Talks with Man-Li Lin
Prepackaged herbal preparation, NY Tung Ren Tang Health & Healthy Way, 2000. © Erin H. Moriarty
Walking along Flushing’s Main Street, one can’t help but notice the seemingly endless amount of traditional Chinese medicine stores. The movement of Chinese immigrants into Queens has resulted in the arrival of many businesses catering to the cultural traditions of Asian customers. Approximately, 120,000 individuals of Chinese descent live in Queens, 70,000 of which reside in Flushing. According to Claudia Deutsch of The New York Times, “Flushing has turned into a bustling Asian enclave that rivals its much older Manhattan counterpart, if not in size, then certainly in ethnic intensity (Mannheim 1998:12).” The flourishing practice of traditional Chinese medicine in the borough is one such example of this ethnic intensity. According to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM), approximately 41 acupuncturists and/or Chinese herbologist are registered in Flushing (NCCAOM 2001). This number does not even begin to take into account the large number of practitioners operating in the area without a license.
Traditional Chinese medicine is among the oldest medical traditions, rivaled only by India’s tradition of Ayurvedic medicine (Chin & Keng 1992:7). In recorded history, traditional Chinese medicine dates back 2,500 years. Most likely, it predates this period (American Society of Acupuncturists 1996). Today, Chinese medicine continues to be practiced in China. It is also practiced outside of China where ethnic Chinese are represented in the population. Countries such as Taiwan, Hong Kong, Singapore, Malaysia, the Philippines, Thailand, Indonesia, Europe, and the Americas have all seen the importation of Chinese medicine from the mainland. A nationally adapted form of this health care system is practiced to a certain degree in Japan, Korea, and Vietnam (Chin & Keng 1992:10).
The multicultural nature of Chinese medicine is amplified in an ethnically diverse community such as Queens. Although the Chinese community remains the main group served by traditional medicine stores, these stores also serve other Asian communities living in the borough. Throughout the borough there exists pockets of Vietnamese, Filipino, Thai, and Korean communities. All of these cultures have, to some degree, a similar set of traditional illness principles as their Chinese counterparts.
My introduction to traditional Chinese medicine began in Queens when I met Man-Li Lin during the summer of 2000. As an active member in the Flushing community, Man-Li works for the Department of Labor, devotes nights and weekends to teaching English and Chinese within the community, writes language instruction manuals for English and Chinese speakers, and works with the Flushing Jewish Community Council on improving multicultural relations. It was Man-Li who led me through a maze of Cantonese and Mandarin dialects, Chinese characters, and unfamiliar roots, barks, and berries, revealing to me along the way the complexities of traditional Chinese medicine.
Man-Li has seen the number of herbal stores in downtown Flushing rise in the past few years. Shun An Tong Herbal Health Corporation, where I visited with Man-Li, is among the older and more established herbal shops located on Roosevelt Avenue in Flushing. The owner, a Chinese herbologist and acupuncturist, offers in-house traditional examinations. Many of the newer stores do not provide such services.
Patients to Shun An Tong are brought into a small room off the main store to be diagnosed. Diagnosis often involves the reading of a patients “pulse”. As it was explained to me by Man-Li, the doctor is not actually reading the patient’s pulse, as it is understood in Western culture. In Chinese traditional medicine, reading the “pulse” involves the reading of one’s organs rather than the contractions of one’s heart. This “pulse” is read from both wrists. A Chinese medical practitioner may also question the patient about their illness (i.e. appetite and pain), observe the patient’s skin color, texture, redness of nose, and body odor. Specifically, smell often provides information regarding the condition of a patient’s organs such as the stomach, lungs, liver, kidney, bladder, and colon (Chin & Keng 1992:12). The doctor-patient interaction I witnessed at Shun An Tong was extremely brief, only lasting a few minutes.
Barrels of Ginseng, Shun An Tong Health Herbal Corp., 2000. © Erin H. Moriarty
Chinese disease and illness perceptions are embedded within the belief “that two basic and opposing principles, yin and yang, govern the Universe and all phenomena result from their Continuous interplay (Chin & Keng 1992:12).” Yin is represented by femininity, darkness, cold, and water. In contrast, Yang is represented by masculinity, sun, heat, and fire. Individuals may either be yin dominant or yang dominant and therefore must make an effort to balance their yin and yang with the foods they eat and drink. When both yin and yang are in balance a healthy state pervades the body. A disruption of this yin/yang equilibrium will result in illness (Hsu 1993:xiii).
Medicinal herbs are used as the main method of treatment within Chinese medicine and they are employed to bring the body back into a state of balance (Hsu 1993:xiv, American Society of Acupuncturists 1996). Herbs have hot or cold characteristics that are used to manipulate the yin/yang equilibrium. Cooling herbs have sour, bitter and salty tastes, while heating herbs have pungent and sweet tastes. These characteristics affect different parts of the body. Pungent and sweet herbs tend to affect the upper and exterior parts of the body, while cold herbs affect the lower and interior part of the body (Ody 1993:16). Man-Li provided me with an example of this hot/cold duality, one day, while we were standing among barrels of ginseng at Shun An Tong. American ginseng (Panax quinquefolium), under the yin/yang principle, is cold and warm , while Korean ginseng (Panax ginseng) is hot. American ginseng would be used to treat a person who has excessive heat in the body. Therefore, individuals with pimples, which represent excessive heat, should be treated with American ginseng that is cooling. Korean ginseng would not be taken in this example, because it would work to further disrupt the imbalance between hot and cold in the body.
Drawers filled with herbs fr prescriptions, Shun An Tong Health Herbal Corp., 2000. © Erin H. Moriarty
Herbal prescription being filled and packaged, Shun An Tong Health herbal Corp., 2000. © Erin H. Moriarty
Generally, prescriptions are made up of a complex combination of herbs. Although the majority of such herbs are of vegetal origin (including leaves, flowers, twigs, stems, roots, tubers, rhizomes, and bark), they may also be of animal or mineral origin (American Society of Acupuncturists 1996). There are more than 100 different prescriptions -containing three to ten herbs- in general use among Chinese medical practitioners. For example, a combination of ginger, jujube, and licorice is typically used in formulas intended for the promotion of the digestive system (Hsu 1993:xii). Although the quantities and number of ingredients in each prescription may vary among practitioners, as they are changed according to the patient’s physical health, sex, and weight, the main ingredients remains fixed (Chin & Keng 1992:12).
At Shun An Tong, employees will work together to fill the complex prescription provided by
the doctor after a diagnosis. Each of the herbs listed on the prescription are removed from the dozens of drawers behind the counter, weighed, and divided among plates spread out on the counter. Each plate represents one dose of the medicine. Prescriptions are usually composed of a main ingredient and many additional ingredients that serve to flavor, preserve, and color the prescription (Chin & Keng 1992:12). The employees work quickly weighing and dividing, by eye, the many roots, barks, berries, and funguses that are included in the prescription. As Man-Li Lin reminded me, the filling of a prescription is not an exact science.
More often than not, the finished prescription is to be taken as a medicinal tea or “soup” and drank for a period of days by the patient. Herbal medicines are often taken in this manner, as a decoction. Wee Yeow Chin and Hsuan Keng explains the process by which a decoction is made:
…the herbal mixture needs to be boiled over a low fire in an enamel or earthenware container in twice the required amount of water. Once the volume of the mixture has been reduced by half, the decoction is poured off and drunk when sufficiently cooled. The remaining herbal mixture in the container can be reused once (1992:12).
This boiling of the herbal prescription allows for the active drug to be dissolved into the water. In addition, boiling decreases the toxicity of certain herbal medicines by deactivating any toxic substances that may cause adverse side effects (Chin & Keng 1992:12).
Liquid herbal medicines, given as decoctions or “soups”, remain the most common method of administering Chinese medicine for several reasons. This particular method gives the practitioner flexibility when writing a prescription. That is, a prescription can be adapted to the varying needs of each individual patient. Furthermore, liquid formulas tend to be the most potent method of prescribing medicine (American Society of Acupuncturists 1996).
For those patients who do not have the time or knowledge to prepare herbal decoctions at home, several alternatives are available. Traditionally, herbal decoctions are prepared in an earthenware crock (Ody 1993:17). Shun An Tong offers a modern appliance that prepares herbal decoctions with the press of a button. Other alternatives include the many prepackaged herbal tinctures, pill, and powders now widely available. Such alternatives appeal to those who cannot stomach the intensely bitter taste of the liquid decoction.
The herbs sold in traditional Chinese medicine stores often serve a dual purpose, both as medicine and food item. Patients often cook with the herbs available in these stores. Man-Li often cooks pork or chicken with the herbs she buys in these stores and eats
Lilly Bulbs: smoked and non-smoked, Shun An Tong Health Herbal Corp., 2000. © Erin H. Moriarty
the cooked dish like a soup. The many varieties of mushrooms available are a popular grocery item. Lilies are bought to cook with green beans and eaten as a dessert. Lotus seeds are cooked during the summer to make a cooling dessert as well. Pailly W.L. Su, Chairman of the Shun An Tong Group explains further in his book entitled Oriental Herbal Cook Book For Good Health:
Cooking and herbal medicine are two valuable heritages in Chinese tradition. The combination of the two is what we call the ‘herbal diet’. Vegetables are not key elements in a herbal diet. Contrarily, we use herbs, and high protein meats like chicken, pork, and beef…Every Chinese person knows the ingredients for the most common herbal diet: stewed chicken soup with some ginseng, [lyceum] fruit, and red dates. There is no restricted formula for the ingredients…The Chinese might get this formula from their grandma, and their grandma got it from her grandma. (1993:2,6).
Dark Bone Chicken Soup with Wild Ginseng, Clove Duck, Ginkgo and Sweet Rice Ball Soup are among the 44 recipes highlighted in this book. In this sense, Chinese medicine is more holistic than Western medicine in that it is concerned with disease prevention and treatment (Hsu & Peacher 1993:17).
Chinese medicine treats a large range of illnesses and conditions. A sample of which include intestinal flu, the common cold, allergies, gynecological disorders, autoimmune diseases, chronic viral diseases, and degenerative diseases associated with aging. For example, after a pregnancy women will often seek out an herbal prescription to clean out the uterus that is thought to contain “dirty blood”. For men’s health, there are many herbal formulas to choose from that will improve virility. Children are often given reduced dosages of common prescriptions to treat a variety of common childhood conditions including colic, teething, earache, diarrhea, cough, and fever (American Society of Acupuncturists 1996). For the elderly, prepackaged tonics can be purchased to stop the hair from graying.
It is not the explicit aim of Chinese medicine to remedy an illness alone. Rather, its aim is to promote the body’s ability to heal and recover from illness (Hsu 1993:xiii, American Society of Acupuncturists 1996). Chinese medicinal prescriptions work to balance hormones, regulate blood components, and improve immune functions (Hsu 1993:xiv). A female patient to Shun An Tong was seeking treatment for her tongue cancer. As the doctor explained to me, the herbal prescription he prescribed for this patient was not intended to her treat cancer, but rather to boost the woman’s immune system.
It is interesting to note that traces of the American mainstream medical system can be found on these shelves. Dimetapp Elixir and other mainstream commercial drugs, have found their way among the bottles and packages of herbal medicines from China. These mainstream drugs, although seemingly out of place in this environment, cater to the Asian traveler seeking American medicines to bring home to their native country. This mingling of traditional and mainstream medicine testifies to the forever changing face of cultural traditions.
Traditional Chinese medicine stores provide an indispensable service to the many Asian immigrants living in Queens. To these immigrants, who often lack health insurance and an understanding of the English language, such stores serve as a familiar and affordable alternative health care system (Steinhauer 2000:33). It seems that traditional Chinese medicine will continue to flourish in China and abroad as it has for centuries.
American Society of Acupuncturists. 1996. Questions & Answers: About Chinese Herbal Medicine Blue Poppy Press.
Hsu, Hong-yen. 1993. How to Treat Yourself with Chinese Herbs New Canaan, Connecticut: Keats Publishing.
Hsu, Hong-yen and William G. Peacher. 1994. Chinese Herb Medicine and Therapy New Canaan, Connecticut: Keats Publishing.
Lin, Man-Li. Notes from conversation, 2000.
Mannheim, Linda. 1998. Harvesting Our History: A Botanical and Cultural Guide to Queens’ Chinese, Korean, and Latin American Communities Flushing, New York: The Queens Botanical Garden Society,Inc.
National Certification Commission for Acupuncture and Oriental Medicine. 2001. http://www.nccaom.org/query.idc
Ody, Penelope. 1993. The Complete Medicinal Herbal London: Dorling Kindersley Limited.
Shun An Tong Group. 1993. Oriental Herbal Cook Book for Good Health (I) Flushing, New York: Shun An Tong Corp.
Steinhauer, Jennifer. “For Many Immigrants, A Health Care System Underground.” The New York Times, August 20,2000.
Wee, Yeow Chin and Hsuan Keng. 1992. An Illustrated Dictionary of Chinese Medicinal Herbs Sebastopol, California: CRCS Publications.