Pills, Teas, and Songs: Stories of Medicine around the World

By Debby Nguyen

According to the Pew Research Center, half of the general American public has tried alternative medicine. Nguyen dares to ask, how often do people do so without understanding the culture where those medicines originated? 

Pills, Teas, and Song

• Language: English
• Publisher: New Degree Press
• Release date: May 14, 2021
• ISBN: 9781637301135

Book preview

Introduction 

Home to me isn’t a place, it’s where my family and the people I love are. Home is 8,754 miles away—the distance between Boston and Saigon. Sometimes when the apartment gets quiet at night, I think about our family dinners, how my grandparents exercise at five o’clock every morning, and how, during car rides, my parents would sometimes tell me about their childhood in 1980s Vietnam.

As I write this introduction, the United States is entering its sixth month of struggling to control the COVID-19 pandemic, and I’m entering my third month of living on my own. I have always believed that my greatest strengths are independence and determination, traits I believed would allow me to weather any crisis unscathed. I have always told myself I would rarely, if ever, feel homesick. To an extent, that has been true, and I’ve enjoyed finding my own apartment to sublet, shopping for groceries, cooking for myself, and learning how to adult.

It would be dishonest to say I haven’t missed home. When I miss home and its sights, smells, and sounds, I like to go to Asian supermarkets. Grocery shopping is no longer a leisurely activity in a pandemic, but I find myself looking forward to my weekly trips to Hong Kong Supermarket in Allston or Jai Ho Supermarket in Boston’s Chinatown. These supermarkets are both quite old, and you can smell them before you enter the door—the distinct smell of freezers mixed with a galore of meat, fruits, and vegetables. Although I like both supermarkets, Jai Ho has a certain homey feeling, with its cramped aisles packed with imported teas from China, special sauces from Vietnam, candies from Japan, and other goods you cannot find anywhere else in Boston yet are staples in Asian households.

Another special feature Jai Ho has is a small pharmacy area, positioned right where you first enter. Its clear display cabinets are full of different Asian medicines you won’t find in a CVS or Walgreens. One day, when I had finished shopping for groceries and was about to head out, something inside told me to take a look at Jai Ho’s pharmacy counter. I crouched down to see the numerous big and small boxes of medicine with Chinese, Japanese, and English writing on them as well as distinctively decorative packaging designs with rich colors and detailed floral patterns.

The train ride back felt faster than usual, and I felt a strong longing for home for the first time in a while. Being in an Asian supermarket has always made me feel like I’m being transported back home, but standing at the pharmacy counter that day was a different experience.

I thought about my dad’s stories about my grandpa, who practiced traditional Vietnamese medicine and helped treat thousands of patients during his lifetime. As a kid, I used to love spending time at my grandparents’ house where my grandpa would see patients on the first floor and store his medicines on the second floor. I loved the big bedroom on the second floor where he kept piles of flat bamboo baskets containing various types of herbs, pellets, and powders for various diseases stacked to the ceiling.

My dad told me my grandpa’s specialty was treating ailments related to the kidneys. My older cousins were always visiting the house as well, and we would help Grandpa package medicine into little baggies with instructions handwritten with black markers. Count six pellets, and seal the bag carefully! an older cousin would remind me. I would meticulously seal the bags and toss finished packages into a separate bamboo basket.

We would do this for hours. I loved the calm and repetitive nature of the job. After my grandfather passed away, the second floor of the house became more dusty and less lively. His old patients stopped coming, and there was no more medicine to be packaged. I visited my grandparents’ house less and less, and with that, days spent on their second floor became memories.

The pharmacy at Jai Ho reminded me of home. It was a small pocket of nostalgia in a modern city full of CVS and Walgreens pharmacies. I felt this tension between the old and the new. I feel a deep connection to traditional medicine as it reminds me of family and home, yet I am following my passion of studying pharmacy to understand Western medicine and its applications. My story is not uncommon; many immigrants come to the United States and work in health care practicing modern medicine and, at the same time, bring with them home remedies and traditional medicinal practices.

According to the IQVIA Institute for Human Data Science 2019 report, the global pharmaceutical market will exceed $1.5 trillion by 2023.¹ The United States remains the largest pharmaceutical market globally, generating 40.4 percent of total revenues worldwide, while China is the second largest market with its sales share of 11.1 percent.² Americans take more pills today than at any other time in recent history.³

Many Americans, and their physicians, have come to think that every symptom, every hint of disease requires a drug, said Vinay Prasad, MD, former assistant professor of medicine at Oregon Health & Science University.⁴ Experts consulted by Consumer Reports say this culture is encouraged by intense marketing from drug companies and a health care system that makes taking medication the easiest fix for a patient’s health concerns.⁵ This could be why there’s an increasing interest in alternatives to Western medicine, as younger generations of Americans have an increasingly distrustful attitude towards health care institutions. For example, 37 percent of millennials consider current American health care poor or terrible, and many believe that the industry is greedy and puts profits ahead of patient well-being.⁶

Instead, they are gravitating towards wellness, which takes into account mental health and full-body well-being. A report from the Pew Research Center in 2017 revealed that half of the general American public has tried alternative medicine—which may include ingested ingredients as well as practices like acupuncture—instead of or in conjunction with conventional medical treatments.⁷ Growing interest in holistic health, coupled with the widespread use of the internet, has led younger generations to embrace complementary and alternative medicine, which includes everything from massage, meditation, acupuncture, and yoga to herbal- and plant-based supplements to prevent illnesses and maintain well-being. Many of these practices have roots in other cultures’ health care traditions, such as India’s Ayurvedic medicine and traditional Chinese medicine (TCM), that for thousands of years have focused on holistic well-being. Old traditions have also morphed in the twenty-first century to become trends, such as goat yoga or how Katy Perry used heart-shaped cups for cupping—a form of therapy that originated in China in which heated cups are applied to the skin to improve overall blood flow—in a music video.⁸

On the opposite end, Christian missionaries of the nineteenth century brought their religion and culture, including Western education, architecture, and medicine, to different parts of the world. Inland missions such as those in Asia established schools that trained native doctors. Missionaries contributed directly toward the expansion of Western medicine and thinking and laid the foundation for health care systems of the twentieth century.

Western medicine can be traced to the age of scientific thought in the period from 1550 to 1700 and is characterized by the idea that the human body is a machine and concentrated on diagnosis and treatment of disease rather than promoting health or preventing illness.⁹ The British scientist William Harvey, who discovered blood circulation, and French philosopher René Descartes, who asserted that the mind and body are separate, are often credited with this modern approach to medicine as an experimental, evidence-based science. In contrast, the long-standing traditions of Eastern medicine and other traditional medicinal practices around the world, including Indigenous medicine in the United States, assert the unity of mind and body with practitioners focusing on treating the person as a whole.

By the end of the nineteenth century, missionaries—and with them, Western medicine—had spread into almost every part of the world. According to a study in 2016, younger generations today in populous countries such as China, India, Ghana, Mexico, Russia, and South Africa use traditional/indigenous medicine at much lower rates than older generations.¹⁰

Whether patients choose traditional healers only when modern medicine is unavailable or unaffordable or because traditional healers provide effective treatments for some conditions that modern medicine cannot remedy, the choice is a personal one. Social trends and cultural beliefs favoring Western education and lifestyles as well as increasing public awareness of modern medicine could be reasons for the decrease in popularity of traditional medicine as a sole source of treatment. Even in China, where traditional medicine is a point of pride and many physicians have training in traditional medicine, less than 3 percent of the population reported TCM as their most frequent source of care.¹¹

Although medicinal knowledge is transferred across cultures, it’s clear that traditional medicinal practices are changing, adapting, or disappearing. On one hand, many are turning to traditional medicine in the Western world but don’t fully understand the cultural contexts in which these methods were developed and could misunderstand the extent to which they are effective in treating diseases. On the other hand, discounting all traditional medicinal practices as unscientific ignores the importance of the diverse populations that make up our world and their cultural customs.

I believe the first step is to learn about the numerous medicinal practices around the world today, both traditional and modern, and to not discount long-standing practices in different corners of the world. Instead, we should acknowledge the cultures these practices come from. Only by starting from a place of understanding and respect can we fully appreciate their histories and dive deeper into how an individual or community approaches health care.

I’m compelled to write this book out of both curiosity and a personal sense of duty. While I’m studying pharmacy in a Western education system, I think it’s important to connect to my roots and honor people like my grandpa, who practiced traditional medicine to save countless lives. For many years, I let memories of helping my grandpa package medicines fade away, until I recently took a Modern Art History class and wrote my final paper on the history of Chinese medicine packaging design.

While Modern Art History tends to focus on European and American artists, I was blown away when I started researching the design and packaging process for Chinese medicine in the twentieth century. From the coating of pills to various kinds of teas and their elaborate decorative packaging, twentieth-century Chinese medicine was very different from the medicine found at CVS or Walgreens. When I told my professor and friends about the topic, I found that not everyone knows about medicinal practices outside of conventional medicine in the United States.

Even though I have Vietnamese heritage, I never dug deeper into the stories of our rich medicine culture. I wonder how many people in my generation are in the same boat, letting unique traditions in our cultures become memories of the past. This inspired me to study my own culture, as well other world cultures and their practices, to tell the colorful stories of the patchwork that is medicine.

This book is for anyone who wants to learn more about the people, history, art, politics, and culture behind the diverse medicinal practices and products around the world. If you are like me and simply love to explore different cultures, this book is a journey focused on medicine that will take you from the United States to Peru, Nigeria, Russia, India, China, and more. I reached out to old friends and teachers I met during my time in India, as well as Indian American friends, to piece together a bigger picture of India’s medicinal practices and products, Ayurveda, and how their remedies are an integral part of life, not just a morning exercise. I learned about herbal medicine and home remedies that transcend continents, discussed cultural appropriation by Western society, and discovered the story behind an antiseptic cream invented to protest colonization.

By telling stories of diverse health care practices, I hope to document pieces of history, culture, and politics, and I aspire to educate others who are interested in incorporating different medicinal systems into their lives to preserve the evolving legacy of medicine that contributes to our understanding of health care. I acknowledge that a single book cannot encompass all cultural medicine practices that exist in our world. The stories I’ve chosen to write about come from my desire to highlight the geographical diversity of different health care practices because mainstream discourse often reduces this to East vs. West. Another reason why I’ve chosen the stories I have is because of the people I’ve had the opportunity to interview, speak with, and learn from along the way who belong to these cultural groups. If given the chance, I would write a second and a third book to get to know even more people and learn about medicine where they come from.

This book is not meant to give medical advice, and it’s not my intention to provide an answer to what is the best way to approach medicine because at the end of the day, it’s a personal choice. Consider this a collection of stories that could deepen respect, inspire understanding, and spark curiosity. You as a reader can choose what to take away!

1 IQVIA Institute for Human Data Science, The Global Use of Medicine in 2019 and Outlook to 2023, (January 2019): 2.

2 Market share of top 10 national pharmaceutical markets worldwide in 2019, Statista, accessed December 20, 2020.

3 Ibid.

4 Teresa Carr, Too Many Meds? America’s Love Affair with Prescription Medication, Consumer Reports, August 03, 2017.

5 Ibid.

6 C Space, Unlocking Customer Inspired Growth, CQ17 (2017): 13–14.

7 Cary Funk, Brian Kennedy, and Meg Hefferon, Vast Majority Of Americans Say Benefits Of Childhood Vaccines Outweigh Risks, Pew Research Center, February 2, 2017, 26.

8 Courtney Chu, From Personal to Popular: The Westernization of Traditional Chinese Medicine, Cold Tea Collective, January 16, 2020.

9 Encyclopedia.com, s.v. Western Missionaries Spread Western Medicine Around the World, accessed December 20, 2020.

10 Oyinlola Oyebode, Ngianga-Bakwin Kandala, Peter J Chilton, and Richard J Lilford, Use of traditional medicine in middle-income countries: a WHO-SAGE study, Journal of Health Policy and Planning 31, no. 8 (2016): 984–991.

11 Ibid.

Chapter 1

Traditional Chinese Medicine: Herbal Tea and Heritage

Are those the famous Po Chai pills from Hong Kong? What do people use them for? I asked the attending store clerk who’s in charge of the pharmacy area at Jai Ho Supermarket in Boston’s Chinatown.

Being