What Were Town Doctors in the Edo Period Grinding into Powder?

Subtitle: The One or Two Ryo Medicine That Cures Mother's Illness and the Invisible Lifelines of Modern People

Introduction | Hearing the Sound of the Mortar

When watching period dramas, there is sometimes a scene where a town doctor is grinding something into powder using a mortar and pestle.

The patient is lying in bed.
The family is watching over them with worried expressions.
The doctor checks the pulse and makes a difficult face.
Then, they bring out medicine from the back room.

"Have them take this medicine."

However, that medicine is expensive.
One ryo, two ryo.
For a poor family, it is not money that can be easily paid.

So, the child goes out to work, the daughter is about to sell herself, or someone tries to steal money.

This is a familiar composition in period dramas.

But here, a question suddenly arises.

What on earth was that town doctor grinding into powder?

Was it a white powder of refined active ingredients like modern medicine?
Or was it something else entirely?

And, in the first place, what was this "expensive medicine that cures mother's illness"?

Chapter 1 | Edo Medicine Was About Materials, Not Ingredients

Modern people think of medicine in terms of ingredient names.

Acetaminophen.
Loxoprofen.
Ibuprofen.
Diclofenac.
Antibiotics.
Insulin.

Medicine is understood as something that contains a certain amount of a specific ingredient and has a fixed effect.

However, medicine in the Edo period was a little different.

Doctors in the Edo period bought crude drugs from medicine wholesalers, stored them in a hundred-flavor chest, and prepared them according to the patient's symptoms. In other words, medicine was not a finished tablet from the start, but a combination of plant, mineral, and animal materials. (Chugai Pharmaceutical)

What the town doctor was grinding in the mortar was not a single ingredient like modern medicine.

Roots.
Leaves.
Tree bark.
Seeds.
Minerals.
Animal-derived crude drugs.

They would finely crush, mix, decoct, roll, and have the patient drink such things.

Many Kampo medicines have names ending in "to" (decoction), "gan" (pill), or "san" (powder).

Kakkonto.
Hachimi-jio-gan.
Goreisan.

These originally represent the form of the medicine.

"To" is medicine that is decocted and drunk.
"Gan" is medicine that is rolled and drunk.
"San" is medicine that is powdered and drunk.

In other words, the town doctor's powdered medicine was not so much a modern medicine with extracted ingredients as it was natural substances powdered according to empirical rules.

Chapter 2 | It Wasn't Just Herbs That Were Powdered

Of course, there were many medicinal herbs.

For the early stages of a cold, crude drugs like kudzu root, ephedra, cinnamon twig, ginger, and licorice are used.

For coughs and phlegm, things like apricot kernel, balloon flower, and pinellia tuber are candidates.

For fever and hot flashes, there are also things like goldthread, skullcap, gardenia fruit, and gypsum.

What is important here is that Edo-period medicine was not based on the idea of "38.5 degrees Celsius, therefore an antipyretic."

Are there chills?
Is there sweating?
Is the mouth dry?
Is the body cold?
Is heat trapped inside?
Is there a cough?
Is there diarrhea?

Medicine was chosen by looking at the state of the entire body like that.

Therefore, it wasn't just herbs that the town doctor was grinding into powder.

In some cases, minerals were also powdered.
Animal-derived items were also made into medicine.
Things that look strange by today's standards were also medicine at the time.

Medicine was not a pure chemical substance, but an accumulation of "things that seemed effective" found in the world.

Chapter 3 | The True Identity of Expensive Medicine

So, what was the "one or two ryo medicine" that appears in period dramas?

The most likely candidate is Korean ginseng.

Korean ginseng was prized as a high-grade medicine in the Edo period, and the shogunate also put effort into its cultivation. It is said that the import of seeds and cultivation of Korean ginseng progressed during the Kyoho era. (Waraku Web: Know More About Japan, the Land of Beauty!)

Korean ginseng is, in modern terms, a medicine for "nourishment and tonic."

It is not a medicine that kills pathogens.
It is not a medicine that only stops pain.
It was treated as a medicine to lift up a weakened body.

That is why it fits "mother" in period dramas so well.

She is bedridden.
She is thin.
She is coughing.
She is feverish.
She is overworked.
Her health has not returned since childbirth.
She has no strength even though she is eating.

For this state, Korean ginseng must have looked like a "medicine that brings back life."

There are other candidates for expensive medicine.

Bezoar.
Musk.
Bear bile.
Rhino horn.
Antelope horn.

Bezoar is a gallstone from a cow and has long been treated as a noble medicine. Musk is also a rare crude drug derived from the musk deer, and both are known as high-grade crude drugs involved in reviving, sedation, and reducing fever. (Kracie Official Website, Kracie Holdings, Ltd.)

In other words, the "one or two ryo medicine" is not just a powdered medicine.

It had scarcity.
It was sometimes an imported item.
Counterfeits also circulated.
The credibility of the medicine merchant was also attached to it.
The story of a secret formula was also attached to it.

It was not just the medicinal effect, but the scarcity, credibility, and hope that became the price.

Chapter 4 | How Heavy Was One or Two Ryo of Money?

When people say one or two ryo, it is difficult for modern people to grasp the feeling.

But at the very least, it was not light money for commoners.

The Currency Museum of the Bank of Japan Financial Institute shows an example where one ryo in the late Edo period is equivalent to about 406 bowls of soba, while noting that it is difficult to simply convert one ryo of the Edo period into modern value. (Bank of Japan Inflation Meter)

Four hundred bowls of soba.

That is not a slightly expensive medicine.

It is a medicine that destroys the household budget.
It is a medicine that sells one's livelihood.
It is a medicine that cannot be reached unless someone in the family makes an unreasonable sacrifice.

That is why in period dramas, the cost of medicine becomes a drama.

They don't cry because the medicine is expensive.

They cry because the high cost of medicine puts a price on life.

Chapter 5 | Was Mother's Illness Really an Illness That Could Be Cured by Medicine?

Here, we need to shift the question a little.

What was mother's illness?

Of course, in reality, it must have been various things.

Tuberculosis.
Beriberi.
Poor recovery after childbirth.
Gastrointestinal disease.
Epidemic.
Chronic cough.
Malnutrition.
Overwork.
Coldness.
Anemia.
Infectious disease.

However, if we look at the "mother's illness" in period dramas as a single structure, the main body is probably not the disease name.

It is exhaustion.

There is not enough food.
Even if they are eating, the nutrition is unbalanced.
They are working too hard.
They are not sleeping.
They have lost physical strength due to childbirth.
The sanitary environment is poor.
There is no room to rest the body.

On top of that, they catch a cold.
The cough lingers.
A fever develops.
They get an upset stomach.
They catch an epidemic.

In other words, rather than an illness suddenly arriving, the final blow is dealt to a body that has already been worn down.

In Edo, beriberi due to vitamin B1 deficiency, the so-called "Edo sickness," became a problem due to the spread of white rice consumption. A diet where white rice accounts for the majority of the meal and side dishes are scarce leads to vitamin B1 deficiency. (Ministry of Agriculture, Forestry and Fisheries)

Also, in the Edo period, epidemics such as smallpox, measles, colds, and cholera repeatedly attacked people.

Materials from the National Archives of Japan also introduce the prevalence of epidemics in the Edo period and the social response. (National Archives of Japan)

Therefore, thinking of mother's illness as "one disease name" is a bit off.

The real disease name might have been poverty.
It might have been overwork.
It might have been malnutrition.
It might have been the life itself that did not allow for rest.

Medicine is inserted into that at the very end.

Chapter 6 | Was Medicine a Treatment or a Hope?

We must not misunderstand.

This is not to say that all medicine in the Edo period was meaningless.

There were things that worked empirically.
There were things that actually alleviated symptoms.
There must have been medicines that induced sweating, regulated the stomach and intestines, suppressed coughs, lowered fever, and lifted the mood.

However, it was not a medicine that targeted the cause like modern antibiotics.

There was no medicine to cure tuberculosis from the root.
Medicines to reliably stop serious infectious diseases were also limited.
It was also impossible to change the life itself, which was worn down by malnutrition and overwork, with medicine alone.

Then, what was medicine?

It was a treatment, and at the same time, it was hope.

Maybe they can still be saved.
If they drink this medicine, maybe they will feel a little better.
Maybe their body will recover.
Maybe they can live tomorrow too.

The family bought that kind of hope with money.

The town doctor was not just grinding crude drugs into powder.

They were grinding empirical rules into powder.
They were grinding scarcity into powder.
They were grinding the family's prayers into powder.
They were grinding the possibility that life might still return to this side into powder.

Chapter 7 | So, Have Modern People Become Stronger?

Here, the story reverses.

People in the Edo period died because there was no medicine.
So, have modern people become strong enough to live without medicine?

Probably not.

Modern people have far better nutritional status, sanitary environments, and medical systems than people in the Edo period.

Water has become clean.
There are vaccines.
There are antibiotics.
There is surgery.
There is anesthesia.
There are intravenous fluids.
There is insulin.
There are antihypertensive drugs.
There is dialysis.
There are ventilators.

Thanks to that, many people who would have died in the past are alive.

But this does not mean that the human body itself has become dramatically stronger.

Rather, it means that the supports outside the human body have increased.

People in the Edo period entrusted their hope to Korean ginseng, bezoar, and medicinal herbs.
Modern people entrust their hope to tablets, injections, drips, and machines.

What is different is the content of the powder.

However, in the sense of the possibility of getting an illness that cannot be helped without medicine, there may not be such a big difference between modern people and people in the Edo period.

Humans are still fragile even now.

It is just that the tools to support that fragility have increased.

Final Chapter | What the Town Doctor Was Grinding into Powder

What was the town doctor in the Edo period grinding into powder?

They were grinding medicinal herbs into powder.
They were grinding minerals into powder.
They were grinding animal-derived crude drugs into powder.
They were grinding expensive medicines like Korean ginseng, bezoar, and musk into powder.

But that is not all.

The town doctor was grinding into powder the fact that humans cannot survive on their own bodies alone.

The one or two ryo medicine that cures mother's illness is not just a story of medical history.
It is a story of the moment when a price is put on life.

And that story is not a thing of the past.

Modern people, too, cannot be saved without medicine.
They cannot survive without medical care.
They cannot reach treatment without a system.

People in the Edo period saw hope in the mortar.
Modern people see hope in prescriptions, health insurance cards, and hospitals.

What has progressed is not the human body.

It was the external devices that support human fragility.

Therefore, the true identity of what the town doctor was grinding into powder can finally be said as follows.

Before it was medicine, it was hope.
And before it was hope, it was human weakness itself.

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