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Abstract
The identification of Chinese drugs, even within the historical materia medica tradition in Chinese characters, has involved the use of regularised, vernacular and chemical names, as well as illustrations, and has been studied over multiple dynasties and regions in East Asia. The authoritative identification of these ethnonyms with scientific species and molecules involves pharmacists, as well as philologists, and continues to be a problem in ‘China’-sourced medical markets. While the textual legacies of major dictionaries and naturalists carry great weight, figures from local wildcrafting experts to global plant hunters, from the heads of national and international scientific bodies to private drug manufacturers and ethnic ritual masters have also contributed extensively. Rather than imagining drug identification to be a settled matter, it is best understood as a dynamic, ongoing process of pharmacognosy that involves many players in the Chinese medical world.
Encounters with Linnaeus? Modernisation of pharmacopoeia through Bernard Read and Zhao Yuhuang up to the present
The translation of traditional Chinese materia medica knowledge into the context of modern biomedicine and botany has involved complex layers of interlinked chemical, political, social, and linguistic processes. This has taken place in multiple sites, from pharmacies, clinics, and research labs to herbaria, trading centres, and the Chinese hinterland, as well as policy centres and mass-education campaigns. The study of these processes thus involves not only the reading of pre-modern literary Chinese works on materia medica, and modern botanical, pharmaceutical, and regulatory literature, but also fieldwork interviewing pharmacists, traders, and manufacturers at urban and rural sites around China. In compiling this chapter, I have drawn on my own fieldwork among suppliers of medicinals in mountainous Western China since 2012, mainly in East Tibet, Sichuan province, in Guizhou province, and along the Qinling mountain range. I performed fieldwork in Kaili City first in 2005 and have returned regularly (Springer forthcoming). My fieldwork in Sichuan began 2012 with a focus on East Tibet (Springer 2015), focussed on Derge County in 2015 and continued among traders continued among traders in Chengdu City as well as the mountains around Neijiang City in 2019. Since 2014, Taibai materia medica has extended my perspective from the Southwest towards the Daoist Northwest in China (Springer 2019). Each ethnographic site has fostered my inclusion of textual study into the narratives, life-worlds and material culture of the apothecaries and scientists, part-time producers, and ritual masters I encounter. The history, science, and local literature of materia medica are strongly present in contemporary culture of medicinal supply in China.
Making ‘Chinese’ medicines, like making medicines anywhere, involves an ongoing social-scientific process of selection, testing, and preparation whereby materials and things obtain medical efficacy. Communication about the production and properties of these medicines constitutes a case of produced knowledge and of its migration in the global long twentieth century via localities, print media and domains of emergent disciplines and professions. This chapter summarises how influential scientists and scholars in modern times have chosen what they recognise as ‘Chinese medicinals’ or ‘Chinese drugs’ (zhongyao 中藥).
Scientists and historians, traders and regulators use two different genres to communicate in Chinese about the various medicinal materials and pharmaceutical products at distinct stages of production and identification: ‘materia medica’ (bencao 本草) and ‘pharmacopoeia’ (yaodian 藥典). ‘Materia medica’ includes crude drugs, pharmaceuticals, and raw materials – but the term also denotes documents about these materials and products, i.e. a genre of textual records archiving them in a corpus of knowledge. ‘Pharmacopoeia’ now refers to another specific genre: the standard volume of Pharmaceuticals that scientists and a particular nation-state (e.g. the ‘British Pharmacopoeia’) recognise for pharma-trade. In Chinese, the second character dian 典 of yaodian 藥典 has legal connotations and can thus mean a ‘code’ in law, or refer to a reference work, such as an encyclopaedia or, later, dictionary. This indicates that the pharmaceutical content in such a volume was derived from a range of texts across the four classical Chinese historical sources, i.e. classics (jing 經), histories (shi 史), masters (zi 子), and collectanea (ji 集). The Chinese term pharmacopoeia thus refers explicitly to the orthodoxy of the text, while alluding to its encyclopaedic scale and heterogeneous content.
The authorised ‘pharmacopoeia’ or ‘drug code’ (yaodian 藥典) in modern China covers the two to five hundred substances that are frequently used as ‘Chinese medicine’, East Asian oriental medicine, or Traditional Chinese Medicine (TCM). The basic aim of scholarship and regulation then is to provide a standard way to stock one’s Chinese ‘apothecary cabinet’ (yaogui 藥櫃) and to tell pharmacists how to control the identity of drugs by reference to a national canon. And yet the relevant scientific discipline of ‘materia medica studies’ (bencao xue 本草學), and the editorial boards that have updated successive editions of the pharmacopoeia, know and deal with thousands of multi-ethnic, regional and unidentified medicines that fall outside the frame of TCM and the recognised nationwide pharmacopoeia. The never-ending process of identification and selective classification illustrates political and societal changes in the status of medical scholarship and various therapeutic and craft practices throughout present-day China. Thus, Chinese attempts at sorting medicines shed light not only on the transformation of China and on modernisation in Asia, but also on the history of science at large.
The scope of any pharmacopoeia in the modern context of science and of legal trade regulation is national(istic). In modern China, the National Pharmacopoeia Commission (Guojia yaodian weiyuanhui 国家药典委员会) produced the Chinese Pharmacopoeia of the People’s Republic of China (Zhonghua renmin gongheguo yaodian 中华人民共和国药典 [commonly abbreviated to Zhongguo yaodian 中国药典], 10th edn, 2015), which has become a government-orchestrated standard – legally enforceable and politically binding. China’s national pharmacopoeia embraces materia medica (bencao) on a vast social, temporal, scholarly, and geographical scale of 9.6 million square kilometres, and stretches even further, from the Tibetan highlands to Korea and Japan, from the eastern Chinese coastline to the neighbouring countries to the west, south, north, and beyond. Within the present-day national territory, the Chinese Pharmacopoeia covers medicines derived from practices communicated in even more languages than those of the 56 officially recognised nationalities. Besides recording these medicines with names in Chinese characters – a major lingua franca in the historical Chinese empire and in Asian-language world science – the Pharmacopoeia illustrates how Latin script, along with botanical nomenclature and taxonomy, has come to dominate scientific discourse in the field. In the pharmacopoeia genre since the late nineteenth century, next to the Chinese characters we find a botanical nomenclature for the mostly plant-based medicines, which follows the Linnaean structure of scientific names in Latin and Greek. Furthermore, this mix of Chinese and Latin characters typically also includes vernacular names in both European and Asian languages. The botanical genus Ephedra, for instance, encompasses 57 species of medicinally used plants, while Chinese discourse, in the two characters ma 麻 and huang 黃, narrows down the range to four of them, i.e. Ephedra sinica Stapf., Ephedra equisetina Bunge, Ephedra intermedia Schrenk & C.A. Mey, and Ephedra distachya L. (www.mpns.kew.org, accessed 03/1/2022). Further, pharmaceutical names in Chinese and European languages for the same medicinal indicate the part of the plant that is used, either the stem and root or the ‘whole herb’ (quancao 全草) growing above the ground. For different items in the pharmacopoeia, the relation between Chinese names and scientific names varies, and the scope of authorised medicinal names in Chinese is constantly evolving.
Prior to the English editions of the Chinese Pharmacopoeia, more extensive versions were published in mostly Chinese characters. Over its ongoing history, the scientific discourse in Chinese about pharmacopoeia has included the range of studies necessary to identify and classify the medicines scattered throughout China. In this process, pharmacognosists match each regionally specific variety to a continuously updated set of botanically standardised names, as well as pharmaceutical names in standard Chinese pronunciation that is transliterated in Latin letters (e.g. mahuang). The set of drugs frequently used and provided in a well-run drugstore for Chinese and other East Asian medicines, be it in China or in the UK, includes the two to five hundred items which China exports via Hong Kong and Taiwan, or directly to international suppliers. Yet, the Pharmacopoeia as of 2015 lists over 5,000 entries (5608), including both crude drugs and manufactured ones. Moreover, these thousands of medicines continuously link to a yet wider background of high biological diversity and medical plurality. This biocultural background feeds into the standard set of medicines; responding to availability and substitution, so that the standard is subject to historical change. Experts in the highly specialised field of pharmacognosy in China illustrate their conversations with multiple layers of authority, from the provincial level down to the nitty-gritty of individual local trade licencing. Currently they research and recognise tens of thousands of items.
The Chinese Pharmacopoeia was neither a sudden discovery nor is it a fixed list, but it has evolved through many decades of studies. The compilers of this state-standardised reference work, who began their work during the first half of the twentieth century, came from across the scientific community, especially botany and chemistry. Growing up in households of the imperial era, early generations of scholars began their education in the system of classical learning required to participate in the exams leading to literati careers. Later, after the abolition of the Chinese imperial educational system in 1905, most of them studied overseas in Europe, America, and Japan. In a shifting institutional landscape, they organised their collaboration via journals and local associations, through which they developed a format for the Chinese pharmacopoeia, keeping names and entries up to date in successive, and increasingly compendious, editions. At a national and regional level, they began using the new national language – modern standard Chinese 2 – to forge a lingua franca for the field in a multi-linguistic territory. Decades before institutions for TCM were established in the 1950s (Scheid 2002; Taylor 2005), these actors envisioned the political regulation of trade in pharmaceuticals without being in a position to implement it, and their pharmacopoeial studies promised to offer a shared pool of reference, national and global. These processes in the sociocultural history of science went beyond such scientific communities, however, spanning specialised academic disciplines and ethnic knowledge systems, and occurred on many levels of society: bringing together clinicians and philologists, physicians and pharmacists, and even monks and politicians, elite professionals, and lay people.
Overview
The range of pharmacopoeial studies in modern China is outlined below. Regional medicines were included in the dynamic national corpus during phases of increased research. However, open-ended investigation poses a constant challenge to integrating sorting systems of nationwide materia medica knowledge. Historical figures have shaped this evolving field. Their works cover emergent disciplinary fields such as pharmacy and botany but also evidential philology (kaozheng 考證) (Zhu et al 2005) and historiography, as well as new modern institutions which collect scattered popular knowledge. Finally, a glance at entries in early works by the founding fathers – such as Bernard E. Read in England and Zhao Yuhuang 趙燏黄 who returned from his education in Japan, Na Qi 那琦 in Taiwan, or Xie Zongwan and Wang Xiaotao who conducted surveys all over mainland China – reveals the languages and seeds of increasingly multi-disciplinary studies. Not only the latest edition of the Pharmacopoeia but also previous trade regulations, textual scholarship, and biocultural collections play major roles.
Regional medicines
Tensions between the variety of regional medicines and centralised standards of identification and classification never get completely resolved, whereas new medicines continuously make their way into the authorised selection of pharmacopoeiae. Ephedra, or mahuang 麻黃 in Chinese, is an example of historic globalisation, i.e. moving, in this case, from imperial China to international European and American scientific discourse. During the twentieth century, chemical extracts of pharmaceutical substances (termed su 素 in Chinese) became the main target of laboratory investigation into medicines. Globally the discovery of Ephedrine (the primary active ingredient of Ephedra), and the reformulation of effective Ephedra as this chemical formula served as a nexus through which scientists in China, Europe, and Japan began to imagine themselves as members of a community. Numerous articles on the subject in scientific journals illustrate the importance that was attached to the translocal and transcultural chemical formulæ, which promised to cut across linguistic and cultural boundaries. However, we have seen above that Chinese materia medica studies have already narrowed down the selection of Ephedra for medicinal use to four of the 56 known worldwide species. The accuracy of Ephedrine’s chemical formula, which circulated within global scientific networks, hardly translated directly to regulatory application in the day-to-day local plant market, where regional and vernacular names needed (and still need) to be used to classify and distinguish the four species, which in that context have already been transformed from raw plants into manufactured plant parts.
Two of the three botanical species of Ephedra which are used for the medicinal plant named mahuang in Chinese are in fact not native to historical China but have a longer and ongoing history in Central Asian habitats and the Himalayan region (Plants of the World Online). Only one botanical species is native to the region China of earlier historical periods. This historical knowhow about regional shifts in materia medica is typical of scattered textual evidence and of oral knowledge and rumours which I have encountered among insiders of supply chains and trends of availability. Similarly, Sichuan pepper and saffron are historic imports of spices via the ‘Silk Roads’ and both serve medicinal purposes. Sichuan pepper is today regarded as a typical Chinese ingredient and sold to connoisseurs of Chinese cuisine worldwide, yet it was perceived as exotic in historical China. Just as such a precious good, it went through a process of acculturation and authorisation as a constituent part of the Chinese culinary and health-promoting repertoire. This process started as early as in the Han dynasty (Lu and Lo 2015) when other imported plant parts such as pomegranate gained especially high value as exotics (Kong 2017). While this is even one of the major medicinals in Tibetan Sowa Rigpa and its precious pills (Czaja 2015), vice versa, Caterpillar fungus (dongchong xiacao 冬蟲夏草) originates from the Tibetan habitat but has been integrated into Chinese materia medica since the fifteenth century (Lu 2017). By the Ming dynasty, today’s Sichuan pepper had finally become a widely spread part of Sichuan cooking and the Chinese cultural landscape (Dott 2020). As suppliers in East Tibet have explained to me, Saffron is known in Tibetan as coming historically from ‘Kashmir’, that is India or Persia, to the west of China, even though they are well aware that today it is available from cultivators in Xinjiang province of China. If imported from Iran, a historical origin of materia medica exchange (Laufer 1919), the Tibetan pharmacists assign Saffron the Chinese name ‘Hong Kong Saffron’ (gang honghua 港紅花) to indicate international import through ports – and thus mock the name ‘Tibetan red flower’ (zang honghua 藏紅花), a term dating from historical trade networks, and today used by the less well-informed Chinese traders further East in China (Springer fieldwork in Derge County 2015 and Chengdu City 2019). In historical Tibet and in Han-China, Persia is known as the origin of imported healthy nutrition (Chen 2012, Chapter 32 in this volume). Such regional origin and historical integration manifests in the location words used as prefixes for the names of medicines (chuan 川, mostly denoting Sichuan province, for instance). Well before such regional medicines are authorised and listed in the Chinese Pharmacopoeia, locational prefixes are used, while suffixes additionally point to the part of the plant to be used (root, rhizome (gen 根) or bark, skin (pi 皮), for example). The pharmacopoeial nomenclature tolerates a mixture of such additional entries besides the Linnaean scientific names in consideration of the information that it encodes about the origin and preparation of medicines. Currently the prefix chuan 川 shows up in eight authorised entries of the national standard.
Fritillaria exemplifies how the addition of prefixes to names of medicines indicates their regional origin. The term beimu 貝母 in Chinese includes twelve botanical species, i.e. eleven species of Fritillaria plus Bolbostemma paniculatum (Maxim.) Franquet, while the term chuan beimu 川貝母 (Sichuan beimu) covers only half that number, i.e. six species (www.mpns.kew.org). The local prefix does not necessarily refer directly to the region of collection or harvesting of the plant (current or historical), but may rather point to the location of those traders who are most familiar with high-quality commodities and who may supply the best available medicines, which need not be of local provenance (Bian 2020). Thus, chuan beimu (lit. ‘Sichuan’ Fritillaria) does not grow in the Sichuan basin but thousands of kilometres higher in the Eastern Tibetan highlands of the present-day province. However, the province’s capital Chengdu houses a nationally important node in the supply network (Springer 2015). The prefix, by referencing Sichuan, obscures the actual habitat of the medicinal plant, but foregrounds the geographic distribution of trade expertise. Political territories that went under this name in the past include regions that have been outside China or have had several different place names in course of China’s long modern and pre-modern history, such as Xikang 西康, ‘Western Kham’, for the modern Eastern Tibetan region (for a general discussion of historical place names see Hua et al 2016).
Global science, local surveys
Historians of botany in East Asia have drawn particular attention to the relation between standardised, state-of-the-art and fragmented practices of scientific and ‘folk’ pharmacy. Rather than natural history or modern science in a narrow sense, early materia medica studies at the beginning of the twentieth century continued to include reference to historical textual archives. These were named ‘old materia medica’ (jiu bencao 舊本草) and re-constituted an archive in Chinese characters going back to the first Pharmacopoeia in world history, first commissioned in the seventh century under the Tang dynasty (See Chapter 8 in this volume). Local surveys and fieldwork in modern times, however, increasingly came to refer to new botanical typologies and methods of description. Already in ancient China, as in Greece, studies of medicinal plants predated botanical plant studies. Ancient botany was part of medical studies, i.e. the study of medicinal plants (Métailié 2015; Hardy and Totelin 2016). In the history of science, modern botany changed this field of materia medica studies (Métailié 2001) under the impact of Japanese-style botany (1860–80) which, paradoxically, relied extensively on the materia medica literature in Chinese characters (Macron 2015; Mayanagi et al. 2015; Métailié 2015).
In East Asia, close exchange of findings and ideas could build on materia medica texts and comments in Chinese characters, generating a community of knowledge united, and bounded by, Sinographic script. Later, ideas of how to write a modern pharmacopoeia within the framework of emergent nation-states also circulated via scientific publications in European and East Asian languages; leading to editions of national pharmacopoeiae first in Japan 1887, and then China (1930), and Korea (1st edn 1958, 2nd edn 1967, 3rd edn 1976, 11th edn 2014). Korea had played an early role in the transmission of medical and botanical knowledge to Japan (Métailié 2015), yet the exchange of drugs, medical texts, or visiting experts in East Asia did not necessarily lead to the Sinification of pharmacy in these regions, or mutual understanding between them (Trambaiolo 2014). Korean pharmacopoeia studies experimented with a unique local style of nomenclature (see Chapter 34 in this volume; Lee 2015). Due to the political-historical context in East Asia, national(istic) pharmacopoeias exist, for instance, in Taiwan and Hong Kong, too, reflecting regional availability as well as national preferences for format and contents.
Today, the Chinese Pharmacopoeia is published in Chinese and in English. Early versions appeared in the 1930s with a small number of entries, years after the first modern pharmacopoeia in Europe or in Japan. The preface of the first edition after the founding of the People’s Republic, published in 1953, marked a shift to the new regime by disparaging and distancing this work from these earlier efforts.
China did not, as the modernisation paradigm has it, passively respond to the challenge of scientific technology by imitating an imperialist model. Rather than in the little Linnaean garden in Sweden, the international societies met in various countries including Japan (Schiebinger 2004).
From the Qing dynasty onwards European naturalists, including British, French, and German language authors, conducted surveys of flora with a focus on southwest China instead of the political or cultural centres, but relying on decisive support by local collaborators (Fan 2004; Mueggler 2014). The work of pharmacopoeial scientists in modern China marks a departure from this postcolonial history.
Trade regulation
Three Chinese terms imply divisions in the regulatory and academic materia medica field: first medicinal material, second pharmaceutical product, and third the variety of product grades and types.
Chinese medicinal material (yaocai 藥材 or medicinal things yaowu 藥物) is crude or raw material, yet the workforce providing this crucial resource, and the work that they do, is barely visible behind the discourse of supply chains (Dejouhanet 2014; Pordié and Blaikie 2014; Springer 2015). To discuss the field of knowledge about regional harvest/collecting of materia medica, the French term terroir, borrowed from high-quality agriculture and cuisine, has become favoured in the field of botany. Under the influence of ethno-botanical and ethno-pharmacological fieldwork and economic theory, that term appears also in recent English scientific publications on what is in Chinese called authentic medicinal material (daodi yaocai 道地藥材) (Zhao et al. 2012; Brinkmann 2015; Bian 2020). Geo-authentic terroir embraces factors of geography, climate, and seasonal variety of materia medica that are crucial during the processes involved in collection and storage. Additionally, processing (paozhi 炮製) – part of the standard entries in the materia medica and pharmacopoeia genres – needs to take the factors involved in terroir into account as it begins with the first steps of manufacture that turn collected or cultivated raw objects into medicinal material.
For the next step of production, expertise in pharmacy is expected. The production and provision of a Chinese ‘pharmaceutical product’ (yaopin 藥品) requires quasi-official personnel to administer the licencing and registration of commodities from local and provincial drugstores up to the national level, wherever the product is to be sold whether directly on the market or recommended by prescription. Besides regulating business between traders and apothecaries, the products thus lie in the dominion of the authorised Chinese Pharmacopoeia and the national committee that authors each new edition. The licencing of a product by that committee involves high-ranking politicians, such as the Minister of Health, and thus reflects the layered governance and international voice of Chinese academia. As representatives of science and trade in China, the committee provides a standard to oversee the production and business of the ever-changing scope of Chinese medicinals, from local to national, and other medicinal materials. It is worth noting that, due to the historical and text-centric history of Chinese pharmacy studies, these authors are not just pharmacists or taxonomists but also historians and philologists.
‘Grades [and] types’ (pinzhong 品種) require a third kind of Chinese materia medica-expertise: experts test the variety of medicinal products and types, often in response to enquiries from the market regulators, and in light of surveys in the field, of textual studies, and of the modern and the pre-modern research records, which name drugs, plant parts, places, illnesses, and chemicals. A typical question that occupies these experts is whether traders are correct in claiming either that their product is based on historical precedent from ancient literature or that it constitutes a particular local variety of the known authorised pharmacopoeia. Opening and stocking a Chinese pharmacy – be it in any hospital or in an independent local clinic – require compliance with governance by the China Food and Drug Administration and Regulatory Bureau of Chinese Medicine and Pharmacy (Zhongyiyao guanli ju 中醫藥管理局) on the one hand, and additionally with case-by-case judgements of local, provincial, and national product licences. Registration numbers for any such pharmaceutical item in China fall under the two separate categories of either ‘national drugs’ (guoyao 國藥) or ‘wellness products’ (baojianpin 保健品).
Historical Figures Combining Chinese Philology and Scientific Fieldwork
Besides the new modern botanical language, what unites the field is the pharmacopoeial study of individual ingredients instead of formulary (fangjixue 方劑學), the composition of prescriptions with several ingredients. ‘Crude drugs’ (shengyao 生藥) are thus the crux of taxonomy while some manufactured drugs (literally ‘slices for drinking’ yinpian 飲片) have come to be included during the twentieth century. After introducing one British, and one Chinese founding father, who have captured some of the pharmacognostic varieties in scientific language while linking it to philological evidence, I will trace records regarding the processing of medicines, and historically recent additions to the pharmacopoeia.
The idea that pharmacopoeial knowledge is hidden in the ‘experience’ (jingyan 經驗) not only of systematised formularies but also individual knowledge holders led to campaigns to collect and systematise knowledge that could be found, using surveys among the population and by recording the practices of the vast majority of unlicenced practitioners and sellers of Chinese medicine (Andrews 2014, Lei 2014). Impelled by the desire for knowledge of medical commodities, as well as by scepticism about earlier surveys of applied knowledge, the search began for a new kind of expert who could sort out materia medica records and thus solve a fundamental issue of healthcare in China.
When Bernard E. Read (1930), educated at UK and US institutions and based in China’s academia – first at Peking Union Medical College and then at the Henry Lester research institute in Shanghai – finally announced the first Pharmacopoeia in 1930 to readers of expert journals, the volume was rather thin and included fewer medicinals than the Ming dynasty model that had been consulted, the Bencao Gangmu 本草綱目 (Encyclopaedia of Materia Medica, completed 1578) (Nappi 2009, Unschuld 2014). Research at markets rather than in herbariums was one of Read’s specialities, but this fieldwork-based approach did not prevent his becoming one of the founding members of a national association for medical historiography (Zhu 2001).
Bernard Read, together with his Chinese co-author J. C. Liu (Liu Ju-ch’iang [Liu Ruqiang] 劉汝強), gave a conference paper underlining ‘the importance of botanical identity’ for Chinese materia medica (Read and Liu 1925).
3
Before expanding on their view, they paraphrased a paper presented at a previous conference held in Japan as having ‘advocated a scientific study of Chinese drugs, of their bibliography, pharmacognosy, chemistry, botany, physiological action, and chemical use’. They continued:
Without the correct botanical identification of a drug, it is impossible to find the scientific literature dealing with the known chemistry of its constituents and their physiological action, as already published by other workers. (…) This paper seeks to clarify the identity of two particular drugs Lang-Tang, 茛菪,
4
and Ti-huang,
5
地黃, and to point out how serious are the consequences if the names of these drugs continue to be misapplied (Ibid.: 987–9).
In 1927, Read and Liu’s compilation of plants in China Flora Sinensis was a thin volume like a journal, yet this was just the first groundbreaking issue of a future series of reference works. The seed for Read’s botanical-chemical and textual research approach is visible already in his ‘reference list’ (Read 1923). The included lists of literature in this thin volume cite major scientific studies in Japanese and European languages on taxonomy, science, just as on linguistics and historical sources. Accordingly, the structuring units of materia medica in modernising China are entries on individual crude drugs in such a ‘reference list’, as Read had prioritised four columns of content in this genre: names of the medicinal plants in Chinese characters; transliteration; references to new scientific botanical names; and finally to a mix of scientific and historical literature on chemistry and pharmacy. His emphasis on botany and on drug identification through consolidated scientific and historical names is a lasting model for research and regulation.
Read found that his own aims of handling toxicity and ensuring the availably of medicines connected his work directly to that of fellow scientists in China and even to that of Li Shizhen 李時珍 (1518–93), the author of the Bencao Gangmu (Chapter 9 in this volume). Read considered himself to be honouring the legacy of Li’s approach for rigorous identification through fieldwork, nomenclature and philology. The craze about Li Shizhen during China’s modernisation can also be seen through the lens of Joseph Needham’s Science and Civilization in China project, via offprints at the East Asian History of Science Library at the Needham Research Institute. Needham’s offprints include a stack of sources on Li produced in the context prior to the institutionalisation of Chinese medicine since 1954. In 1958, fellow historian and philologist of medicine in China Wang Chi-min 王吉民 (1889–1972) provided a catalogue from the History of Medicine Museum in Shanghai introducing a 1954 exhibition. This commemorated Li’s death 360 years prior and showcased his role in a legacy of pharmacognostic adaptations and continuous scientific developments well into modernising China (Figures 48.1 and 48.2).
Figure 48.1 Bernard Read and Liu Ju-Ch'iang's Flora Sinensis (1927). Courtesy of Needham Research Institute
Figure 48.2 ‘Catalogue of the Li Shih-Chen Exhibition’ (1954) History of Medicine Museum, Shanghai. Courtesy of Needham Research Institute
Similarly, Zhao Yuhuang 趙燏黄 (1883–1960) published his groundbreaking studies on materia medica (Springer forthcoming) in journals rather than as books, and with only three detailed entries plus a list of forty-three more envisioned for future publications. Like Read, Zhao, had also been educated outside China, but in Japan. He was politically influential in the new field of pharmaceutical research and regulation in China, and included applied market-related discussion of production sites and product variety (Zhao 2006 [1932]). He explicitly emphasised that physicians were just broadly responsible for hygiene (weisheng 衛生), while pharmacognostic studies required the new expertise in pharmacy. His distinction of ‘old materia medica’ and ‘new materia medica’ allowed for the inclusion of ancient texts as well as the newest scientific terminology in German and Latin, photographs, chemical formulæ and plant morphology. While his focus was crude drugs, he also surveyed the historical record and contemporary market at Anguo in Hebei Province (Ibid., 1934, 1936, 2004).
Works
If Read and Zhao were the founding fathers of pharmacopoeia studies in modern China, the official author of the first national pharmacopoeia in 1930 was Meng Mudi 孟目的 (1879–1983), whose career had centred on Nanjing city and academic education. This publication was modelled on scientific taxonomy in Europe, North America and Japan and had the political function of counteracting the ‘old’ and ‘obscure’ medical theory of physicians from the past.
Among subsequent editions of the Chinese Pharmacopoeia, the prefaces of the recent editions mention the 1953 Pharmacopoeia as the first edition after the founding of the People’s Republic of China (PRC) in 1949, while the edition of 1963 marked a new development in the field. Experts in the field recognise this edition as the main source for the contents on ‘processing’ (i.e. paozhi 炮製) in entries of Xie Zongwan’s Compilation of Chinese Herbal Medicinals (Quanguo zhongcaoyao huibian 全國中草藥匯編), and as the first integration of Chinese elements into a format that had until then been overly modelled on the global scientific mainstream (Xie 1996).
Japanese-educated Na Qi 那琦 published his Pents’aology (Bencao xue 本草學) (Na 1974), a term used today in Taiwan and by some graduates of UK institutions, for instance. He was Professor of Pents’aology and Pharmacognosy and Chief of the Chinese Pharmacological Institute at the Chinese Medical College.
In the 1980s, historical and philology-based studies were taken up again in the PRC. An influential personality in combined old- and new-style materia medica studies, Wang Xiaotao 王孝淘 (born 1928), published extensively on methods of ‘processing’ (paozhi) (Wang 1981, 1986). Xie Zongwan 謝宗萬 (1924–2004) carried out extensive surveys in the field and archive during the 1950s with a focus on terroir and authenticity of materia medica and also on the history of changes in types of single-ingredient pharmaceutical products, and on vernacular names (Xie 1964, 1984, 1996). The task of materia medica historians still consisted in outlining the efforts at systematising and sorting the textual records of Chinese medicinals through space and time in Chinese history (Shang et al. 1989).
The Chinese Materia Medica ( Zhonghua bencao 1999) is the result of an ambitious and prestigious project that took on momentum in 1988 under the guidance of the newly established (above-mentioned) Regulatory Bureau. This project aimed to cover medicinals known among scattered popular practitioners and was later inspired by the prospects of databases in the digital age. Its latest additions are volumes on Tibetan (2002) and on Mongolian (2004) medicinals. Another similarly ambitious major project in the field that goes back to founding father Zhao Yuhuang has been the illustrated Complete Books of Materia Medica in China (Lu et al. 1999). In contrast to the current Chinese Pharmacopoeia’s relatively handy size of 1809 pages in one volume, both of these publications fill entire shelves with several volumes, complete with very detailed entries on numerous names of medicinals in crude and manufactured versions, as well as their misleading names, fakes, and substitutes.
Entries
In order to write the national pharmacopoeia, surveys of ‘materia medica’ were carried out both in the field and in scattered archives and scientific publications. The wide range of materials that this has yielded remains a constant challenge. As noted above, ‘materia medica’ comprises not only all the things that are used as medicines in China, but also entries about them in various textual records documenting them: in Han-Chinese and in a range of other languages (Sanskrit, Tibetan, Mongolian, Uighur, Arabic, Japanese, etc., and European languages such as Latin, English, French, and German). This ongoing archival (or textual) project also informs the evaluation and testing of ancient knowledge as well as popular practice. These multilingual records of ‘Chinese’ materia medica serve to position authoritative knowledge about them within a broad field of intellectual, political, epistemological and ethno-economic (Comaroff and Comaroff 2009) controversies about medical cultural relations and Chinese medicine’s relevance in society, and about the envisioned future of sociocultural exchange processes.
Socioeconomic and ethnic scope
In addition to combined surveys in the field and archives, societal relations express fundamental change in a conspicuous manner, making it amenable to research.
Throughout Chinese history and to this day, to a striking degree, unlicenced practice feeds into this material repertoire and contributes to setting standards for pharmacological treatments; so that while the Chinese materia medica is certainly the product of elite writing and reflection it also constitutes learned responses to more pervasive and popular forms of knowledge. The physicians who prescribe, and often also trade and consume, Chinese medicines share knowledge and terminology with the various collectors, producers, traders, and researchers of these materials and their culture. When suppliers or physicians in China of non-Han ethnicity communicate with their Han-Chinese counterparts about the exchange of medicinals between the two groups, I have observed in the ethnographic field that they speak about ‘Han-medicine’ (Hanyi 漢醫) to denote the portion of materia medica that is used and recognised within the orthodox framework of Chinese medicine, and which, by extension, exerts a hegemonic power in relation to local conceptions. Specifically, Han-centred Chinese medicinals continually emerge within the broader scope of the Chinese materia medica; thus, they are the product of a centralised authoritative record, as well as changing scientific taxonomy, and of perceived ethnicities.
Assigning new forms of authority in applied medical tradition to living senior masters has added a new layer of ethnicity to the representation of TCM and materia medica knowledge. In this context, Jin Shiyuan 金世元 (born 1926) is the only member of the vast, multi-ethnic editorial board of the above-mentioned Zhonghua bencao to be appointed ‘Great Master of National Medicine’ (guoyi dashi 國醫大師). He was appointed for his specialisation in materia medica and processing and was the first and only knowledge holder of Chinese pharmacy to be authorised as such (Liu 2014: 170–73). The exclusivity of this award silently bestows ‘Han’ materia medica heritage, personified by Jin, the imprimatur of ‘National’ status, next to TCM physicians, and also the ‘scientific’ status, since he belongs to the editorial board.
The rich social diversity and even fragmentation of healthcare in China raises the question of how folk medicine – as we encounter it in ethnographic fieldwork or in the non-elite as well as medieval manuscript literature – relates to mainstream medicine (Unschuld and Zheng 2012; Lo and Cullen 2014). Yet China is unique in the extent to which its own ‘traditional’ medicine – and even rural industries constituting the supply behind it – has been incorporated into modern healthcare and into research institutions of the long twentieth century (Springer forthcoming; Lei 2014). The term ‘traditional’ was introduced for use in English journals referencing learning medicine since the mid-1950s (Taylor 2005). Even the WHO-orchestrated global science and healthcare policy has, since the late 1970s, claimed to include ‘Chinese experience’ from communist and earlier modern China (Kadetz 2015), although, as Lei (2014) observes, this inclusion privileged Western scientific forms of knowing. This privileging notwithstanding, the wider non-elite personnel behind ‘Chinese medicinals’ are restricted neither to figures hailed in heroic ‘barefoot doctor’ narratives (Fang 2012, Chapter 45 in this volume) nor to ancient healers and practitioners of ‘obscure’ educational backgrounds. Revolutionaries in China not only developed a concern for an urban science-based healthcare industry, but they also saw holders of materia medica knowhow in rural industries as the basis for ensuring this development and for sustaining the availability of new industrial drugs for a future society.
Popular, practical medicine
During the Maoist era, mass science campaigns opened materia medica in China to non-elite and folk practices and ethnic minority knowhow, in the attempt to distil the best folk practices and feed them back to the population, together with science-based healthcare. These campaigns propagated an ‘alternative modernity’ (Hsu 2009) in order to popularise knowledge about medicinal plants across society and on a ‘world-revolutionary’ scale. In biology ‘with Chinese characteristics’, genetics, for instance, was politically criticised as overly interested in decadent issues of heritage (Schneider 2003). In that political context, contrary to scholarly refinement, simple prescriptions were celebrated that ‘Served the People’. While most Chinese medicinals are prescribed as recipes and are prepared as a mixture with other ingredients, prescriptions of only one medicinal (simples) have a special name in Chinese (danfang 單方, or danweiyao 單味藥) and are associated with the usage of raw medicinals (shengyao 生藥) in folk medicine, especially in southwest China.
That supposedly simpler, less elite, yet biologically rich knowledge is seen as located in southwest and south China, i.e. away from the regions around China’s previous capitals in the southeast, northwest, and northeast (on the mainstream region of Chinese medicine see Bretelle-Establet 2010, Hanson 2011, Scheid 2007). This medical geo-history recognises the southwestern province of Sichuan as China’s dispensary-province. This view is not without merit: for example, the extraction methods to produce artemisin (qinghaosu 青蒿素) that won China’s first Nobel Prize in science in 2015 were sourced from southeastern Anhui but reproduced by scientists in Yunnan (the southwesterly province which borders Sichuan).
Individual simple remedies as well as entries of Chinese materia medica are referred to by the technical term wei 味, a term which simultaneously refers to their ‘sapor’, indicating the close connections of pharmacopoeia to refined food culture (Lo and Barrett 2005). As opposed to the historically predominant formulæ, the preference for individual ingredients or very simple prescriptions from any ethnic background, and their integration into the catalogues of the regionally available medicinal plants in developing territories, was underscored under the influence of the WHO in the 1970s, with the publication of the National Essential Medicines List (Zhongguo jiben yaowu mulu 国家基本药物目录) (Fang 2012). This period further saw an increased emphasis on individual drugs with the 1973 excavation of four books with medical contents from a tomb at Mawangdui in Changsha dating to 168 BCE. These finds included the ‘Formulae for 52 Diseases’ (Wushi’er bing fang 五十二病方), which was celebrated by scientists at the time as a text recording 396 individual medicinals, i.e. clearly identified ingredients of formulæ. At the same time, in 1972/3, the committee authoring the Pharmacopoeia met again after an interval of twenty years, and published the second edition in 1977, shortly after the Great Proletarian Cultural Revolution (1966–1976).
The editorial note of a post-Maoist reference work, the Compilation of Chinese Herbal Medicinals (Quanguo zhongcaoyao huibian 全國中草藥匯編) (1996: 11–13) mentions the vast extension of authorised entries in the earlier Maoist edition. It had been based on ‘summaries since the 1970s of simple tested, handy and healthy pharmaceutical prescriptions from the clinical practice of the broad masses and medical workers’ and had included some ‘frequently used formulae from Chinese clinical practice’. The preface goes on to outline that for each medicinal it allowed ‘five compounds’, and ‘one to two traditional formulae’ as well as ‘two to three modern experience-based prescriptions’ (author’s translations).
A work newly published in this period, which gained authoritative status and then subsequently expanded in the Maoist period, is the Chinese Dictionary of Pharmacology (Zhongguo yaoxue dacidian 中國藥學大辭典 1979). The editors of the 1982 reissue recall in their preface that after much work had been accomplished from 1958 to 1966, the years from 1972 to 1976 saw a vast extension of the number of entries in the authorised pharmacopoeia. The newly titled Jiangsu Academy of New Medicine (Jiangsu xinyi xueyuan 江蘇新醫學院), the collaborating Chinese Medical Hospital and the Medical Hospital in Nanjing republished this book in 1982. Its 5,767 entries on simples (wei 味) include 4,773 plants, 740 animals, 82 minerals, as well as 172 additional ‘danweiyao’ medicinals. Despite the changing scientific emphases during different political eras of the twentieth century, publications in the materia medica field reuse and sometimes cite previous ones.
Publications by authors outside China have continued to contribute to the field. The widely used Chinese Herbal Medicine: Materia Medica, for international practitioners of Chinese medicine, was first published in the US (Bensky et al. 1986). In 1991, a first translation of the Chinese Pharmacopoeia into German was published (Stöger 2021). In China, botanists accomplished the publication of a Chinese plant catalogue in 2004: comprising 125 books it ran to 80 volumes (Flora Reipublicae Popularis Sinicae or Zhongguo zhiwuzhi 中國植物志). After thirty-five years of preparation, this Chinese catalogue of its flora, was, however, an isolated taxonomy. It had to be translated into the botanical terms and classifications of the global scientific community. A much shorter account in English made Flora in China (2015) accessible to a wider audience (www.floraofchina.org). The authors of the latter echo Read’s above-mentioned appeal from the 1920s in asserting that ‘The Flora holds tremendous potential for those wishing to study the medical value of a given species’ or ‘for searching the relatives of commercially valuable plants that are more resistant to disease or drought’.
Irrespective of political context or changing availability, materia medica studies require textual analysis and reading abilities in classical Chinese and familiarity with the often insider jargon and regional knowhow of Chinese medicine practitioners (Unschuld 2012) and/or knowledge of recent developments in folk medicine (Farquhar and Lai 2014) and material histories of toxicity (Akahori 1989; Liu 2015). While the context of Chinese materia medica is culturally rich and geographically and biologically vast, expertise in this field mainly calls for old-style philology, as well as familiarity with the newest scientific findings and surveys in the field. The contours of Chinese pharmacy have been shaped over time by economic and natural availability and by multiple bibliographic, epistemological, political, material, and ethnic praxes. It is the task of historians and anthropologists of science and medicine in China to contextualise these variations, in the face of historical as well as ongoing efforts to produce reductive simulacra of this Wunderkammer of known and manipulated material objects in the necessarily flexible form of standardised, unified, scientific norms.
Acknowledgements:
This chapter is part of a project that has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant agreement No. 856543) and was kindly supported by the Jing Brand Scholarship in Chinese Science and Civilisation at the Needham Research Institute, Cambridge.
Notes
Thanks to the Needham Research Institute and John Moffet for the images and kind permission to print them.
The new-style baihua 白话, as advocated by intellectuals of the May Fourth Movement, notably Hu Shi 胡適 and Chen Duxiu. 陳獨秀. See Elisabeth Kaske (2009) and Chen Pingyuan (1999, ch. 5 et passim ).
Read and Liu (1925) ‘The importance of botanical identity’, reprint from the Transactions of the 6th Congress of the Far Eastern Association of Tropical Medicine, held in Tokyo.
Langdang, also Tianxianzi 天仙子; Hyoscyamus niger L. (botanical name); Black Jurinea or (Common) Henbane (English name).
Rehmannia glutinosa (Gaertn.) DC. (botanical name).
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