Tales from the Archives: Human Milk as Medicine in Imperial China: Practice or Fantasy?

The Recipes Project has over 500 posts in our archives and over 120 pages for readers to sift through. That’s a lot of material! With so much excellent material on the site, it’s easy for earlier pieces to be forgotten. This Tales from the Archive post ties into this month’s theme on TEXTURES and also reminds us of some of our wonderful past content.

This month we’re sharing a 2016 post by He Bian.  It offers a rich, revealing look into the ways that human milk – like and yet unlike milk from other animals – was imagined as a medicine in Imperial China.  We hope that you enjoy this latest installment from our Recipes Project archives, and if you have any posts that you’d like for us to revisit, please send in your nominations
Amanda & Marissa (editors)

By He Bian

What does milk have in common with blood? According to Kou Zongshi (fl. 1110-1117), author of Bencao yanyi (Extended Interpretations on Materia Medica), they are basically the same vital fluid produced by the female body at two critical moments in a woman’s life. While the first menstrual period signifies the maturation of reproductive power, motherhood is the consummation of that power–miraculously causing the vital fluid to flow upward as milk. After nursing ends, the flow of milk again reverses back to blood, as evident from the return of the menses.

“Human milk.” Anon. Buyi Leigong paozhi bianlan (n.p, 1591), Book 8.

However, Kou’s original aim was to make sense of medical recipes. In particular, he was trying to figure out why do so many recipes for eye medicine use human milk to mix up powdered mineral drugs: a practice that has parallels in different cultural contexts. Since blood is essential for the five senses to function and human milk is essentially blood, Kou reasoned, this makes it an excellent medicine for eye diseases. Another recipe that may have been on his mind is the recommendation to drink “three portions of human milk” to help with obstructed menses. It makes sense if they were considered of the same origin. Like cures like.

Let’s pause here to consider what this means. Working with Chinese materia medica texts often means untangling different strands of thought, modes of compilation and miscellaneous quotations. The entry on each substance (e.g. human milk, renru or ruzhi) often begins with a learned survey of previous literature, including passages from classical literature and histories, and ends with a large (and often unwieldy) body of recipes. The problem is that the prescribed uses of the substances in the first part do not always sit well with the recipes, which are messy, opaque, and often outright strange.

In fact, Kou Zongshi’s work could be understood as a scholar-physician’s attempt to impose order and coherence on the unruly recipes, which were becoming increasingly available in print. [2] The incongruities and tension between theory and recipes, however, allows us to follow the intricate dance between empiricism and rationalism in such texts: when did authors equate recipes with real-life experiences, and when did they treat them as exemplars of theory and formulaic principles? When did book culture begin to shape the ways in which medicines were prepared, consumed, and invented?

Back to Kou Zongshi’s ingenious, if somewhat contrived, speculation over the nature of lactation. It did not seem to have caught much attention immediately. The twelfth and thirteenth centuries witnessed a growing suspicion among medical experts to discipline and curb wet nurses’ sway over childcare, and pediatric treatises abound with warnings against drunken, naughty wet nurses whose milk turns unwholesome to the infant.[3] Again, the female body’s power to nourish but also intoxicate with her transformed milk resonates with similar discourses discussed elsewhere on this blog; notably, alcoholic drinks were seen to be a bad thing that excites her passions, in contrast to ancient Roman recommendations.

In addition, the conquest of Mongols brought about increased consumption of cow and goat’s milk.[4] A leading physician active in the fourteenth century advised consuming those over human milk, which is easily “tainted with poisonous passions.” It looks like the arrival of more abundant dairy products would transform the existing pharmacopeia once and for all.

But not so simple. By the sixteenth century in China, human milk had become a “super food” of sorts, especially among elite families. Kou Zongshi’s dusty theory became a dominant trope, fanning the imagination of the female body as a machine of alchemical wonders, and her milk a sort of elixir that revitalizes the frail and depleted bodies. In the sixteenth-century encyclopedia Systematic Materia Medica (Bencao gangmu), Li Shizhen, the erudite naturalist and capable physician, criticized the excessive fetishizing of human milk. The prudent Li nevertheless included twelve “new recipes” that involve human milk as medicine. Li’s encyclopedia was first printed in 1596; soon after the turn of the century, dietary manuals began to teach people how to prepare dried milk powder at home, after collecting fresh milk from “strong women who just gave birth to boys”. Presumably, women sold their milk not as wet nurses, but directly to pharmacists (as depicted in the picture above).

So did people in imperial China consume human milk as medicine? Quite likely. But was it ubiquitous? Probably not. Recipes can be practical and fantastic, and theorists can explain and inspire. What matters is that human milk as medicine gradually came to be taken out of the context of nursing and acquired a more abstract quality as commodity.

[1] Charlotte Furth, A Flourishing Yin: Gender in China’s Medical History: 960–1665 (Berkeley, CA: University of California Press, 1999).

[2] Asaf Goldschmidt, The Evolution of Chinese Medicine: Song Dynasty, 960-1200 (London ; New York: Routledge, 2009).

[3] Ping-Chen Hsiung, “To Nurse the Young: Breastfeeding and Infant Feeding in Late Imperial China,” Journal of Family History, 20, 3 (1995), pp. 217-38.

[4] Paul D. Buell, E.N. Anderson, and Charles Perry, A Soup for the Qan : Chinese Dietary Medicine of the Mongol Era as Seen in Hu Sihui’s Yinshan Zhengyao, 2nd Rev. and Expanded ed. (Leiden, The Netherlands: Brill, 2010).

 

Boiling Milk: Experimenting with Boerhaave’s Little Furnace, Part III

By Ruben Verwaal and Marieke Hendriksen

Fig. 1. Ruben keeps an eye on the temperature.
Fig. 1. Ruben keeps an eye on the temperature.

It has been exactly 350 years since Herman Boerhaave’s birthday. What better way to honour the renowned professor than to redo some of his old experiments? 

On Monday 31st of December, in the year 1668, Herman was born. And already as a kid, he and his brother James probed the curiosities of nature: plants, minerals, liquids and bodily fluids. As Herman recalled some 30 years later, “how many whole days and nights we have spent successively together in the chemical examination of natural bodies” [1]. It must have been around this time that Herman invented his little furnace.

“I’ll put an alarm to take the milk out of the freezer,” Marieke texted Ruben the week before New Years’. Between all the Christmas dinners, the 31st was the only day still free to meet up over the holiday. Weeks before we had bought Irish turf online and collected raw milk from a farm near Delft, as well as from a breastfeeding friend . Having finally found the time, we gathered their materials together and started experimenting.

Why Milk?

As a physician, Boerhaave was fascinated with the human body. How does it work? What is it made of? Boerhaave soon realised that a newborn solely grows on breastmilk. Mothers eat their food and digest it with juices from their intestines; after circulating in their bodies, the fluid concocts into chyle and develops into the maternal sustenance in their breasts. Not only human babies, Boerhaave reasoned, but all mammals are nourished by milk and can grow solely on it. “Milk, therefore, appeared to be the first thing to be examined.” [2]

Making Curd

Fig. 2. 4PM: Raw milk heated with vinegar gives you cheese - well, sort of.
Fig. 2. 4PM: Raw milk heated with vinegar gives you cheese – well, sort of.

We set out to replicate the first experiment, titled “fresh cow’s milk coagulates with acids, even in a boiling heat.” We lit the turf in the fireplace. Once it was hot, glowing, and smelling, Marieke put some in an earthenware bowl and placed it in our wooden furnace to let it heat up. Meanwhile Ruben added vinegar to fresh milk in a glass vessel. As the fluid was gradually heating up in our furnace, parts of the mixture were slowly coagulating into curd.

We were basically imitating the cheese-making proces – a more than common practice in the early modern Dutch Republic. Boerhaave, however, assigned physiological significance to this process. For the cheese could be hardened and burned, smelling like bone – proving that even the hardest parts of a baby’s body could have its origin in milk. “This is a strange change of so fluid a matter as milk, but is, perhaps, the origin of all the solids in the body.” [3]

Red Milk

The second experiment was to show how “recent cow’s milk coagulates, turns yellow, and red, by boiling over the fire with fixed alcali.” We basically repeated the previous steps, but instead of using vinegar we added ammonia. Slowly but surely, the white fluid indeed turned yellow, then a dark orange – and was about to turn red. Here we had to stop, unfortunately, because the turf was cooling down, and it was getting dark outside.

Yet via this relatively simple process, Boerhaave confirmed a common illness: milk fever. The milk from mothers suffering from fever “becomes yellow, saline, thin and sanious.” [4] It also clarified why Dutch cows gave yellow milk during the 1714 outbreak of cow’s fever.

Fig. 3. 6PM: Raw breast milk heated with ammonia: 'bloody' milk?
Fig. 3. 6PM: Raw breast milk heated with ammonia: ‘bloody’ milk?

So What Have we Learned?

First, turf smells! We can only surmise that our early modern colleagues were simply oblivious to the smell due to its omnipresence. Second, our apparatus passed the test. Boerhaave’s little furnace successfully kept the heat inside at an evenly distributed yet high temperature (around 60℃). This is an important feat, especially when working with milk. Anyone who has ever boiled milk knows how easily it becomes a big mess when you don’t pay attention for just two seconds. Yet we were able to have 15-minute glühwein and oliebollen breaks without any problem. 

Third, our experiments have shown us how relatively easily some of Boerhaave’s experiments can be replicated – as opposed to some of his contemporaries who made secret potions or applied intricate and dangerous procedures with metals and minerals. Historical reproduction, reconstruction, and re-enactment are methodologically complex and potentially problematic because of the impossibility of repeating history and reliving the experiences of historical actors. Yet our experiments do enhance our understanding of the past; they make our historical understanding more holistic, less linear and text-based. [5] For example, these experiments help us to understand why Boerhaave was such a popular teacher; with the help of a small oven based on his design, students could learn by doing. 

Fourth, with more time and patience we could have gained better results. This is the case with everything, of course. Yet some of Boerhaave’s experiments with milk – for example the milk turning sour by digestion (i.e. at 37℃) – is described as taking twelve days! Lastly, replicating early modern experiments is fun. We won’t deny that working on your object of study outside the library is refreshing. The photos and videos of the process have a public appeal too. We hope you enjoyed it.

 

 

[1] ‘Dedication’ in Herman Boerhaave, Elements of Chemistry (London, 1735), A3r.

[2] Herman Boerhaave, A New Method of Chemistry (London, 1741), 2, 185.

[3] Ibid., 187–188.

[4] Ibid., 188–189.

[5] Pamela H. Smith and Tonny Beentjes, “Nature and Art: Making and Knowing: Reconstructing Sixteenth-Century Life-Casting Technniques,” Renaissance Quarterly 63 (2010): 128–79. Marieke M.A. Hendriksen, Elegant Anatomy. The Eighteenth-Century Leiden Anatomical Collections (Leiden & Boston: Brill, 2015), Chapter 1. Donna Bilak et al., “The Making and Knowing Project: Reflections, Methods, and New Directions,” West 86th 23, no. 1 (2016): 35–55. Hjalmar Fors, Lawrence M. Principe, and H. Otto Sibum, “From the Library to the Laboratory and Back Again : Experiment as a Tool for the History of Science,” Ambix 63, no. 2 (2016): 85–97.

A Cool Oven: Boerhaave’s Little Furnace, part II

By Ruben Verwaal and Marieke Hendriksen

Ruben Verwaal is curator of the historical collections at Erasmus Medical Centre, Rotterdam, and at the Museum for Communication in The Hague. He obtained his PhD in June 2018 with a thesis on the role of bodily fluids in eighteenth-century chemistry. Marieke Hendriksen is a researcher on the Artechne Project and PI at the Art DATIS Project at Utrecht University and a long-time contributor to The Recipes Project. She specializes in the material culture of science and art in the long eighteenth century. Ruben and Marieke share an obsession with an eighteenth-century object that has since disappeared: a small chemical furnace. In a previous post, they wrote about reconstructing Boerhaave’s little furnace. Now they have two…

The newly build oven, August 2018

In August of this year, we wrote about our first attempt to recreate Boerhaave’s little furnace from old coal stoves. Meanwhile, Marieke’s dad, André, who is a skilled carpenter, was building a furnace from scratch, using Boerhaave’s description and a nineteenth-century example of a Boerhaave furnace in the collection of Museum Gouda as his guidelines. This resulted in a sturdy furnace of solid dried oak, much larger than the furnace we created from coal stoves.

The interesting thing about Boerhaave’s furnace is that many of the experiments that he described in his chemistry book, the Elementa Chemiae, for which the furnace can be used, required a very moderate degree of heat – one could say a cool rather than a hot oven. Two examples we mentioned previously were the distillation of rosemary, and the hatching of eggs, which Boerhaave said he believed his furnace could be used for too. The kind of egg is not specified, but for chicken eggs, the ideal temperature for hatching is 37,6 Celsius. Could we attain that temperature with our furnaces? 

Boerhaave advised to use glowing coals or Dutch turf as fuel, with which a constant and moderate heat should be achieved that could be kept up to 24 hours. As turf is no longer won in the Netherlands, we started with some ordinary barbeque coals – and indeed managed to establish a fairly constant heat of around 30 Celsius in the large oven for an hour or so. But coals did not hatch any chicks.

Coals: a stable 30 Celsius

Suspecting that turf may give better results, we set out to buy turf, which is still won in regions in Germany and Ireland. It turned out to be surprisingly difficult to buy in the Netherlands though. Eventually we managed to purchase a box of Irish turf through the American website of the online retailer we love to hate – but it took eight weeks (!) to arrive.  Though our cool oven still hasn’t incubated a chicken, the first results look promising.

Irish peat via the US
Irish peat via the US

Meanwhile, we started thinking about the experiments we’d like to recreate once we had all necessary materials. Since Ruben wrote his PhD thesis about bodily fluids, he is keen on reconstructing an experiment with milk from different mammals. Preferably, we’d compare the effects of prolonged mild heat on cow’s milk and human breast milk. Raw cow’s milk can be purchased at some farms, so Ruben cycled out to get some, while Marieke hesitantly contacted a friend who was pumping to feed her infant daughter to ask if she was willing to donate some of her leftovers to science. Note for future generations: Marieke has the coolest friends – she instantly said yes! For weeks, she gathered the left overs that her daughter did not drink in freezer bags.

Suddenly, it is December, and we have two furnaces, a box of Irish peat, and milk in two freezers. Now we ‘only’ have to make time for this reconstruction experiment… We live an hour apart and this is our pet project, so we’re desperately searching for a couple of days when we can take time of work. It turns out that the most difficult aspect of this reconstruction project is not the building of the furnaces or the sourcing of the necessary materials, but the absence of what Boerhaave obviously did have: cheap labour in the form of young assistants, who could take turns keeping the furnaces going day and night. We can only hope that once we do manage to take those days off, the Dutch winter is still as mild as it has been up till now! 

You’ll thank me later

In my previous post, I presented a comic parody of an ancient eye-remedy. That recipe, created by the comedian Aristophanes, was too horrid to be true. Yet eye-remedies were far from pleasant in the ancient world. Witness the achariston, the ‘thankless’. There are various recipes for acharista (that’s the plural of achariston) preserved in ancient medical writings. The following one, transmitted by Galen, is representative of this lovely (not) type of medicament:

Oculist stamp  Roman Britain, 1-4 century CE, Kenchester  Herefordshire This stamps bears the inscription: 'Titus Vindacius Ariovistus',  Source: British Museum
Oculist stamp
Roman Britain, 1-4 century CE, Kenchester
Herefordshire
This stamps bears the inscription: ‘Titus Vindacius Ariovistus’,
Source: British Museum

The so-called ‘thankless’ against persistent flows of tears. Physicians who used it, in Egypt only, were succefsul, especially when using it on rustics: cadmia, 16 drams; acacia, 8 drams; burnt, washed copper, 8 drams; opium, 4 drams; seed of tree heath, 4 drams; myrrh 4 drams; gum, 16 drams. Take up with water. Use with woman’s milk.  (Galen, Remedies according to Places 4, 12.749 Kühn).

It is fair to say that this remedy, before curing any flow of tears, would have made the eye cry some more. Each of the ingredients, taken separately, might have had a beneficial effect on the eye, but this remedy just goes for the rather brutal approach of accumulating as many unpleasant ingredients as possible. Thankfully, perhaps, the remedy had to be applied with woman’s milk,a very mild product, which midwives still recommend today for a baby’s sticky eyes.

These ingredients were crushed in a mortar, mixed with a small amount of water, then moulded into ‘lozenges’ and dried. These lozenges were light and easy to carry around. When a physician needed to apply the medicament, he (or the patient) crushed one of the lozenges and mixed it with a liquid – here woman’s milk. The remedy was then applied to the eyelids. Not that this particular recipe specifies any of this… One needs to have read quite a few ancient eye recipes to fill in the gaps left by Galen.

This recipe, on the other hand, gives some interesting and unusual details. The remedy was used ‘in Egypt only’. Eye-ailments seem to have been common in the land of the Nile, and eye-remedies are recorded in hieroglyphs on papyri from the Pharaonic period, going as far back as the second millennium BCE. By the time of Galen (second century CE), Egypt was a Roman province, whose elite spoke Greek (yes it’s all rather confusing). The ‘physicians’ mentioned in the recipe above were probably Greek-speaking, although it is not possible to exclude the possibility of Egyptian-speaking physicians.

Eye-shaped votive. Roman period.  Source: Wellcome images
Eye-shaped votive. Roman period.
Source: Wellcome images

The recipe also specifies that the remedy was particularly successful when used on ‘rustics’. The ancients believed that ‘rustics’ and members of the elite required different types of medicaments. Where peasants could cope with harsh, but very effective remedies, rich people, softened by their luxurious ways of life, needed milder concoctions.

Thankless eye-remedies did not just exist as texts in recipe books; they are also attested archaeologically. Ancient oculists used stamps to mark their medicines (the ‘lozenges’ I described above). Numerous stamps have been preserved. Some of these carry the inscription ‘acharistum’ (the Latin form of the Greek word achariston). One can just imagine a mother telling her reluctant child suffering from an eye disease: ‘You will thank me later’… or perhaps not!