In 1702, a pharmacy shop named Tongrentang (同仁堂, Hall of Common Humanity) opened for business in Beijing, claiming authenticity in the ingredients and technical skills in compounding medicine, often based on ancient recipes. Tongrentang was one among many pharmacies that flourished in the Qing dynasty (1644–1911) in China, and continues to be recognized as a respectable pharmacy today. Were these pharmacies always such a vital part of the medical landscape in China, claiming knowledge and authority on therapeutics? In making the pharmacy the object of study, Know Your Remedies traces the rise of the traditional Chinese pharmacy from the sixteenth to the eighteenth centuries. Drawing on primary sources in the field of pharmaceutical texts (bencao 本草), local gazetteers, as well as medical texts and literati writings, Bian examines how the ascent of the traditional Chinese pharmacy involved the creation of new hierarchies of knowledge, intersecting with the rise and regulation of markets and state fiscal policies, and the flourishing of book publishing, showing that the process of the decline of the authority of textual pharmacopeia ultimately led to the rise of the traditional pharmacy.
The book is divided into two parts with three chapters each. Part I focuses on the Ming dynasty (1368–1644), showing how the prestige of state-sponsored pharmacopeias from earlier dynasties declined. The publishing boom of the sixteenth century saw local authorities taking up the publication of pharmacopeias, leading to a “localization of bencao pharmacopeia” (p. 35). This decentralizing pattern and the growing significance of local knowledge in medicinal materials is also tied to the conversion of local tributes, including medicinal herbs, into monetized payments as the state pursued tax reforms. This contention over authority of knowledge continued in the first decades of the seventeenth century with the neo-Confucian literati’s interest in studying the nature of drugs, leading to an “amateurization” of the pharmaceutical knowledge in some literati circles. In the eyes of the author, the downfall of the Ming dynasty was “a result of prolonged impasse over the legitimate ownership of technical knowledge” (p. 101).
Part II moves on to the Qing dynasty (1644–1911) through the eighteenth century, primarily focusing on the Jiangnan (Lower Yangzi) region. It delineates the hardening of boundaries between Confucian scholarship and medical training in the early eighteenth century. As more Confucian literati began to practice medicine, a trend against the amateurization of medicine and toward pharmacy emerged. Beginning in the eighteenth century, physicians began to lose control over the pharmaceutical process and of the artisanal techniques that was once their monopoly. By the eighteenth century, physicians no longer dispensed their own medicine, and patients were obtaining their medicine from marketplaces and from urban dispensaries. The proliferation of pharmacies such as Tongrentang was closely connected to the flourishing of a mercantile marketplace. This marketplace not only brought goods from different regions of China but also from foreign places through maritime trade.
Know Your Remedies will interest the specialist in the history of medicine in China and non-specialist alike. Bian’s careful research shows not only the ideological and intellectual struggles over pharmaceutical knowledge but also that these changes intersected with reforms in fiscal policies and with the emergence of specialized marketplaces for medicinal trade. The gradual shift of tax payment into a single currency of silver led to debates over the locality and existence of certain herbs, animals, and minerals. Here, local knowledge often challenged the authority of the state-sponsored pharmacopeia. Often intimate knowledge of topographical and ecological features of the lands that produced these medicinal treasures was necessary. Pharmaceutical trade grew as interregional trade flourished and the market economy, particularly in Jiangnan, matured during this period. The supply of medicinal ingredients often depended on long-distance trade from faraway places. Certain places specializing in the trade of medicinal herbs gained fame as “medicinal wharfs” (yao matou 藥碼頭). One such “medicinal wharf” was the market town of Zhangshu (樟樹) in Jiangxi Province, which became the center of interregional trade by the sixteenth century, attracting not only interregional traders but also interest from the imperial court.
In the sixteenth and seventeenth centuries, a maritime world economy centered on the South China Sea tied the Ming dynasty to systems of trade that flowed to and from the Indian Ocean. The Ming and Qing dynasties’ maritime trade into the South China Sea and Southeast Asia brought new dietary foods such as shark fin and “swallow’s nest” (yanwo 燕窩). European, American, and Siamese merchants not only purchased goods from China but also supplied consumer goods to Qing China, such as American ginseng and sappanwood, linking them with the domestic wholesalers such as that at the aforementioned “medicinal wharf” of Zhangshu. The pharmaceutical trade could also be problematic for the empire as networks of interregional pharmaceutical merchants could easily and quickly disseminate heterodox and slanderous materials. Bian cited several cases that epitomized the problematic nature of the network of pharmaceutical trade.
Know Your Remedy confirms the consensus of recent scholarship that the early modern period of Ming and Qing dynasties was one of dynamism and vitality and places China in a global context. By the nineteenth century, the Chinese pharmacy, with similar sets of arrangements, can be found in Hong Kong, Southeast Asia, and all over the world, supplying pharmaceutical materials. The People’s Republic of China created an institutionalized form of Traditional Chinese Medicine (TCM). As the Chinese pharmacy came to epitomize “Chineseness,” the alliance of this institutional form of Chinese medicine and the state has led to the claim of adherence to ancient recipes, which is particularly appealing politically in nationalistic sentiments. The increasing international profile of TCM also brought attention and condemnation over safety, environmental, and ethical issues, but, as Knowing Your Remedy shows, claims of the efficacy of exotic ingredients often involves contested claims of knowledge and reflects the sometimes problematic nature of the pharmaceutical trade.
Professor Chao is the author of Medicine and Society in Late Imperial China: A Study of Physicians in Suzhou, 1600–1850 (2009).
