New book explores how poison shaped medieval Chinese medicine and culture

BUFFALO, N.Y. – The apparent contradiction begins immediately, with the book’s title: “Healing with Poisons.” But in this sweeping examination of poison’s role in medieval Chinese medicine, Yan Liu, an assistant professor of history in the University at Buffalo College of Arts and Sciences, convincingly harmonizes what seem to be wildly different elements in this fascinating look into a subject that has until now largely escaped the attention of researchers.

The book approaches its subject in part through a study of material culture, a practice that has been gaining popularity in scholarly circles, including the history of science. Instead of looking solely within theoretical analysis and textual representations, Liu probes the history of Chinese medicine through its medicinal substances to tell a previously unwritten story of the value poison acquired in Chinese medicine and culture.

There exists a perception of Chinese medicine as natural, safe and benign, especially when compared to the synthetic drugs of Western biomedicine. It’s a notion embraced by both scholars and the general public, but the belief doesn’t survive careful scrutiny, according to Liu.

It’s one of the reasons he began to work 10 years ago on “Healing with Poisons: Potent Medicines in Medieval China,” published June 27 by the University of Washington Press.

“One of the things I want to highlight is breaking this misconceived dichotomy between Western and Chinese medicine,” says Liu. “It’s problematic. Chinese medicine used poisons just like Western medicine.”

But the question of why medical practitioners during China’s formative era of pharmacy (200 to 800 CE) were willing to administer poisons also motivated Liu’s research. If poison was medicinal, then what was medicine?

“People in the past found this idea of using poison to be rational,” says Liu, an expert in medical history. “Hard-to-treat illnesses required powerful strategies, and this included using powerful substances which possessed ‘du,’ a quality found in specific plants, minerals and animals that was thought to have the potential to eliminate ailments.”

Although “du” translates most commonly today as “poison,” its ancient connotation was “potency,” which could mean the ability to both harm and heal. This required a careful approach to treatment since the dangers of using these substances were well understood in medieval China.

In fact, Liu says this duality was common to both medieval China and Europe.

The English word “pharmacology” derives from a Greek term that referred to both remedy and poison. In medieval Europe, a distinction developed between the two qualities, which  did not arise during the same period in China.

“Chinese medicine saw everybody as different, contingent on age, gender and their particular constitution,” explains Liu, who is a biologist as well as a historian. “Every substance also varied greatly depending on how it was prepared and deployed. Context mattered.”

While medieval Europe eventually viewed poisons as distinct from medicines, those substances remained central to healing in pre-modern China, despite the awareness of their risks.

“European medicine prescribed poisons in spite of their toxicity; Chinese medicine, because of it,” writes Liu.

But practice of medieval Chinese medicine was as concerned with prolonging life as treating illness, and again, poisons figured prominently in these dimensions.

“Chinese pharmacology was shaped by the goal of transforming the body into higher states of being and achieving longevity,” says Liu. “Medicine in China thus developed through the interaction of two related but distinct enterprises: the fight against sickness and the quest for ever-enhanced vitality.”

Liu’s book ultimately is not just a matter of exploring the distant past, but also a signpost with contemporary relevance.

“We should think of drugs broadly, as something fluid rather than fixed and definitive. We should go beyond considering each drug carrying a material essence, the so-called ‘active ingredient,’ and pay attention to a variety of factors that could alter its effects,” he says. “How are we using a substance? How are we assigning its value? How might drug-induced responses vary across different individuals and social groups, for example, in the cases of consuming opioids and medical marijuana?”

Medicines and poisons appear to be opposites, Liu acknowledges. But if their intertwined history is paradoxical, then this book contributes to the resolution of that paradox.

“I hope my readers will be left with a more nuanced understanding of this history,” he says.

“Healing with Poisons” is freely available in an open access edition thanks to TOME (Toward an Open Monograph Ecosystem) and the generous support of the University at Buffalo Libraries.