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Table of Contents
Year : 2021  |  Volume : 4  |  Issue : 3  |  Page : 141-147

Approaches and perspectives of the westward spread of traditional Chinese medicine: A case study of the Radicis Chynae

Department of History, Fudan University, Shanghai 200433, China

Date of Submission20-Apr-2021
Date of Acceptance03-Aug-2021
Date of Web Publication30-Sep-2021

Correspondence Address:
Prof. Xi Gao
Department of History, Fudan University, Shanghai 200433
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/CMAC.CMAC_36_21

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Some Western scholars have re-examined the concept of “Chinese medicine” and its knowledge system under the influence of global history research methods in recent years, in an attempt to understand the factors that led to the spread of Chinese medicine around the world, and what kind of Chinese medicine is constituted outside of China. Thus, researchers have studied the initial stage of traditional Chinese medicine (TCM)'s entry into the western world, tracing its roots and observing new knowledge systems formed in the process of cross-cultural communication. Responding to the research of Western scholars, this paper studies the Radicis Chynae (《中国根书简》 Letters on Chinese Root), a monograph written by Andreas Vesalius, a famous European anatomist who lived in the 16th century. The author of this article examined the understanding and interpretation of Chinese medicine by the European intelligentsia from 16th to 19th century, investigated the influence of the westward spread of TCM on the scientific revolution and medical progress in Europe, and analyzed its relationship with the rise of Sinology in Europe. This article discusses the knowledge interaction between Chinese medicine and the formation of modern European medicine from the perspective of global history and cross-culture.

Keywords: Andreas Vesalius, Charles V, China root, Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae), westward spread of traditional Chinese medicine

How to cite this article:
Gao X. Approaches and perspectives of the westward spread of traditional Chinese medicine: A case study of the Radicis Chynae. Chin Med Cult 2021;4:141-7

How to cite this URL:
Gao X. Approaches and perspectives of the westward spread of traditional Chinese medicine: A case study of the Radicis Chynae. Chin Med Cult [serial online] 2021 [cited 2021 Oct 26];4:141-7. Available from: https://www.cmaconweb.org/text.asp?2021/4/3/141/327163

  Introduction: New Trends in Research on the Westward Spread of Traditional Chinese Medicine Top

Research interest in Chinese medicine spread to the West has taken two paths. First, at the theoretical level, European sinologists, scientists, and anthropologists have used traditional Chinese medicine (TCM) scriptures, materia medica monographs, folk medical formularies, and translations of TCM classics through which to study the theoretical and cultural aspects of TCM. Some of these scholars are also translators, and their researches have revealed cultural understandings of TCM from the western perspective. Second, on a practical level, European doctors have examined the efficacy of TCM and its cultural characteristics through patients' experiences, particularly focusing on acupuncture treatment and technical instructions. However, Chinese medicine has typically been regarded as a heterogeneous field in the West, whether through academic research or the promotion of foreign doctors in practicing TCM. Although TCM has been applied in the West for almost 500 years, it remains largely independent of the Western culture, with its theories and treatment methods treated as distinct from those of Western medicine.

In recent years, some western scholars have re-examined the concept of “Chinese medicine” and its knowledge system under the influence of global history research methods, in an attempt to understand the factors that led to the spread of Chinese medicine around the world, and what kind of Chinese medicine is constituted outside of China.[1] Thus, researchers have studied the initial stage of TCM's entry into the western world, tracing its roots and observing new knowledge systems formed in the process of cross-cultural communication. Two of the most influential papers on this topic are co-written by Marta Hanson (韩嵩) and Gianna Poma (波玛塔), medical professors at Johns Hopkins University in the United States. The authors' first paper examined a book translated by the Polish missionary Michal Boym (卜弥格 1612–1659) in the 17th century. The second paper was a study of the Latin and French translations of Tu Zhu Mai Jue Bian Zhen (《图注脈诀辨真》 Illustrated Differentiations of The Pulse).[2],[3] In their studies, Hanson and Poma considered medical prescriptions as a unique type of knowledge and examined how Boym and other European writers translated this specialized knowledge from Chinese into Latin and French. According to Hanson and Poma, Boym noted that the textual structure pattern of the Chinese medical and its formula shared a common feature with the text of premodern European medical prescriptions, which were both based on doctors' experience.[2] This notion prompted translators like Boym to attempt to find other commonalities between European medicine and TCM. Hanson believed that these translations in the 16th century indicated an attempt to construct a textual format that could be shared by the intelligentsia in eastern and western societies and to enable the transfer of knowledge between the two cultures.[2] The study of intercultural communication of medical knowledge constitutes a new research approach, potentially leading the study of Chinese medical history in Western countries into a new paradigm.

In terms of the domestic research in China, in 2018 the National Social Science Found of China launched a research project to support less popular disciplines that have received little attention, including the “Study on the westward spread of Chinese medicine by European scientists and sinologists before the 19th century.”

This study examined the understanding and interpretation of Chinese medicine by the European intelligentsia from the 16th to 19th century from the perspective of global history, investigated the influence of the westward spread of TCM on the scientific revolution and medical progress in Europe, and analyzed its relationship with the rise of sinology in Europe. At present, Chinese researchers and international scholars agree that after the Age of Exploration in the late 15th and early 16th centuries, the eastern and western hemispheres were connected by frequent sea traffic, and the world entered the first era of globalization.[4] At that time, the theoretical aspects of TCM as well as its diagnostic and treatment methodologies began to find its way into many parts of the world. However, Western scholars tended to focus more on medical texts introduced to Europe by Jesuit missionaries after the 17th century. Chinese scholars, however, noted the influence of Chinese medicine knowledge on European society and doctors during the Renaissance in the 16th century as well. A typical example was the “Chinese root”: Tu Fu Ling (土茯苓Rhizoma Smilacis Glabrae), which was referred to as the “magic medicine” in Europe.

  Charles V Firmly Believed in Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae), the Chinese Root Top

The prevalence of Chinese root in 16th century Europe was related to two important historical figures: Charles V (1500–1558), Emperor of the Holy Roman Empire, and his imperial physician, Andreas Vesalius (1514–1564), a Belgian anatomist.

Gout and syphilis were widespread diseases at that time, and Charles V had suffered from gout for many years. In 1546, Vesalius followed Charles V to Brussels, where his disease relapsed. Together with other imperial physicians, Vesalius was involved in the treatment of Charles V. However, the emperor did not believe the therapeutic methods provided by his team were effective and sought a panacea. Charles V learned of an exotic herb named Chinese root, which was used for the treatment of gout, calculi and syphilis. Syphilis, an infectious disease that suddenly appeared in Europe in the early 16th century, was mainly transmitted among royalty and other elites. For European doctors, syphilis was a new infectious disease and there was no cure for it. The only method was the traditional mercury inunctions, which, if not properly administered, caused patients to “become poisoned, their noses and feet festered, and turned into chronic diseases that would last a lifetime.”[5] Syphilis was stigmatized because of its severe symptoms and peculiarities regarding the way the disease was transmitted, and it involved a heavy moral burden for patients. Later, doctors used herbal medicines such as Yu Cang Mu (愈疮木 Guaiacum officinale) and Ba Qia (菝葜 Smilax china) imported from North America to treat syphilis. Some doctors decocted Chinese root brought back from the East by Portuguese and Spanish traders. Both treatments could effectively deal with syphilis.

The use of Chinese root spread in Europe for nearly 10 years and gained a positive reputation. At that time, Spanish nobles recommended this treatment to Charles V as a more effective medicine than the Yu Cang Mu (愈疮木 Guaiacum officinale) used by the imperial physicians. Charles V had high hopes for treatment with Chinese root and was convinced of its effectiveness. According to historical records, on February 10, 1546, Charles V ordered Vesalius to make a decoction according to the court medical regulations and drank it immediately. Moreover, Charles V also personally issued a drug license, which enabled the use of Chinese root widely available via proper regulated channels.[6]

Chinese root is translated from the medical term in Latin Radicis Chynae, and its scientific name in Chinese is Tu Fu Ling (土茯苓Rhizoma Smilacis Glabrae). This Chinese name first appeared in the West in 1653, when the Polish missionary Boym recorded it in Chinese and illustrated it in his Flora Sinensis (《中国植物志》 Flora of China): “Fo lim (Poria).” In this book, Boym explained: “the Portuguese call the Chinese root Pao de Cina, Europeans call it China vocant and Chinese call it Pe-fo-lim (白茯苓White Poria).”[7] In Chinese herbal medicine, Bai Fu Ling (白茯苓 White Poria) belongs to the Fu Ling (茯苓 Poria) family. However, Bai Fu Ling (白茯苓 White Poria) and Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) are two different medicines. The Chinese root used for treating syphilis was actually Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae). Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) appeared very late in Chinese medical texts and materia medica monographs. Officially it first appeared in 1522. Yu Bian (俞弁), a doctor from Suzhou (苏州), mentioned this treatment in the “Bi Xie” chapter of his medical history book Xu Yi Shuo (《续医说·萆薢》Supplement to Treatise on Medicine “Yam Rhizome”), noting that it was used for treating syphilis.

”Tu Fu Ling grew in the valley of Zhending (真定), and Jingchu district (荆楚 in what is now Hubei province) produces it nowadays. There are two kinds of them, one of which is nonprickly and soft, whereas the other is prickly, white, and hard. The former is superior to the latter. It is called Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae), alias Xian Yi Liang (仙遗粮 Leftover Grain by the Immortal), and is commonly known as Leng Fan Tuan (cold rice balls).”[6]

There are many different names in Chinese for Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) aside from Bi Xie (萆薢 Yam Rhizome). According to Li Shizhen (李时珍)'s Ben Cao Gang Mu (《本草纲目》 Grand Compendium of Materia Medica), some other names include Xian Yi Liang (仙遗粮), Yu Yu Liang (禹余粮 Limonitum) and Leng Fan Tuan (冷饭团). Some of these names are homonymous, i.e., two things having the same name, while some are synonymous, i.e., same thing but different names. Bi Xie (萆薢 Yam Rhizome), Xian Yi Liang (仙遗粮) and Yu Yu Liang (禹余粮 Limonitum) were found in medical texts and materia medica monographs of the Han and Jin dynasties. They were also mentioned in Huang Di Nei Jing (《黄帝内经》Huangdi's Internal Classic), Zhang Zhongjing (张仲景)'s Shang Han Lun (《伤寒论》 Treatise on Cold Damage), Wang Shuhe (王叔和)'s Mai Jing (《脉经》 The Pulse Classic) and Tao Hongjing (陶弘景)'s Shen Nong Ben Cao Jing Ji Zhu (《神农本草经集注》 Collected Commentaries on Shen Nong's Classic of the Materia Medica). Ben Cao Yuan Ming Bao (《本草元命苞》 Complete Compendium of Materia Medica) was a book written in 1331 by Shang Congshan (尚从善) in the Yuan dynasty. This text mentioned that “Bi Xie” could be used to treat “malignant sores.”[8] Thus, it is unsurprising that Boym confused the names of these medicines. It was not until the late 18th and early 19th centuries that westerners came to recognize Chinese root as “Tu Fu Ling,” while traders in the East and West preferred to call it “Leng Fan Tuan.”[9]

In 1525, Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) was introduced to Europe to promote perspiration and urination,[10] which fit the humoral theory that was popular in the West at the time. In 1535, it was used as a specific medicine for treating syphilis in Europe,[9] albeit awareness was limited among mainstream doctors, as they were reluctant to accept a new drug originated from foreign place. There was no mentioning of Tu Fu Ling in the European pharmaceutical works during the same historical period. When the royal physicians and medical advisers of dignitaries in European countries learned that Chinese root had been favored and approved of by the emperor, the medicine began to be in great demand, and Vesalius, the physician of Charles V, was consulted about its preparation method and treatment plan.[9]

Vesalius was born into a family of doctors in Brussels. His great-grandfather taught medicine at the Katholieke Universiteit Leuven (Catholic University of Louvain) and his grandfather was the royal physician for Emperor Maximilian I, of the Holy Roman Empire. His father Anders Van Wesel was Maximilian's apothecary and later became Charles V's personal attendant. Vesalius' father encouraged him to continue the family tradition of medical practice. In 1528, he studied arts in the Catholic University of Louvain. In 1533, he went to France to study medicine at the Université de Paris (University of Paris). There he studied under the Renaissance humanist German doctor Johann Winter von Andernach (1505–1574) and the famous French anatomist Jacobus Sylvious (1478–1555). As a student, Vesalius showed a deep interest in anatomy and often visited the Le cimetière des Innocents (Holy Innocents Cemetery) in Paris to study the human skeletal system. In 1536, he moved to Venice and studied at the Università di Padova (University of Padua) in Italy. After graduating with a doctorate degree in 1537, he stayed in Padua to teach surgery and anatomy. At this time, he was invited to lecture on anatomy at the Alma mater studiorum-Università di Bologna (University of Bologna) and Università di Pisa (University of Pisa). All professors and students of anatomy in Europe at that time had studied Galen's theory, which was illustrated by using animal anatomy. However, no one had attempted to empirically test Galen's theory. Vesalius taught students differently. He demonstrated the operations himself using anatomical tools, while the students gathered around the table to watch and learn. Vesalius considered face-to-face hands-on teaching to be the only reliable way of teaching, representing a major breakthrough in medieval anatomy teaching and practice. His book De Humani Corporis Fabrica Libn Septem (《人体之构造》 On the Fabric of the Human Body in Seven Books) emerged from this background.

Vesalius was only 28 years old when De Humani Corporis Fabrica Libn Septem was published. The book was immediately welcomed by medical students. By openly disavowing Galenism, however, Vesalius threatened the Galenists in medical schools across Europe. Among them, the famous anatomist Sylvious, Vesalius' anatomy tutor at the University of Paris, was particularly angry. He criticized Vesalius' remarks in class as “offensive” and “pompous” and accused him of “disloyalty” for questioning Galenism. He also used his academic influence to alienate friends and colleagues from Vesalius. In the face of attacks from the authorities, the young Vesalius burned his manuscripts and the materials he had collected for research and left the university. Under the mediation of his father, the royal pharmacist, he became the imperial physician for Charles V, the Holy Roman Emperor. Nevertheless, European anatomists never stopped attacking him.

On June 13, 1546, Vesalius wrote a 60-page letter to Dominus, the royal physician of Belgium monarchy on a delicate parchment. In the letter, he fully introduced his understanding and use of Chinese root, including the screening of academic names, the history of the medicine in Europe, its botanical characteristics and properties, processing, therapeutic regime, and comparative study with other related drugs. Combined with his own practical experience and clinical cases, Vesalius performed a scientific analysis of the curative effects of Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae).

  Knowledge of Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) in Radicis Chynae (《中国根书简》 Letters on Chinese Root) Top

Vesalius' writing on Chinese root is more of a rigorous scientific treatise than a letter. He successfully demonstrated how to observe and study “new things” scientifically, and how to evaluate the effects and value of new drugs objectively.

In 1536, Vesalius witnessed the introduction of Chinese root and was aware of the enthusiasm and expectations of local doctors for the medicine while he was a clinical intern in Venice. According to Vesalius' research, Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) had a variety of names in Europe, namely “Chyna” “Chynna” “Cyna” “Echina” or “Achyna.” Vesalius called it “Chynæ” because the Chinese root popular in Europe in the 16th century was brought back by Portuguese traders by sea, hence Europeans associated the medicine with the sea and seafarers and believed that the plant grew on the beach. In contrast, Vesalius believed that Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) may have come from India or the New World of America, based on the trade routes of Europe. In the letter, Vesalius described the shape of the Chinese root in detail: Huge, rough, jagged fragments, woody-like texture, and “looks like fungi.” Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) is a tuberous root, and Vesalius explained that the “fresh root is juicy” but became dry and worm infested after been shipped to Europe. Vesalius understood that the Chinese root (Tu Fu Ling) was similar to but slightly different from, the American Ba Qia. This confusion was similar to that between Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae), Ba Qia and Bi Xie (萆薢 Rhizoma Dioscoreae Hypoglaucae) in the 16th century in the Chinese materia medica.

The most important part of Vesalius' letter was a description on how to process the Chinese root, and Vesalius had a copy of the processing method written in Italian and a fragment of the recipe written in Spanish, which he translated into Latin and recommended it to his friend.

”Take 24 ounces of Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) daily and divide it into 24 parts to make a fresh decoction. The medicinal materials should be prepared one day in advance. Cut it into small pieces, as small as possible, and then soak these pieces with a little water until the next day before boiling them. Put Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) together with its soaking water into a new pot, add three pots of spring water, and boil them until a third of the water has evaporated. Ensure the decoction does not overflow from the pot and then put the cover on the pot to prevent the decoction from overrunning. Once the decoction is fully cooked, remove it from the fire or oven and cover it with a large towel to keep it warm. The fresh decoction should be made every day, or it will turn sour over time. If the medication does not work, add 1/2 ounce celery root to one serving of water and cook with the Chinese root.”

A purgation will be carried out at the beginning, middle, and end on the advice of the physician, who will take into account the condition of the patient. Twenty-four ounces of the root should be divided into twenty-four parts to make a fresh decoction every day. If you want to boil the root tomorrow, then cut it into small pieces on the previous day, making the pieces as small as possible. And after that, pour a little water into the pot together with the pieces, leaving them to be soaked until the next day. Then put the infusion of the root and its water into a new pot and pour three pitchers of spring water into it and let it boil until a third of it has evaporated. The pot should be of a size to ensure that the boiling decoction does not overflow and it should always be covered so its potency does not escape. Once cooked and removed from the fire, it needs to be covered with large towels lest it cool off completely, and it needs to be made fresh every day because otherwise, it would become acid. If the patient is unable to have physical benefit, add to each preparation of this water half of an eighth ounce of celery root cooked with this China root.[9]

European doctors developed strict protocols regarding the way in which Chinese root should be taken. In addition, doctors tailored individualized treatments for different patients. The process of treatment was divided into three stages. Before taking the medicine, patients were instructed to clear their bowels. During the 24 days of the first stage, patients took the medicine with an empty stomach and lay in bed for 2 h in the morning for sweating while avoiding wind. The dosage of medicine was reduced in the second stage and the patient should continue with the medicine for another 8 days. If the treatment was not effective, the patient should be given the medicine for another 24 days. The third stage was to clear the bowels. If patients with syphilis had ulcerations, or pain caused by gout, a towel soaked with medicament could be applied to the affected parts, or cleaned the sores with medicament. During medication, patients were instructed to observe various rules, including many diet and lifestyle taboos such as avoiding sexual activity, staying away from seafood, refraining from going outdoors, performing appropriate exercise indoors, keep warm when going out, and applying a towel soaked with medicine after returning to the house.

Vesalius' processing and administration methods for Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) were similar to current treatment principles of Chinese medicine. However, there is no direct historical evidence suggesting that western medicine at that time was influenced by Chinese medicine. Western medicine in Europe in the 16th century was in the phase of the classical humoral theory, so the application of herbal medicine and medical use of perspiration and diuresis were largely in line with the Western medical philosophy of that era. However, from the perspective of materia medica monographs and doctors' experience, the processing and application of Chinese root as a medicinal material from an exotic region represented new methodology and technology. Doctors at the time had mixed opinions about the effects of treatment with Chinese root. In his letter, Vesalius addressed the efficacy of Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) by describing two cases of failure he witnessed in Antwerp. He wrote that the patients were too ill to be treated and that the failure of treatment was not caused by Tu Fu Ling.

Vesalius' letter provided a comprehensive explanation regarding the clinical application of Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) from a scientific point of view, akin to the clinical guidance and instructions for treating with Chinese root. Handwritten copies of the letter were soon circulating among Belgian medical students, and Vesalius' younger brother obtained a copy from a friend and sent it to a Swiss publisher who published its epistles in August 1546. Although the section on “Chinese root” only accounted for one-fifth of the book, the main content of this book was Vesalius' explanation of his thoughts on De Humani Corporis Fabrica Libn Septem, as well as refutation of Sylvius' claim that Galen was infallible. The book was eventually published with the title Radicis Chynae [Figure 1]. Why did Vesalius put the two unrelated parts together and choose “Chinese root” as the title of his book? Vesalius' younger brother gave an answer to this question in the preface:
Figure 1: Cover of the Radicis Chynae published in 1547

Click here to view

”This book included a new drug 'Chinese root,' especially its processing, and other drugs along with explanations. It makes it easy for truth-seekers to think about the teaching of Galen. This famous anatomist and professor did not dissect people but described many differences between humans and animals.”

For in addition to the use of new remedies, especially the method of administering the decoction of China root (which I see is given to those who are most devoted to your glory), and other medicines that are not unpleasant to know and are included in this epistle, reasons are added as well by which a devotee of truth can consider that Galen, easily the foremost of professors of anatomy, did not dissect humans but described other animals differing in many places from humans.[9]

The “pursuit of truth” is the core value of Radicis Chynæ, and it is clear that Vesalius sought to justify the creation of his own new theory against Galen's classical theories by examining Chinese root as a new drug treatment. As commented by later researchers on the Radicis Chynæ:

”He discusses the Chinese root and at the same time attacks Galen in the same letter, dealing with both issues inspired by his distrust of authority and his belief in scientific explanation.”

If it is due to the accident that his discussion of China-root is comprised in the same letter with a renewal of his onslaught on Galen, the juxtaposition is still a happy one. The treatment of both topics is inspired by the same mood, distrust of authority, and renewed hope in the possibility of a scientific understanding of the mechanism of the human body.[11]

Vesalius was a leader in the transformation of western medicine from classical theory to modern scientific approach. The Radicis Chynae recorded academic disputes between new scientific medicine and classical medicine, as well as academic disputes between Galen, Galen's disciples led by Sylvius and himself. In this direct contest between the “new” and “old,” the new drug treatment with Chinese root played a guiding role and catalyzed the emergence of new scientific ideas.

The Radicis Chynae is a clear demonstration of scientific methodology and thinking. It is also an example on how how to criticize old theories and develop new ideas. First, Vesalius demonstrated scientific attitudes and cognition. Vesalius understood that the western demand for Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) resulted from the emperor's endorsement and pointed out that Charles V made his own decision to take “Chinese root,” which was not based on his doctor's advice. Vesalius implied that the curative effects of Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae) touted by Charles V were based entirely on his personal experience and did not represent a doctor's professional opinion. His criticism was directed at doctors who jumped on the bandwagon, “these pestilential men are so dependent upon calumny that if they notice that someone knows things they do not, they admit that he is indeed an expect about those things, but they deny he is doctor.”[9] Vesalius disliked both doctors' adherence to power and blind faith in academic authority. Secondly, Vesalius re-examined the content of classical learning using an observational and empirical approach. In De Humani Corporis Fabrica Libn Septem, Vesalius realized that he had been “blind” to Galen's conclusions at first and that his knowledge and discovery of scientific truth had been built up by observing, dissecting with his own hands, drawing accurately while reading and comparing his results with Galen's writings. Vesalius explained the true effects of Chinese root through empirical methods of investigation, analysis, and comparison. He insisted on the anatomy of the human body, describing what he had seen with his own eyes and criticizing Galen's factual mistakes. Thirdly, although the European medical community had long believed Hippocrates' view that “anatomy is the foundation of medicine,” Vesalius was the first to explain its relevance to clinical medicine. Fourthly, Vesalius explained how to treat “new” knowledge, methods, and drugs. Vesalius wrote in the letter that he was the first young man to challenge Galenism through his investigation of the truth, and he believed that his contemporaries would be proud of the younger generation for surpassing the older.

  Contributions of the Radicis Chynae to the Westward Spread of Traditional Chinese Medicine Top

One thousand five hundred and forty-three was a milestone in human history. In May of that year, Copernicus' De Revolutionibus Orbium Coelestium (《天体运行论》 Revolutions of the Heavenly Bodies) was published in Nuremberg, Germany, and in June, Vesalius' De Humani Corporis Fabrica Libn Septem (《人体之构造》On the Fabric of the Human Body in Seven Books) was published in Basel, Switzerland. Vesalius' name may be unfamiliar to Chinese readers. Before the publication of De Humani Corporis Fabrica Libn Septem, the knowledge of European intelligentsia regarding the human body was largely derived from De Anatomicis Administrationibus (《解剖学》 On Anatomical Procedures), written by Roman doctor Claudius Galenus (129–199) in the first century AD. Galen's anatomical thought, constructed based on animal anatomy, was regarded as ideal by medieval doctors and could not be questioned. The European medical community canonized Galen as a “medical sage,” and most of Vesalius' contemporaries were Galen's followers. Vesalius' work focused on human anatomy and observations of living bodies, criticizing the errors in Galen's theory and creating exquisite images of the human body to describe the normal body structure. If De Revolutionibus Orbium Coelestium enabled people to see the world differently and repositioned themselves in the universe, then De Humani Corporis Fabrica Libn Septem revised people's perception of their own bodies, helping them understand who they really were and completely overturning Galen's dominant theory in an innovative way. Western historians have proposed that the publication of these two works paved the way for the scientific revolution in Europe. In 1543, European scientific knowledge emerged from the Middle Ages. In the history of western science, Vesalius is regarded as the figure who ended the dominance of western classical medicine and is considered to be a scientist of equal standing to Copernicus in terms of their academic contributions.

Although Chinese scholars typically know little about Vesalius' scientific work on Tu Fu Ling (土茯苓 Rhizoma Smilacis Glabrae), the Radicis Chynae is the first and only western monograph named after this medicine. In 1546, the first edition in Latin was published in Basel, Switzerland. From 1546 to 2015, 13 editions of this work were published, including versions in Latin, French, Dutch, German, Spanish, and English. These included both complete translations and fragments comprising only the first part of the text. Interestingly, most reprints and translations included only the section on Chinese root, with no anatomical content. In the 17th and 18th centuries, translations of the Radicis Chynae were used to guide the treatment of syphilis. If Vesalius' De Humani Corporis Fabrica Libn Septem was a challenge to the classical medicine of the Galen school, then through the analysis and research of Chinese root, the Radicis Chynae deepened the criticism of Galen's anatomy, creating the methods and approaches of medical science research and leading western medicine from the classical stage into the new era of the Renaissance.

In the past, China's research on the westward spread of Chinese medicine, science and technology focused on missionaries' letters and translated texts. The discovery of the Radicis Chynae, however, reveals the fact that there is not only one route for the transmission of Chinese medicine to the West and that the spread has not been limited to the influence of those sinologists with fluent competence in Chinese. This can inspire us to expand our research horizons by going back to the 16th century and discovering more information about medical, scientific or cultural exchanges between China and foreign countries from the writings and letters of European scientists during the Renaissance, and to explore the knowledge exchange between Chinese medicine and the formation of modern European medicine from an intercultural perspective. Cook writes that:

”For many centuries Chinese medicine has been a presence in the lives of people well beyond its homelands. The period that first saw sustained commerce across the Atlantic and Pacific oceans also witnessed a widening interest in forms of medicine emanating from China. The wealth and prestige of the celestial empire affected distant places, and as information and rumor about the customs to be found in circulation there, people living elsewhere sometimes responded by adapting in their own ways ideas, practices and medicinal identified with its heritage. To put it another way, some elements of the medical ways of China made a difference elsewhere and even circled back. Of course, in the process of translating ideas, practices, and substances among different cultures transformations of meanings were frequent. This thesis has explored how those multivalent processes of call and response occurred and has noticed some of the large effects produced, suggesting that attempts to slide over or through cultural boundaries, even when common understanding is not fully in evidence, may prompt changes.”[1]

Western historians have begun to extend their research in this field, and we should also join the bandwagon instead of just eagerly anticipating the results.

Translator: Guo-Qi Shi (石国旗).

Ethical approval

The author has no ethical conflicts to disclose.


This study was financed by the grant from the National Research Project for Less Popular Disciplines of China.

Conflicts of interest

Xi Gao is an editorial board member of Chinese Medicine and Culture. The article was subject to the journal's standard procedures, with peer review handled independently of this editorial board member and his research groups.

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