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

Remembering Terry Turner (1929-2019): Pharmaceutical History Collector Extraordinaire

By Laurence Totelin, with input from Briony Hudson

A few years ago, my colleagues Heather Trickey (social sciences), Julia Sanders (midwifery) and I decided to put together a small exhibition on the history of infant feeding, with a focus on Wales where we are based. I immediately thought that the exhibition would benefit from the input of Terry Turner OBE, emeritus professor of Pharmacy at Cardiff University. I had met Terry on several occasions, usually in the Cardiff University staff refectory at Aberdare Hall, and knew that he would have something to contribute to the project.

Two ceramic tops with holes in the middle. The topc are both inscribed.
Two ceramic tops for the so-called ‘murder bottles’ from Terry Turner’s personal collection. A tude was passed through the hole. Because that tube was very difficult to clean, it harboured dangerous bacteria. This type of bottle caused the death of many babies, hence the name of ‘murder bottles’. Photo: Laurence Totelin

With his habitual generosity with time and expertise, Terry accepted to talk to me and invited me to his house. In the morning that I spent with him on this occasion, I learnt more on infant feeding than I would have done reading several books. Terry showed me examples of historical feeding bottles and nipple-shields from his collections and explained how they were used; told me about the mixing of baby formulas; discussed past treatments for breast engorgement; and gave me useful insights into the commercial aspects of the pharmaceutical trade. He also returned to some of his favourite topics: the pharmacognosy of the Strychnos plant genus, with which he started his academic career (MPharm 1960); some of his adventures in collecting pharmaceutical artefacts and plant specimens; and his disdain for modern pain relief, and in particular paracetamol.

Photo of two historical metallic nipple shields with their original carboard box.
Two metallic nipple shields and their original cardboard box from Terry Turner’s personal collection. Photo: Laurence Totelin

Terence (Terry) Dudley Turner was a key actor in the pharmaceutical community in Wales. He entered the profession at the grand old age of 14, working at the renowned Cardiff Pharmacy Robert Drane. He formally registered as a pharmacist in 1955, and saw his profession change almost beyond recognition over his long career: almost gone today are the pestles and mortars, which had been the symbols of the profession for so long; almost complete now is the separation between botany and pharmacy. Terry was rightly proud of his knowledge of plants and his ability to extract from them healing substances. He travelled the world to collect plant specimens and knew their names in several vernacular languages (in addition of course to their Linnaean names).

Picture of two glass historical baby feeding bottles. The bottles are made of glass and are banana shaped. They are accompanied by two rubber teets in their original wrappings.
Banana-shaped baby feeding bottles with rubber teets from Terry Turner’s personal collection. Photo: Laurence Totelin

With a changing profession in the background, Terry developed an interest in the history of pharmacy. He was a founding member of the British Society for the History of Pharmacy (established 1967), which honoured him with the Leslie Matthews Medal in 2017 for his contribution to the history of British pharmacy. He taught his students about the history of the discipline, he wrote on the topic, but above all he collected artefacts in their thousands and could tell entertaining stories about many of them.

His collection soon became too large for his residence, and he started in the early 1980s to exhibit, loan, and donate it. It is currently displayed in two main locations: the Redwood Building, Cardiff University, and in the Apothecary’s Hall at the National Botanic Garden of Wales. The Turner Collection, formally donated to Cardiff University in 2009, comprises some 1500 artefacts, exhibited over three floors of the Redwood Building, currently curated by Sarah Daly and Briony Hudson. At the National Botanic Garden of Wales, the visitor will enjoy a reconstructed historical pharmacy. While it is in many ways ahistorical, gathering in the same place artefacts produced over many decades, it does capture the feeling of being in a pharmacy around the end of the nineteenth century. I am particularly fond of the scales for weighing babies. Terry also donated and catalogued around 500 materia medica specimens for the National Museum of Wales. While these are not on display, they are a key part of the museum’s economic botany collections.

Terry passed away aged 90 on 13 October 2019. I often wonder what he would have to say about the current pandemic. His wit, optimism and humour are sorely missed.


You can find more information about the history of the School of Pharmacy at Cardiff University, and the Turner Collection in Briony Hudson’s 2020 book 100 Years (1919-2019): Cardiff University School of Pharmacy and Pharmaceutical Sciences, dedicated to Terry Turner, and available freely on Achive.org.

 

Cherries Galore in a Cesspit

By Merit Hondelink

As an archaeobotanist, an archaeologist specialised in studying plant remains found in archaeological excavations, I aim to reconstruct and interpret the relationships between humans and plants in the past. Archaeological plant remains, also known as subfossil plant remains, help us to reconstruct the former landscape and inform us how humans exploited it and even transformed the vegetation. Archaeobotanists do not necessarily study one time period, nor a specific region or topic. They can study plant remains from the Palaeolithic or the 20th century, and everything in between. They can focus on one specific site, work across the country or continent, and even work worldwide. They can delve into topics such as natural vegetation, forestation, domestication, trade, food consumption and much more. The one thing that all of this has in common is the link between humans and plants. But most archaeobotanists do specialize, most notably in the plant parts they study, such as fruits, seeds, pollen, wood or phytoliths. And most archaeobotanists have a beloved time period, favourite region or topic that they find most intriguing. In my case my research focuses on early modern Dutch urban food consumption.

I study what people ate in early modern Dutch cities, and how this changed through time. The best way to study what people ate in the past, is to look at their excrement and kitchen refuse, both of which can be found in the archaeologists treasure trove: the cesspit. These latrines were used to empty one’s bowels, but also served as a place to discard kitchen refuse and household waste. The content of a cesspit consists of organic remains from plants and animals, inorganic (culinary) material culture such as earthenware, glassware and ceramics, but also wooden cups and plates, as well as (decorative) objects, personal belongings and much, much more.

Figure 1: A selection of faunal and floral items found in a late medieval cesspit sample from Groningen. Photo: Dirk Fennema.

The content of an archaeobotanical cesspit sample consists of, among others, floral remains in different shapes and sizes (Figure 1). The items are sorted with the use of a microscope (Figure 2) and identified on a species level (and sometimes even on the level of species variety) by using a reference collection (Figure 3). The Groningen Institute of Archaeology offers a wonderful digital, open access, reference collection, see https://www.plantatlas.eu/.

Figure 2: A peek through the microscope. Visible is a fragment of text and different seeds and fruits, taken from an early modern Delft cesspit sample. Photo: Merit Hondelink.

When the content of a cesspit sample is analysed, sorted and identified, the interpretation begins. What can these plant remains tell us about past human-plant relationships? Most plant species are interpreted in a standardized way: wild plants inform us about the vegetation composition, make-up of soils and hydrology, whilst agricultural weeds in particular inform us about the crops grown and their local, regional, international or even global provenance. Wild but poisonous or toxic plants inform us about potential medicinal applications. A majority of plant species found in cesspits are classified as economic plants, grown as a food crop or cultivated for other useful purposes, such as fibres for textiles or seeds for oil. Identifying edible plants helps us better understand what plants people used for food and which parts people consumed. It also helps us better understand how food was prepared in the past, as preparation marks can be left behind on seeds and fruits.

Some preparation marks are easier to identify than others: nuts need to be cracked to get to the seed; apple seeds may be sliced when cutting up an apple, cereals can be ground, resulting into fragmented bran. But sometimes the archaeobotanist finds fragmented plant parts that, at a first glance, do not make sense.

Figure 3: A small selection of the tubes from the archaeobotany reference collection housed at the Groningen Institute of Archaeology (GIA) at the University of Groningen. Photo via GIA.

I have come across dozens and sometimes hundreds (or even more) cherry stones and plum stones in a single cesspit sample. No surprise there, cherries and plums were grown in local orchards, sold in the market and consumed with gusto. Most of these stones will have been discarded in the cesspit as a result from eating the fruits and spitting out the stones, or after de-pitting the fruits for dinner preparation. Only a small percentage is assumed to have been accidentally swallowed and secreted as excrement. Still, archaeobotanists find many fragments of cherry and plum stones (Figure 4). This is something that raises questions when you think about it. Why would these sturdy fruit stones be fragmented? A more pressing question when you are aware that the Rosaceae family, among others also including almond, peach, and even apple, contains – to varying degrees – hydrocyanic acid, also known as hydrogen cyanide and sometimes called prussic acid. The seed coat and fruit wall protects the consumer from digesting this acid, which can be poisonous when consumed. So why would someone break the stones of these fruits?

Figure 4: Two fragments of cherry stones found in an early modern cesspit in Vlissingen. Photo: Merit Hondelink.

To test the assumption that cherry stones were fragmented intentionally, and not through, for instance, pressure, an experiment was devised. Cherries were bought at the farmer’s market and taken to a physics lab to measure the pressure required to fragment the stones. After a number of tests, the calculated force to fragment a cherry stone averaged 23,9 kg or 239 Newton (Graph 1). This makes it more plausible that the stones were intentionally fragmented, as opposed to – for instance – fragmentation due to soil pressure.

Graph 1: Force needed to fragment a cherry stone. On the vertical axis the force (N), on the horizontal axis the elongation (μm). The point where the line falls is the moment the cherry stone breaks (max. force – max. elongation).

Consulting early modern cookbooks provided me with a list of recipes requiring the cook to de-stone cherries for the preparation of jams, sauces, syrups and tarts. Delicious experiments ensued, but I did not manage to fragment cherry stones whilst cutting and de-stoning, pressing through a cloth or colander, or by just baking the fruit with stones in a tart in the oven. Working a batch of cherries with a mortar and pestle did the job, though. But than you would have to pick the fragmented stones from the mushy cherries: not ideal at all. Picking up the eighteenth century encyclopaedia compiled by Noël Chomel gave me the hint I needed. In the Dutch version of his Dictionnaire œconomique (Algemeen huishoudelijk-, natuur-, zedekundig- en konst- woordenboek), he mentions different recipes for preparing cherries. Two recipes for cherry liquor instruct the reader to fragment the cherry stones by using a mortar and pestle (Figure 5). The fragmented fruits, including the stones and (I assume) the seeds are added to the brandy (Dutch: brandewijn) and, after closing the bottle, the mixture is put in the sun to infuse. Adding spices such as cinnamon, cloves and sugar is optional, according to the author.

Figure 5: How to make a pleasant cherry liquor (Noël Chomel, 1778).

So, it is plausible that the fragmented cherry stones found in early modern cesspits are the result of the domestic production of cherry liquor. Other fruits, such as plums and peaches, are also used to make a fruity liquor according to Chomel’s encyclopedia. However, what happens to the acid contained in the seeds? That requires further research. It might be that the prescribed infusing in the sunlight helps denature the acid into harmless molecules, leaving only the (bitter) taste behind. This line of research will be undertaken come summer with the aid of a brewer and some chemical analysis. In the meantime, a cherry and cinnamon flavoured lemonade is my poison of choice. Bottoms up!

A Roman Vegetarian Substitute for Fish Sauce

By Edith Evans

Roman cookery has been one of my research interests since the 1980s; I’ve accumulated a large repertoire of ancient recipes and usually do at least one live demonstration a year.  Most of the recipes include garum or liquamen – fish sauce – as a taste enhancer, providing salt and umami. Whilst finding fish sauce is fairly easy nowadays in Britain (the Romans used the same techniques to make it as the modern Thai and Vietnamese), using it at demonstrations disappoints vegetarians who would otherwise like to sample the plant-based dishes.

I found the answer to this problem in a Late Antique agricultural treatise:

Liquamen from pears: Ritually pure liquamen (liquamen castimoniale) from pears is made like this: Very ripe pears are trodden with salt that has not been crushed. When their flesh has broken down, store it either in small casks or in earthenware vessels lined with pitch. When it is hung up [to drain] after the third month without being pressed on, the flesh of the pears discharges a liquid with a delicious taste but a pastel colour. To counter this, mix in a proportion of dark-coloured wine when you salt the pears.
– Palladius: Opus Agriculturae 3.25.12

Liquamen castimoniale must have been required for people observing certain religious strictures (castimoniale means ‘to do with religious ceremonies’). Why would ordinary liquamen have been thought unsuitable? Was it the fish? (Pliny the Elder writes of a special fish sauce for Jews (Natural History 31.95) that he calls garum castimoniarum, although he’s obviously got the wrong end of the stick when it comes to Jewish food laws because he says it’s made using fish without scales). Alternatively, was it because liquamen was the product of fermentation? Fermentation was often considered a form of decomposition, which might have led it to be regarded as ritually unclean.

This has a bearing on how we interpret the recipe. Although Palladius tells us the ingredients to use (whole pears and salt, plus optional red wine) he does not give any information about the relative proportions. This leaves us with two possible techniques. Either you use a high proportion of salt and effectively create a brine utilising the juice of the pears, or you use a low proportion and promote a lactic fermentation by incubating the mix a suitable temperature (although Palladius doesn’t mention this). When used to flavour food, the product of the first method adds a strong taste of salt but no umami. The second would add some umami but also acidity, but a much lower amount of salt. However, if the problem was the fermentation itself, the second method would have been as unacceptable as standard fish sauce.

I’ve had a go at the lactic fermentation method, using 2% of the weight of the pears in salt, but when I tried it, the mix went mouldy before fermentation had a chance to take hold.  I’ve had much more success with the first method and have repeated it enough times to get a consistent product. The best pears to use are juicy varieties with very tannic skins, like Williams (also known as Bartlett) and Comice. I mash up the pears – stalks, skins, cores and all – mix them with 25% – 50% of their weight in coarse sea salt (I don’t bother with the wine), and leave them at the back of the fridge in a glass jar with the lid only lightly screwed on. At the end of two months (unlike us, the Romans counted inclusively), the pulp has started to separate out. The heavier elements form a pale layer at the bottom of the jar, whilst the top part of the mixture is more liquid and is a pale pinkish-brown. When drained through a nylon sieve, the colour of the resulting liquid is a very pale version of the colour of fish sauce. 

I’ve tried various proportions of salt, and found that, if you use 50%, you seem to get more liquid, probably because the mixture doesn’t draw in moisture from the air to the same extent.  But a smaller percentage of salt allows more of the delightful pear flavour comes through – I find it much more difficult to detect in the 50% version. Stored in a clean bottle it will keep for months without refrigeration.

Figure 1: The pear liqumen is in the flask with dark blue trim

I’ve only had a problem once, when spots of mould had appeared on the surface of a batch six months after I’d made it. As I was due to give a Roman cookery demonstration in a few days’ time I had to quickly rustle up something I could use, so I cored and cut up a pear, boiled it with 25% salt and a little water, removed the peel and pulped the flesh in the blender. It was much too pale, but the taste was the same and I decided it would be a useful method for someone who couldn’t wait two months – in fact that’s what I recommend for my Roman Cookery School videos (https://m.youtube.com/user/GGATArchaeology and https://en-gb.facebook.com/GGATarchaeology/).