11 May

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.

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