expansive sense of the complex nature of being human.

The details of this book may require some wading, but Kuriyama’s ability to hold paradox invites curiosity and a “museum eye”: he asks us to look at the details and contemplate them.  We begin to see medicine as representative of our broader search for knowledge, and, in this light, we also begin to see medicine as a creative and perpetually unfolding form.  Kuriyama’s inquisitive scholarship and delight in his subject — how different cultures observe and describe the world and how this impacts our view of ourselves in our bodies — propels the reader forward in this page-turner of history as inquiry.

The Expressiveness of the Body
By Shigehisa Kuriyama
Zone Books, New York, 1999