The first section deals with his life from the cradle to 1845, the year he published the first edition
of his Die Pathologie und Therapie.
turbulent 1840s, and his political involvement in Tubingen led to his forced departure to Zurich.
Soon after completing his medical studies, he spent a period in Paris and this seems to have
kindled a love for travelling that took him repeatedly to Vienna, London, and even to exotic
places like Egypt, where he worked for a time after 1850.
Physiology was hismain preoccupation during these earlier years, and his first six publications
are in general medicine. His first psychiatric paper, on 'Psychische Reflexactionen', appeared in
1843, and his magnificent book of 1845 was published after another eight medical and
neurological publications. In this long first section, Dr Warhig-Schmidt analyses Griesinger's
views on physiology, philosophy, and his opposition to Naturphilosophie.
The second halfofthe book is dedicated to Griesinger's psychiatry. It starts with a penetrating
analysis of the state of alienism in the Germany of the 1840s and of its uneasy relationship to
brain physiology. A glimpse is also offered ofthe early process that led to the divergence between
asylum and academic psychiatry, which was to hamper so much the progress ofboth during the
second half of the century. It ends with a fifteen-page study of Griesinger's 1845 Textbook,
which, on account of its freshness and depth, merits separate English publication. Dr
Warhig-Schmidt fails to explain, however, one of the running mysteries in the history of
psychiatry, to wit, how did Griesinger manage to write such a comprehensive textbook, which,
apart from the usual theorizing, contains a great deal ofclinical material, when in fact he had had
a meagre experience with the mentally ill?
But it would be wrong to begrudge this oversight. Like all good historical books, this one
includes over forty pages of notes, a list of Griesinger's writings, and a good bibliography. One
hopes that the author may want to regale us with a second instalment, in which the later
Griesinger, the founder ofthe Archivfuir Psychiatrie, the fierce critic ofthe therapeutic pessimism
ofasylum psychiatrists and the champion ofacute psychiatric units and psychiatric education, is
considered with similar care.
.. Griesinger grew intellectually in the Germany of the
G. E. Berrios
University of Camnbridge
PAUL U. UNSCHULD, Medicine in China. A history of ideas, Berkeley, Los Angeles and
London, University of California Press, 1985, 8vo, pp. x, 423, £33.95.
In complex societies such as that of China an enormous variety of differently conceptualized
systems of therapy is encountered, all of which are representative of Chinese culture. The
author's intention is to contribute to an understanding of plurality and change in health care
concepts. China, with a long established literacy from the fifteenth century BC to the present
time, provides the necessary historical sources. During this period of nearly 3500 years, the
following types of medicine were practised: (1) oracular therapy from the cracks in sheep's
shoulder bones; (2) demonic medicine ascribing the source ofthe disease to demons; (3) Buddhist
and Taoist religious healing; (4) pragmatic drug therapy; (5) the medicine of systematic
correspondences including acupuncture; and (6) modern western medicine. The author
distinguishes Buddhist medicine from religious (presumably Taoist) healing, thus dividing the
process into seven systems. Item (4), for reasons given later in this review, would be better named
"empirical plant therapy". Many of these systems overlap most of the time, and it is a matter of
the preponderancy of one or the other at a given time.
This excellent presentation ofa vast panorama is marred by the author and his two translators
being insufficiently acquainted with English usage. He consistently translates the word "patient"
as "victim", uses the word "gall" indiscriminately for "gall bladder" and "bile", speaks of
illnesses instead of diseases, and refers to Chinese yao as "drugs" rather than "remedies" or
"materia medica". This goes so far that he calls Ts'ai-yao "the gathering ofdrugs" rather than
"herbs" or "plants". The word ch'i is consistently translated as "influences"-admittedly, there