Handbook of Obstetrics and Gynecology

One of the most exciting developments in modern Chinese medicine is the integration of traditional medical knowledge with modern biomedicine. The center for this important and stimulating work is Shanghai, and one of its best known proponents is Yu Jin, M.D.

Drawing on four decades of experience as a clinician, researcher, and teacher of obstetrics and gynecology, Dr. Yu has written a handbook for practitioners which presents an integrated approach to obstetric and gynecologic disorders, the first of its kind in a Western language.

Dr. Yu presented the evidence for the use of acupuncture in the treatment of gynecologic, endocrine, and reproductive indications at the 1997 National Institutes of Health Consensus Development Conference on Acupuncture in Washington, D.C.

Dr. Yu Jin recently presented the evidence supporting the
use of acupuncture in the treatment of gynaecologic endocrine
and reproductive indications at the 1997 National
Institutes of Health Consensus Development Conference
on Acupuncture in Washington D.C. She trained initially in
Western medicine but has studied and practised traditional
Chinese medicine for 40 years, mostly in obstetrics and
gynaecology. She is a professor in this field at Shanghai
Medical University where she is director of the gynaecologic
division of the Institute of Integrated Traditional and
Western Medicine. It is this integrated approach that informs
the content of this book. It is not a comprehensive
gynaecology textbook like Giovanni Maciocia’s recent Obstetrics
and Gynecology in Chinese Medicine in that it does not
attempt to cover basic theory, detailed differentiation, extensive
optional herbal formulas etc. Rather it is a clinical
manual for the treatment of a very wide range of (Western
medicine defined) gynaecological diseases that seems to be
based equally on traditional theory, clinical experience and
integrated Western medicine and pharmacological research.
After a short introduction there is a brief introduction to
traditional self-care during menstruation and prenatal, pregnancy,
post-partum and perimenopausal life phases. This is
very traditional in outlook, for example the suggestion that
pregnant woman avoid sexual intercourse. The chapters on
diseases cover vulval disorders (dystrophy and pruritis),
inflammatory diseases (vulvitis, vaginitis, PID, gonorrhoea
etc.), anovulatory menstrual disorders (e.g. dysfunctional
uterine bleeding, polycystic ovary syndrome, hypothalamicpituitary
amenorrhoea), non-ovulatory menstrual disorders
(e.g. luteal phase deficiency, functional dysmenorrhoea,
menorrhagia, uterine bleeding during menstruation,
menstrual migraine), complications of pregnancy (e.g.
viral hepatitis, spontaneous abortion, ectopic pregnancy,
hypertension), post-partum complications and miscellaneous
conditions (postmenopausal syndrome, uterine prolapse,
fibrocystic breast disease, Behçet’s syndrome, endometriosis
etc.). The approach taken to these diseases is
original, varied and often inconsistent, as befits a primarily
clinical manual. In some cases, for example menorrhagia, in
place of conventionally complex differentiation and treatment
strategies, there is a one-fits-all prescription without
modifications, followed by a basic explanation of ingredients,
a Western medicine based explanation of its action,
and the information that this prescription was found in
clinical studies to benefit 85% of cases. For the treatment of
menstrual migraine, only ear acupuncture is indicated with
no herbal medicine or body acupuncture approaches discussed.
In other diseases, for example pelvic inflammatory
disease, a variety of herbal prescriptions (internal and
external) are given for acute and chronic phases, with TCM
differentiation, modifications and traditional and modern
medical explanations. The text throughout is rich in invaluable
clinical advice e.g. prognosis for most conditions (including
timescale) and relative effectiveness and strategies
according to different modern medical diagnoses.
As is common in TCM gynaecology texts, the space
devoted to acupuncture treatment is brief, but even here the
information is clinically very helpful, for example how to
induce ovulation with acupuncture. Dr. Jin reports that
inhibition of the sympathetic nervous system after
acupuncture is a good indicator of the potential success of
ovulation induction and this can be ascertained in each
patient by needling Hegu L.I.-4 and Neiguan P-6 for 30
minutes whilst monitoring the patient’s hand temperature.
If this rises after treatment, the sympathetic nervous system
is inhibited and the serum-endorphin level has been lowered,
indicating that the patient is a good subject for acupuncture.
For anyone who is committed to developing their treatment
of gynaecological and obstetrical conditions this is an
invaluable clinical manual, and although it is published in
paperback, the high production values (stitched softcover)
will ensure many years of use.

Journal of Chinese Medicine