​1 The Last Pharmacopeia

1 The Last Pharmacopeia

 In the summer of 1505, Zhu Youcheng, the emperor of Ming China under the reign name of Hongzhi (Grand Governance), became ill and died at thirtyfive. Leading officials attributed the young emperor’s premature death to hotnatured drugs that should never have been prescribed to treat diseases arising from summer heat. They blamed Liu Wentai, superintendent of the Imperial Academy of Medicine, and Zhang Yu, the chief palace eunuch, for the crime of regicide.1 The irony in this accusation lies in the fact that Liu and Zhang had only recently claimed a great accomplishment in the field of pharmacy. The late Hongzhi emperor had always cherished the art of medicine, frequently donating medications to the poor.2 In 1503, the emperor asked Liu and Zhang to compile a new bencao pharmacopeia with a team of palace physicians. Two years later, the team presented the throne with a beautifully illustrated manuscript that documented 1,815 kinds of materia medica, further adorned with a short preface by the emperor himself, under the title Yuzhi Bencao pinhui jingyao (Imperially Commissioned, Essentials of Assorted and Collected Materia Medica; hereafter Essentials). A few months later, Liu and Zhang fell from grace following the sudden passing of Hongzhi. The pharmacopeia was sealed off and never distributed outside the palace.3 In scholar-official circles, stories about Liu Wentai lingered throughout the sixteenth century. One popular anecdote claimed that Liu was in fact also responsible for the death of the Chenghua emperor (Hongzhi’s father) back in 1487. Having narrowly escaped severe punishment, so the story goes, Liu lashed out against his foes, forcing a well-respected minister to retire.4 More stories portrayed the Hongzhi emperor on his deathbed begging for water, his nose bleeding from excessive heat, with Liu refusing to let him drink. Another Bian.indb 23 1/16/2020 7:17:18 AM 24 chapter 1 questioned how Liu and Zhang managed to escape the death penalty—or, might it have been the emperor’s widow, deceived by her trust in Liu and Zhang’s long-time service, who intervened and exonerated them?5 The making of the Hongzhi pharmacopeia, too, was replete with dissonance: when Liu Wentai requested the help of two Hanlin academicians to serve as “proofreaders,” the grand secretariat took it as an insult. Arguing that a scholar’s proper job was the “discussion and deliberation” (lunsi) of state policy, they refused to work with the palace physicians.6 This divisive battle over an emperor’s death offers us a crucial context for understanding the rapid transformation of bencao as a field of knowledge during the sixteenth century. By casting Liu in an unholy light, the tales fit into the contentious mood stoked by later controversies over imperial succession during the long Jiajing (1522–66) and Wanli (1572–1620) reigns. Scholarofficials, seeking to rectify public affairs with their moral learning, felt compelled to weigh in on issues pertaining to the health and maintenance of the imperial family. The sensational anecdotes emerged out of their fear that it took only one incompetent physician—or even worse, an intentionally malignant person—to shake the “root of the State” (guoben).7 Medical experts and eunuchs, meanwhile, were quick to punch back whenever they had a chance. In his preface to the Hongzhi pharmacopeia, Liu Wentai took a subtle jab at the scholar-official who would not deign to work with him. “The old bencao is intelligible only to virtuous gentlemen and erudite scholars,” noted Liu, whereas his text would be “easy to understand by novices and mediocre persons without much hard thinking.”8 Hiding behind his self-deprecating tones is a defiance that is hard to miss. In the short term, the fate of a state-commissioned pharmacopeia was doomed by the political impasse between scholar-officials and technical experts in the Ming polity. In this chapter, I offer a different narrative that examines instead the longer trajectory of textual transmission and reception for these “pandects” of pharmaceutical objecthood. I argue that the decentralization of authority had already been well under way since the eleventh century, when the Northern Song court did commission multiple bencao pharmacopeias. Proceeding chronologically, three trends stand out when we examine bencao as a field of inquiry. First, the Song state could not exert much control over these elaborate texts in transmission. A variety of authors, acting independently of the imperial court, made changes to the official edition and promoted their work through the manuscript or the newly available technology of printing. Bian.indb 24 1/16/2020 7:17:18 AM the last pharmacopeia 25 Second, major medical innovations during the Jin-Yuan period (thirteenth through fourteenth centuries) inspired physicians to explain pharmacological action in cosmic, systematic terms. Turning away from the pharmacopeia’s erudition, these authors aimed instead to create a practical curriculum of pharmacy informed by correlative cosmology. Their efforts were augmented by the rising influence of commercial publishers at that time. Lastly, regional official publishing—a hallmark of Ming book culture—made the elaborate Song pharmacopeia widely available in print from the mid-fifteenth century. As a result, an unprecedented number of texts emerged that attempted to integrate cosmic pharmacology with the pharmacopeia, creating new discourses and textual genres. Ming readers came to learn pharmacy by the book, creating textual communities among themselves that no longer depended on the imperial court.9 Armed with this insight drawn from book history, we can revisit Li Shizhen’s Bencao gangmu as a peculiar product of sixteenth-century book culture. On the one hand, Li Shizhen benefited from the widespread availability of bencao texts and other important sources in print. On the other hand, we should also see how unusual it was for Li Shizhen to presume that he could make a new pharmacopeia that, as we have seen, fell short as a political project in the early sixteenth century. In the end, it was not imperial patronage that made Li Shizhen’s magnum opus a lasting success, but the demands of learned readers. The Persistence of Pharmacopeias during the Song-Yuan-Ming Transition Even prior to the advent of printing, the content of early bencao was transmitted widely in manuscript copies. The original Tang pharmacopeia housed at the court archive, however, consisted of multiple parts divided by different kinds of analysis: commentaries, local reports, and illustrations. The pictorial component was hardly seen beyond the capital city, whereas fragments of text traveled much more freely. Both Tao Hongjing’s fifth-century commentaries and the Tang bencao circulated as far as Dunhuang and Turfan to the west, and Hei’an Japan to the east.10 Come the eleventh century, Song courtiers followed the Tang precedent to create a two-part pharmacopeia: an expanded commentary and a compilation of local reports (tujing, or “map guides”). Headed by separate teams, the two parts were completed within five years (1057–61) and were much longer Bian.indb 25 1/16/2020 7:17:18 AM 26 chapter 1 compared to the Tang version. Although the court commissioned each part to be reproduced in woodblock print and distributed to local offices, they proved unwieldy to use. Local readers soon started to compile their own digests and commentaries based on the official pharmacopeia. For example, a physician named Chen Cheng (fl. 1086–1110) produced a composite bencao by combining relevant sections in each part of the official text, which eventually earned him a desirable post in the imperial medical administration.11 Similarly, Kou Zongshi (fl. 1111–17), a minor official stationed in later-day Hunan, compiled his own commentary to “propagate the meanings” (yanyi) of the official pharmacopeia. He was later promoted to the “purveyor and inspector of materia medica” (bianyan yaocai) in the capital city, and his relatives promoted his bencao commentaries in print as well.12 From these examples, we see how bencao became a field of common interest in which physicians and scholar-officials could freely converse, and accomplishment in bencao scholarship could lead to promotions in officialdom. In the early 1100s, the local administrator of Hangzhou sponsored the printing of a new bencao manuscript. No one in Hangzhou knew anything about the author, Tang Shenwei, and yet they were impressed by his work, which not only combined the two-part official pharmacopeia but also included five hundred new entries of materia medica culled from a wide range of medical and literary sources. This 1108 print edition, known as the Daguan bencao after the current reign title, thus surpassed the Song official pharmacopeia in many ways. Ever enthusiastic about medical matters, Emperor Huizong ordered court physicians to quickly produce a new edition with official revisions. The result was rebranded as the Zhenghe bencao (the reign name when the new edition was released in 1116). Following its appearance, the two-part Song official pharmacopeia gradually ceased to circulate, and only in the twentieth century did scholars reconstruct each part for historical research.13 In 1127, the Song regime fell to Jurchen attacks from the north, and one prince retreated to the south, consolidating his rule in Hangzhou. The resulting hostility and blockade between the Jurchen Jin dynasty and the Southern Song resulted in the unintended separation of two slightly different editions of Tang Shenwei’s bencao. In both south and north, new information emerged to shed light on Tang Shenwei’s identity. A southern source revealed that Tang Shenwei was a physician living and practicing in West China, and that a military official had recruited him to live in Chengdu.14 In the north, Yuwen Xuzhong (1079–1146), a veteran Song official imprisoned by the Jurchens as a state emissary, wrote a Bian.indb 26 1/16/2020 7:17:18 AM the last pharmacopeia 27 short epigraph to the Zhenghe bencao during his captivity. In it, Yuwen claimed to have witnessed Tang Shenwei treat his father with miraculous efficacy during Tang’s stay in Chengdu. Describing Tang as a man “ugly in appearance and slow in demeanor and speech,” Yuwen explained that he treated literati not for money, but instead asked for texts with medical content. In so doing, Yuwen hinted, Tang was able to gather enough secret recipes and rare texts to compile a bencao that surpassed the official pharmacopeia in erudition. In this story, Tang Shenwei became an idealized symbol in Yuwen’s melancholy reminiscence of literary culture in Song times.15 Publishing records suggest that the north-south cultural rivalry during much of the twelfth and thirteenth centuries in fact perpetuated the authority of bencao pharmacopeias. In the south, soon after installing himself in Hangzhou, the Gaozong emperor (r. 1127–62) commissioned a new pharmacopeia. In a pattern foreshadowing the Liu Wentai controversy 350 years later, the Southern Song bencao was completed but never gained public endorsement due to the bickering between officials and the chief palace physician.16 Palace physicians continued to refer to the Song pharmacopeia to recruit new personnel. In written examinations, candidates were asked to identify certain kinds of materia medica and construct formulas based on the properties of each ingredient as documented in the bencao. Interestingly, court physicians complained that most qualifying candidates for the exams hailed from the vicinity of the capital, indicating that the circulation of these elaborate texts probably did not go very far.17 Instead, “vulgar imprints” (suke) of the pharmacopeia, often greatly truncated from its original length of over 1,600 pages, appeared in the growing publishing sectors in Southeast China. In response, civil officials felt compelled to fund additional editions to correct these imprints’ errors, a pattern that we shall also see repeat in the late fifteenth and early sixteenth centuries.18 In the north, an important edition of Zhenghe bencao came out in 1249 in the Pingyang Prefecture, a center of literary culture and publishing in southern Shanxi (see map 0.1). The publisher, Zhang Cunhui, recruited skillful artisans to produce beautiful woodcut illustrations that accompanied the description of every drug, including three full-page illustrations of sea salt and rock salt yards (the latter native to that part of Shanxi). Two prominent literati officials wrote prefaces for the text, stating the centrality of bencao as a cultural asset, at a time when the Jin regime in turn had just been conquered by the Mongols.19 The Chinese literati were, however, not the only advocates for bencao: in the last decades of Jin rule, a slightly altered version of Tang Shenwei’s Bian.indb 27 1/16/2020 7:17:18 AM 28 chapter 1 pharmacopeia appeared in the Daoist Canon, a monumental undertaking fueled by the widespread popularity of Quanzhen Daoism. Bencao remained thereafter part of the Daoist corpus, and many readers later got access to them via Daoist connections.20 To sum up, for 150 years of divided rule after the Northern Song’s demise, the bencao pharmacopeia retained its appeal and prestige in both the north and south. The multitude of actors involved in saving, transmitting, and appropriating bencao crossed political divisions and religious creeds. After the Mongol conquest of the Southern Song, the Yuan dynasty briefly entertained the idea of a new bencao under the rule of Kublai Khan, but the resulting text, if it ever existed, is long lost.21 Contingencies aside, the shift of attention away from pharmacopeia-making may also have had to do with changing priorities in medical learning. The Rise of Cosmic Pharmacology Monumental in scale and eclectic in content, the Tang and Song pharmacopeias were not intended for the average medical practitioner of the day. During the twelfth century, when the extensive pharmacopeias remained visible among elite literati circles, a new type of pharmacology rose to prominence via the writing and teaching of a few master physicians. The so-called Masters of Jin-Yuan made their fame by articulating not what individual drugs could cure, but also why they did so, and in what ways medical practices could be invigorated by a thorough understanding of pharmacology. Their success also depended on inventing new textual genres that proved extremely successful in an expanding culture of print.22 One product of this new pharmacology is a short text titled Pearl Pouch and Rhymes on the Nature of Drugs (Zhenzhu nang yaoxing fu), attributed to Zhang Yuansu (1151–1234). In contrast to the Song pharmacopeia’s coverage of more than 1,700 drugs, Pearl Pouch selects only 200–300 common drugs, and divides them into four groups by their “nature” (xing) as cold, hot, warm, or “flat.” Although such descriptions existed in the bencao tradition, the Tang and Song pharmacopeias did not offer a systematic explanation of these properties, nor did they classify drugs by their pharmacological action. Pearl Pouch is also very easy to read: Each drug gets a one-sentence description with no reference to previous literature, and every two sentences form a couplet that rhymes with the next pair. This text belongs to the rising genre of primers and mnemonic guides—a phenomenon linked to the ascendance of the civil service examinaBian.indb 28 1/16/2020 7:17:18 AM the last pharmacopeia 29 tion in popular culture at the time. Various renditions of Pearl Pouch would remain popular as an introductory text on pharmacology well into the early twentieth century.23 Another short text, attributed to Li Gao (1180–1251), articulates a more specific theory of cosmic pharmacology. A well-educated physician whose practice emphasized the use of warming tonics, Li witnessed the Mongol conquest of northern China and taught medicine that emphasized alleviating diseases caused by hunger and distress. The short treatise on pharmacology proposes seeing cold, hot, warm, and flat (cool) as not mere sensations of pharmacological action, but “regular images” ( faxiang) of the four seasons, or different yin/ yang configurations of heaven (historian Ulrike Unschuld translated this theory as describing a kind of “thermogenic nature”).24 Similarly, the taste of drugs, also described in pharmacopeias but not systematized, became standardized in order to match the five phases that constituted the Earth. A coherent picture of the cosmos, combining heaven and Earth, thus encompassed endless combinations of those variables that in turn mapped on to different seasonal cycles and pharmacological actions. Employing this model, the master physician’s diagnosis and prescription thus became a complex process of reasoning that took everything into account: time, location, the site of the disease, the patient’s bodily constitution, and the nature of individual drugs (see table 1.1). In other words, to be a good physician was to read the hidden mechanisms of the macro- and microcosms like a diviner. Historians have written at length about the innovative aspects of this new cosmic medicine and its long-lasting legacy.25 Since Zhang Yuansu, Li Gao, and their disciples all lived in the north under Jin rule, their cosmic pharmacy came to be remembered as a northern phenomenon. Yet contemporary to Zhang’s time, we also find Zhu Xi (1130–1200), a leading figure in Southern Song Confucianism, taking an active interest in the nature of drugs. In the recorded conversations between Zhu and his disciples (who were, in general, not training to practice medicine), Zhu Xi repeatedly brought up the topic of materia medica to make two claims important to his doctrine. First, despite their “withered and dried” (kugao) appearance, drugs were no inert matter, but obviously potent. In this sense, Zhu discussed the “nature” of aconite being hot (causing the sensation of heat) and that of rhubarb being “cold.” This, argued Zhu Xi, proves that human beings possess the invisible, but nevertheless potent, capacity of moral judgment in their “Nature” (xing). Through the nature of drugs, Zhu pointed to the existence of a greater coherence (li) of the world.26 Bian.indb 29 1/16/2020 7:17:18 AM Table 1.1. Cosmic Pharmacology in Jin-Yuan Medicine Yin/Yang dyad Yin of Yang Yang of Yang Yang of Yin Yin of Yin Primary qi Warm Hot [Neutral] Cool Cold Five phases Wood Fire Earth Metal Water Primary taste Sour Bitter Sweet Pungent Salty Bodily viscera Liver Heart Spleen Lung Kidney Season Spring Summer (Long Summer) Autumn Winter Pathogenic factor Wind Heat Humidity Dryness Cold Cosmic action Rising Floating Transforming Descending Sinking Physiological stage Birth Growth Maturation Harvest Storage Representative drug Ephedra (mahuang) Aconite ( fuzi) Ginseng Fungus ( fuling) Rhubarb Pharmacological action Astringent Dehydrating Tonic Moistening; dissipating Purgative Source: Prepared based on Li Shizhen’s summary in Bencao gangmu. Bian.indb 30 1/16/2020 7:17:18 AM the last pharmacopeia 31 A second point derives from the first one in seemingly contradictory ways. While the nature of drugs could illuminate the moral nature of humanity, Zhu Xi sought to uphold a strict hierarchy between the high and the low, the grand and the minuscule. He dismissed the idea that one could know perfect truth from mere appearances—for example, by examining the dried herbs in a pharmacy. Zhu took great pains to explain that perfect coherence existed in this imperfect material world like a “bright pearl dropped into turbid water.”27 For Zhu Xi, materiality prevented the full manifestation of this coherence, and he was only interested in the nature of drugs insofar as it helped him prove that coherence was indeed invisible and omnipresent. In chapter 3, we will revisit this influential doctrine and its critics in the seventeenth century. The important point here is that there existed a confluence of interest in cosmic medicine in both north and south, and that the new theories received endorsement by both physicians and Confucian literati. A synthetic treatise along these lines emerged in the late thirteenth century, titled Tangye bencao (Materia medica for decoctions) and authored by Wang Haogu (fl. 1264), a disciple of both Zhang Yuansu and Li Gao. Whereas Zhang and Li made no attempt to replace the bencao pharmacopeia with their own teachings, Wang felt confident to claim the “orthodox learning” (zhengxue) of the Divine Farmer in his own teachings. In his preface, Wang rejected the Tang and Song pharmacopeias’ classification system that sorted objects by the order of minerals, plants, and animals, proposing instead to discuss the 200–300 common drugs according to their nature and sites of pharmacological action.28 Printed collections of Zhang, Li, and Wang remained popular under Mongol rule, after the latter vanquished the Southern Song in 1279. Arguably, during no other period in Chinese history had there been a closer, or more mutually beneficial, interaction between Confucian literati and medical experts. How, then, should we understand this moment of triumph for medicine during what historians have called the Song-Yuan-Ming period? The confluence of Confucian and medical learning seemed to be the dominant narrative of the day, so much so that Zhu Zhenheng (1281–1358), a later disciple of the Jin-Yuan masters, claimed that medicine was one and the same with the Confucian pursuit of moral truth through the “investigation of things” (gezhi).29 A unique medical culture developed in South China under the Mongol rulers of the Yuan dynasty, where “medical households” (yihu), along with astrologers (known as yinyang experts), were recognized by their hereditary status in local administrations. The most successful practitioners attracted literati advocates, established long-standing family reputations, and even occupied key Bian.indb 31 1/16/2020 7:17:18 AM 32 chapter 1 governmental positions by virtue of their art. Even though members of the medical households could not freely mingle and intermarry with literati families—being “not quite gentleman”—their borrowing of Confucian tropes and rituals in their own practices was not necessarily a sign of inferiority.30 When Zhu Yuanzhang founded the Ming dynasty after defeating the Mongols in 1368, he staffed the court with a robust presence of technical experts along with scholar-officials and continued the practice of hiring hereditary physicians to staff local medical academies (yixue) and philanthropic pharmacies in every county seat. My point here is that, up to the fifteenth century, medical practitioners still possessed solid control over their art, and their status as experts received recognition institutionally by the Yuan and early Ming states. Confucian philosophers looked up to medicine and other technical arts as sources of cosmic reasoning, which in turn left indelible marks on their own thinking. Wang Lü (1332–?) represents an interesting polymath figure during this period. He composed excellent landscape paintings and reportedly studied medicine with the master physician Zhu Zhenheng. In his literary anthology, Wang made one off-handed remark about the foundational myth of bencao, in which the ancient sage-king Divine Farmer (Shennong) allegedly tasted one hundred herbs to tell good medicines from poison. Yet for Wang, it was inconceivable that a sage-king might have to put anything into his mouth in order to know its nature. He argued that the origin of bencao must instead be from divine intuitive knowledge about the workings of the cosmos (for Wang, the Eight Trigrams of the Book of Changes), and nothing else.31 Here we see the compelling power of cosmic medicine that shaped the general epistemic discourses of the day. The rise of intuitive thinking as an essential conduit toward moral knowledge was modeled after the theoretical cosmic medicine of JinYuan times and remained deeply mystical in its outlook. In chapter 3, we will return to see how the hostile attitude toward materiality and sensual knowledge began to give way to one more positive, which in turn impacted literati approaches to the field of bencao.