Healers, Medicines and Everyday Care in Ming China, 1368-1644

Medical care in Ming China involved household decisions, visiting practitioners and the preparation and purchase of medicines. Travelling healers, learned physicians and midwives offered different forms of help, while relatives sought advice and arranged payment. Medical books gathered and debated treatments, but care also depended on personal reputation, local availability and a household’s resources.

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Practitioners ranged from itinerant healers to court physicians

Li Shizhen’s family illustrates the range of work associated with medicine. His grandfather travelled between communities offering treatment, carrying pills and acupuncture needles and announcing his arrival with a bell. His father was a physician and scholar who wrote medical works. These were distinct social positions: the travelling doctor served clients on the move, while Li’s father combined medical practice with a more scholarly identity.

Li learned medicine through his father and treated patients himself. He also worked at the court of the Prince of Chu and briefly held a position at the Imperial Medical Institute in Beijing. There he had access to medical books; he later returned to practice as a doctor.

Other parts of Li’s work depended on knowledge outside formal medical libraries. In gathering material for his writing, he consulted farmers, fishermen, hunters and people who cultivated medicinal plants. Their observations and local remedies helped him compare written descriptions with substances and practices encountered in particular places.

Patients, fees and household resources

A sick person’s relatives could send for a practitioner and provide the money or goods needed for treatment. The late Ming novel Jin Ping Mei portrays medical visits as negotiations involving reputation, urgency and ability to pay. Its midwives receive silver, cloth or clothing; in a poorer household, a man without ready cash offers a silver hairpin. These scenes make payment in possessions and the work of summoning help visible, even though a novel is not a ledger of actual fees.

Medical writers recognised that poverty affected access. In his 1617 work on external medicine, Chen Shigong urged practitioners to waive fees for poor patients and wandering monks, help hungry patients obtain food and avoid substituting inferior ingredients for costly materials supplied by a family. These demands identify pressures within paid care and the behaviour he wanted physicians to adopt.

Individual practitioners also offered charitable treatment. A late Ming account praised Jin Lan’s father for visiting sick children despite cold or heat and seeking to help poor families instead of putting profit first. Such care depended on a doctor’s time and resources, alongside whatever support neighbours or benefactors could provide.

Medicines depended on identifying and preparing materials

The bencao tradition, or materia medica, described substances believed to have medicinal uses. It included plants, animals and minerals, as well as materials such as water, earth and fire. A substance’s name and appearance mattered because different names could refer to the same material, or similar names to different ones. Information about where something grew or was found, when it was gathered and which part was used helped distinguish one material from another.

Preparation was also part of medical knowledge. Entries in Li’s Bencao gangmu , or Compendium of Materia Medica , recorded processes such as drying, removing parts, heating and grinding materials. They also described recipes and their forms. These records show that practitioners treated preparation as relevant to a substance’s qualities and use.

Medical explanations combined observation with concepts such as qi , the vital influences through which body and environment were understood to interact, and the complementary forces of yin and yang. Some writers used correspondences between substances, bodily organs and features of the natural world to explain a remedy’s effects.

Li Shizhen brought clinical work into a major medical compilation

Li spent decades collecting and reorganizing medical knowledge. He consulted hundreds of earlier works as well as histories, poems and other writings, travelled to gather information and drew on his own work as a physician. He completed a draft of the Bencao gangmu in 1578. The book was printed in Nanjing in 1596, three years after his death.

The compendium arranged about 1,900 substances in 16 divisions and 60 categories. Its entries gathered information on names, origins, appearance, preparation, qualities and proposed uses, alongside quotations from earlier writers and recipes. The work included about 11,000 prescriptions and more than 1,100 illustrations. Rather than simply repeating earlier classifications, Li corrected some identifications and added observations from his own investigations.

Li compared earlier descriptions with his own observations and sometimes preserved disagreements rather than resolving them. His patient accounts linked bedside decisions to arguments about particular substances. Taking a pulse, asking about symptoms and considering diet or previous treatment helped a physician construct an explanation of illness before selecting a prescription.

Medical ideas remained diverse

Drug-based treatment was not the only approach described in Ming medical writing. Acupuncture and moxibustion, the burning of prepared mugwort near or on selected points of the body, also belonged to medical work. Ritual therapies for spirit-related causes of illness had a place in medical institutions in earlier centuries and remained present among the population after their teaching at court ended around 1570. Practitioners inherited several approaches to illness and debated their explanations and methods.

An epidemic prompted a late Ming account of illness

In 1641, an epidemic in the home region of Wu Youxing caused many deaths. Wu wrote the Wenyilun, or Treatise on Pestilence, in 1642. He argued that the illness differed from conditions explained through wind, cold, heat or dampness. In his account, an unusual influence entered through the mouth and nose and lodged in a region between the body’s exterior and interior.

Wu described a distinctive, transmissible cause of epidemic illness entering through the mouth and nose. This challenged explanations that treated the outbreak simply as an ordinary cold-damage disorder. He opposed some warming medicines and advocated treatments he classified as bitter and cold. His argument belongs to seventeenth-century medical reasoning: it identified an epidemic problem without the later laboratory concepts of bacteria and viruses.

For the wider setting, see Daily Life in Ming China: Households, Work, and Consumption.