According to the Nei Ching, a diet balanced in accordance with the ﬁve- fold system of correspondences will promote health and longevity, strengthen the body, and drive out disease. The ﬁrst remedies were to be found among the herbs, trees, plants, and animals that served as foods. But medical theory and folklore taught that normally harmless foods could be dangerous under special circumstances, such as preg- nancy. For example, if a pregnant woman consumed the meat of a hare, the child would be mute and lack an upper lip; eating mule meat would cause a difﬁcult birth. Dietary physicians also warned against eating foods that were spoiled, meat that moved by itself, and apricots with two pits.
The use of tea illustrates the overlap between foods and drugs. For about six thousand years, the Chinese have been making a beverage from the leaves of the tea shrub. Tea contains small amounts of nutri- ents, but it is rich in physiologically active alkaloids, including caffeine, theobromine, and theophylline. Perhaps the most important health aspect of tea drinking in the ancient world, and in many regions of the world even today, was the use of vigorously boiling water. In gen- eral, the boundary between medical prescriptions and dietary pre- scriptions was not as sharply deﬁned in many ancient traditional systems as it is in modern Western medicine. Yet, modern medicine is once again focusing on the role of diet as an aid to good health, disease prevention, and longevity.
The importance of dietary management is illustrated in a classic text presented to the Mongol Emperor at the Yu¨ an court in 1330 by Hu Szu-hui, who served as court dietary physician for more than 10 years. Hu’s Proper and Essential Things for the Emperor’s Food and Drink explains early Chinese and Mongolian ideas about the importance of dietetics. For historians, the book is of special interest for the medical and hygienic ideas it contains rather than the recipes. Still, it is interesting to consider both the medical and culinary values of entries such as Roast Wolf Soup and Boiled Sheep’s Heart. Most such recipes were said to increase ch’i, but some were more speciﬁcally valued for conditions like backache and agitation of the heart. The text suggests foods that promote longevity, warns against certain foods or combinations of foods, and gives special attention to proper diets for pregnant women. Edible plants and animals were carefully classiﬁed in terms of medical theories of systematic correspondence.
When dietary measures were insufﬁcient, physicians could search for remedies among the many known drugs. Because the nature of drugs was often violent, scholars warned against recklessly prescribing or consuming them. Nevertheless, when brought together in the proper proportions, drugs could accomplish wonderful effects. Some ﬁve thou- sand native plants are in common use as medicinal herbs, and modern scientists are attempting to isolate speciﬁc active ingredients from traditional remedies. For guidance in this quest, they often turn to the Pen-ts’ao Kang Mu, an encyclopedic study of medicine, pharmacology, botany, and zoology, complied by Li Shih-Chen (1518–1593), China’s ‘‘prince of pharmacists.’’ Published in 1596 by his sons, Li’s great work included close to two thousand drugs from the animal, vegetable, and mineral kingdoms, more than eight thousand prescriptions, references to over nine hundred other texts, and more than a thousand illustrations. Today, experts in Asian medicine hope that high-volume screening and rigorous clinical trials will demonstrate the value of traditional Chinese herbal remedies. For example, in 2003, the U.S. Food and Drug Administration approved a phase II trial to test the efﬁcacy of one such remedy in treating non-small-cell lung cancer.
The three classes of drugs—vegetable, animal, and mineral—were said to correspond to heaven, man, and earth. Animal organs were highly regarded as sources of remarkable ‘‘vital principles,’’ such as tiger liver for courage and snake ﬂesh for endurance. Among the more prosaic and presumably effective remedies were sea horse powder and seaweed, which are good sources of iodine and iron, for goiter and chronic fatigue, and ephedra for lung diseases and asthma. Generally, the Chinese exhibited admirable skepticism about foreign ‘‘wonder drugs,’’ but expeditions were launched in response to rumors that Indian physicians had discovered the herb of immortality. Many Chinese healers, however, considered ginseng, the ‘‘queen of medicinal herbs,’’ as the equal of India’s wonder drug.
Medical therapy can take two general forms: healers can attempt to strengthen the body so that it can heal and defend itself, or they can attack the agents of disease directly. The primary goal of Chinese medicine is to enhance the body’s ability to regulate itself and to restore the normal balance of energy. The reverence inspired by ginseng illus- trates the classical Chinese approach to healing. Ginseng has been used as a tonic, rejuvenator, and aphrodisiac. Modern researchers have called it an ‘‘adaptogen,’’ a substance that increases resistance to all forms of stress, from disease to misfortune. Li Shih-Chen described an ingenious experiment to demonstrate the effect of ginseng: select two men of about the same size and have both run a certain distance after giving ginseng to one of the runners. At the end of the test, the man given ginseng would not be fatigued, whereas the other man would suffer shortness of breath. The same test could be used to determine whether a given specimen was genuine ginseng.
The gathering and preparation of ginseng were surrounded by a rich body of folklore, ritual, and myth. Because metal implements would destroy the virtues of a ginseng root, only wooden knives and earthen- ware pots could be used in its preparation. Wild ginseng was said to assume a luminous glow and walk about at night disguised as a bird or a child who lured ginseng hunters to their death. China’s emperors established ginseng monopolies, appointed their own gatherers, and kept the best roots for themselves.
Classical sources describe ginseng as a tonic for the ﬁve viscera: it opens the heart, quiets fears, expels evil efﬂuvia, improves understanding, invigorates the body, and prolongs life. Ginseng is prescribed for fati- gue, anemia, insomnia, arthritis, disorders of the nerves, lungs, and stomach, impotence, tuberculosis, and so forth. Ginseng is sometimes marketed as an aphrodisiac. Herbalists claim that it increases stamina and allows even very elderly men to become fathers, in addition to preventing baldness, gray hair, wrinkles, and age spots.
The Chinese materia medica also included typical examples of dreckapothecary—remedies made of noxious and repulsive ingredients, such as dried salamander, donkey skin, medicinal urines, and human parts and products. Human bones were among the ingredients in remedies used to treat syphilis. According to a text by Ming Dynasty physician Wang Ji (1463–1539), a magician claimed that he could cure syphilis with a preparation made from the bones of a dead infant. After the bones were roasted, the resulting ashes were ground into a powder and mixed with alcohol. The patient was advised to take the remedy on an empty stomach. Wang Ji objected that a preparation made by roasting bones in a ﬁre would be ﬁerce and violent. Other physicians, however, objected to the use of human bones in medicines on the ground that it was incompatible with the role of medicine as the ‘‘art of benevolence.’’ Smallpox inoculation can also be thought of as a ‘‘medicine derived from man.’’ To provide protection against 40 forms of the ‘‘heavenly blossom disease,’’ doctors collected the crusts from pustules of a mild case of smallpox. The powdered material was blown into the nostrils; males snorted the powder through the left nostril and females via the right side.
Chinese alchemists developed a very different approach to human health and longevity. Alchemy generally conjures up the image of mystics and quacks vainly attempting to turn lead into gold. Alchemists were, however, also associated with the search for the mysterious elixir of life. To an unusual extent, Chinese alchemists were obsessed with both the theoretical aspects of gold-making (and gold-faking) and ‘‘macrobiotics,’’ that is, the search for the great drugs of well-being and immortality. Ko Hung (ca. 300), an eminent alchemist, Taoist adept, and physician, taught that minor elixirs could provide protection from ghosts, wild animals, and digestive disorders. More powerful elix- irs could restore those who had just died, while superior elixirs would confer immortality.