Healing with Poisons: Potent Medicines in Medieval China by Yan Liu

Based on his revised dissertation, Liu Yan's new book Healing with Poisons: Potent Medicines in Medieval China is a welcoming addition to the English-language scholarship on the history of medicines in China, focusing on the medieval transformation of poisons as medicines. In the past two decades, the history of pharmacology, pharmacy, and medicines in China has experienced a booming development across the globe. Many books focus on early modern, modern, and contemporary periods. For example, just in the past couple of years, we have seen the publications of Know Your Remedies: Pharmacy and Culture in Early Modern China (Princeton, 2020) and Mao's Bestiary: Medicinal Animals and Modern China (Duke, 2021). However, many books on premodern periods have been published in Chinese, Japanese, and French, as Liu Yan also noted in the introduction of his new book. On the one hand, these books resulted from the flourishing of cultural history that focused on the body, health, medicine, and life. On the other hand, there was also inspiration from newly available materials, such as manuscripts found in Dunhuang and other sites in Central Asia and entombed stone inscriptions. Indeed, Chinese and Japanese scholars have continued the tradition of studying materia medica (bencao) to compile, edit, and study these manuscripts. In recent years, some East Asian scholars also attempted to incorporate new concepts to interpret these new materials in light of the history of medicine and material culture. One of the strengths of Liu's book is to digest numerous secondary sources in East Asian languages.

Besides incorporating secondary sources, Healing with Poisons focused on two genres of texts as primary sources, meteria medica (bencao) and formula books (fangshu). I would further point out that from the perspective of material culture, since there were three major material sources for Chinese medicines in medieval China: animals, plants, and minerals, many texts on the roles of plants, animals, and minerals in Chinese medical history might not be categorized into the two genres noted in Healing with Poisons, so their values for this theme might have been underestimated. For example, the text on zoomancy or animal divination collected in Treatise on the Auspicious Signs of Heaven and Earth (Tiandi ruixiang zhi 天地瑞祥志) often mentioned the animals serving as medicine for healing illness.

Healing with Poisons has three parts and seven chapters. The first two parts trace the origins and evolving transformation of the "du" as "potent" or "potency" from poison to medicine in the textual sources from the Han to the Tang dynasties. And the second part focuses on the relationship of state power to pharmaceutical knowledge and its medical and political implications. The third part turned to the role of poison in life enhancement. The Conclusion summarizes the discussions and makes several arguments. First, Liu argues that the traditional Chinese pharmacy encompassed various substances possessing great transformative capacity. Second, he argues that the materiality of Chinese drugs was fluid, and the medical knowledge was transformative across political and social spaces. Third, he also argues that medicines could alter the body for both positive and negative functions. Fourth, Liu suggests that the center of medical activities was shifted to the northwestern region in the seventh century due to the establishment of state power. The state and the elite class played active roles in producing, regulating, and institutionalizing medical knowledge.

In particular, part 1 has two chapters. Chapter 1 traces the changing meanings of "du" in early Chinese sources, from the earliest materia medica, The Divine Farmer's Classics, to Tao Hongjin's Collected Annotations. He argued that "du" was more sophisticated than simply the negative connotation of "poison" in early Chinese texts, which denoted the strong sense of potency for a medicine's therapeutic power, and the role of "du" in healing was established in the sixth century. He also suggested that political visions and cosmological views contributed to the blurry boundary between poison and medicine due to the Yin-yang dynamism. Chapter 2 analyzes the technical issues involving "du" as medicine, such as dosage control, drug combination, processing aconite, and the drug trade, and concludes with the fluid materiality of Chinese medicines.

Part 2 consists of three chapters. Chapter 3 examines the medieval concepts of demonic infestation (guizhu), poison (gu), and witchcraft (gu) in the context of Sui and Tang political history. It traces the idea in the Han dynasty of disquieted demonic spirits as the sources of hauntings, and that "zhu" (pouring) referred to the transmission of illness through a dead body as the source of contagious pollution, which led to epidemics. Then early medieval Daoist tradition developed many techniques for harmonizing these restless spirits. However, Sun Simiao developed formulas for using potent drugs to drive the sinister demons out of infested bodies, which became a method of "fighting poison with poison." Then, this chapter continues to discuss the gu vermin and its implication of the seductive power of women. Using the "cat demon story" in the political history of the Tang dynasty as a case study, Liu illustrates that in the Tang dynasty, the state power aimed to expel the gu practitioners to stabilize social order, which replaced the old discourse developed in the Han dynasty when medical writing focused on the resonance between the individual, the state, and the cosmos.

Chapter 4 offers a concise institutional history of medicines and medical texts, in particular, Newly Revised Materia Medica in the Tang dynasty, and analyzes the local medical knowledge using the manuscript sources from Dunhuang. However, the section exploring the manuscript from Dunhuang seems insufficient. Numerous primary sources have been found, and there are many secondary sources on this topic in Chinese, Japanese, and Western languages. In terms of the institutional history, I find that there might be a parallel development of medical history and the history of divination in ancient and medieval China since there was no clear boundary between physicians and diviners in ancient China. Many aristocratic families possessed divination knowledge and techniques since the Han dynasty. Still, in the medieval periods, the state also attempted to play more active roles in regulating divination knowledge and techniques by institutionalizing them.¹

Chapter 5 is a case study on Sun Simiao and his Essential Formulas to show the importance of the formula books in the study of medieval medicines and medical practice. It briefly mentioned Sun's connection with Buddhism. As I noted earlier, there were more genres of medical texts in medieval China beyond that of materia medica and formula. My earlier study indicated that Daoxuan, a Vinaya master in the Tang dynasty, actually listed three crucial categories of materials that could be offered to the monastic community: healing devices, medical texts, and medicines. In the category of medical texts, he listed many genres of texts such as materia medica (bencao), various formula books (zhufang 諸方), classics of the pulse (maijing 脈經), and the methods of flowing and blocking from the Bright Hall (mingtang liuzhu 明堂流注). Of course, chapter 5 focused on medicines, and naturally omitted other traditional Chinese medical technology such as acupuncture. However, combining this chapter with chapter four on the institutional history of medicines and medical texts, we see a crucial discussion how various medical texts were categorized by both state power and the religious powers of Buddhist and Daoist monastic communities For instance, the "treatise of classics and texts" (Jingji zhi 經籍誌) of the History of the Sui Dynasty offered an example of the state institutionalization of texts since the History of the Sui Dynasty was an official history sponsored by the court and overseen by the prime minister.²

The last part has two chapters dealing with enhancing life by taking drugs. Chapter 6 focuses on mineral ingredients such as the five-stone powder and its function for revitalizing the body and illuminating the mind. Chapter 7 deals with taking elixir and its position in medieval Chinese alchemy.

Overall, Healing with Poisons is an exciting and concise book that shows a sophisticated picture of Chinese drugs in the medieval period. Besides the author's promise of further exploring the medical writings of Tang scholars, I also wonder about the contributions of non-Han cultures surrounding China in the medieval period. Numerous Indo-Iranian, Tibetan, and Turkic-Uyghur physicians, diviners, and political and religious agents deal with drugs and potency on the Silk Roads and they greatly changed the landscape of medical knowledge and techniques in China. Is it possible to ask if there was a global network of drugs in the medieval periods? These questions delve beyond the scope of this book. Still, I hope the readers keep in mind that medieval China was very much open to the influence of various cultures beyond Dunhuang and was impacted by neighboring cultures in East Asia.