Category Archives: Medical Practitioners

A Tale of Chiles, a Servant, and a Travelling Medical Scholar in Early Modern China

By Brian Dott

Fig. 1. A few of the many varieties of chiles available at a market in Kunming, Yunnan, China. (Image Credit: Dott, 2017)

 

Fascinated by early modern Chinese cultural history, I research popular religion, especially pilgrimage, and the culinary and medical uses of chile peppers.  Eating Sichuan food, I wondered “how did the Chinese begin to consume such a spicy, introduced plant?”  All the myriad varieties of the chile pepper originated in the Americas.  They probably reached China in the 1570s.  The earliest known Chinese source dates to 1591 (Gao Lian, Zunsheng bajian [Eight discourses on nurturing life]).  While past and present Chinese use chiles most for culinary flavoring, Chinese adoption and adaption of this American pod did not take off until the chile was classified medically and some of its empirical effects within the human body observed. In Traditional Chinese Medicine (TCM), there is no clear distinction between things taken into the body as sustenance and as medicine – everything taken in affects health.  Indeed, one medical text talking about chiles informs the reader: “To make medicine, chop finely, mix with pork fat and fry to make a dish” (Xu Wenbi, Xinbian shoushi chuanzhen [New compilation of the transmitted truths on longevity], 1771).  Furthermore, the earliest text to explicitly mention using chiles to flavor food is best described as a medical text (Shiwu bencao [Pharmacopeia of edible items], 1621).

As Carla Nappi has explored in her series of posts, Translating Recipes, some recipes read as stories or conversations.  Sharing medical recipes allows modern readers to listen in on narratives from the past.  A key author for my exploration is Zhao Xuemin (1719-1805).  Zhao was a medical practitioner and author who worked to update Chinese medical knowledge by including newly introduced ingredients (such as the chile pepper) and knowledge from less well-known practitioners.  He traveled extensively to consult with local experts, and incorporated materials from their manuscripts into his own work.  Indeed, less than a hundred years after his most famous work was completed, more than half of the works he cited were no longer extant (Bencao gangmu shiyi [Correction of omissions in the Systematic pharmacopeia]).

Chiles as Treatment for Malaria

Chiles were used as both a treatment for people who had contracted malaria and as a prophylactic to prevent infection.  A local history from Guangdong stated that “All [varieties of chiles] can remove water-borne malaria and disperse rheumatism.  . . .  In Guangxi malaria is even more prevalent.  One cannot go a single day without [them]” (Enping county gazetteer, 1766).  Zhao Xuemin recounts the following story about chiles and malaria:

Because [the chile’s] property is hot [it can act as a] dispersant by entering the heart and spleen meridians.  It can also disperse water damp.  In guihai (1743), I was in Lin’an [near Hangzhou], in the 6th month a young servant drank cold water and slept on the cold, damp ground, by autumn they had developed malaria.  [They took] myriad medicines without result.  In early winter, by chance [they] ate some chile paste.  They found this very palatable, and needed it with every meal.  In addition they also used [chiles] in a medicinal broth with meals.  Before long the malaria was cured. (Zhao Xuemin, Bencao gangmu shiyi, j. 8, 73b)

Zhao gives a scene setting – place and time.  He introduces the patient, including an emphasis on class, which indirectly provides an explanation for the poor choice of sleeping place.  Zhao also provides us with his explanation for how the infection occurred – conditions involving cold and water.  The heating and damp expelling characteristics of the chile are the traits Zhao sees as important for effecting this cure.  That the servant ate chile paste by chance means that it was probably commonly used, even in a region where the elite culinary traditions rejected strong flavors.  Here, we may be seeing class differences, as the lower classes in China tended to adopt the chile long before the elites.  Chiles could be homegrown, did not have to be purchased in a market, and helped make a starch-based diet tastier. 

The fact that the servant found the chile paste to be “palatable” reflects an understanding in TCM that an individual’s body can instill a craving for things it needs.  Furthermore, while that need and craving exist, strong or even unpleasant tastes and smells become bland or “palatable.”  Zhao is refreshingly candid that older cures (presumably including some of his own) had no effect.  We can also see the importance he placed on empirical knowledge – not just relying on systems and traditional classifications.  It appears that once he noticed an improvement in the patient’s condition, after the chance introduction of chile paste into their diet, Zhao introduced another form of chiles—medicinal broth – into the treatment regimen.  To modern readers, Zhao is frustratingly vague about the recipes for these treatments.  At one level, such details were probably not necessary for his intended audience – exact ingredients in the paste probably did not matter, as long as chiles were present, and everyone knew how to brew a medicinal broth.  More importantly, the anecdotal aspect of the description created an informal tone that may have made this treatment more believable to past readers than any mere list of ingredients.

 

For further reading (and recipes), see  Brian Dott, The Chile Pepper in China: A Cultural Biography, Columbia University Press, 2020.

“Very good are the words of the wise”: Plagues and Remedies of the Colonial Maya

By R.A. Kashanipour

Early Spanish settlers, administrators, and chroniclers frequently lamented how Old World diseases ravaged native communities in the New World. The famed Dominican Bartolomé de Las Casas described the ferocity of the first epidemics: “Then came a terrible plague, and almost everyone died, and very few remained.”[1] We know much about the devastation, but less about the everyday responses of the victims of disease, especially in the Americas where death and destruction accompanied conquest and colonialism.

In colonial Mexico, native scribes and healers recorded local remedies and cures as they treated populations ravaged by endemic and epidemic sicknesses. During the eighteenth century, a series of anonymous Maya curanderos (folk healers) recorded local ideas of science and medicine in a manuscript titled Tratado de las siete planetas y otro de medicinarium (Treatise on the Seven Planets and another on Medicine). Commonly known as the Chilam Balam de Kaua, this work circulated beliefs and practices about the natural world as it passed among healers. The work synthesized European accounts of astrology with Maya understandings of the ritual calendar.

Title Page of the manuscript known as the Chilam Balam de Kaua. The work derives its name from a sixteenth century Maya shaman known as the Chilam Balam (Jaguar Priest) and the community in which the manuscript was written, Kaua. This image is of a Photostat from 1920 housed at the Library of Congress. The original manuscript is lost.]
Title Page of the manuscript known as the Chilam Balam de Kaua. The work derives its name from a sixteenth century Maya shaman known as the Chilam Balam (Jaguar Priest) and the community in which the manuscript was written, Kaua. This image is of a Photostat from 1920 housed at the Library of Congress. The original manuscript is lost.]

Healers recorded remedies for common afflictions and ailments that reflected the intertwined relationships of the colonizers and colonized. An early passage of the work admonished readers to hold the knowledge with respect and care. “Very good are the words of the wise. [These are] recipes in the Maya language for those Indians that want to understand this medicine. Arte, it is called for those who are sick, also for those that are strong and well. Very good are the words of the wise.” [2]

The healers of the Chilam Balam de Kaua recorded remedies in indigenous terms that often reflected European categories of disease. Cures addressed common illnesses, such as cough (en), cold (sis), fever (chakuil), and periodic epidemic diseases like smallpox (nohoch kak), yellow fever (vómito de sangre), or measles (sarampión). There were remedies for everyday afflictions: headache (chibal pol) and earache (chibal xicin). Others were punctuated with magical intervention, including sorcery (pulbil yaah) and evil flowers (mal floral). Treatments attempted to reduce the aches that welcomed life–childbearing (alancil) and painful swollen breast (ya umil chup)–and the pains that greeted death–bleeding (kik) and cancer (caanzeel). There were remedies to treat the difficulties of manual labor: wounds (cinpahal), swellings (chuchup), and broken bones (sayal bac). In total, the Chilam Balam de Kaua contains over three hundred and thirty remedies.

One of the numerous cures for fevers captures the interaction between Mayan and Spanish knowledge systems.

A remedy for fever (tzacal chacuil) by the ancient people, here is the consumption tree (nech bac che), its other name is fever tree. This is boiled in water to wash people who have a fever. [The affliction] is called weakness (nach bahal) in their language and this is ético in the language of the Spaniards. Then leaves of the plant should be taken with the leaves of the night herb (akab xiu), whose leaves are pleasant smelling. The same amount of leaves are mixed together and boiled until soft. They may be taken [this way]. When the water is half finished, the affirmed may be bathed with the hot water, as hot as can be allowed. Four or five times, this is done… When covered and cool, they may arise to chocolate (cacau) leaves and the night herb… The consumption tree is to be twisted with the chocolate plant.[3]

Fevers were undoubtedly common in colonial Yucatán. As with most Yucatec remedies, the application appeared straightforward and matched symptoms with treatment. The heat of the fever was to be broken with a simmering herbal bath, followed by a concoction of herbs with chocolate.

The record keeper, however, also noted that remedy’s pre-Hispanic origins, establishing a connection to the past. In diagnosing the affliction, however, ancient Maya knowledge linked with contemporary Spanish perspectives. These fevers were called nach bahal or ético and, as such, the remedy could apply to Mayas and Spaniards alike.

The materials for the remedy were exclusively comprised of wild herbs, tying the uncontrolled disease with the unconquered frontier. While most healers may have sourced domesticated plants from herb vendors (yerbateros), this remedy required plants of the forest. The cure required knowledge of Mayan biological landscapes; to produce this remedy, the healer needed access to the untamed frontiers of the province.

This remedy, like so many of colonial Yucatán, showed that “the words of the wise” involved the convergence of distinct traditions in the everyday practices of curing. The Chilam Balam de Kaua and other medicinal manuscripts from colonial Latin America illustrate the localized processes in the production and circulation of medical knowledge in the early modern world.

[1] Bartolomé de Las Casas, Historia de las Indias (México: Fondo de Cultura Economica, 1951) 3: 270.

[2] Chilam Balam de Kaua (photostat reproductions), f. 7, Container 25,Ac. 4056, Indian Languages Collection, Library of Congress, Washington, DC.

[3] Chilam Balam de Kaua, f. 175.

A Spider at the Pulse

By Yijie Huang

I received a gift from my supervisor this spring, a vial of “POSITIVITY Pulse Point Oil” from ESPA. As a historian of pulse diagnosis in early modern medicine, I am fascinated by it–not so much by the joyful fragrance, but by what “pulse” indicates in its label. It reminds me of the popular tip to wear perfume on one’s wrists, said to help the scent to spread over the whole body and to last longer. It also reminds me of a story about Robert Boyle (1627-91), a leading natural philosopher and one of the founders of the Royal Society. Among his many accomplishments, Boyle contributed significantly to the corpuscularian philosophy: that matter is made up of numerous invisible corpuscles whose quality determines its overall properties. He was particularly interested in explaining the efficacy of recipes at the corpuscularian level–which shaped his understanding of the pulse.

This is an image of the ESPA pulse point oil box.
ESPA Positivity Pulse Point Oil.

 

Boyle was immersed in a diagnostic tradition, extending from antiquity into the early modern period, in which people took assessed the pulse’s quality (magnitude, speed, strength, hardness) to assess the bodily state, especially the heart. In his Essays of Effluviums (1673), Boyle recounted a seemingly absurd anecdote from German physician Daniel Sennert (1572-1637). Some Nicolaus of Florence reported that a Lombard in the city had burned a big black spider upon a nearby flame, then soon after fell into a faint. Although the Lombard’s heart was severely affected, with his pulse scarcely perceivable overnight, he was eventually cured. In the Essays, Boyle discussed how objects release effluvia–that is, streams of minute constituent particles–to cause effects upon the human body. It was by the means of effluvia, he claimed, that ambrosial objects like ambers could perfume the body even one does not wear them next to the skin. Yet effluvia might also bring dreadful threats across distance. Contagious patients carrying them could infect others without physical contact. Poisonous effluvia could kill people in a scarcely noticeable manner. The poor Lombard’s weak pulse warned of such danger. According to Boyle, the vapour of the lit spider was inhaled into the Lombard’s body, resulting in a contactless poison.

While this spider interrupted the pulse indirectly, another spider might be placed exactly there as a cure. Boyle referred to the ancient Greek pharmacologist Dioscorides (c. 40-c. 90) and the Swiss alchemist Paracelsus (1493-1541) who described individuals sealing a spider inside an empty nutshell and binding it to certain bodily parts. The amulet was to prevent ague, as spider–especially its oil–was believed remarkably efficacious in curing agues and quartans (Works, vol. 13, 248).

Nonetheless, Boyle doubted the validity of this type of spider remedy. He discussed a case in which a gentleman wore at his wrist a half of a walnut shell, within which was sealed a great, living spider. He was trying to prevent a coming fit of ague, but (ironically) died from it. Why did the spider kill the man despite being kept separate from his body by the walnut shell? Some physicians’ judgements echoed Boyle’s ideas about effluvia: the spider permeated its malignant steam into the veins near the pulse. Through the circulation of the blood, it finally reached and destroyed the heart.

Boyle paralleled this deadly spider at the wrist with many other noxious amulets, arguing that they probably influence the human body in a similar way. His argument gestures at the invisible fluidity of materials across the skin. Everything penetrates everything, thus toxics applied “outside” the body could have detrimental effects deeply “inside”. This made the pulse more than a site of diagnosis. With poisonous objects attached to it, the pulse could became a fatal portal into the body, potentially allowing the poison to flow to the heart at the centre.

Yet the portal of death may also be the portal of life: what if things put at the pulse were healthful, not toxic? Boyle was aware of this potential method of healing, which he put into practice by tying many herbal, mineral and animal ingredients to the wrist. He referred to them as pericarpia, wrist remedies (in Greek, peri means around, karpos means wrist). Recommending them as incredible cures to a range of diseases from agues to eye ailments, Boyle shared his own experience of a wrist remedy. Once he suffered from a violent quotidian fever, and no normal therapies had proved effective. Eventually, a physician applied to his wrists “a mixture of two handfuls of Bay-Salt, two handfuls of the freshest English Hops, and a quarter of a Pound of blew Currants very diligently beaten into a brittle Mass” and successfully cured him (Works, vol. 3, 420). This remedy should have been prescribed many times; Boyle reported that despite occasional failures, it showed “great Effects” on quotidian, tertian agues and continual fevers.

The underlying concept of the body has proven resilient. Under microscopes we observe the porosity of skin under microscopes; by X-rays and infrared photography, we see the deep landscape of the body and its material exchange with the outside environment. Such corporeal facts, many may assume, can only be excavated with the help of advanced visual technologies belonging to our age. But Boyle’s pulse-related discussions are testimony to the provocative insights into the openness and fluidity of the body which far predate our rediscovery of it (Murphy). Early modern people approached these facts using their distinct technologies, including the spider at the pulse. But it is that spider at the pulse that can serve as symbol of how early modern people imagined–and experienced–medical interventions that worked beyond, across, and beneath the skin. 

The spiders at the pulse, Boyle’s wrist remedies, and the ESPA aromatherapy substantiate a probably coherent historical lineage of the pulse as a therapeutic locus. Medical activities we engage in today seldom preserve this notion, as most of us view the pulse simply as the synonym of pulsebeat. In such fashion, pulse becomes nothing but a numerical result, told by counting and clocks, not touch. However, our wrists anointed by fragrances remind that we still enjoy the legacy of the pre-modern recognition of the pulse not only as a means to assess the body, but one to manipulate it. 

References

Boyle, Robert.  Essays of Effluviums. London, 1673.

Boyle, Robert. The Works of Robert Boyle, Electronic Edition, Vols. 3 and 13: Unpublished Writings, 1645-c. 1670, ed. Michael Hunter and Edward B. Davis. Brookfield, Vt.: Pickering and Chatto, 2000.

Murphy, Hannah. “Skin and Disease in Early Modern Medicine: Jan Jessen’s De cute, et cutaneis affectibus (1601).” Bulletin of the History of Medicine 94, 2 (2020): 179-214.

 

Chinese American Herbal Medicine: A History of Importation and Improvisation

By Tamara Venit Shelton

“Chinese herbalists imported everything from China.” This is what I consistently heard from herbalists I interviewed when writing Herbs and Roots: A History of Chinese Doctors in the American Medical Marketplace. As far as anyone knew, when the first generation of Chinese herbalists began to immigrate to the United States in the 1850s, they imported all their medicinal ingredients from China through the port of San Francisco. By 1878, there were eighteen wholesale companies in San Francisco that serviced Chinese herb shops across the United States. In later years, herbalists could find what they needed through wholesalers in Portland, Seattle, St. Louis, and Chicago.[i]

Fig 1: Frontispiece of The Science of Oriental Medicine, 1902. Los Angeles Herbalists Tom Leung and Li Wing advertised their remedies to English-speaking patients through long and short-form print advertisements. Public Domain.

Historians of China are aware of the importance of improvisation and substitution in traditional Chinese medicine, and yet the prevalent assumption that all Chinese medicines were imported to the United States made some sense. After all, according to thousands of years of Chinese herbal lore, therapeutic efficacy relied on a highly specific process of procuring medicinal plants, animals, and minerals. The collection or cultivation of traditional medicinal ingredients in China happened only in well-defined areas, under certain seasonal, climatic, and astrological conditions.

Yet as I dug into archives, historical newspapers, memoirs, and oral histories, it became apparent that historically, practitioners of traditional Chinese herbalism in America sourced most, but not all of their supplies in China. There is ample evidence – both anecdotal and archaeological – that the Chinese in America grew and foraged for local sources of medicinal ingredients. These findings speak to the ways in which diasporic Chinese medicine responded to new conditions as well as to the resourcefulness and adaptability of its practitioners.

Fig 2: A.P. Russell, a West Virginia merchant, shows off a 1700 pound shipment of ginseng destined for China in 1928. Wild ginseng, foraged in Appalachia, was a major American export to China from the late eighteenth century until its overharvesting led to near extinction in the mid-twentieth century. Public Domain.

Looking back to the end of the nineteenth century, we see examples of Chinese and non-Chinese farmers growing medicinal herbs and roots for Chinese herb businesses. In 1898, a newspaper in Washington D.C. reported that Lee Poit, recently transplanted from California, had given up trying to compete in the crowded field of laundry and retail and was instead growing “many queer vegetables and herbs” on four acres of land that he rented near Terra Cotta Station, on the Baltimore and Ohio Railroad Line.[ii] Across the country, J. B. McCloskey, an American farmer who studied commercial ginseng production in Korea, opened his own farm on two acres in Oxnard and became the major supplier for Los Angeles-area Chinese physicians in 1904.[iii]

Zoological-based medicines also seem to have been locally sourced. The Chinese collected all manner of reptiles and amphibians – snakes, lizards, frogs, and toads – to supplement dried, imported varieties in America. Sometimes, doctors substituted local species that seemed similar to what would have been available in China. In Boise, Idaho, C.K. Ah Fong famously used rattlesnake (a North American reptile) in traditional Chinese tinctures to treat arthritis, and amidst other Chinese health-related artifacts from Lovelock, Nevada, archaeologist Sarah Heffner has found bobcat bones that may have been used in place of expensive, imported tiger bones.[iv]

Fig 3: Canton Harbor and Factories with Foreign Flags, 1805. European and American traders exchanged medicinal goods through this port city. Public Domain.

Substitution was just one form of improvisational thinking among Chinese herbalists in the United States. Studies of hand-written prescriptions from Chinese American apothecaries reflect a tendency to include an unusually long list of ingredients. This divergence may have been an artifact of herbalists’ swift business in mail-orders for patients unable to meet face-to-face. Patients wrote letters describing their ailment or filled out a pre-printed “symptom sheet,” and the doctor sent back a package of medicine along with a detailed instruction sheet. With an extra-long list of ingredients, Chinese American herbalists could cover a lot of bases when confronted with ambiguous descriptions of symptoms.[v]

Fig 4: Cover image of Herbs and Roots: A History of Chinese Doctors in the American Medical Marketplace. Yale University Press.

 

Chinese doctors in the United States were not so bound by tradition that they resisted adapting their formularies to their new environment. We should remember them as the innovative immigrant entrepreneurs that they were. As herbalist Li Wing Fawn explained to the Los Angeles Times in 1897: “We shall not confine ourselves exclusively to the importations from the Orient, but shall seek out also the very many valuable medicinal herbs growing in our own country [the United States].”[vi]

 

 

 

[i] Haiming Liu, “Chinese Herbalists in the United States,” in Sucheng Chan, ed. Chinese American Transnationalism: the Flow of People, Resources, and Ideas between China and America during the Exclusion Era (Philadelphia: Temple University Press, 2005), 138.

[ii] “Lee Has a Chinese Farm,” New York Times, 31 October 1898, ProQuest Historical Newspapers: New York Times.

[iii] “Local Ginseng Culture Promises Rich Returns,” Oxnard Courier, 27 May 1904; “Queer Chinese Medicines, Los Angeles Times, 11 August 1907, ProQuest Historical Newspapers: Los Angeles Times.

[iv] Sarah Heffner, “Exploring Health-Care Practices of Chinese Railroad Workers in North America,” Historical Archaeology 49 (2015): 141.

[v] Susie Lan Cassel et al, The Chinese in America: a History from Gold Mountain to the New Millennium (Lanham MD: AltaMira Press, 2002), 178.

[vi] Li Wing Fawn and B.C. Platt, “A Step in Advance,” Los Angeles Times, 26 May 1896, ProQuest Historical Newspapers: Los Angeles Times.

 

About

Tamara Venit Shelton is a professor of history at Claremont McKenna College and author of the award-winning book, Herbs and Roots: A History of Chinese Doctors in the American Medical Marketplace