What the Physician Carried

A physician lays three fingers on a patient’s wrist and presses, lightly at first, then deeper, then deeper again. The technique is Chinese. This week’s film imagines it being studied in Tabriz, in Persia, around 1313, and asks how it traveled that far. It is a history of carrying, not of curing: nothing in it claims that any old remedy worked.

Many medicines, one road

No single medicine ruled the thirteenth-century world. Physicians in Cairo and Persia followed Galen and Avicenna and their four humors. Chinese doctors thought in channels and in the balance of yin and yang. Indian healers spoke of three doshas. The theories had little in common, but most healers leaned on herbs, diet and the pulse, and that shared practice gave them something to exchange.

The Mongols made the exchange possible, partly by force. The historian Thomas Allsen points out that they collected physicians much as they collected soldiers and craftsmen. Khubilai Khan, who had gout, kept a crowd of healers in his traveling camp, and a Mongol ruler could draw on Muslim, Chinese, Tibetan, Korean, Uighur and Indian healers, and on Nestorian Christians too. In 1263 Khubilai set up an Office of Western Medicine under Aixue, a Nestorian whose service to the Mongols went back to Güyük Khan’s reign. His church had a long medical memory: Hunayn ibn Ishaq, a ninth-century Nestorian of Baghdad, had translated Galen into Syriac and Arabic. In 1292 the court founded a pair of Muslim drug bureaus, one in Dadu and one in Shangdu.

The empire’s founder wanted more than medicine. Camped near the Hindu Kush in 1222, Chinggis Khan is said to have asked the Daoist master Qiu Chuji whether there was a way to escape death. As Qiu’s disciple tells it, the reply was that life can be nourished, but no elixir makes a man immortal.

What was in the bag

Drugs moved in both directions. Marco Polo describes rhubarb growing thickly in the mountains of western China, bought up by merchants and shipped far and wide. The Yuan history, as the scholar Angela Schottenhammer reads it, records Khubilai sending a hundred thousand taels of gold to his kinsman Abaqa, the Ilkhan of Persia, to buy medicinal drugs from Ceylon. Her list of the “Huihui” (Muslim) drugs used in Yuan China includes myrrh, frankincense, mastic, saffron, camphor, asafoetida, opium and theriac, and an early Ming formulary still keeps prescriptions of Persian origin, annotated in Arabic script.

In the west, Ibn al-Baytar of Málaga, who died in Damascus in 1248, finished a compendium of roughly fourteen hundred plants, foods and drugs, gathered from about a hundred and fifty Arabic and twenty Greek writers. China had its own state drug trade. The Song set up a public pharmacy in 1076, selling medicines already made up and keeping speculators in check, and within a century there were dozens of branches.

Hospitals and a book

In Cairo, Sultan Qalawun began a hospital in 1284 that was taking patients by early 1285. The deed that endowed it promised to keep patients, men and women, rich or poor, local or foreign, until they were well, at the hospital’s expense. Accounts mention wards split by sex and illness, running water and fountains, and, some say, a ward for mental illness. Ibn al-Nafis, a Cairo physician who died in 1288, had argued in a commentary of around 1242 that blood crosses from one side of the heart to the other by way of the lungs rather than through Galen’s invisible pores.

In China, Khubilai’s Imperial Academy of Medicine was split into thirteen specialties, acupuncture, eye disease, bones and the illnesses of children among them, and physician families were registered as hereditary households, spared most levies.

The book at the center of the film came from Tabriz. Rashid al-Din, born to a Jewish family in Hamadan, became a Muslim, served Abaqa as a physician and rose to vizier in 1298. Chinese physicians were sent to Iran, their texts were put into Persian, and the result, completed in 1313, was the Treasure Book of the Ilkhan on the Sciences of Cathay. It drew on Chinese writing about the pulse, acupuncture and drugs. Skills, historians stress, usually moved in people, not in written plans. Rashid al-Din himself was put to death in 1318, aged seventy, when rivals charged him with poisoning Öljeitü, the Ilkhan he had served.

Paper, powder and plague

The roads carried other things too. Paper, a Chinese invention, was being made in Spain by about 1050 and in Genoa by 1235, and by the 1280s the mills of Fabriano were watermarking their sheets. A Persian story collection of about 1232 describes an iron fish, rubbed with a lodestone, floating in a bowl and swinging round to point south. Saltpeter first turns up in Arabic in Ibn al-Baytar’s drug book, under a name that means Chinese snow.

And the roads carried disease. Gravestones near Lake Issyk-Kul, dated 1338 and 1339, blame pestilence for the deaths, and scientists have recovered plague DNA from those graves. By 1346 the Black Death had reached the Black Sea, and trade may have brought it there. In 1377 Ragusa made new arrivals wait thirty days before entering, a rule often called the first quarantine. No remedy in any healer’s kit could have stopped it.

The film is the quickest way into this story, and the sources below are the way to test it.