The History of China - #232.5 (185 Mk. 2): Back to the Medicine Shoppe (De Materia Medica Rebroadcast+ 2022 Update))

Episode Date: March 31, 2022

A new update with all the new craziness 2 years on before we once again step into Ye Olde Chinese Medicine Shoppe for the tour... Traditional Chinese Medicine – as its name duly implies – has been a part of China for at least 2,500 years. But what does it mean? Where does it come from? How does it work? And does it have a place it modern society? Learn more about your ad choices. Visit megaphone.fm/adchoices

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Hey everyone! So I have been hard at work hammering through the crazy back half of the Zhengde Emperor's reign in the 16th century, and I thought I was on track for my usual fortnightly release schedule. But then, as you might have heard, something kind of weird started happening here. First, individual regions of my city started locking down, but we were told it was fine. Don't listen to those crazy rumors. Everything was normal. Then one day, my school was simply told that everyone needed to be immediately tested, students and staff alike, and that no one could leave the property until they got the results back. It took hours, well into the evening. As it turned out, we were pretty lucky.

All the schools in Shanghai had been forced to undergo similar testing, and some of the less fortunate ones were sealed inside for an indefinite period. Other places and individuals found themselves suddenly sealed inside wherever they happened to be at the time. Their office building, a hot pot restaurant, their gym, or days upon days of isolation and testing, confusion, and frustration. About a week later, the schools were told that they were going to close down entirely. Learning from home for the entire city would return, just as we'd done for what amounted to half a year back in 2020.

Now entire districts were being locked down, including my own, and then subjected to daily testing. Protocols and plans seemed to shift day by day. We saw, and are still seeing, the system overwhelmed and confused in a way it simply had never been before. Finally, a city-wide strategy was announced. A complete lockdown of the city of Shanghai, but in halves. First, the eastern half, Pudong, would be closed down. No cars, no taxis, no metros, no buses. Everyone was just to stay put in their apartments. After that, it would be the eastern half's turn for the same. That for us begins right now as I record this. Here, I'll open a window real quick. As I sit here, I have never heard a city of 25 million people so utterly silent. We've all of us spent the last four days or so of this notice

doing our best to calmly, coolly, and collectively buy as much food as possible, because in spite of the assurances that this is just temporary and would only be for a period of four or five days, who really knows? If more cases of Omicron are found nearby, or worse yet, within our compound, it would be extended by who knows how long. A week? Two? Three? I've heard people in lockdown for 20-something days at this point, with no end in sight. And I mean that. Literally nobody knows. Not even the people ostensibly in charge.

It is nerve-wracking. But more than that, it's disappointing, frustrating, and exhausting. the people ostensibly in charge. It is nerve-wracking. But more than that, it's disappointing, frustrating, and exhausting. We've all spent the past more than two years now surviving this stupid disease. And to have all that work and sacrifice and difficulty amount to now going back into lockdown is a real sort of heartbreak. It's a bummer. But we'll be fine. We have, after all, been through much worse. I tell you all this not to evoke pity or sympathy, but mostly to explain why my production schedule for the next Great Ming has fallen a bit further behind than

I would have liked. It is coming, and soon, have no doubt, but I didn't want to leave you all hanging for so terribly long. So what I did to hopefully tide you over is look back into my archives and find an episode that I made about two years ago, as we were all living through what seemed like it might be the end times. Or the first time. I thought then that it would be a good idea to put together a brief history of ancient Chinese medicines, its traditions, and its understandings and conceptualizations of the roots of health and sickness. Now seems like a pretty gosh darn good time to give it another spin. So I hope you'll enjoy our walk through Ye Olde Medicine Shop. Please go easy on the

laudanum, and no tasting the Cinnabar immortality pills. Cinnabar is for closers only. Without further ado, I represent De Materia Medica. Hello, and welcome to the History of China. Episode 185, De Materia Medica. Today we're going to be stepping outside of our regularly scheduled continuation of the Yuan Dynasty in order to take a closer look at a topic that is, as of this recording, rather on the minds of just about everyone, everywhere. I'm talking about disease and medicine in China. I'd first been flung down this rabbit hole of research some months ago by a question sent in for the show's 6th anniversary question and answer, asking about

the prevalence of plagues in Imperial China. And my answer, in brief, was that definitely, yes, there were lots. And as luck would have it, I'm trapped in my house right now, as China appears to be dealing with yet another one. Good old novel coronavirus 2019. So, as it turns out, I've got a fair bit of extra time on my hands, and a sudden overriding interest in the topic. Go figure, right? Now, to be perfectly clear from the outset,

though it has served as an effective inspiration point, this is not going to be a show about coronavirus or the ongoing outbreak. I am no authority on that beyond what's going on inside my own apartment walls, which is a whole lot of not a lot. Instead, we're going to be staying more within my wheelhouse and going to have a general survey and overview of the history of Chinese medicine, its foundations, its principles, and how it has viewed and treated disease over time. Capiche? Great. Let's get going.

Now, where I'm drawing from is where I've gotten much of the technological and scientific information about China in the course of this whole show, which is from Joseph Needham et al.'s magnum opus compendium, Science and Civilization in China. It is immense. It's not quite a big enough word, but that's the one I'll go with. Begun in 1954, it spans seven volumes, consisting of some 24 books at present, and it's still ongoing. The specific volume I draw from in this case is volume six, Part 6, Medicine. A good place to begin is rather definitionally, by what we mean when we talk about the medical arts of Imperial China. That is to say, what does traditional Chinese medicine, or as it's

commonly abbreviated, TCM, really entail? It is philosophically rooted in the dualistic concepts of yin and yang. Yes, exactly like the cool spiraling circle symbol. The yin tail? It is philosophically rooted in the dualistic concepts of yin and yang. Yes, exactly like the cool spiraling circle symbol. The yin represents the aspects of the universe which are dark, moist, cool, yielding, and feminine in nature, whereas the yang represents the opposite half of the universe, the bright, dry, hot, active, and bold masculine aspect of the universe. This conception seems to have come about circa the 6th century BCE, around about the same time, and probably not coincidentally, as the formation of Confucianism and Taoism during the Warring States period. As of about 540 BCE, in any case, this had further formalized and been categorized by He the Physician,

who's recorded as having attended the medical needs of the king of Qin. All disease, by He's explanation, was divided into six classifications. An excess of yin led to hanji, or cold sickness. An excess of yang led to reji. Of wind, moji, which is affliction of the extremities. Excess of rain, fuji, sickness of the abdomen. Excess of twilight, to huoji. The first four were later grouped together as or sicknesses involving fever. The fifth, psychological diseases,

and the sixth, cardiac diseases. Needham writes that, quote, Chinese medicine never lost entirely its six-fold classification. The yin and yang viscera were mustered as six of each, although physicians and laymen spoke of them collectively as wuzang, meaning five viscera, end quote. In modern Chinese medicine, the five viscera are grouped as the organs of the yin and include the heart, liver, spleen, lungs, and kidneys. The yang organs, or six bowel organs, are the stomach, small intestine, large intestine, gallbladder, urinary bladder, and the so-called triple energizer, or sanjiao, which is something of a more complicated explanation than a simple organ.

It's sort of an organ in the way that blood is an organ, but also not entirely corporeal. Doctor of acupuncture and Chinese medicine, Kimberly Thompson, gave an explanation that I found helpful. She said, Interesting, huh? At the core of all of this, much as with acupuncture, which is also a part of Chinese medicine, is the concept of qi. Now, qi is one of those words that you hear get tossed around a lot, especially if you watch like kung fu movies. And it feels like everyone just already knows about it and its mystical nature and so never bothers to stop and explain it. And now you're 45 minutes into the movie and it seems like it would be rude to pause and ask. So let's go ahead and pause and ask, what is qi? Most literally, qi means breath or inner wind. And that's a pretty apt descriptor,

very much in the same vein as the Latin spiritus or the Greek pneuma, both of which mean vital breath, as a separate concept from the immortal or incorporeal soul, which is anima in Latin, psyche in Greek, and linghun in Mandarin. Thus, qi functions, as its name suggests, as a vital inner energy flow that both affects health, but can also be manipulated and redirected by skilled practitioners. The history of the logographic character itself is quite interesting. Its modern use in simplified Chinese actually has reverted it to a far more ancient form, three horizontal flowing lines, not at all unlike one would use to draw a cartoon to show wind. This was, in fact, more or less the same character as those

used on the Oracle Bones and Small Seal script. This was replaced, or rather added to, during the Han Dynasty by adding in the character mi, meaning rice, underneath the wind. Thus, in Japanese and traditional Chinese script, it literally indicates the steam coming off of rice as it cooks, which, given rice's central place as the energy staple food of much of Asia, is an apt metaphor indeed. Ain't etymology fun, kids? So all this to say, qi functions like something of a blend between the force of Star Wars and the four humors of medieval European plague doctors and barber surgeons. The most important thing in all this is balance. And though it was, and unlike those meddlesome midichlorians, something that was strictly internal to the body, so no, sorry there will be no wuxia crouching tiger forest top

jumping or Darth Vader force chokes or bulletproof skin, yes, I'm looking at you, society of the righteous and harmonious fists. It could, and was, affected by the elements external to the body. From Needham, quote, another doctrine prominent in ancient Chinese thought was that of the macrocosm and the microcosm. It envisaged a great interdependence of the state on its people, and of the health of the people on the cosmic changes of the four seasons. The five elements were associated in symbolic correlations with many other natural phenomena in the groups of five. These conceptions were applied in a remarkably systematic way to the structure and function of the living body of man. End quote.

Of great and central importance in Chinese history is the idea of preventing trouble before it occurs, rather than reacting to it already in progress. An ounce of prevention, after all, is worth a pound of cure. That was true in the political and social realms, of course. So, too, was it in the medical realm. As such, TCM has tended, across time, to be focused far more heavily on maintaining an overall holistic good health through balance and prevention, rather than in combating active, acute diseases, as is the focus of much of modern Western medicine. This is one of the most evident differences between the two practices, and one of the ways that Needham asserts, not without merit,

that TCM actually continues to outperform its Western counterparts even in the modern day. But we will get back to that a little later. Though there were, and to one extent or another still are, more esoteric and quasi-magical elements to the discipline, such as the concept of qi, or of having professors of exorcism as part of the official imperial court performing their rights to cleanse the palace of malicious spirits and forces, on the whole those always occupied a niche space that was much more the realm of local quacks, non-professional healers of the poor, and overtly religious rituals conducted by local monks and priests, rather than the more serious scholars and practitioners of quote-unquote proper medicine. On the whole, Chinese medicine was,

and is, a disciplined, rational field of study that sought practical, measurable solutions to real-world afflictions and problems. It would be going much too far to call such a discipline scientific in any modern conception of the term. That said, it was certainly the most scientific of the pre-Renaissance medical arts. Now, let's turn our focus briefly to look at the figure who might be said to be the Hippocrates of China. Though preceding the Greek father of medicine by a solid century or so, he nevertheless fills a similar role in the establishment and formalization of the concepts that would define the medical arts of China in the millennia to follow. His name is given to us by the grand historian Sima Qian in the Shiji as Bianchui. The account

goes that while traveling through the state of Guo in 501 BCE, during the spring and autumn period, Bian learned that the heir apparent had died from a mysterious sickness that now also afflicted the king. Bian was shocked to learn of the amateurish way in which the symptoms had been described and collected, and claimed that he could both diagnose and then save the king. The palace servant listening to him, taken aback by such a bold assertion from this stranger, replied that unless he, like the legendary physician of the time of the Yellow Emperor, Yu Fu, could open the patient's body, cleanse and repair the vitals within, and then seal him back up again, an unthinkable concept as surgery was simply not

a thing that was done at the time, then Bien's boasts were empty and childish. From the Shiji, quote, Bien Chui, looking up and sighing, replied, Your ideas of medicine are no better than viewing the sky through a narrow tube or reading a piece of writing through a narrow crack. In my practice of medicine, I need not even feel the pulse, look at the complexion of the patient, listen to him, or visually examine his physical condition in order to say where the disease is located. And quote. Bien, as per the story, went on to do exactly that for the king, correctly diagnosing him without even seeing him,

and giving him the proper remedy to restore him to health. This passage in his biography is notable not so much for the tale of the miraculous curative powers of Bien Chue, so much as it clearly lays out the four main diagnostic observations intrinsic to TCM, and that they were already well understood at the time. The four are general physical inspection, listening to the sounds of the inner body and the smell of the patient, verbally asking the patient about their medical history and how they feel, and finally the taking of the pulse and feeling the afflicted portion of the body.

Bian's biography in the Shiji also tells us that acupuncture, heat treatment with pulped maksa of medicinal leaves, counter-irritants, drugs and alcoholic suspensions, medicated plasters, massage, and even gymnastics were all in wide therapeutic practice even at the time of Confucius. This is, of course, if we can take Sima Qian's account as reliable, which is as dicey as it's ever been. Was Bianchui an actual individual, or was he, like many of the famous ancients, like such notables as Sun Tzu, a composite character of practices, stories, general

knowledge, and tall tales that all rolled together into a story that sounded good. It's put forth, even by some modern Chinese scholars, that Bianchui may not have even been a name, but instead a kind of ceremonial title for especially well-esteemed physicians of the era. Whatever the true status of his historicity, if Bianchui is our Chinese Hippocrates, then what is the Chinese Hippocratic Corpus of Medical Knowledge? Though there certainly is one, it sadly does not even allege to come from the brush of Bianxue. Instead, it is called the Huangdi Neijing, the Yellow Emperor's Manual of Corporeal Medicine. A note on the translation of the title. Needham goes into depth on his choice of translating ne as corporeal.

As a character, it has a multitude of meanings, depending on the context. Most literally, it means inner, such as Inner Mongolia being called ne monggu in Mandarin. Many volumes in ancient China adhere to this inner-outer dichotomy. Indeed, there is also a huangdi waijing. Were we to take this at the face value meaning, we might think that one volume talks about inner medicine in the same way that we think of internal medicine today, while the second volume might be referring to external medicine, such as diseases of the skin. This, however, is not the case, nor is it such that this inner-outer refers to the kind of public and private versions of something, as in the case of the inner and outer courts of the imperial palace. Instead, Needham points out that its actual meaning derives from the classical Taoist statement of walking outside society, or moving outside of

space and time. Thus, the Huangdi Neijing is about worldly afflictions, the corporeal. It's about all aspects of physical medicine. The Huangdi Waijing, on the other hand, is all about the otherworldly afflictions of the spirit and soul, i.e. that which is non-corporeal. From Needham, quote, why, or outside, means everything otherworldly, everything to do with gods and spirits, sages and immortals, everything exceptional, miraculous, strange, uncanny, Sounds pretty awesome, right? Sounds like I should do a Strange Tales episode on that, right? Unfortunately, the Waijing was lost very early on, leaving only its worldly, mundane sibling to us. It appears that it was lost not in some great tragedy, more than out of the simple fact that it was not nearly as well regarded as the former,

and it eventually simply fell out of print and then out of the world. Which is sad for all of us, but it does serve to emphasize precisely the quite secondary character of the magico-religious aspect of medicine in China, for curses affected by charms, cantraps, and invocations must certainly have been included in the outside corpus. So, back to the Neijing. The manual deals, just as its Hippocratic cousin, with all aspects of the medical arts, from the human body and its functions, both normal and abnormal, as well as the process of diagnosis, prognosis, therapy, and regimen. It is guessed to have been compiled in the version that we have by about the 1st century

BCE, certainly well after the time of the mythical Yellow Emperor, and falling instead squarely somewhere in the Qin or Han eras. And if we think about it, that really does make a lot of sense. The unification of the Qin dynasty brought with it Qin Shi Huang's near-obsession for standardization and systemization, and the assorted but highly valuable medical knowledge of the old warring states would have been a prime candidate for just such a compiling. In terms of diagnosis, it gives an updated format to the yin-yang six-fold schema we discussed earlier, in accordance with the symptoms presented

and their relationship to the six circuits of bodily qi flow, which crisscross the body, quote, like the streets of a city laid out in a rectangular grid arrangement, end quote. If you want a visual for that, just search acupuncture body chart, and it looks like a street map of Manhattan projected onto a person. And it reads about as dry as you would expect a medical textbook to read, except it's in old Chinese and written in highly technical language and archaic terminology. Its various commentaries, intended to be companion reads to help explain the initial text, were themselves likewise almost as impenetrable. As a result, only truly learned and devoted students of medical knowledge could ever even get their heads around much of the Nei Jing, much less claim mastery. Needham writes,

The difficulty of the Nei Jing is that the technical terms were often ordinary words that had been given special meanings. Sometimes they occur along with the same word used in its ordinary sense in the same passage. Much confusion about Chinese medicine has arisen from misunderstanding of the Neijing, end quote. Yeah, you don't say. Napoleon Bonaparte rose from obscurity to become the most powerful and significant figure in modern history. Over 200 years after his death, people are still debating his legacy. He was a man of contradictions, a tyrant and a reformer, a liberator and an oppressor, a revolutionary and a reactionary. His biography reads like a novel, and his influence is almost beyond measure. I'm Everett Rummage, host of the Age of Napoleon podcast, and every month I delve into the

turbulent life and times of one of the greatest characters in history, and explore the world that shaped him in all its glory and tragedy. It's a story of great battles and campaigns, political intrigue, and massive social and economic change, but it's also a story about people, populated with remarkable characters. I hope you'll join me as I examine this fascinating era of history. Find The Age of Napoleon wherever you get your podcasts. By this point in the 185-plus episodes of this show, I sure hope we're all well enough aware that China developed a highly sophisticated, highly regulated, bureaucratic society far earlier

than much of the rest of the world, and maintained it for far longer periods of its history. It's fair to say that the Spring and Autumn and Warring States periods, and certainly the Zhou and earlier, can be characterized fairly as a feudal, hereditary order of warrior nobles and peasants. Yet beginning with the Qin Unification and reformation, extending through the Han period, and truly culminating with the Sui, Tang, and Song dynasties, rather than a hereditary, military-based hierarchy, the Chinese Mandirate coalesced around a non-hereditary, civil-based bureaucratic officialdom. Quote,

Social mobility was great, families rose into office-holding and sank out of it within a few generations. End quote. This, naturally, extended to the medical profession as well. While it often sounds stifling to live in such a regimented, bureaucratic world, in terms of a field like medicine, it is extremely fertile soil. Good medicine, after all, thrives on excellent record-keeping and procedure known and adhered to by all. We need only imagine a doctor trying to explain to an ancient youth or Scythian or Mongol raider of the importance of taking precisely six pills every eight hours, but only after a full meal, and certainly not with any alcohol, and it's markedly easier to imagine an axe finding a resting place in that doctor's skull in short order than of the

barbarian actually following through on the medical advice. For further examples, see the biography of Khal Drogo of the Great Grass Sea. Rather, in many professional fields, medicine, but also astrology, manufacturing, agriculture, and many others, China had reached startling achievements and heights, in some cases more than a thousand years before they'd be reinvented in the Western world. Though we've often had cases to gawk at the sometimes impossibly stringent and often seemingly arbitrary standards of the imperial civil service examination process that determined social mobility, it must be remembered that nothing even approaching it would be developed in Europe until it was done so by France in the 18th century, more than a

thousand years after its formalized development in the Mid-Tang. It's with no small degree of rather tragic irony that, having based many of their own such innovations on translated and years after its formalized development in the Mid-Tang. It's with no small degree of rather tragic irony that, having based many of their own such innovations on translated and transported ideas from imperial China, Europe happened to arrive in any meaningful way along China's shores only during the Ming and Qing dynasties, under both of which many of the long-standing social organizations, including hospital and medical systems, have broadly decayed. Between that general decay, the dizzying complexity of extant Chinese texts on the subject, and a generous dash of their own racist hubris, it is sadly unsurprising that Europeans gained an altogether wrong idea of the history of medical administration in China.

The basis of hospital care, and the presence of such facilities devoted to it, can be traced all the way back to China's first socialist, the bright, short, and thoroughly disruptive reign of the usurper emperor Wang Meng from the years 9 to 23 CE. Needham writes, Even so, this was only an emergency measure, and a truly permanent hospital system would have to wait until the end of the 5th century under the reign of Xiao Ziliang, the Buddhist king of southern Qi. This was emulated soon thereafter in the north by the year 510, when the king of northern Wei, Tuobayu, ordered the court of imperial sacrifices to select a group of buildings, and attach a staff of physicians for all kinds of sick people who might be brought there.

This hospital, called merely biefang, or separate buildings, had a distinctly charitable purpose, being intended primarily for poor or destitute people suffering from disabling diseases. Under the Tang, and even further under the Song, the hospice care itself was bureaucratized, regularized, and expanded by additional government actions and programs. By the Song, between the mid-11th and mid-13th centuries, such ventures were not limited only to the palace or the capital, but extended well out into the provinces as well. Infirmaries for the elderly and those too poor to care for themselves are all documented. Even by 1132, at least one hospital devoted mainly to the care of the burgeoning foreign

population of the empire, and another, circa 1165, specifically for the Jurchen prisoners of war captured during the Song's incessant warfare against the Jin dynasty of the north. Orphanages and government-regulated apothecaries are also recorded. None of this is to trivialize or to disregard the significant medical achievements of other civilizations and at other times. The Karakamasita of 1st century India, the Valetudinaria for wounded legionaries and gladiators of the Roman Empire, and the great hospital at Jundishapur in Persia, are but three examples of truly impressive proto-hospital systems in their own right, each of which were likely a near match for the technical expertise of any of the concurrent Chinese systems mentioned before. But in terms of systematizing, rigorously examining applicants to allow only the truly well-qualified to enter the profession, and then maintaining the system in place over periods of centuries,

China seemingly stands alone. Record-keeping and systemization and maintenance of information was another field in which the Chinese medical system often stood apart. Now, of course, Imperial China was by no means immune to tragic destruction of priceless, irreplaceable tomes of information, most infamously being the Xianyang Imperial Archive at the end of the Qin Dynasty in 206 BCE, and of the Hanlin Academy Library in 1900 during the Boxer Rebellion. Yet we do have surviving texts from all across time,

not only the Yellow Emperor's Manual of Corporeal Medicine, but also the purportedly far more ancient Shennong Dengxiaojing, the pharmacopoeia of Shennong the Divine Sovereign. We also have Emperor Xuanzong of Tang's Guangjiefang, the formulae for widespread benefaction, and during this song, the Beixiao Tujing, the illustrated pharmaceutical natural history. Much of what we've talked about so far,

especially in terms of China's propensity towards bureaucratization, we can categorize together under the Confucian influence on the development of Chinese medicine. Yet China's other two most significant cultural-religious schools, that of Buddhism and Taoism, likewise had significant impacts. Buddhism, as both a relative latecomer to China and a foreign religion beside, had less of an impact. Its primary input seems to have been that it stressed the concept of karuna, the limitless compassion for all life and living things. Thus it came about that no Buddhist abbey was likely to be without its medical specialists. We can probably say with certainty, though, that of the three sets of principles,

Taoism had the most direct impact on the direction and form Chinese medicine took. As we've talked about at the beginning of the show, the very basis of understanding and treatment was rooted firmly in the dualistic Taoist understanding of the universe. Moreover, Taoism was much more physical and hands-on than Confucianism. Quote, At the heart of ancient Taoism, there was an artisanal element. For both the wizards and the philosophers were convinced that important and useful things could be achieved by using one's hands. They did not participate in the mentality of the Confucian scholar-administrators, who sat on high in his tribunal, issuing orders and never employing his hands

except in reading and writing. End quote. Where the Taoist element really takes center stage, and has time and again throughout this show's run, and never employing his hands except in reading and writing, end quote. Where the Taoist element really takes center stage, and has time and again throughout this show's run, is that of the alchemists. Known under the general categorization of fang she, or the gentleman who possesses magical recipes,

Chinese alchemists did not, like their Western counterparts, confine themselves to trying to turn base metals into gold. Instead, they used their arts in a large number of professions and interesting ways. They were astrologers, weather forecasters, farm lorists, irrigationists, and bridge builders, architects, decorators, and much more to side. Virtually any profession or task that required more hands-on know-how than dusty bookishness, you could probably find a Taoist monk to help you out. Where they acquired much of their historical fame, or perhaps infamy, however, was in their employment as elixir makers, that is, macrobioticists, who just knew that with the right combination of elements, zoological, botanical, mineral, or otherwise, it must be possible to prepare medicinal compounds

that could work wonders. The greatest of these attempts, of course, was that of the philosopher's stone, that elixir or compound which could prolong life itself, rendering the bearer longevity and perhaps even true immortality. Quote, the object of the devout Taoist was to transform himself by all kinds of techniques, not only alchemical and pharmaceutical, but also dyadic, respiratory, meditational, and sexual, into a Xian. In other words, an immortal, purified, ethereal, and free, who could spend the rest of eternity wandering as a wraith through many centuries shunned completely the idea of using mineral-based compounds as drugs for consumption, Chinese alchemists, and wider Chinese society as a whole, went radically in the other direction. Especially in the earlier dynasties, kings and emperors often became likewise fascinated with the idea of denying mortality through alchemical means, and frequently

employed their own royal alchemists to concoct a regimen for them to achieve such a state. These experiments were taken up eagerly by many an alchemist, who were surely thrilled to have such a willing test participant as well as the limitless bankroll of the monarch. These immortality elixirs, however, were all notably catastrophic for the bodies of those taking them. One of the most popular compounds for immortality elixirs was, of course, the various elemental compounds based on mercury, probably the most used of which was cinnabar. Madness, morbidity, and painful death were often quick to follow those who really committed to a mercury-based solution to the immortal predicament. Which often makes the rest of us go, what, he didn't know that that was poisonous? He hadn't read about other emperors? Was he some kind of an idiot? Yet, let's go ahead and take one more look at Needham's description of a Xian immortal. Back to the quote, purified, ethereal, and free,

who could spend the rest of eternity wandering as a wraith, end quote. Indeed, it's often understood that those who underwent the process hadn't, like, not read the fine print or something, but rather knew exactly what they were doing and of its consequences. One could only become a Xian by shedding one's mortality entirely, and that meant the physical body and all of its trappings. It, like all alchemy, was a process of transformation and metamorphosis, and one of the necessary steps was death itself, which was understood in this case to be only a temporary inconvenience. Actually, during the elixir regimen, it's repeatedly noted that the patient would have brief periods of heightened activity and sexual energy shortly after taking a dose, followed by a long, death-like state, after which they would revive.

This was understood as being kind of rehearsals for the big show to come. Nevertheless, the idea that chemical concoctions could be employed to effectively treat disease and improve and extend life slowly but surely made its way, as it did with all things, across the Silk Road in a very traceable path. The idea began to percolate into Arab society circa 700 CE, to the Byzantines by about 1000, and by 1250, the English Franciscan monk, Roger Bacon, was sounding almost Taoist in his De Redartatione Accidentium, Senectusius, or On the Slowing of Old Age and Accidents, when he wrote that, quote, if only we knew more about chemistry, we could lengthen life tremendously,

end quote. And by the early Renaissance of the late 15th century, we knew more about chemistry, we could lengthen life tremendously, end quote. And by the early Renaissance of the late 15th century, we have the Swiss physician Paracelsus stating that, quote, the business of alchemy is not to make gold, but to make medicines, end quote. Ladies and gentlemen, we have the foundations of modern medical chemistry. So let me finish out today with something of a face-to-face comparison between the various merits of each system of medicine, modern Western versus traditional Chinese. And yes, right off the bat, I'll be clear that it is in no way a fair contest. Modern medicine, especially in terms of acute, severe illness and conditions, utterly blows TCM out of the water, just like it would an apothecary's remedies from 1400s Italy.

TCM is not scientific, nor can it ever truly be scientific. It is based on a system of understanding right down to its very base conceptual level that is not just unquantifiable in nature, but borderline, if not outright, magical. As the Chinese had no basis in atomic theory, which was a Greek invention and thoroughly Western idea prior to the modern era, their concepts of qi flow and the near force-field-like yin and yang balance of the five elements is of course more suitable to European barbers bleeding patients to balance the four humors, or Aristotelian or Hippocratic ideas of medicine, than anything you'd find in a modern hospital. So, if you've got an infection, be it gangrene, or an inflamed appendix, or the flu, or coronavirus, for God's sake,

go to a real hospital and get some actual medical care. Don't tell them that some podcast told you otherwise. No one, not even TCM doctors themselves, would ever reasonably tell you otherwise. That said, modern medicine isn't perfect, and does have some of its own drawbacks. Though it ever continues to improve, Western modern pharmacology continues to grapple with, quote, the active principles in certain drugs are administered as simple agents, producing side effects in the patient. These are sometimes very serious, end quote. Where TCM continues to shine, and really has maintained its worth,

in spite of its rapid near-eclipse by modern medicine, is its organic, individualistic system of treating its patients. Again from Needham, quote, Two patients with identical symptoms may be given quite different treatments, depending on their backgrounds and the general pictures of their body processes, as ascertained in examination, end quote. Another positive is that TCM views illness not as an acute thing to destroy here and now, but as a natural process that will go through various stages.

The changing nature of the disease can lead to sophisticated and tailor-made cures by the doctor that change with each stage and follow-up reviews with the patient. Where TCM continues to do well is its treatment of long-term chronic conditions and illnesses, as well as its emphasis on overall maintenance of good health via good practices, rather than waiting until disorder arises to seek care. So that's where we will leave off. Next time we'll get back to the Yen Dynasty's misadventures in Southeast Asia. But until then, wash your hands, eat well, drink some hot water, and have a good rest.

It's good for the healthy. And as always, thanks for listening. 400 years ago, a trio of tiny kingdoms were perched on some damp islands off the coast of Europe. Within three short centuries, these islands would become the centre of an empire which ruled a quarter of the globe and on which the sun never set. I'm Samuel Hume, a historian of the British Empire, and my podcast Pax Britannica follows the people and events that built that empire into a global superpower. Learn the history of the British Empire by listening to Pax Britannica everywhere you find your podcasts, or go to pod.link slash pax.