text:
Poisons in the Premodern World
An apothecary publicly preparing the drug theriac, under the supervision of a physician. / Image courtesy Wellcome Images, Wikimedia Commons
The English word pharmacology or pharmacy derives from the Greek word pharmakon, which means both remedy and poison, among other things.
By Dr. Yan Liu
Assistant Professor of History
Poisons present an intriguing topic in the history of science because of their unique materiality that can often induce damaging changes to living beings. The majority of the scholarship on poisons in the premodern world focuses on Europe, and generally follows two lines of inquiry. The first situates the study of poisons in the history of the field of toxicology, exploring how the idea and use of toxic substances shaped the formation of a new scientific discipline. The second examines the political and social functions of poisons, identifying their roles in configuring familial, legal, and gender relationship. In both directions, historical accounts of poisons tend to focus on the nefarious side, highlighting their power to harm or kill. Beyond Europe, however, poisons have different histories, which are largely untold.
Prominently, in China, although the malevolent use of these puissant substances is abundant, there is also a strong tradition of harnessing them as healing agents. Comparing the history of poisons in premodern China and Europe thus reveals the divergent understandings of these powerful materials across cultures. The comparison provides more than just a useful account within the history of illness; it also traces a broader history, from alchemy to politics, of medicine, gender, and society.
'Du' and 'Pharmakon'
Although poisons have been employed for hunting, warfare, and murder for millennia in China,1 medical uses of them also emerged early in Chinese history. The paradox of the healing power of poisons is manifested in the ancient meaning of the word du (毒). In the modern context, du is the standard word for poison, and carries the negative connotations of murder, harm, and substance abuse. Yet, in premodern texts, the meaning of the word is more ambivalent. According to a first-century dictionary, the word means "thickness," which denotes the quality of lofty mountains. Thickness implies heaviness, abundance, and intensity; it doesn't carry a negative sense.2 Since there is no perfect English translation of du that captures its paradoxical meaning in premodern China, I use the word "poison" as shorthand for du -possessing substances that can both harm and heal.
The ambivalent meaning of du is patently expressed in Chinese medical writings, in which the word speaks above all of the potency of drugs. Du was a primal index to categorize medicines in classical Chinese pharmacy. The first pharmacopoeia in China, Divine Farmer's Classic of Materia Medica (Shennong bencao jing, ca. first century), divides its 365 drugs into three groups based on the level of du they possess: most of the drugs in the bottom group carry du, which are employed to cure illness; drugs in the middle group are either with or without du, which aim to prevent illness and strengthen the body; drugs in the top group are mainly devoid of du, which promise to prolong life.3 As a result, the text incorporated a large number of poisons identified with diverse medical indications. Prominent examples include cinnabar (a mercury compound), aconite (a highly poisonous herb), bezoar (ox gallstones), and cannabis. Poisons were thus an integral part of healing in ancient China.
This du -centered scheme of categorizing drugs persisted in pharmacological writings throughout imperial China. With the expansion of Chinese pharmacy, more poisons were added into the repertoire. Newly Revised Materia Medica (Xinxiu bencao, 659), the first government-commissioned pharmacopeia in China, contains a number of poisons that flowed from foreign places into the Tang empire (618–907) thanks to the flourishing of the Silk Road. These include litharge, which is a lead product from Persia, and "unicorn gutta" (or dragon's blood in European sources), which is a resin of dark reddish color from a tree growing in Southeast Asia.4 Relatedly, foreign antidotes also entered Chinese pharmacy during this period. For instance, theriac, one of the most popular drugs in medieval Europe, appeared in the Tang pharmacopeia, believed to be a powerful panacea.5
The writing of pharmacology in China reached its apex in the sixteenth century, epitomized by Systematic Materia Medica (Bencao gangmu, 1596) written by Li Shizhen (1518–1593).6 Keenly aware of the medical virtue of poisons, Li dedicated a section to "poisonous herbs" ( ducao ) that contained forty-seven plants identified with various medicinal uses.7 Li also incorporated a new foreign poison that exerted immense impact on late imperial Chinese history. Opium, called " a-fu-rong " in Li's text, was defined as a warming drug that could treat diarrhea. During Li's days, opium was restricted to the medical realm and its recreational usage, with a wider consumer base, had yet arisen.8 In sum, poisons remained central to healing in premodern China, consistently taking up a substantial portion of its ever-expanding pharmacy (about 20%, Image 1).
Image 1: Proportion of poisons in premodern Chinese pharmacy. Made by the author.
The therapeutic use of poisons was not unique to China. The English word pharmacology or pharmacy derives from the Greek word pharmakon, which means both remedy and poison, among other things.9 Pharmakon appeared in some of the earliest medical and botanical works in Europe. The Hippocratic Corpus (fifth–fourth century BCE) prescribes a number of narcotic drugs such as mandrake, opium poppy, nightshade, henbane, and hellebore. The last one appears most frequently, serving as a purgative to treat gynecological disorders, humoral imbalance, and lung problems. Hippocratic writers also noted the harmful, even lethal effects of hellebore, if administered carelessly. There was no simple division between poisonous and healing substances in the earliest medical writings in Greek antiquity.10
The therapeutic role of poisons became strengthened in De Materia Medica (first century CE) by the Greek physician Dioscorides of Anazarbus, a foundational work in the history of European pharmacology.11 Among its 800-odd drugs are many poisonous substances, which can be divided into two groups. The first group contains about fifty drugs that, when used to treat illness, produced unpleasant but mild side effects such as headache, dim-sightedness, and discomfort of the stomach. Prescribers would claim that the curative potential of these poisons outweighed their adverse effects. The second group contains about a dozen drugs with stronger effects, including opium poppy, henbane, mandrake, and hemlock. Proper dosage was critical to the use of these powerful substances; Dioscorides repeatedly warned his readers that consuming them in excess could lead to dire consequences—often death. Evidently, the medical use of poisons was salient in ancient European pharmacology.12
This ambiguous relationship between medicines and poisons parallels the Chinese concept of du. Yet, if we look further, we detect a more pronounced effort in Greek pharmacy to distinguish poisons from medicines. For example, the first-century CE treatise On Deleterious Substances and Their Prevention discusses thirty-three poisons, each including the properties of the poison, the symptoms it induces, and the corresponding treatment. The text builds upon a toxicological rationale that each poison generates specific, discernable signs on the body, the proper identification of which then is the key to trace poison and guide remedy. This symptom-based method of poison detection constitutes the hallmark of Western toxicology in antiquity.13 Although Dioscorides did not create a clear division between poisons and medicines, he did include in his text a number of poisons for which he saw no therapeutic value, such as strawberry tree, sea cole, wolfsbane, yew, dogbane, and meadow saffron. He listed these poisons simply to warn against their use.14 Despite the blurred boundary between medicine and poison in Greek antiquity, then, a group of substances began to move out of the pharmakon continuum and were considered to be poisons without any medicinal virtue. This separation became more evident in late medieval Europe when physicians perceived poisons as ontologically distinct substances from medicines, which paved the way for the rise of toxicology in the early modern era.15
By contrast, classical Chinese pharmacy did not see the emergence of toxicological treatises; nor did it include any poison without healing power. All drugs in Chinese pharmacy, regardless of their potential to harm, acquired status as having medicinal value. This does not mean that knowledge of the danger of poisons was unknown in premodern China. Quite the opposite, we find appreciable discussions about poison detection and treatment in Chinese medical writings. Yet unlike the separation of poisons from medicines in medieval Europe, such knowledge remained an integral part of pharmacology throughout imperial China.
No example better illustrates the divergence of Greek and Chinese pharmacy than the distinct fates of aconite. In De Materia Medica, this powerful herb, called wolfsbane, is cited only as a poison to kill wolves, without any curative value. In no less than seventeen places did Dioscorides offer treatment for aconite poisoning, indicating its great danger.16 But in China, aconite, called fuzi, was valued for its therapeutic power, to the degree that it was hailed as the "lord of the hundred medicines" (Image 2). This is not a hyperbole as the herb was one of the most frequently prescribed drugs in premodern China.17 This striking divergence is likely derived from the distinct therapeutic rationales in European and Chinese pharmacy. If Dioscorides considered poisons to be the cause of unpleasant side effects, Chinese physicians deemed them to be the very source of curative capacity. In other words, European medicine prescribed poisons in spite of their power; Chinese medicine, because of it.18
Image 2: Illustration of aconite ( fuzi ) in Verified and Classified Materia Medica (Zhenglei bencao, eleventh century). Source: Library of Congress.
What are the possible explanations for this striking pharmacological divergence? The different philosophical traditions in China and Europe may have partly contributed to their distinct ways of thinking of poisons. Those influenced by the Platonist perspective questioned any ambiguity within pharmakon because it jeopardizes rational thinking, confuses true knowledge, and compromises the integrity of soul.19 This view, which implies absolute and unchanging metaphysical truth, shaped the later theorization of poisons as distinct entities, especially by the second-century Roman physician Galen.20 In Chinese antiquity, however, the separation of a metaphysical truth from the phenomenological world was not salient. Particularly in ancient Daoist writings such as the Laozi and the Zhuangzi, all substances contain both the yin and yang forces, which are mutually transformative and in perpetual motion. This cosmology emphasizes the dialectical relationship among all things that denies stable categorization. In this cultural milieu, it is not surprising that poison and medicine, in the pattern of the yin/yang dynamism, are not fixed and distinct essences. They are, in fact, mutually constitutive.21
Poisons and Etiology
The therapeutic rationale of deploying poisons in Chinese pharmacy was tightly connected to Chinese physicians' views of the cause of illness. According to Divine Farmer's Classic of Materia Medica, poisons are particularly effective to treat two types of disorders: demonic infestation and gu poisoning.22 The first refers to attacks by malevolent forces ( gui ) that befall a victim with severe symptoms. This etiology can be traced back to ancient China when such forces were imagined to either strike a person on a whim or assault those who were guilty of moral failing.23 In the medieval period, this way of conceiving illness became more widespread due to the rise of religious healing. Especially in the early development of Daoism during the Era of Division (220–589), adepts in the sect of "Celestial Masters" considered a variety of demons to be responsible for obdurate conditions. They often recommended the carrying of certain poisons as talismans, such as realgar (an arsenic compound), to expel baneful influences.24 Later medical texts in medieval China, by contrast, emphasizes the depleted state ( xu ) of the body as the prerequisite for demonic invasion. As a result, they advise that one build up a sturdy body that would keep the vicious forces at bay.25
The second type of disorder treated by poisons is called gu, which is itself a poisoning condition induced by vermin. Different from the erratic attack of demonic entities, gu poison was believed to be manufactured by a vicious mind. Medieval medical texts provide vivid details of such a preparation: A gu maker leaves a miscellany of poisonous worms and snakes in a vessel and let them freely devour each other. The single creature that remains is called gu and could afflict people with severe illnesses once introduced into their food.26 Apparently, gu poison involved the magic manipulation of vermin that could trigger disastrous effects. To counter gu poison, Chinese doctors regularly prescribed powerful drugs such as aconite and realgar to expunge poisons from the body. One telling formula in an eighth-century text recommends that one collect gu vermin from a victim's body and burn them into ashes. Ingesting these ashes can then cure a person suffering gu poisoning. Underneath this treatment lies a principle of similarity; things of the same type can repress each other. According to this rationale, gu vermin is both an illness and a cure.27
Despite their distinct mechanisms—poison as healing because of its similarity or difference—demonic infestation and gu poison both invoked the concept of illness as concrete and specific entities that either attacked the body from the outside or undermined it from within. The prescription of poisons, then, sought to destroy or expel these nefarious agents, be it demons, worms, or in any other form, in order to restore the body. A popular saying in China captures this logic well: use poison to attack poison ( yi du gong du ). This ontological way of imagining illness is distinct from a functional model that saw illness as the disruption of harmony and balance in the body, often as a result of the aberrant flow of qi. The treatment of an illness in the latter model involved the regulation of the qi circulation so as to readjust the body to the normal state. By contrast, illnesses conceived in the ontological model cannot be harmonized or rebalanced; they must be dislodged or annihilated. Hence the use of poisons.28
In Europe, intriguingly, a rudimentary idea of "acquired tolerance" emerged in antiquity, that is, ingesting a poisonous substance in small doses over a period of time trains the body to resist poisons. One such antidote, mithridatium, was associated with King Mithridates VI of Pontus (reigned 120–63 BCE), who regularly ingested the compound medicine made from poisons to protect himself from being poisoned. It was widely believed that when the mighty king was captured by the Romans and attempted suicide by taking a poison, he failed and had to ask a friend to kill him by sword.29 Several centuries later, a related medicine with a similar function appeared in medical writings. Called theriac, the drug figures prominently in the works of Galen. He wrote a book on this matter ( On Theriac and Poisons ) in which he developed a formula that contained the key elements of viper's flesh, opium, honey, wine, cinnamon, among many other ingredients. Considering it to be an effective antidote, Galen persuaded Emperor Marcus Aurelius (reigned 161–180) to take it regularly to build up resistance to poisons. Thanks to the prestige of Galen, theriac became a popular antidote and later gained the reputation of a cure-all in medieval Europe.30
By contrast, the practice of auto-prophylaxis remained marginal in premodern China. In a story from a third-century work, Cao Cao, the King of Wei (155–220), routinely ingested a small amount of the herb gelsemium and a wine called zhen, both of which were highly poisonous, presumably to build his bodily resistance to them.31 The story resembles that of Mithridates, but such examples are few and far between in premodern Chinese sources. In general, the discussion of antidotes in premodern China was much less extensive than premodern Europe. It was not until the sixteenth century when new ideas and practices of auto-prophylaxis started to flourish in China, exemplified by the development of the technique of variolation to treat smallpox.32 This cultural difference can perhaps be attributed to the distinct ways of perceiving the relationship between poisons and medicines in China and Europe. European doctors' acute attention to antidotes insinuates their anxiety about the ever-present menace posed by harmful poisons. Chinese doctors, on the other hand, directed their attention to harnessing these powerful substances to cure intractable illnesses. You didn't need to inoculate yourself against poisons if you understood them as inescapably intertwined with medicines.
Poisons and Epidemics
One category of illness that poisons were particularly linked to is epidemics. The association concerned both remedy and etiology in China.33 In particular, there was a strong connection between demonic infestation and epidemics. During the turbulent time of the third century, for example, the collapse of the Han dynasty led to wars, famines, and waves of plagues that were often believed to be triggered by swarms of demons. Poisons were regularly utilized to combat epidemics. A story from a seventh-century source narrates that when an epidemic broke out in central China in 169, a scholar offered a pill made of poisonous minerals and herbs that powerfully expelled demons and saved the victims. Once the pill was burned in a house, the story further relates, the vapor could also protect people from demonic attack. The later circulation of such accounts hints at the ways poisons were understood as powerful weapons to dispel malign entities.34
There were other ways of understanding epidemics in premodern China than as demonic infestation. Medical texts, for example, emphasized the spread of poisonous qi. A third-century lexicon glosses the contagious illness of zhu as a condition in which a recently dead body might emanate noxious qi, which can pour into a healthy body, leading to further illness and death.35 The famed physician Zhang Zhongjing (150–219) crystalized the idea into a systematic theory that proved influential in classical Chinese medicine. Called "cold damage" ( shanghan ), the disease category designates a set of acute, severe, and infectious conditions often induced by the poisonous qi penetrating the body from the outside. To combat such conditions, Zhang regularly prescribed poisons often of heating nature to dispel the cold, virulent qi out of the body—we find aconite appears in one-fifth of all his formulas.36 The Han physician's works became influential centuries later during the Northern Song period (960–1127) when the government canonized and disseminated a series of medical texts aided by printing.37 A wave of epidemics that ravaged eleventh-century China played a key role in the state's decision to promulgate Zhang's treatises. Unsurprisingly, the period also witnessed the substantial expansion of pharmacy, incorporating many more poisons into the healing repertoire (see Image 1).38 For example, refined arsenic ( pishuang, arsenic trioxide) became a popular drug during this period to treat malaria-like disorders, manifesting Chinese physicians' continuous effort of deploying poisons to fight epidemics.39
The connection between poisons and epidemics was also patent in premodern Europe. The link can be traced back to the ancient period; Galen, for example, proposed that external materials such as poisons or seeds of plague could trigger contagious diseases that killed many. This ontological view of disease, however, remained marginal in his writings, overshadowed by the conception of humoral imbalance accounting for diverse ills.40 In the medieval era, poison-oriented etiology became more useful for explaining epidemics. The Black Death in the fourteenth century was a critical moment for the development of this exposition. The devastating consequences of the epidemic urged physicians in Europe to come up with new explanations outside the categories of humoral imbalance. Prominent among them was the notion that the epidemic was induced by poisonous air that, once penetrating the body and reaching the heart, led to one's demise. Different from the classical explanation of complexional imbalance, this new discourse emphasized the putrefying power of poison, with its characteristic "special form," that corrupted the body and destroyed life. In the following centuries, European physicians further elucidated such "special form" of poisons that made them a distinct category of substances outside the humoral framework, and linked poisons to various diseases.41 Besides the environmental factors, human actors were also blamed for epidemics. Similar to gu poisoners in medieval China, they were accused of spreading the disease by deliberately poisoning the waters, air, and foods. During the Black Death, marginalized groups in society—religious minorities, the poor, women, foreigners—were particularly susceptible to such stigmatization, a phenomenon that lasted to the early modern era.42 Poisons served an etiological function by facilitating both extra-humoral accounts of disease and the placing of blame on specific human actors.
Poisons, Alchemy, and the Body
Poisons figured prominently in alchemy in both China and Europe. Often called "outer alchemy" ( waidan ) in China, alchemists set up elaborate devices and followed sophisticated procedures to produce extraordinary medicines, or elixirs, that promised to not just transmute base metals into silver or gold but also, and more importantly, elevate one's body to higher states of being to become immortal. Alchemy has a long history in China. From its inception during the Han period (206 BCE–220 CE) to its ultimate decline in the tenth century, the practice lasted more than a millennium. The majority of alchemical writings in China are preserved in Daoist scriptures.43 The materials employed in this tradition were mainly minerals, including mercury, arsenic, sulfur, and lead. Sharing drug knowledge in medical literature, Chinese alchemists recognized the potency ( du ) of these substances, the consumption of which often induced violent effects on the body.
There is a large body of literature examining the history of Chinese alchemy. Joseph Needham and his collaborators conducted pioneering studies that focus on the scientific elements in this tradition as seen through the lens of modern chemistry.44 Other scholars went beyond the positivist framework and explored the theoretical foundation of alchemy in China's own cultural milieu, with due attention to the cosmological thinking and ritual procedures that afforded meanings to alchemical operations.45 Due to the abundant use of poisons in this tradition, we find many accounts of elixir poisoning in medieval Chinese sources, which prompted heated debates among alchemists, physicians, and scholars.46 The phenomenon begs the following question: Why did Chinese alchemists avidly ingest elixirs despite their alarming danger? Approaching this question gets to the heart of the unique effects of poisons on the body as conceived in Chinese alchemy.
The first element of an answer concerns the materiality of poisons. Chinese alchemists considered certain poisonous minerals to be both robust and mutable, hence ideal for making elixirs. According to the fourth-century alchemist Ge Hong (283–343), hardy minerals, such as cinnabar (a mercury compound), were prime materials for alchemy because, unlike fragile herbs that perish easily, they withstand decay and last much longer. Once ingested, the materiality of these sturdy minerals was understood to alter the body, making it similarly enduring. Additionally, the fluid transmutation between red cinnabar and white mercury made them magical materials that could trigger drastic changes of the body. The unique nature of cinnabar, thus, justified its ingestion to strengthen and transform the body.47
What happened to the body of an alchemist who took a poisonous elixir? A specific notion of immortality was at play. Different from the idea of immortality in Western Christianity that implicated a disembodied soul and a fixed state in Heaven for all eternity, immortality in Chinese Daoism concerned multiple levels of bodily state that operated in a continuum between the terrestrial and celestial worlds. Depending on the quality and quantity of a poisonous elixir, one could achieve different levels of transcendence that correlate to different degrees of life extension. Immortality in this context is more dynamic, linked to the changing states of the body. Ge Hong, for example, conceived of three levels of immortality in a hierarchy—those ascend to the void, those roam in famous mountains, and those die first and metamorphose later—and correlated them to the amount of an elixir one ingested. Hence the death triggered by the elixir, to these Daoist believers, was only apparent; one ultimately achieved transcendence.48
With such aspiration, the temptation of ingesting elixirs seems irresistible. Yet Chinese alchemists were fully aware of the pains induced by these potent substances. A variety of accounts emerged in medieval China that explained these sensations, including intense thirst and piercing pain in the heart. Some alchemists interpreted them as the worrying signs of "fiery poison" ( huodu ) remaining in an elixir and proposed various techniques to eliminate it. Especially during the Tang period (618–907), when Chinese alchemy reached its apogee, many alchemical treatises discuss ways of taming elixirs. Prominent among them were the use of certain yang materials, such as vinegar and sal ammoniac, to eliminate poison in mercury and lead. Rituals also played an important role for detoxification. For example, a seventh-century alchemical text specifies three taboos in the making of an elixir: weeping; calling the name of the demon that destroys the elixir; the presence of mourners, filthy things, and dead newborns. Proper ritual thus requires management of emotions, avoidance of malicious forces, and unpolluted spaces. Any transgression leads to a lethal elixir.49
Other alchemists interpreted the elixir-induced sensations in a positive light. An eighth-century alchemical treatise, for instance, offers a vivid description of the violent effects of elixirs on the body, including itching, swollen limbs, nausea, diarrhea, vomiting, and headache and abdominal pain. Yet instead of regarding these symptoms as pathological, the text considers them to be the signs of therapeutic therapy. The underlying rationale is that the powerful elixir would trigger the purification of the body by eliminating latent illnesses, which prepares one for their eventual transcendence. Such drastic experiences, however, should not last long; once the malady is removed, one should begin to feel normal again. Otherwise, medical intervention must be provided to alleviate the symptoms. This positive interpretation of bodily pains was not unique to alchemists. In fact, the text cites an ancient aphorism to justify the explanation: "If a medicine does not cause dizziness, it cannot cure severe illness." Medieval Chinese physicians readily adopted such reasoning to account for the effects of poisons on the body.50
Alchemy in Europe, with a history that can also be traced back to antiquity, involved two major goals: to transmute metals and to enhance the body. Most of the studies have focused on the first aspect, exploring its technical innovations, diverse practices in elite and non-elite circles and among women, and its connections to modern chemistry in the early modern era.51 The second aspect, medical alchemy, emerged in Greek antiquity and became more prominent in the early medieval period, especially in the Islamic world exemplified by the writings of Jābir and Rhazes in the ninth century.52 In the late medieval period, alchemists in England such as Roger Bacon and George Ripley passionately proposed the ingestion of certain purified alchemical ingredients, such as mercury, for life prolongation.53 This idea was further elaborated by the Swiss alchemist Paracelsus (1493–1541), who famously claimed that "all things are poison, and nothing is without poison: the Dosis alone makes a thing not poison."54 Although this idea of poison sounds pharmakonic, the bulk of Paracelsus's discussion reveals a rather different message: all things contain the beneficial and harmful components, and the latter must be removed through alchemical purification to allow the former to fully function and render health benefit. The trace of irreversibly bad poison is palpable.55
In comparison, medieval Chinese alchemists were equally aware of the importance of eliminating poison in their alchemical endeavor, yet they paid more attention to the reversion of poisons, such as mercury and lead, back to the primordial oneness, often imagined as a state of pure yang. In Daoist cosmogony, this pure yang state refers to the origin of cosmos that precedes the differentiation of all things. It is also a state that escapes time. By ingesting such a timeless substance produced by reversing the cosmic unfolding inside a crucible, Chinese alchemists sought to transform their bodies to a similar state beyond time, thereby achieving immortality.56 Hence, it was the transformation, not separation, that figured more conspicuously in Chinese alchemical thoughts.
Beyond alchemy, the link between poisons and transformation also figured saliently in Chinese medicine. Precisely because there was no categorical distinction between poisons and medicines, Chinese doctors devised a variety of techniques, such as dosage control, combination with other ingredients, and drug processing, to transform poisonous substances into curative agents. This fluid materiality of drugs configured by technical intervention merits our attention; the effect of any substance—whether it healed as a medicine, or killed as a poison, or altered a person's body in myriad other ways—varied remarkably according to the way in which it was prepared and administered. Any poison in Chinese pharmacy was not deemed as an independent, self-sufficient entity with a fixed essence, but as something acting in an assemblage—to borrow the term from Gilles Deleuze and Félix Guattari—in which it is always disposed to transformations.57
Poisons, Politics, and Gender
For historians of medicine, poisons thus could bring many benefits. But more broadly, in Chinese history and otherwise, there are abundant accounts of the nefarious use of poisons, real or imagined. Aconite, for example, was often employed in court murders precisely because of its dual function of medicine and poison—a murder that took place in the first century BCE involved a court physician who used aconite to covertly kill the empress. The physician claimed that she prescribed the "medicine" to help the empress recover from a recent childbirth but likely manipulated the dose of the poisonous herb to end her life. The murder was concealed by the reality that women often died after giving birth at the time.58 Unsurprisingly, governments in China from antiquity established a series of regulations and legal codes to detect poisons and punish poisoners. One early method of poison detection is drug tasting. The Han court in the first century designated an officer titled "Directorate of Drug Tasting" who was responsible for trying a medicine before presenting it to the emperor. The system became more elaborate in later periods; during the Tang era, for example, the court established the Palace Drug Service that provided medical services to the imperial house. The institution included physicians of various specialties and a large number of artisans who prepared drugs. To guarantee safety, a medicine produced by the service was tasted by two court officers and the crown prince before entering the mouth of the monarch. Those who were negligent in either preparing or prescribing a medicine were subject to severe punishment. A similar mechanism was also established to safeguard the diet of the royal family. It is hard to imagine a more stringent system to prevent poisoning.
Beyond the court, governments in medieval China issued legal codes to regulate the use of poisons. According to the Tang Code (Tanglü, 653), the earliest legal code in China that is extant in entirety, those who use poisons to kill people will be executed. Those who sell poisons will be punished too, but only if they collude with the buyers who have the sinister intention. This specification is noteworthy, which indicates that the sellers could offer poisons for a legitimate purpose, that is, to heal a person. The blurred boundary between medicines and poisons reappears in legal documents. That being said, the Tang court made an effort to restrict the circulation of highly poisonous substances, such as zhen -bird poison and gelsemium, and prohibited private families to possess them. By controlling access to these dangerous materials, the state tried to prevent them from falling into the "wrong hands." But even gelsemium, a highly poisonous herb grown in the south, had therapeutic virtue recognized by medical literature at the time. Due to its limited access, local people had to identify suitable substitutes to achieve healing.59
Political regulation of poisons in China concerned not just the control of specific substances but also the subjugation of those who were accused of poisoning. I have mentioned the gu poisoners, who were suspected of manipulating virulent vermin to harm people. There are two important features of gu in premodern China. First, the practice has a particular geographical association. During the Tang period, it was linked to regions south of the Yangzi River. In the eyes of the rulers, who established their political center in the north, the southern regions were believed to be dangerous, mysterious, and uncivilized, full of poisonous creatures and pernicious effluvia. The gu practice thus embodied an unfamiliar and intractable south that defied proper ruling.60 Second, gu preparers were often women, especially those from the lower echelons of the society. This association can be traced back to antiquity when the female body was perceived to be the site of delusion and seduction, ideal for carrying out black magic. Moreover, women often engaged in shamanistic practice in the south, making them particularly prone to accusations of such vicious deeds. Altogether, gu poison, emblematic of the unruly south and of furtive women, posed a serious menace to state control. In response, governments in medieval China established stringent policies to punish accused gu practitioners, banishing them to the periphery of the empire. As a result, those convicted of practicing gu were marginalized in both geographical and social spaces. During the late imperial era, they were also linked to minority peoples, especially the Miao in the southwest.61 Lurking at the edges of empire, they remained an ever-present menace to the established order. The regulation of poisons was always a matter of political control.
The association of poisons with women and political control is not unique to China. Perhaps most well-known is the persecution of witchcraft practice, which often involved the manipulation of poisons, in early modern Europe.62 The connection is already visible in antiquity. In the time of an epidemic, women were regularly accused of administering poisons to spread the plague.63 In medieval Europe, this female association of poisons remained strong partly due to the fact that women operated in a domestic space where they had easy access to food, clothing, and medicine. The secretive and elusive nature of poisoning aligned well with women's social position that did not allow them to take actions in a more direct and forceful manner. Yet it is important to note that the link between women and poison, similar to the situation in China, is more rhetorical than real. There is no evidence that women committed crimes of poisoning more often than men in medieval Europe—in fact, men still dominated this type of murder. It is rather the social imagination and the anxiety elicited by such an imagination that produced the cultural stereotype of female poisoners.64
In both premodern China and Europe, poisons acted as a powerful yet surreptitious weapon that destabilized political order and elicited social anxiety. How could the same type of substances also serve as useful medicines? In China, the answer lies not so much in the innate qualities of poisons as in the context in which they were administered. A superb doctor could dexterously harness aconite to cure an intractable illness while the same herb, used by an inept or ill-natured practitioner, could harm or even kill. Mercury was undoubtedly a lethal poison, yet upon sublimation by zealous alchemists, it could turn into a life-enhancing wonder drug. Gu vermin might be deployed by celebrated male healers as an effective antidote to treat gu poisoning, yet the same material, once falling into the hands of suspicious female practitioners, became the supply of witchcraft that was swiftly condemned by the state. Therefore, it was not the substance itself, but the ways of its preparation and usage in the medical context as well as its assigned value or blame in the social, political, and cultural contexts that defined its identity. Poison is a good thing to think with. For it compels us to ponder the shifting boundaries and intrinsic paradoxes that figured conspicuously in the history of science and beyond: between the curative and the noxious, the good and the bad, the legitimate and the illegitimate, and the mortal and the immortal.
In his classic 1925 work The Gift, the French anthropologist and sociologist Marcel Mauss notes the double meaning of the German word Gift as gift and poison. He further comments that "[t]he theme of the fateful gift, the present or possession that turns into poison, is fundamental in Germanic folklore."65 The duality of gift and poison was never limited to Germanic or European folklore, however. There is no doubt that there is a long tradition of the medical use of poisons in Europe, evidenced by the ancient concept of pharmakon. Physicians from Dioscorides, Galen to Paracelsus all paid due attention to such usage.66 Yet there is also a strong tradition in premodern Europe that studied poisons as a distinct group of substances from medicines, in other words, a long history of toxicological thinking. Such thinking was already evident in antiquity, manifested by Galen's writings, and became more pronounced in late medieval Europe. Concomitantly, the fervent pursuit of antidotes to combat poisons persisted throughout premodern Europe, and continued in the early modern period with the experimentation on antidotes by poison trials.67
By contrast, the separation between poisons and medicines was much less evident in premodern China—no medical works were explicitly dedicated to poisons and antidotes in China until the sixteenth century, a change in stance possibly influenced by European medicine.68 In premodern China, no material essence defined what was a poison or medicine or any substance in the world. It was not the distinction but perpetual transformation among myriad things that had been stressed.69 The lesson may shed fresh light on the understanding of pharmaceutical practice today, from the pressing issue of licit drug abuse, exemplified by the American opioid crisis, to the debates surrounding the decriminalization of cannabis.70 Debates around carcinogenicity and pollution also pose questions about the danger of particular substances that draw on similar terms: is poisonous air or water a question of type or of quantity, of balance or of purity? Interrogating the very notion of "poison" helps frame many of these debates in deeper perspective.71
There are, of course, discussions of poisons in many other traditions. For example, prior to the intense study of poisons in late medieval Europe, Arabic medical writers, such as Ibn Wahshīya (ninth century), had already produced devoted treatises on poisons and poison treatment, which played an important role in transmitting early Greek and Indian toxicological knowledge to Western Europe.72 In Tibetan culture, although there was a distinction between poison ( duk ) and medicine ( men ) at the conceptual level, the boundary was less stable in practice—mercury sulfide compound, for example, has been used to enhance the potency of medicines since the thirteenth century.73 The duality of poison and medicine was also prominent in Ayurvedic healing, exemplified by the frequent use of aconite and arsenic.74 In precolonial Africa, though no systematic studies have been conducted, preliminary inquiries suggest a similar ambiguous relationship between harmful and curative substances.75 Although the juxtaposition between China and Europe inevitably falls short of accounting for many of the subtleties present in other contexts, the duality of poisonous materials seems echoed throughout. Whether a substance is or is not labeled as a poison is never solely a matter of its deleterious effects.
Overall, scholarly literature on poisons in the premodern world has primarily focused on the medical understanding and the social and political uses of poisons in Europe. These studies position the medical investigations of poisons in the history of toxicology and trace the political regulation of poisons and social responses to poisoning. Recent scholarship goes beyond the European context and explores the rich traditions of poisons in other parts of the world. The story in China does not just reveal an intimate relationship between poisons and medicines but also, in a more fundamental way, redefines the notion of poison itself. Study of poisons in the non-Western societies thus offers insights into the materiality of these potent substances as configured by specific cultural conditions. Besides examining the unique history of poisons in a given culture, it is also important to explore the circulation of poisons and knowledge associated with them across cultural spheres, a topic that awaits future research. Recent works on the transmission of scientific knowledge across premodern Eurasia have charted a new direction of inquiry in the history of science, and it would be interesting to see how poisons fit into this global picture.76 Furthermore, we may also ask the important question of how the premodern knowledge of poisons in a given culture was transformed in the modern era, with the introduction of Western scientific knowledge in recent past.77 For instance, how did the concept of du change from an ambivalent term in premodern China to a word of negative connotation today? Such inquiries will shed light on the changing meaning and usage of poisons over history as a result of the dynamic negotiation between different systems of knowledge.
Bisset, "Arrow Poisons in China. Part I," 325–84.
Unschuld, "Zur Bedeutung des Terminus tu 毒," 165–83; Obringer, L'aconit et l'orpiment , 25–26; Liu, Healing with Poisons , 20–22. Obringer's book is a critical source of studying the medical use of poisons in premodern China, especially from a pharmaceutical perspective. Liu's new monograph further explores the topic in the social, political, and religious culture of medieval China.
Unschuld, Medicine in China , 17–28; Wilms, trans., The Divine Farmer's Classic of Materia Medica , 14–17.
Schafer, The Golden Peaches of Samarkand , 211, 220; Chen Ming, Zhonggu yiliao yu wailai wenhua , 114–223.
Maejima, "Teriaka kō," 41–154.
Nappi, The Monkey and the Inkpot .
Li Shizhen, Bencao gangmu , 17.1113–29.
Unschuld, Medicine in China , 158–60; Zheng Yangwen, The Social Life of Opium in China .
Artelt, Studien zur Geschichte der Begriffe "Heilmittel" und "Gift" ; Rinella, Pharmakon .
Moisan, "Les plantes narcotiques dans le Corpus hippocratique," 381–92; Girard, Connaissance et méconnaissance de l'hellébore dans l'Antiquité .
Riddle, Dioscorides on Pharmacy and Medicine .
Beck, trans., De Materia Medica ; Luccioni, " Pharmakon et problèms de dosage chez Dioscoride," 29–44.
Touwaide, "Les poisons dans le monde antique et byzantine," 265–81; Touwaide, "Harmful Botanicals," 387–99. Touwaide's studies offer critical insights into the history of toxicology in Greek antiquity.
Beck, trans., De Materia Medica , 86, 142, 281–83; Riddle, Dioscorides on Pharmacy and Medicine , 65–66.
Gibbs, Poison, Medicine, and Disease . Gibbs's monograph offers a crucial study of the medical understandings of poisons and the rise of toxicological thoughts in medieval and early modern Europe.
Beck, trans., De Materia Medica , 281; Riddle, Dioscorides on Pharmacy and Medicine , 66.
Obringer, L'aconit et l'orpiment , 91–143.
Liu, "Poisonous Medicine in Ancient China," 437–38. It is worth noting that aconite encompasses more than 250 species in the genus of Aconitum . The one for fuzi in China ( Aconitum carmichaelii ) and the one for wolfsbane in Europe ( Aconitum napellus ) are of different species, both of which are highly poisonous.
Derrida, "Plato's Pharmacy," 61–171.
Touwaide, "Galien et la toxicologie," 1887–986.
Kaptchuk, The Web That Has No Weaver , 7–15.
Wilms, The Divine Farmer's Classic of Materia Medica , 26–27.
Li Jianmin, "They Shall Expel Demons," 1103–50.
Strickmann, Chinese Magical Medicine , 58–88.
Chang, "'Jiyi' yu 'xiangran'," 157–99.
Chen Cangqi, Bencao shiyi jishi , 6.242–43.
Liu, Healing with Poisons , 61–80. On the discussion of these two etiological models, see Temkin, "The Scientific Approach to Disease," 629–47; Rosenberg, Explaining Epidemics , 293–304; on the application of the two models in Chinese medicine, see Unschuld, "Traditional Chinese Medicine," 1023–29; Hinrichs, "The Catchy Epidemic," 19–62.
Mayor, The Poison King .
Watson, Theriac and Mithridatium ; Totelin, "Mithradates' Antidote," 1–19.
The episode is cited in the commentary to the History of the Wei (Weishu). Zhen refers to a legendary bird whose feathers, once dipped into a wine, could kill a person instantly. See Mayanagi, "Chintori," 151–85.
Chang, "Aspects of Smallpox"; Needham et al., Science and Civilisation in China , vol. 6, pt. 6, 114–74.
On general orientations of the history of epidemics in China, see Kuriyama, "Epidemics, Weather, and Contagion," 3–22; Volkmar, "The Concept of Contagion in Chinese Medical Thought," 147–65; Hanson, Speaking of Epidemics in Chinese Medicine .
Sun, Beiji qianjin yaofang jiaoshi , 9.340.
Li Jianmin, "Contagion and its Consequences," 201–22.
Mitchell, Ye, and Wiseman, trans., Shang Han Lun .
Hinrichs, "Governance through Medical Texts and the Role of Print," 217–38; Brown, The Art of Medicine in Early China, 110–29.
Goldschmidt, Evolution of Chinese Medicine, 69 – 136.
Obringer, "Song Innovation in Pharmacotherapy," 192–213.
Nutton, "The Seeds of Disease," 1–34.
Gibbs, Poison, Medicine, and Disease , 116–49.
Arrizabalaga, " Pestis Manufacta ," 62–80.
Schipper and Verellen, eds., The Taoist Canon , vol. 1, 99–106, 377–401; vol. 2, 850–69.
Needham et al., Science and Civilisations in China , vol. 5, pt. II, pt. III, and pt. IV; Ho, Explorations in Daoism .
Sivin, "Chinese Alchemy and the Manipulation of Time," 512–26; Pregadio, Great Clarity .
Ho and Needham, "Elixir Poisoning in Medieval China," 221–51.
Liu and Kuriyama, "Fluid Being."
Ge, Baopuzi neipian jiaoshi , 2.20; Pregadio, "Which is the Daoist Immortal Body?," 385–407.
Huangdi jiuding shendan jingjue , 19.14a; Pregadio, Great Clarity , 79–99.
Liu, Healing with Poisons , 164–66.
The body of literature on European alchemy is large. Representative studies and surveys are: Smith, The Body of the Artisan ; Moran, Distilling Knowledge ; Nummedal, Alchemy and Authority in the Holy Roman Empire ; Principe, The Secrets of Alchemy ; Ray, Daughters of Alchemy .
Temkin, "Medicine and Graeco-Arabic Alchemy," 134–53.
Bagliani, "Rajeunir au Moyen Age," 9–23; Getz, "Roger Bacon and Medicine," 337–64; Rampling, The Experimental Fire , 61–99.
The quote is from Paracelsus's Seven Defenses , III, cited in Gibbs, Poison, Medicine, and Disease , 201. On Paracelsus and alchemy, see Webster, Paracelsus; Moran, Paracelsus .
Gibbs, Poison, Medicine, and Disease, 200–204; Hedesan, "Alchemy, Potency, Imagination," 81–102; Moran, Paracelsus , 68–93.
Pregadio, "Elixirs and Alchemy," 179–80.
Liu, Healing with Poisons , 39–58. On the notion of "drug assemblage," see Deleuze and Guattari, A Thousand Plateaus , 282–86.
Li Jianmin, "Nüyi sha'ren," 285–324.
Liu, Healing with Poisons , 82–86. On the substitution for gelsemium in local practice, see Liu, "Transmission of Drug Knowledge in Medieval China."
Schafer, The Vermilion Bird .
Diamond, "Miao and Poison," 1–25.
Bever, "Poison," 906–907.
King, "'First Behead Your Viper'," 29–30.
Collard, The Crime of Poison in the Middle Ages , 97–101. Collard's book remains a critical source of understanding the social functions of poisons in medieval Europe.
Mauss, The Gift , 61–62.
Two important collections of essays examining this topic in European history are: Collard and Samama, Le corps à l'épreuve ; Grell, Cunningham, and Arrizabalaga, " It All Depends on the Dose ."
Rankin, The Poison Trials .
One such text is Formulas to Counter a Hundred Poisons (Jie baidu fang), written by Gao Lian (1573–1620).
To be sure, there are exceptions. Gu poison and people who manipulated it were usually perceived to be non-transformable in premodern China.
Herzberg, White Market Drugs ; Lee, Smoke Signals .
Kohrman, Gan, Liu, and Proctor, eds., Poisonous Pandas ; Fleming and Johnson, eds., Toxic Airs .
Levey, Medieval Arabic Toxicology .
Gurke, Taming the Poisonous .
Arnold, Toxic Histories , 24–27.
Whyte, "The Power of Medicines in East Africa," 218–20.
Smith, ed., Entangled Itineraries ; Yoeli-Tlalim, ReOrienting Histories of Medicine .
New studies have started to address this issue in the African and Indian contexts. See Osseo-Asare, Bitter Roots , 107–30; Arnold, Toxic Histories .
Arnold, David. Toxic Histories: Poison and Pollution in Modern India. Cambridge: Cambridge University Press, 2016. ( Link to IsisCB )
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Bisset, N. G. "Arrow Poisons in China. Part I." Journal of Ethnopharmacology 1.4 (1979): 325–84.
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Collard, Franck and Évelyne Samama, eds. Le corps à l'épreuve: Poisons, remèdes et chirurgie: aspects des practiques médicales dans l'Antiquité et au Moyen-Âge. Langres: D. Guéniot, 2002. ( Link to IsisCB )
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Ge Hong葛洪 (283–343). Baopuzi neipian jiaoshi 抱朴子內篇校釋 [Inner chapters of the master who embraces the unhewn, collated and explained]. Edited by Wang Ming 王明. Beijing: Zhonghua Shuju, 1985.
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Schafer, Edward H. The Vermilion Bird: T'ang Images of the South. Berkeley: University of California Press, 1967.
Schipper, Kristofer, and Franciscus Verellen, eds. The Taoist Canon: A Historical Companion to the Daozang. Chicago: University of Chicago Press, 2005.
Sivin, Nathan. "Chinese Alchemy and the Manipulation of Time." Isis 67.4 (1976): 512–26. ( Link to IsisCB )
Smith, Pamela H. The Body of the Artisan: Art and Experience in the Scientific Revolution. Chicago: University of Chicago Press, 2004. ( Link to IsisCB )
Smith, Pamela H. ed. Entangled Itineraries: Materials, Practices, and Knowledges across Eurasia. Pittsburgh: University of Pittsburgh Press, 2019.
Strickmann, Michel. Chinese Magical Medicine, edited by Bernard Faure. Stanford: Stanford University Press, 2002. ( Link to IsisCB )
Sun Simiao孫思邈 (581?–682). Beiji qianjin yaofang jiaoshi 備急千金要方校釋 [Essential formulas worth a thousand in gold for emergencies, collated and explained]. 650s. Edited by Li Jingrong 李景榮 et al. Beijing: Renmin Weisheng Chubanshe, 1997.
Temkin, Owsei. "Medicine and Graeco-Arabic Alchemy." Bulletin of the History of Medicine 29.2 (1955): 134–53.
Temkin, Owsei. "The Scientific Approach to Disease: Specific Entity and Individual Sickness." In Scientific Change: Historical Studies in the Intellectual, Social and Technical Conditions for Scientific Discovery and Technical Innovation, from Antiquity to Present, edited by A. C. Crombie, 629–47. New York: Basic Books, 1963.
Totelin, Laurence M. V. "Mithradates' Antidote: A Pharmacological Ghost." Early Science and Medicine 9.1 (2004): 1–19.
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Touwaide, Alain. "Galien et la toxicologie." In Aufstieg und Niedergang der Römischen Welt, Band II, vol. 37.2, edited by W. Haase and H. Temporini, 1887–986. Berlin: Walter de Gruyter & Co., 1994. ( Link to IsisCB )
Touwaide, Alain. "Harmful Botanicals." In History of Toxicology and Environmental Health: Toxicology in Antiquity, edited by Philip Wexler, 387–99. London: Elsevier, 2019.
Unschuld, Paul. "Zur Bedeutung des Terminus tu 毒 in der traditionellen medizinisch-pharmazeutischen Literatur Chinas." Sudhoffs Archiv 59.2 (1975): 165–83.
Unschuld, Paul. Medicine in China: A History of Pharmaceutics. Berkeley: University of California Press, 1986. ( Link to IsisCB )
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Originally published by the Encyclopedia of the History of Science, Carnegie Mellon University, 05.2021, under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license.
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Harry Stack Sullivan
American psychiatrist and psychoanalyst (1892–1949)
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Herbert "Harry" Stack Sullivan (February 21, 1892, Norwich, New York – January 14, 1949, Paris, France) was an American Neo-Freudian psychiatrist and psychoanalyst who held that "personality can never be isolated from the complex interpersonal relationships in which [a] person lives" and that "[t]he field of psychiatry is the field of interpersonal relations under any and all circumstances in which [such] relations exist".[1] Having studied therapists Sigmund Freud, Adolf Meyer, and William Alanson White, he devoted years of clinical and research work to helping people with psychotic illness.[2]
Sullivan was a child of Irish immigrants and grew up in the then anti-Catholic town of Norwich, New York, resulting in a social isolation which may have inspired his later interest in psychiatry. He attended the Smyrna Union School, then spent two years at Cornell University from 1909,[3] receiving his medical degree in Chicago College of Medicine and Surgery in 1917.
Along with Clara Thompson, Karen Horney, Erich Fromm, Otto Allen Will, Jr., Erik H. Erikson, and Frieda Fromm-Reichmann, Sullivan laid the groundwork for understanding the individual based on the network of relationships in which they are enmeshed. He developed a theory of psychiatry based on interpersonal relationships[4] where cultural forces are largely responsible for mental illnesses (see also social psychiatry). In his words, one must pay attention to the "interactional", not the "intrapsychic". This search for satisfaction via personal involvement with others led Sullivan to characterize loneliness as the most painful of human experiences. He also extended the Freudian psychoanalysis to the treatment of patients with severe mental disorders, particularly schizophrenia.
Besides making the first mention of the significant other in psychological literature, Sullivan developed the idea of the "Self System", a configuration of the personality traits developed in childhood and reinforced by positive affirmation and the security operations developed in childhood to avoid anxiety and threats to self-esteem. Sullivan further defined the Self System as a steering mechanism toward a series of I-You interlocking behaviors; that is, what an individual does is meant to elicit a particular reaction.
Sullivan called these behaviors Parataxical Integrations and he noted that such action-reaction combinations can become rigid and dominate an adult's thinking pattern, limiting their actions and reactions toward the world as the adult sees the world and not as it really is. The resulting inaccuracies in judgment Sullivan termed parataxic distortion, when other persons are perceived or evaluated based on the patterns of previous experience, similar to Freud's notion of transference. Sullivan also introduced the concept of "prototaxic communication" as a more primitive, needy, infantile form of psychic interchange and of "syntactic communication" as a mature style of emotional interaction.
Sullivan's work on interpersonal relationships became the foundation of interpersonal psychoanalysis, a school of psychoanalytic theory and treatment that stresses the detailed exploration of the nuances of patients' patterns of interacting with others.
Sullivan was the first to coin the term "problems in living" to describe the difficulties with self and others experienced by those with mental illnesses. This phrase was later picked up and popularized by Thomas Szasz, whose work was a foundational resource for the antipsychiatry movement. "Problems in living" went on to become the movement's preferred way to refer to the manifestations of mental disturbances.
In 1927, he reviewed the controversial, anonymously published The Invert and his Social Adjustment and in 1929 called it "a remarkable document by a homosexual man of refinement; intended primarily as a guide to the unfortunate sufferers of sexual inversion, and much less open to criticism than anything else of the kind so far published."[5]
He was one of the founders of the William Alanson White Institute, considered by many to be the world's leading independent psychoanalytic institute, and of the journal Psychiatry in 1937. He headed the Washington, DC School of Psychiatry from 1936 to 1947.
In 1940, he and colleague Winfred Overholser, serving on the American Psychiatric Society's committee on Military Mobilization, formulated guidelines for the psychological screening of inductees to the United States military. He believed, writes one historian, "that sexuality played a minimal role in causing mental disorders and that adult homosexuals should be accepted and left alone." Despite his best efforts, others included homosexuality as a disqualification for military service.[6]
Beginning on December 5, 1940, Sullivan served as psychiatric adviser to Selective Service director Clarence A. Dykstra, but resigned in November 1941 after Gen. Lewis B. Hershey, who was hostile to psychiatry, became the director.[7] Sullivan then took part in establishing the Office of War Information in 1942. [8] Beginning in 1927, Sullivan had a 22-year relationship with James Inscoe Sullivan, known as "Jimmie", who was 20 years younger than Sullivan.[9]
Although some contemporaries and historians have regarded Inscoe as an unofficially adopted son, and Sullivan as closeted, his colleague Helen Swick Perry's biography of Sullivan mentions the relationship and it is clear his close friends were well aware they were partners.
Although Sullivan published little in his lifetime, he influenced generations of mental health professionals, especially through his lectures at Chestnut Lodge in Rockville, Maryland, outside Washington, DC. Leston Havens called him the most important underground influence in American psychoanalysis. His ideas were collected and published posthumously, edited by Helen Swick Perry, who also published a detailed biography in 1982 (Perry, 1982, Psychiatrist of America).
Works[edit]
The following works are in Special Collections (MSA SC 5547) at the Maryland State Archives in Annapolis: Conceptions of Modern Psychiatry, Soundscriber Transcriptions (Feb. 1945-May 1945); Lectures 1-97 (begins Oct. 2, 1942); Georgetown University Medical School Lectures (1939); Personal Psychopathology (1929–1933); The Psychiatry of Character and its Deviations-undated notes.
His writings include:
The Interpersonal Theory of Psychiatry (1953)
"The Psychiatric Interview" (1954)
Conceptions of Modern Psychiatry (1947/1966)
Schizophrenia as a Human Process (1962)
Associates[edit]
After Sullivan's death, Saul B. Newton and his wife Dr. Jane Pearce (a psychiatrist who studied with Sullivan in the late 1940s) established the Sullivan Institute for Research in Psychoanalysis in New York City.
^ Sullivan, H. S. (1947). Conceptions of Modern Psychiatry. Washington D.C.:William A. White Psychiatric Foundation. pp. 4-5.
^ Clara Thompson, "Sullivan and Psychoanalysis" in Mullahy, Patrick, ed. (1952). The Contributions of Harry Stack Sullivan. Hermitage House. p. 101.
^ Kimble, Gregory A.; Wertheimer, Michael; White, Charlotte (1991). Portraits of pioneers in psychology, Volume 1. Routledge. p. 328. ISBN 0-8058-1136-2.
^ Rioch DM (May 1985). "Recollections of Harry Stack Sullivan and of the development of his interpersonal psychiatry". Psychiatry. 48 (2): 141–58. doi:10.1080/00332747.1985.11024276. PMID 3887444.
^ Vande Kemp, 15
^ Bérubé, pp. 9—11
^ Vande Kemp, 16-7
^ Perry, 168
^ Hendrika Vande Kemp, "Harry Stack Sullivan (1892-1949): Hero, Ghost, and Muse," in E. Mark Stern and Robert B. Marchesani, eds., Saints and Rogues: Conflicts and Convergence in Psychotherapy (Haworth Press, 2004), 10-14, available online, accessed February 18, 2012
Bérubé, Allan (1990). Coming Out Under Fire: The History of Gay Men and Women in World War Two. New York, The Penguin Group. ISBN 0-452-26598-3.
Chapman, A. H.: Harry Stack Sullivan - His Life and His Work, New York, G.P.Putnam's Sons, 1976.
Evans III, F. Barton: Harry Stack Sullivan - Interpersonal theory and psychotherapy. London/New York, Routledge, 1996.
Mitchell, Stephen A.: Harry Stack Sullivan and Interpersonal Psychoanalysis. In: St. A. Mitchell & M. Black: Freud and Beyond - A History of Modern Psychoanalytic Theught, Basic Books, New York, 1995, ISBN 978-0-465-01405-7, p. 60-84.
Mullahy, Patrick: Psychoanalysis and Interpersonal Psychiatry - The Contributions of Harry Stack Sullivan, New York, Science House, 1970.
Mumford, Robert S.: Traditional Psychiatry, Freud, and H. S. Sullivan. Comprehensive Psychiatry, Vol. 2, No. 1, February, 1961.
Perry, Helen Swick: Psychiatrist of America - The Life of Harry Stack Sullivan. The Belknap Press of Harvard University Press, Cambridge MA and London, 1982, ISBN 0-674-72076-8.
Wake, Naoko: Private Practices: Harry Stack Sullivan, the Science of Homosexuality, and American Liberalism. Rutgers University Press, 2011
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MASHA Conference - April 27, 2017. Annual Mid-Atlantic Safety & Health Alliance conference held at the Regional Learning Alliance in Cranberry, PA. Registration is now open -- Details can be found on the Conference Page - click here for more information. Space is limited, so register early.
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Béland-Goyette on OneSoccer: 'Very low chance' of staying with Valour after 2019
Marty Thompson, CanPL.ca
Louis Béland-Goyette pulled no punches about his time with Valour FC on OneSoccer's first episode of a daily series of Player & Pundit Hangouts.
Joined by OneSoccer's Kurt Larson, Oliver Platt and Adam Jenkins on Twitch, the HFX Wanderers FC midfielder discussed his move to Halifax, the need for a new project after Valour, and much more.
Speaking from self-isolation, 'LBG' reflected on the 2019 CPL season with Valour and how there was a "very low chance" he was to stay past a disappointing Year 1.
"You do a year of a contract, have a good season, and look at your options," Béland-Goyette told OneSoccer of his post-2019 plans. "From the start of the season, in my head, there was a very low chance I would stay in Winnipeg – despite the season we had."
The 24-year-old midfielder impressed on a Valour side that struggled to a 28-point regular campaign, operating as one of the top box-to-box midfielders in CPL. He joined Valour last season after a long injury layoff, dating back to the 2018 campaign with the Montreal Impact.
"Halifax showed their interest… Having spoken to players last year, it was a clear opportunity and a nice project to jump into,"Béland-Goyette said.
"It was clear I needed a new project after Winnipeg."
To watch the full Player & Pundit Hangout with Louis Béland-Goyette, click here.
Subscribe to OneSoccer on YouTube for more Player & Pundit Hangouts and follow on Twitch to watch live Monday-Friday at 1pm ET.


It had been more than three years since his last Great Eastern-Hyundai S.League game.
But last night, Balestier Khalsa winger Hanafi Akbar showed the kind of skill and vision that once made him Singapore football's hottest prospect, in his side's 1-0 win over Garena Young Lions (GYL) at the Toa Payoh Stadium.
The 22-year-old, who re-joined Balestier only this week after a year in prison for drug offences, was surprisingly deployed by coach Marko Kraljevic for the second half, with the game still goal-less.
Just eight minutes after his introduction, he controlled the ball on his chest before sending a glorious cross-field volley to teammate Hazzuwan Halim, who squared the ball for Myanmar forward Aung Kyaw Naing to slot home the winner from close range.
Kraljevic said he was delighted for the former 2010 Youth Olympic Games star.
"I'm very happy for Hanafi," said the German-born Croat.
"Honestly, this boy is on a different level. Most players will find it hard to perform after just a month of not playing. He was out for three years and showed he was different tonight.
"Give him some time and he will come good."
Hanafi is determined to put his troubled past behind him, and said that just being back on the pitch in an S.League game is worth savouring.
"It's a great feeling," he said with a big grin, post-match.
"I didn't expect coach would put me on at half-time and I thought I would struggle, so I was a bit nervous. But I thought I had a fair game.
"For now, I don't want to look too far ahead. I just want to get fully fit and be in the best shape that I can be."
Hanafi is eligible for August's South-east Asia (SEA) Games in Kuala Lumpur and his talent could come in handy for the national Under-22 team, who have struggled for goals.
While he understandably looked a little rusty at times and appeared spent towards the end of the match, his performance did not go unnoticed.
SEA Games head coach Richard Tardy, who was in the stands, said: "I know he was a very good young player before, but he must prove today he deserves a place in the squad.
"We have training camps in May and June, and a big (AFC Under-23 Championships qualifying) tournament in July, before the SEA Games.
"For now, as with other players (outside of the Young Lions), I will follow him closely."
With a majority of their squad likely to form the SEA Games team, the Young Lions' problems in front of goal was highlighted last night with their inability to find the target for the third successive game.
Young Lions shot-stopper Fashah Iskandar had already pulled off a terrific stop to deny Aung from the penalty spot in the 23rd minute, but they just could not score.
The closest they got to an equaliser was when Ammirul Emmran's header in injury time was tipped away at full stretch by Zaiful Nizam.
Said their coach V Selvaraj: "I felt luck wasn't on our side. We deserved at least one goal in this game."


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Football: Donovan Leary's development, Tarheeb Still's leadership guiding Timber Creek resurgence
Timber Creek quarterback Donovan Leary has improved dramatically after a rough freshman season and
Football: Donovan Leary's development, Tarheeb Still's leadership guiding Timber Creek resurgence Timber Creek quarterback Donovan Leary has improved dramatically after a rough freshman season and Check out this story on courierpostonline.com: https://www.courierpostonline.com/story/sports/high-school/football/2019/10/03/south-jersey-high-school-football-timber-creek-rolling-behind-donovan-leary-tarheeb-still/3842789002/
Josh Friedman, Cherry Hill Courier-Post Published 1:24 p.m. ET Oct. 3, 2019
Timber Creek sophomore quarterback Donovan Leary (left) and senior receiver Tarheeb Still have excelled during the Chargers' 3-1 start to the season. (Photo: Josh Friedman/Staff Photographer)
The first interception came on the first pass of Donovan Leary's first career varsity start.
A linebacker showed blitz, backed out and jumped a hitch route, racing the other way for six.
The touchdown wound up being negated for an illegal block, but the play typified Leary's and the Timber Creek High School football team's entire 2018 season.
Leary would throw four picks that evening in a 42-20 loss to Millville. The freshman finished the season with 14 interceptions and the Chargers closed the campaign with their first losing record (4-7) since 2006.
More: South Jersey Football: Hammonton's Jaiden Abrams is Player of the Week
More: H.S. football: Things you may have missed from September
"It was a mixture of a lot of things," Leary reflected. "I was a 14-year-old and it was a lot of change coming from eight grade, playing kids my age to playing kids two, three years older than me."
However, the experience, albeit negative, helped turn Leary into the blossoming quarterback he is today.
Leary has put up gaudy numbers as No. 12 Timber Creek is off to a 3-1 start with 11th-ranked Highland on the docket Friday.
He's completed 68-of-105 passes (64.8 percent) for 1,290 yards and 13 touchdowns. Even more important, he's thrown just one interception.
More: South Jersey football: Donovan Leary one of the best players from September
"It's getting to know my receivers, getting the connection down," Leary said. "It's been studying the playbook. I've been watching old film trying to realize what I did wrong, what I did right, talking to my brother, seeing what he could say about it. Overall it was a lot of hard work."
Leary's brother Devin set state records for career passing yards (9,672) and touchdowns (105) before taking his talents to North Carolina State, where he's currently a sophomore.
Donovan, who already has offers from Maryland, Rutgers and Temple, among others, learned a lot from his brother's teachings, not just because of Devin's talent, but because of his familiarity with the system. But there was one note that stuck out above the rest.
"You don't have to impress anybody, just play your game," Donovan said Devin told him.
That was an issue last season for Donovan, who split snaps with Justin Jefferson, now at Delaware Valley.
Timber Creek's Donovan Leary (right) has thrown six touchdown passes to Tarheeb Still already this season. (Photo: Josh Friedman/Staff Photographer)
"I think it was a little bit of too much self-confidence," head coach Rob Hinson said. "He's a confident kid and last year he thought he needed to do more than what we needed him to do."
He's relying more on his coaches and teammates this year, like offensive coordinator Jamal White, quarterbacks coach Bill Belton and his receivers, particularly Maryland commit Tarheeb Still.
"Tarheeb told me in the offseason, he said every time you go to the field call me, I'm coming up," Leary said. "So, every time I went to the field I called him and I'd get there and he's there before me. He's practicing and he's ready to go out. I get out there and he's telling me what to do, he's telling me different things about my throws and everything, trying to get reads because he's been in the system. This will be his third year now. He's been through all the quarterbacks that are great. He gave me a lot of input."
More: South Jersey Football Mean 15 Rankings for Sept. 29
Their connection has been impeccable this year. Still has 21 catches for 663 yards and six touchdowns already.
"I definitely couldn't do it without Tarheeb. That's a no-brainer," Leary said. "He's one of those guys where you could throw to (a spot) and he's going to get it no matter what."
Still showed that last week in a 44-10 win over Vineland, catching five passes for 238 yards and two scores despite rolling his ankle after his first reception.
"Teams are putting an outside backer inside of him, corner outside and safety over top and he's still getting by them," Hinson said.
Maybe more important though is Still's leadership.
"I took a lot of responsibility (for last year)," he said. "I was trying to be a leader, that guy on offense to show the guys what to do, the right way, and just taking accountability. Even if you mess up be like oh, my bad, shake it off, stuff like that, just try to keep the offense rolling. It didn't really work out how we wanted to last year, but I used that to help fuel this year."
Leary is starting to follow suit.
"Last year he wasn't really vocal," Still said. "He had his head down and stuff just trying to earn respect from the older guys, but this year I feel like he's taking on that leadership role. He's the leader of the offense. He's always yelling, telling guys where to line up, commanding the office for good stuff. Make sure were on the ball moving. He's being a leader we actually need on offense, that voice."
It's one of Hinson's favorite similarities between Donovan and Devin. The arm talent is great, but the ability to command a crowd could be even more impressive.
"The kids follow him," Hinson said. "… They all wanted to follow Devin (too)."
Still hopes South Jersey is following along too because Timber Creek is coming back in force.
"This is just the beginning," he said. "We're putting up big numbers and stuff like that, but we still have a lot of room to grow, a lot of stuff we can do a lot better. Once we clean up all the mental mistakes and mental errors, we're just going to take off. So, something to watch."
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Josh Friedman has produced award-winning South Jersey sports coverage for the Courier Post and The Daily Journal for more than a decade. If you have or know of an interesting story to tell, reach out on Twitter at @JFriedman57 or via email at jfriedman2@gannettnj.com. You can also contact him at 856-486-2431. Help support local journalism with a Courier Post subscription.
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Emotional letdown? 'You know that word that starts with B?'


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Endogenous growth hormone keeps older athletes young
If you're in your mid-forties and exercise every day, then you probably make as much rejuvenating growth hormone [spatial formula shown below] as some
If you're in your mid-forties and exercise every day, then you probably make as much rejuvenating growth hormone [spatial formula shown below] as someone in their mid -twenties. Exercising this way delays the process of aging, according to researchers at the University of Parma.
Growth hormone stimulates recovery of body tissues, such as muscle fibre, bone, skin and joints. What's more, growth hormone also stimulates fat burning. The older you get, the less growth hormone the pituitary gland in your brain secretes. Researchers think that this slowing down sparks off a series of aging processes, such as osteoporosis and weakening of the joints and muscles. Synthetic hormones are still a very popular way of slowing down the aging process, but studies have shown that they have drawbacks. That's why the Italians are searching for a natural way of maintaining the body's production of growth hormone later in life.
Athletes produce more growth hormone after physical exertion. You also make more growth hormone while you sleep, but in adults this peak is nowhere near as high as the growth hormone peak after exercise. So do older athletes, because of regular exercise, maintain youthful levels of growth hormone production? That's the question the Italians set out to answer.
The researchers got 40 women to cycle for 20 minutes. The researchers gradually increased the resistance of the bike, and the women had to continue cycling until they were no longer able to turn the pedals. The researchers measured the level of growth hormone in the women's blood during the experiment.
Ten of the women were aged between 26 and 30 and did no regular sport [in the figure below: the black squares]. Ten other women were also aged between 26 and 30, but ran about 25 km a week [white squares]. Another ten of the women were aged between 42 and 46 and did not exercise [black circles]. And the last ten were aged between 42 and 46 but had been running about 25 km a week for the last 8 years [white circles].
If you're younger than 30, then training doesn't influence your growth hormone production, the researchers conclude. After a training session the subjects' growth hormone level rises by a factor of 7.5 – whether they take regular exercise or not.
Fifteen years later, however, it's a different story. By that age a difference has arisen between the athletes and the non-athletes. For the subjects in their forties with a sedentary lifestyle, the growth hormone level after training goes up by a maximum of a factor 4.4. But the growth hormone level of the subjects in their forties who take regular exercise reacts the same as the subjects in their twenties.
The researchers think that as you age you produce more growth-hormone inhibiting hormones such as somatostatin. Regular physical training could inhibit the production of these hormones, they think. This way you could halt growth-hormone related aging processes.
Effect of physical training on age-related reduction of GH secretion during exercise in normally cycling women.
To evaluate whether prolonged physical activity (25 km/week running for 8 years) modifies GH decline.
The GH response to maximal exercise on bicycle-ergometer was tested in younger (26-30 years) and older (42-46 years) healthy women. Each age group included 2 subgroups of 10 sedentary and 10 runners, which were compared. The workload was increased at 3 min intervals from time 0 until exhaustion. Subjects with a low maximal capacity (as established in a preliminary test) pedalled for 3-4 min against no workload at the beginning of the test, so that exercises lasted about 15 min in all individuals.
At exhaustion, heart rate and systolic pressure were significantly higher in sedentary than in trained subjects, whereas V(O(2)max), blood glucose and plasma lactate levels were similar in all groups. Exercise induced similar GH responses in younger sedentary and exercise-trained subjects and in older exercise-trained subjects, with mean peak levels 7.5 times higher than baseline. In contrast, in older sedentary women peak GH level was only 4.4 times higher than baseline and was significantly lower than in the other groups.
These data suggest that in women prolonged physical training exerts protective effects against age-dependent decline in GH secretion.
Source: http://www.ncbi.nlm.nih.gov/pubmed/20117890
Articles 5791 Fitness 497 Growth Hormone 11 Science 1093 Studies 2547
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