Category Archives: herbal medicine

Fetch Me at Pearl Nest Street: Rhubarb Pills as Panacea in Qing China

He Bian

In the late eighteenth century, American ginseng opened up a new niche market in Qing China. At the same time, Chinese rhubarb (dahuang) roots, harvested from the northwest regions of the empire, were transported by Chinese traders all the way to the southeast coast and sold off to foreign customers in Canton (Figure 1). Part of these transactions took place in the Ryukyu Kingdom (present-day Okinawa Islands), a vassal state of the Qing but also an important node of global trade that crisscrossed the West Pacific. At some point in 1789, the Qing court issued an edict to the Ryukyu king that explicitly forbade him from selling rhubarb to Russians, with whom the Qing was then engaging in an all-out trade war. Rhubarb featured prominently in the Qing strategy because they believed that Europeans imported so much of this drug that they could not live a day without it.[1]

Figure 1. Chinese or Turkish rhubarb (Rheum palmatum): flowering and fruiting stem with leaf. Coloured zincograph after M. A. Burnett, c. 1842. Credit: Wellcome Collection, https://wellcomecollection.org/works/cvty3qqk
Figure 1. Chinese or Turkish rhubarb (Rheum palmatum): flowering and fruiting stem with leaf. Coloured zincograph after M. A. Burnett, c. 1842. Credit: Wellcome Collection, https://wellcomecollection.org/works/cvty3qqk

Yet is it really true that pharmacological visions in early modern China and Europe were so different that they could not possibly reach a consensus over rhubarb’s properties ? Classical Chinese pharmaceutical literature listed rhubarb as a drug with a “very cold” nature, and generations of physicians were taught not to use the cold drug in curing cold-natured diseases. This suggested that Russians (and other Westerners, as seen in this post on rhubarb in early modern England) had different bodies than the Qing Chinese, as they depended on rhubarb as an all-round cure. Pharmacological theories, in other words, engendered a vision of difference that seemed insurmountable.

During my recent reading of Qing medical recipe books, however, I discovered that rhubarb in fact functioned as nothing short of a panacea for Qing Chinese. This is evident in the text Bianyong liangfang (Excellent Recipes for Expedient Use), which appeared in the Jiaqing reign (1796-1820). Compact (only 2-juan in length) and very nicely printed (with carved woodblocks), it arranges pills, powders, tinctures, and decoctions by symptom. The book has about 120 pages, and most recipes are merely a few lines in length. What surprised me was that one very long recipe at the end of the text takes up the entirety of 13 pages. The remedy in question, mi shou Qingning wan (Secretly transmitted pill of purity and tranquility), calls for “several dozen pounds” of good quality rhubarb roots as the principal ingredient. Rubbed clean and steeped in rice water, the rhubarb was sliced, sun-dried, processed with “ash-less good rice liquor” for three days, and then put through a lengthy, elaborate protocol of fifteen rounds of steaming. Each steam involved a different set of herbs. Finally, makers took the resultant rhubarb paste, mixed it with “yellow ox milk” (using cooked honey as substitute if there was no milk), boy’s urine, ginger juice, and rolled it into tiny pills. The recipe listed hundreds of common illnesses that could be treated with this pill, ranging from headache and hemorrhage to gynecological disorders.

Figure 2. Luo Benli ed. Bian yong liang fang. Vol. 2b, p. 50b. c. 1796-1820. Princeton University Library. Downloadable PDF available at http://pudl.princeton.edu/objects/fn107159v
Figure 2. Luo Benli ed. Bian yong liang fang. Vol. 2b, p. 50b. c. 1796-1820. Princeton University Library. Downloadable PDF available at http://pudl.princeton.edu/objects/fn107159v

I have tried to look up this recipe in earlier Chinese medical texts, and my preliminary findings suggest that it probably came into existence no earlier than the seventeenth century. It became wildly popular in the eighteenth century, and recipe books serve as evidence of its widespread consumption. On the last page of Bianyong liangfang (Figure 2), the compiler, Luo Benli, announced that he had a batch of rhubarb pills prepared during his tenure in Guizhou – a southwestern province of China – and that, in case of emergency, readers could “call upon my house on Pearl Nest Street” and look for the “residence of Mr. Luo of the Ministry of Defense (bingbu Luo zhai).” Pearl Nest Street (zhuchaojie), a neighborhood in Qing Beijing not far from the Forbidden City, featured prime real estate. As a military official who had served in the frontier provinces, Luo was less bound by medical norms of the day and possessed the financial and political capital to manufacture elaborate pills like these. Was there, in other words, a sub-culture of health and medication championed by military elites such as Luo, which stood distinct from classical prescriptions?

One last word about this recipe that hints at a hidden connection between different cultural realms in early modern China: Sun Xingyan (1753-1818), a prominent scholar who combed through medieval sources for fragments of ancient texts, published the same recipe for Pill of Purity and Tranquility in his scholarly series. The inclusion of this Qing text alongside ancient monographs so bewildered modern bibliographers that they mistakenly attributed the recipe’s author to a seventh-century figure. In fact, Sun Xingyan made it clear that it was a contemporary remedy and provided an elaborate scholarly argument to defend rhubarb’s all-around efficacy to cure both hot and cold-natured illnesses. He also suggested that “vulgar physicians” despised the pill because if everyone had access to this remedy then their businesses would be lost. Therefore it does appear that, when it comes to rhubarb, Qing Chinese scholars and military commanders were no less enthusiastic than what they imagined about the Russians.

 

[1] I recommend this excellent essay by Chang Che-Chia (translated by Penelope Barrett) for more on this curious episode.

Recipes and the Senses: An Introduction

By Hannah Newton

Lubin Baugin, Still-life with Chessboard (The Five Senses) (1630). Wikimedia.

 

Our enjoyment of food depends not just on how it tastes and smells, but also on what it looks, feels, and sounds like. Crispness, for instance, is perceived when we hear a ‘snap’ as the food breaks between our teeth. This relatively new understanding of gastronomic experience explains the recent explosion of recipe books designed to entice all five senses. In fact, a ‘sensorial revolution’ is taking place across most fields of history. This month’s thematic series, edited by Hannah Newton and Elaine Leong, gives a flavour of what might be gained by applying such an approach to the history of recipes; there are 7 contributions, spanning several disciplines, chronologies, and regions, from ancient Rome to eighteenth-century England. To put the posts in context, this introduction provides some background on sensory history.

Approaches

There are many ways to do sensory history. Perhaps the most influential has been the ‘grand narrative’ approach: scholars such as Marshall McLuhan and Walter Ong claimed that a ‘major sensory transition’ took place between medieval and modern times in the way the senses were ranked. In medieval Europe, societies privileged the ‘lower senses’ of touch and taste, but with the march of modernity the ‘nobler’ senses of sight and hearing came to the fore. Although this scholarship has been heavily criticised – not least for its disparaging attitude towards medieval people – the question of change over time rightly remains fundamental to sensory history. Yan Liu’s post in this series is a good example: he shows how the use of the spice saffron in China has been transformed since medieval times, from an antidote against evil powers to a flavour enhancer in cooking.

Another approach to sensory history involves focusing on a particular sensory organ, or a context directly linked to that sense. Examples include Stuart Clark’s Vanities of the Eye (2007), which explores anatomical and philosophical understandings of vision, and Holly Duggan’s Ephemeral History of Perfume, which uses scent as a window into cultural attitudes to smell.  One downside to the single-sense approach is that in daily life we perceive the world through all our senses, not just one, and the senses themselves influence one another. Several of the contributions to this series demonstrate these interactions nicely: Barbara Di Gennaro Splendore  reveals that the 17th-century apothecary ‘knew substances through “his whole person”’, and William Tullett makes similar observations about 18th-century perfumers.

A third way to study the senses is the ‘sensescape’ approach. This is where scholars take a particular environment or activity, and analyse the multiple sensations that were perceived within it. Bloomsbury’s six-volume series, Cultural History of the Senses, showcases some of the most popular sensescapes, which include the marketplace, street, and church. Donna Bilak’s post is an example of this approach: she uncovers the intriguing sensations reported in the iatrochemical laboratory of the 17th century New England puritan Gershom Bulkeley, which included ‘urinous’ flavours. What Bilak, and many of our other contributors reveal, is that people from the past consciously mobilised their senses when going about their everyday work, whether as a medical practitioner, perfumer, or chef.

Challenges

One of the biggest obstacles to doing sensory history relates to evidence: most sensory stimuli are ephemeral, leaving no direct historical trace, which means we have to rely on written descriptions or images to access past sensory experience. Unfortunately, this is far from straightforward, due to the difficulties people encountered when putting sensory experiences into words. Peter Charles Hoffer labels this the lemon problem: ‘I can taste a lemon and savour the immediate experience, but can I find words to convey to another person exactly what that sensation was?’

To meet these challenges, exciting new techniques have been devised by historians to recreate past sensations, which involve the use of ‘immersive technology’, such as artificial smells and tastes. By activating our own senses, the intention is to ‘replicate sensation in a world we have (almost) lost’. Historians of science and food deploy similar techniques, re-enacting past experiments (e.g. or making foodstuffs (e.g. here and here), to reach a closer understanding of contemporary worldviews. Tillmann Taape and Erica Rowan, two of our contributors, are both engaged in this sort of innovative work. Admittedly such approaches do attract sceptics. For instance, Mark Smith warns that while it is possible to reproduce a particular sensation from history, the way we ‘consume’ that sensation may be different from the way it was experienced at the time. Indeed, an experience of a sensation may even change over a person’s own lifetime, as Hannah Newton’s post reveals: for early modern patients, what they would normally perceive as pleasant tastes – such as sweet cordials – were found during illness to be disgusting, owing to the effects of noxious humours on the taste-buds.

Despite the challenges involved, our contributors are optimistic about applying a sensory approach to the study of recipes. So long as we accept that sensory perceptions are culturally contingent, there is no reason why it is not possible to glimpse how past societies understood and experienced sensations.

 

Following Valerian: New Name, Old Idea

Katherine Foxhall

In late August, 1781, Sir Charles Blagden, physician, Francophile, army surgeon and Fellow (later to be Secretary) of the Royal Society of London received a letter from his friend, Thomas Curtis. Curtis was concerned about the health of his son, who for more than a decade had suffered a ‘very peculiar kind of head ach’ with ‘a dizziness, or partial vision’, and which recently seemed to coincide with the fortnightly full or changed moon. Curtis had sought the opinions of plenty of doctors, but their prescriptions had failed. Blagden responded swiftly. He proposed that the young man was suffering from what the French called migraine. Blagden was not convinced that the moon’s phases were causing Curtis’ illness, but if the young man’s disease returned on 12 September 1781 (the date of the next full moon), Blagden instructed that the young Mr Curtis should have twelve ounces of blood taken a week later, and then to trial valerian ‘in considerable doses’, increasing the dose until his stomach could bear no more.

'Valerian'. Credit: Wellcome Collection: https://wellcomecollection.org/works/rw9eqv2m.
‘Valerian’. Credit: Wellcome Collection: https://wellcomecollection.org/works/rw9eqv2m.

Having long been known as an anticonvulsant, by the middle of the eighteenth century the herb Valerian had become something of a fashionable prescription for treating migraine. The distinguished physician Richard Mead, author of the famous Treatise concerning the influence of the sun and moon upon human bodies (1748) recommended frequent use of valerian root for periodic diseases of the head ‘pulverized before it shoot out its stalk’.[1] This seems to have prompted the Scottish physician John Fordyce to try it for his own hemicrania. Finding it of very great benefit, he recommended taking drachm doses of valerian three or four times a day in his essay De Hemicrania (1765). Erasmus Darwin included both bleeding and valerian in Zoonomia as treatments for the symptoms of hemicrania, and physicians throughout the nineteenth century would continue to recommend the herb. Such influential texts explain why Blagden turned to valerian for his young patient’s periodic ailment, but it struck me that this had not been one of the herbs that I had come across during the many months I had spent researching the Wellcome Library’s collection of recipe books for seventeenth century migraine remedies, though Nicholas Culpeper talked of valerian’s warming properties, and recommended the root for headache, diseases of the eyes, wounds splinters and thorns. I forgot about Curtis, and moved on. Then, by accident, I discovered that the valerian family also contains a plant called spikenard, and the penny dropped. Like valerian root, spikenard has an earthy musky odour, and a similar effect on the body – having sedative and relaxing properties. Suddenly, valerian didn’t appear to be an eighteenth-century story, but an episode in a longer history, which I’ve written about here before.

But the story goes back even further. The dispensatory of the Nestorian physician and pharmacologist Sābūr ibn Sahl, from southwestern Iran, is one of the earliest pharmacopeia written in Arabic. Dating from the ninth century CE, it provides important evidence of medieval Eastern Arabic medical practice. In Chapter Four of the dispensatory instructions set out the preparation of nard oil, an expensive essential oil with sedative properties used to treat hemicrania, among other things. This was an expensive recipe requiring a large investment to collect over twenty herbal ingredients (including cyprus, laurel, elecampane, citronella, myrtle leaves, wild caraway, forget-me-not, sweet marjoram, stalkless roses, fresh myrtle-water, myrrh and grape ivy), and prepare them with different liquids in three stages taking several days. The third stage took Indian spikenard (the ingredient that gave ‘nard oil’ its name), pounded together with cloves, storax, nutmeg, added to fresh water, balm oil and the strained oil from the previous two stages. Then the whole concoction should be boiled until the water had disappeared, before being bottled, stored and used as required.

Remedies for 'Mygreyn' in a Fifteenth century leechbook. Credit: Wellcome Collection MS.MSL.136: https://wellcomelibrary.org/item/b19295467#?c=0&m=0&s=0&cv=192&z=0.0194%2C0.2362%2C0.8409%2C0.673.
Remedies for ‘Mygreyn’ in a Fifteenth century leechbook. Credit: Wellcome Collection MS.MSL.136: https://wellcomelibrary.org/item/b19295467#?c=0&m=0&s=0&cv=192&z=0.0194%2C0.2362%2C0.8409%2C0.673.

Several centuries later, we find a mid fifteenth-century English ‘leechbook’ contained a recipe for migraine attributed to ‘Galen the good philosopher’ that required several of these same ingredients: nutmeg, ginger, cloves, a pennyweight of ‘spiknard’, anise, elecampane, liquorice, and sugar. By the sixteenth century, spikenard was appearing in print. In 1526, the anonymously published A New Book of Medecynes gave a recipe for migraine, postume and dropsy requiring ‘iiii peny weyght of the rote of Pyllatory of Spayne / a half peny weyght of Spygnarde’, ground together and boiled in good vinegar. The compilers of recipe books (including this blog’s favourite Mrs Corlyon) adapted these remedies to local conditions, substituting herbs of similarly warm, dry and aromatic qualities (such as sage and rosemary) that they could more easily obtain or grow. Following translations is notoriously hard, as Sietske Fransen’s post shows, but spikenard and valerian have weaved their way through more than a thousand years of migraine history. Does it work? Perhaps. It certainly has sedative properties, so today it’s more commonly used for insomnia.

[1] Richard Mead, A Treatise concerning the influence of the sun and moon upon Human Bodies and the Diseases thereby produced trans. Richard Stack (London: J. Brindley, 1748), 84-6

*****
Katherine Foxhall is Lecturer in Modern History at University of Leicester. Her new book, a history of migraine, will be published by Johns Hopkins University Press in 2019.

Storytelling and Practical Skills in Medical Recipes

By Ying Zhang

What constituted a medical recipe in late imperial China? Literati physicians often touted the efficacy of a medical formula by contending that it conforms to traditional order of the emperor and his officials. They might also praise the suitability of the drug combination for treating that individual body’s ills. (See discussion on drug knowledge in China elsewhere on this blog). While texts by literati physicians have attracted most scholarly attention, they might not contain some of the most widely circulated and used medical recipes in everyday settings. People in late imperial China had access to a wide range of vernacular texts to find a recipe for self-treatment. During this period, we see the circulation of many practice-oriented recipes through vernacular literature as well as personal networks. These sources included daily-use encyclopedias, almanacs, meritorious books, and fiction. These recipes functioned as a practical instruction for domestic use and a textual form that articulated practical health care knowledge through literary narratives. They highlighted the techniques of making medicine as an essential part of a medical recipe that non-expert could follow in their own homes.

The first page of the “Recipe from a bare-foot immortal for pills made with fish maw to help insemination.” Image credit: Berlin State Library.

One fascinating example which I’d like to bring to you today is the “Recipe from a bare-foot immortal for pills made with fish maw to help insemination,” which was collected and recorded in A Convenient Survey of Medical Recipes (Yifang bianlan), a manuscript written by a person with the sobriquet Gaoyangshi in the nineteenth century. This recipe presents a story at its beginning, which starts with the encounter in a certain famous mountain between an immortal and a sixty-one-year old men with the surname Zhou from Yunnan who has one wife and nine concubines but has been unable to conceive a child:

…[Zhou] talked about his family [with the immortal], saying that he does not have any children and asking for a good recipe. Moved by his sincerity, the immortal gave him a recipe. The medicine [made according to the recipe] has a character that is clearing but not cooling, warming but not heating. If men take it, [it] could strengthen the muscles and bones, invigorate the vitality, replenish the marrow, nourish the yin, and reinforce the primordial. If women take it, it could regulate the menstrual period, replenish the Blood, prevent miscarriage, regulate the qi, benefit the yin, and ease fertilization. Zhou bowed and received it [meaning the recipe] (bai er shou zhi), and refined and mixed [the medicine] according to the recipe (yi fang xiuhe)…

Following the story, the recipe lists the individual drugs required and, after each drug, it provides instructions on how to process it. For the chuan fuzi (Aconitum carmichalii Debx, Chinese aconite) from Sichuan, for instance, one needs to select the following:

Two pieces with each weighing four liang and five qian, cut off their sprouts and cut each of them into four pieces, soak them with raw gancao (Glycyrrhiza uralensis, Licorice) water for seven days, change the water every morning, and then cover them with half jin of wet flour, heat until cooked over a slow charcoal fire, cut them into pieces, and then heat to dry.

At the end of its drug list, the recipe summarizes, “to cook and make the listed drugs according to the [described] methods” (yi shang zhu yao ru fa paozhi). The word “paozhi” here refers to processing the drugs according to the methods listed under each drug. The recipe then continues with instructions on how to grind the drugs into powders and mix the powders into pills, and also explains the way to take the medicine.

It is interesting to note that the story at the beginning of the recipe uses the word “yi fang xiuhe,” a more general term referring to all of the work from processing individual drugs to mixing them together into pills. It suggests that the recipe worked well exactly because Mr. Zhou made the pills following all the technical details required by the recipe as a way of self-cultivation and demonstrated his piety in the making process. It was Mr. Zhou, not any physician or pharmacy, made the pills. The narrative episodes not only validated the efficacy by stating the mythical origin of the recipe, but also affirmed the efficacy by stating that this Mr. Zhou then had seven sons after taking the pills and lived to ninety-seven years old. They thereby presented the production of medicine as a personal endeavor that anyone could pursue. While the recipe exhibited a world of practical skills to handle medical substances and required utensils, the story advertised these specialized skills of drug processing as everyday household knowledge. The story also functioned to attract collectors through literary embellishment. This was especially desirable when recipes traveled out of medical contexts and became collectable artifacts in the context of literati sociability, connoisseurship, and moral practice. Recipes garnished with literary creation and moral teaching in this context usually encouraged its collectors to distribute it to more people to accumulate merit. Thus, when we exam the circulation and use of recipes out of medical context, we could find storytelling an essential part of medical recipes intended for household use.

Ying Zhang received her Ph.D. degree from Johns Hopkins University in 2017. Her dissertation titled “Household Healing: Rituals, Recipes, and Morals in Late Imperial China” investigates China’s rich tradition of household healing practices and reinterprets these practices in relation to religion, gender roles, and morality from the seventeenth to the early twentieth century. Drawing on a wide range of texts people used in their daily healing practices and texts about household healing, this research contributes to a deeper understanding of the heterogeneous health-related practices beyond the domain of learned medicine. It demonstrates the various ways in which the home served as a central site of healing technology in late imperial China. Through the study of the circulation of health related texts, it also sheds new light on the circulation of information in the context of literati sociability, philanthropic activities, and religious commitment in late imperial China. She can be reached at yzhang82@jhu.edu.