Category Archives: herbal medicine

Cold Wombs and Cold Semen: Explaining Sonlessness in Sixteenth-century China

By Yi-Li Wu

Figure 1. Depictions of boys at play were a popular Chinese decorative motif during the sixteenth century, imbued with auspicious meaning and conveying hopes for male offspring. This porcelain bowl was made in Jindezhen during the Jiajing reign period (1522–66). From the collection of the Metropolitan Museum of Art, New York, NY. Gift of Denise and Andrew Saul, 2001. Accession number 2001.738. On-line at https://www.metmuseum.org/art/collection/search/64484

Throughout imperial China, a family’s well-being and longevity required the birth of sons. [Fig. 1]  Sons performed the ancestral rites, inherited land, and were responsible for supporting aged parents. And only men could take the examinations for government office which conferred elite socio-economic status. But at age 40, Liu Xiaoting was still sonless (wu zi). He appealed to the physician Gong Tingxian (15`38-1635), promising him rich recompense if he could help. As Gong recorded in his influential treatise, Curing the Myriad Diseases (Wanbing huichun, preface dated 1587), Liu’s “male member was weak, and his semen was icy cold.” Furthermore, his pulses were flooding when felt at the first position (cun) at the wrist, but deep and faint at the third position (chi). Gong’s diagnosis: a profound deficiency of primordial qi (yuan qi), the source of all the body’s vitalities and material manifestations. This was caused, he explained, by excessive drinking and sexual indulgence.

Depletion from debauchery was a common diagnosis for upper-class men of the time, those who had the means to own concubines and patronize courtesans. Doctors agreed that such carousing exhausted the body’s vitalities, not least because male semen was produced from “essence” (jing), the vitality that enabled growth, generation, and reproduction. Besides depleting the body, excessive outflows of semen harmed the kidneys, the organs that produced, stored, and transformed essence.  To cure Liu, Gong prescribed a 16-ingredient formula called “Elixir to Solidify the Root and Strengthen Yang” (Guben jianyang dan) (see below).  After taking one recipe’s worth, Liu felt that his nether parts were warm again.  After an additional half-recipe, he felt recovered. To his great joy, he then begat a son. Liu subsequently shared the formula with a Liu Boting and a Liu Min’an (probably kinsmen) who also used it successfully. [Figs. 2 and 3]

Figs. 2 and 3: The recto and verso of a page from a seventeenth-century edition of Gong Tingxian’s Curing the Myriad Diseases, showing his recipe for Elixir to Solidify the Root and Strengthen Yang (Fig. 2, recto) and explaining how he used it to cure Liu Xiaoting (Fig. 3, verso). Note that Chinese books were read from right to left. From Expanded edition of “A Collection on Curing the Myriad Diseases” by Mr. Gong Yunlin, Confucian doctor (Zengbu ruyi Gong Yunlin xianshen Wanbing huichun ji), Renren shushe woodblock edition, 1641. Yulin was Gong Tingxian’s sobriquet (hao). In the collection of the Berlin State Library, Germany. Digitized and on-line at the Staatsbibliothek zu Berlin-PK digitalisierte Sammlungen, permanent URL: http://resolver.staatsbibliothek-berlin.de/SBB000160F000000000.

Gong Tingxian placed Liu Xiaoting’s case in his discussion of “seeking descendants” (qiu si), which was part of a larger section on “women’s diseases” (fu ke).  “Descendants” here referred specifically to sons.  Although Chinese medical writings on childbearing focused primarily on the female body, people had also long recognized that male ailments could impede conception. These concerns were especially salient in Gong and Liu’s time, when population pressure, urbanization, and commercialization were creating new forms of socio-economic mobility and instability.  As Charlotte Furth has shown, this inspired a proliferation of writings on male self-cultivation and producing sons. Such material appeared in various textual genres, and it was not uncommon to find the reproductive illnesses of men discussed in chapters on women. These discussions assumed, furthermore, that a deficient man might still be able to father daughters, but that only a properly regulated male body would create sons. The question was how best to achieve that regulation.

In medical discussions of infertility, cold could refer to somatic sensations of chillness, as well as to a sense of deficiency and absence of vitality.  Writings on women were primarily concerned with ensuring the ample and free flow of female blood, which constituted the female seed, nourished the fetus, and later transformed into breast milk.  But doctors also worried about coldness in the womb, whether from an invading wind, or arising from internal depletion. Cold would cause female blood to stagnate and become corrupt.  But concerns about female cold were also expressed in terms of agricultural metaphors which portrayed the womb as a field that needed to be warm and nurturing to receive the male seed.

Women with cold wombs would simply not produce children. But when couples produced only girls, this suggested deficiencies in the man, who played a key role in determining the child’s sex. The various theories of sex selection might differ as to details, but they agreed that a man could produce boys by shooting (she) his seed into the woman on certain days, in a certain manner, at a certain point in the copulatory act.  Particularly important was the belief that both men and women released reproductive seed during orgasm, and that the fetus’ sex was determined by the seed that came last.  A man who wanted sons thus needed to bring his female partner to climax before releasing his own seminal essence. His semen also needed to be sufficiently “dense” (mi), lest it dribble uselessly out of the womb.

Coldness in men was thus associated with impaired copulatory function, manifesting as cold and watery seed and as a weak penis unable to control its emissions. Gong Tingxian’s fertility formula echoed this understanding, relying heavily on substances that were classified as “principal drugs for treating spermatorrhea” and/or as “principal drugs for treating impotence” in Li Shizhen’s authoritative  and encyclopedic Compendium of Materia Medica (Bencao gangmu,preface dated 1590).  At the same time, Gong’s formula implicitly rebuked those who would treat male coldness with heating drugs.  This objection was rooted in a particular understanding of how cosmological yin and yang forces expressed themselves in the male body.

To simplify enormously: yang referred to things that were external, active, and hot, while yin was internal, receptive, and cool. Men were the yang of humankind, and male potency and fertility were understood as expressions of bodily yang. As a result, people routinely tried to treat sonlessness with heating drugs. But some doctors warned that too much heat would damage and consume yin, harming the kidneys (yin) and consuming its essence (yin). Excessive heat would sicken the man, and even if he managed to conceive a son, the heat would remain as a latent poison in the fetal body and the boy would die young. Instead, they argued that the proper way to regulate yang was to address the underlying deficiency of yin.  Gong Tingxian shared this viewpoint, and the key drugs in his prescription acted by nourishing bodily yin and the kidneys.  As Liu Xiaoting swallowed the dozens of pills that Gong prescribed, he may have had initial doubts about their efficacy. But the birth of his son would have convinced him that, at least in this instance, Gong’s approach to male coldness was the correct one.

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Elixir to Solidify the Root and Build Yang (Guben jianyang dan)
Dodder seed (tu si zi) cooked in wine, one and a half taels[1]

White poria, root end (bai fu shen), skin and woody bits removed
Dioscorea (shan yao), steamed with wine
Achyranthes root (niu xi), stems removed, washed in wine
Eucommia bark (du zhong), washed in wine, skin removed, roasted until crisp
Angelica root, main body (dang gui shen), washed in wine
Cistanche (rou cong rong), soaked in wine
Schisandra fruit (wu wei zi), washed in wine
Black cardamom (yi zhi ren), stir-fried in salt water
Tender deer antler (nen lu rong), roasted until crisp
One tael each of the above

Prepared rehmannia (shu di), steamed in wine
Dogwood fruit (shan zhu yu), steamed in wine, the pit removed
Three taels each of the above

Sichuanese morinda (chuan ba ji), soaked in wine, the heart removed, two taels

Teasel (xu duan), soaked in wine
Milkwort (yuan zhi), processed
Cnidium seeds (she chuang zi), stir fried, the husks removed
One and a half taels each of the above

Add:
Ginseng (ren shen), two taels
Goji berries (go ji zi), two taels

Grind the above into a fine powder, and mix with honey to form pills as large as the seeds of the parasol tree. For each dose, take 50 to 70 pills on an empty stomach, washed down with salt water. With wine is also fine. Before bedtime, take another dose. If the woman’s monthly affair is already concluded, then this is the time for planting sons, and if one takes three doses a day, that is no problem.  If essence is not stable, then add dragon bone (long gu) and oyster shell (mu li), heated in fire and quenched in salted wine three to five times. Use one tael, three mace of each. Moreover, add five taels of tender deer horn.

[1] The weight of the tael (Ch. liang) has varied over time, but during Gong Tingxian’s lifetime would have been equivalent to approximately 37 grams.  A mace (Ch. qian) is one-tenth of a tael.

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Yi-Li Wu is a Center Associate of the Lieberthal-Rogel Center for Chinese Studies at the University of Michigan, Ann Arbor (US).  She earned a Ph.D. in history from Yale University and was previously a history professor at Albion College (USA) for 13 years.  Her publications include Reproducing Women: Medicine, Metaphor, and Childbirth in Late Imperial China (University of California Press, 2010) and articles on gender and the body; medical illustration; forensic medicine, and Chinese views of Western anatomical science.  She is currently completing a book manuscript on the history of wound medicine in China.

Harnessing Heat in Greco-Roman and Islamicate Medicine

By Aileen R Das

Associated and sometimes identified with the life-giving (or vital) principle, heat occupied a central place in ancient Greek, and subsequently Roman and medieval Islamicate, theories about the human body and its care. The medical literature surviving from classical Greece shows that early doctors’ understanding of human physiology was greatly informed by philosophical speculations about the basic constituents of the world. Heraclitus of Ephesus (fl. 500 BCE) appears to be the first natural philosopher to give fire a primary role in the cosmos; according to him, everything originates from fire, which undergoes various changes to become the materials that we see around us. His now fragmentary writings do not discuss medical or biological themes, but later ‘Pre-Socratics’ – a modern term that describes Heraclitus and other thinkers before or roughly contemporary with Socrates – such as Empedocles (495–435 BCE) did explain how this element affected the body. Both a physician and a philosopher, Empedocles of Akragas is the progenitor of the four element theory, according to which earth, water, fire, and air are the building blocks of the universe, and he asserted that heat was responsible for sexual differentiation. In his philosophical poem On Nature, Empedocles remarks, ‘For in its warmer part the womb brings forth males, and that is why men are dark, more manly, and shaggy’ (fr. 67).

The authors of the Hippocratic corpus developed several of their therapies in light of the notion that an innate heat sustains essential processes in the body such as growth and digestion. The intensity of this heat supposedly varied not only according to sex – with men being warmer than women – but also from person to person. Thus, when deciding on a course of treatment, the doctor had to make sure that they did not excessively increase or reduce the natural heat of their patients. Dietary regimens were the mainstay of Hippocratic therapeutics, for doctors working in this tradition assigned to food a range of properties (cooling, warming, drying, and moistening, to name just a few) that could influence the condition of the body. For example, the Hippocratic treatise Regimen II recommends that the herb coriander, which is described as being ‘hot and astringent’, be eaten to combat heartburn and to induce sleep.

None of the Hippocratic writers offer an overarching theory of the powers of nutriment and other natural substances. Rather, centuries later the physician Galen (d. c. 217 CE) of Pergamum, who drew on the Hippocratics, their philosophical precursors, and earlier pharmacological writers, formulated a system that ranked the properties of plants, minerals, and animal products. The dividing line between what counted as a drug as opposed to a food was blurry in the ancient (as well as medieval) world, so Galen elaborates his theory in both his dietetic and pharmacological works. On the Powers and Mixtures of Simple Drugs, which lists several hundred one-ingredient drugs, offers the most comprehensive account; it relates that all substances possess a mixture of active (hot or cold) or passive qualities (wet or dry) in four varying degrees of intensity, with the first degree being weak and the fourth strongest. For example, in the entry on the chaste-tree (vitex agnus-castus), Galen reports that the leaves and seeds of this Mediterranean plant is warm and dry to the third degree. By learning the properties and strengths of a range of materia medica, the doctor can select the appropriate remedy that will match their patient’s imbalance. Regarding the power of the chaste-tree, Galen recommends that the seeds be used to dissolve wind in the stomach and to relieve uterine pain, but he cautions that they are so warming that they can cause a headache. Thus, to avoid this affect, he advises that they be ingested with sweetmeats or other dessert items.

While Galen’s theory of the potency of natural substances was extremely influential throughout antiquity and the middle ages, later medical thinkers looked to redress his failure to explain how a doctor (or pharmacist) calculates the right proportion of ingredients in a multi-ingredient (that is ‘compound’) drug to achieve the desired potency. The Muslim philosopher Abū Yaʿqūb ibn Ishāq al-Kindī (c. 801–66), who was not a doctor himself but had sponsored the Arabic translations of Greek medical works, developed a complex arithmetical theory to quantify the strength of a drug that contained varying degrees of warmth, for instance. According to it, a substance’s intensity increases with an increase in degree according to the double ratio. Thus, if one takes a ‘temperate’ drug that has equal parts of warmth and coldness and doubles the parts of warmth, the drug will be hot in the first degree; if the parts of warmth are quadrupled, then the drug is hot in the second degree and so on. With these proportions in mind, the practitioner can weigh out the simple ingredients of the compound drug to obtain the intended strength. Al-Kindī’s solution to the gap in Galen’s pharmacology was popular not only among medieval Islamicate but also European doctors, who read it through a 12th-century Latin translation.

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.