In this opening episode, hosts Profs. Michael Stanley-Baker and Ronit Yoeli-Tlalim introduce the podcast and reflect on the paths that brought them to the history of medicine and the healing arts. They share how their thinking and scholarly practice have developed over time, the questions that continue to animate their work, and some of the encounters, insights and formative moments that have shaped the way they understand medicine, healing, history and care.

Across the series, Michael and Ronit will be joined by scholars, practitioners and thinkers to explore historically rooted medical knowledge as a resource for rethinking health, illness, care and well-being in the present. Together, they consider how different cultures and traditions have understood the body, healing, suffering, environment and the meaning of health.

This first episode sets out the central questions of the podcast: what can ancient Asian medicine, global healing traditions and the long history of medical knowledge teach us about the challenges facing medicine today?

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Links and resources:

• MIT Global Humanities Initiative- Medicine and the Healing Arts pillar: https://comparativeglobalhumanities.mit.edu/pillars/healing-arts-and-human-well-being/

• Life of Breath project: https://lifeofbreath.webspace.durham.ac.uk/

• Asian Medicine and COVID 19 Special Issue: https://brill.com/view/journals/asme/16/1/asme.16.issue-1.xml

• IASTAM: https://iastam.org/

• IASTAM COVID webinars: https://iastam.org/category/webinars/

• NTU and Max-Planck Center for Bio-Cultural Worlding: https://ntu.ccasingapore.org/researchs/max-planck-ntu-singapore-centre-for-biocultural-worlding/

Resources mentioned in the episode:

* Pierce Salguero, Meditation Sickness: A Sourcebook of the Dangers of Buddhist Practice (2026).

* Pierce Salguero, “Meditation Sickness” in Medieval Chinese Buddhismand the Contemporary West (2023).

* Pierce’s previous appearances on Buddhist Yoga: Buddhist Medicine and Contemplative Pedagogy ; The Contemporary Landscape of Buddhist Healing

* Pierce’s resource website: BuddhistMedicine.Net

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com

If you want to hear scholars and practitioners engaging in deep conversations about the dark side of Asian religions and medicines, then subscribe to Black Beryl wherever you get your podcasts. Also check out our members-only benefits on Substack.com to see what our guests have shared with you. Enjoy the show!

Resources related to this conversation:

* Tawni Tidwell, “Life in Suspension with Death: Biocultural Ontologies, Perceptual Cues, and Biomarkers for Tibetan Tukdam Postmortem Meditative State” (2024)

* Tawni Tidwell et al, “Effect of Tibetan Herbal Formulas on Symptom Duration Among Ambulatory Patients with Native SARS-CoV-2 Infection: A Retrospective Cohort Study” (2024)

* Tawni Tidwell, “Tibetan Medical Paradigms for the SARS-CoV-2 Pandemic: Understanding COVID-19, Microbiome Links, and Its Sowa Rigpa Nosology” (2021)

* New open access book! Crafting Potency: Sowa Rigpa Artisanship Across the Himalayas

* Tawni’s research profile at the Center for Healthy Minds

* Please note that Tawni is not taking new patients at this time, but she recommends the American Tibetan Medical Association

Check out the Black Beryl Podcast on blackberyl.substack.com!

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com

Prof. Volker Scheid PhD, FRCHM, FBAcC is an internationally known practitioner, teacher, and scholar of Chinese medicine. He was Director of EASTmedicine at the University of Westminster, a trans-disciplinary research centre for the study of East Asian medicines, from 2004 to 2018, and is now a Visiting Researcher at the China Centre, University of Kiel. His latest book, Searching for the Dao of Medicine: Landscapes of Thoughtful Practice in Late Imperial Study (Berghahn 2026), explores different pathways to clinical virtuosity proposed by physicians and medical writers in China between the fourteenth century and the present.

In 1941, Ho Kai Cheong (何繼昌), a Guangdongese herbalist born in Malaya, established a modest tea stall in Ipoh, which eventually grew into Ho Yan Hor (何人可), today’s most iconic Chinese herbal tea brand in Malaysia. Rooted in a multi-ethnic community and shaped by an industry-driven economic context, the brand has evolved over 84 years from a local enterprise into a heritage icon and a leading pharmaceutical company with a global presence (Ho Yan Hor Museum, 2025). Despite the long-standing presence of Chinese herbal tea in Malaysia, research on its cultural heritage and social impact remains limited.

Tin and Tea: Creating Wealth and Health in Perak

Located on the west coast of the Malay Peninsula in Malaysia, Perak’s prominence began with the discovery of tin in Larut in 1848. This discovery catalyzed rapid development as mining activities proliferated throughout the 19th century, attracting significant Chinese immigration (Khoo and Abdur-Razzaq 2005, 15–20). Under colonial administration, Perak emerged as a leading tin producer, contributing over half of Malaya’s tin output and accounting for a quarter of global production. Tin mining brought significant prosperity and population growth to the region. In addition to tin, rubber played a crucial role in shaping Perak’s economy and attracting a large influx of laborers. By 1947, the Chinese diaspora in Perak had reached 444,509, constituting 46.6% of the state’s total population and surpassing both the Malay and Indian populations (Economic History n.d.). The Chinese maintained a high percentage among the ethnic groups for the following decades.

The 19th century witnessed the concurrent development of traditional and colonial healthcare systems in Malaya. Indigenous and folk medicine practices were prevalent throughout the peninsula. Traditional Chinese medicine (TCM) has long been an integral part of local community in Malay Peninsula. In 1879, Eu Kong, a native of Guangdong, established the first Chinese herbal medicine shop, Yan Sang, in Gopeng, Perak. It subsequently evolved into Yu Yan Sang (餘仁生), a highly esteemed listed company specializing in the production and sale of traditional Chinese herbs and medicines (Yeung 2004, 138). The practice of traditional Chinese medicine continued to grow, and in 1925, the Perak Chinese Herbal Medicinal Hall was established in Ipoh, further advancing its accessibility and influence in the region (Wong et al. 2019).

During World War II, Malaya, which included the state of Perak, underwent significant economic, social, and political transformations. The conflict resulted in widespread poverty, scarcity of resources, and severe health issues, burdening the population’s access to healthcare services. Government records show that public health deteriorated seriously in 1940s. Malaria was the great killer, although dysentery and malnutrition probably contributed to a significant portion of the mortality (Annual Report 1947, 68). After the war, the Perak Chinese Physicians Association and the Perak Chinese Physicians and Druggists Association were established, reflecting the growing demand for traditional Chinese medicine (Wong et al. 2019). In 1947, the Perak Choong Wah Hospital (霹靂中華醫院) was established by the Association to provide charitable, non-profit healthcare for the underprivileged (Perak Choong Wah Clinic 2025).

Chinese herbal tea, a folk healing tradition also known as “cooling teas,” was introduced to British Malaya alongside the introduction of Chinese medicine. Typically, a Chinese physician prescribes a remedy in the form of a formula consisting of multiple components. These formulas are usually boiled for a specified duration to produce a medicinal liquid known as a tang (湯), or decoction. In contrast, Chinese herbal tea uses much simpler formulas with only a few ingredients, which are typically local and readily available plants (Zong and Liscum 1996, 2). Chinese herbal tea has been popular in Southern China for centuries and are celebrated for their distinctive abilities to clear heat and detoxify. These teas come in a variety of formulations, each containing a broad spectrum of bioactive compounds (Liu et al. 2024). It is tailored to address common ailments such as dyspnea, rapid breathing, cough, or phlegm-related conditions. In early 20^th century, Chinese herbal tea shops were promoted in Southeast Asia and other countries. Among these, the most renowned was Wong Lo Kat herbal tea (Guo 2024).

The Legacy of Ho Yan Hor

The history of Ho Yan Hor herbal tea traces back to the 1940s, originating on Treacher Street in Ipoh, Perak. Ho Kai Cheong, the founder of Ho Yan Hor, was born in 1910 in Kati, Perak. His parents, who hailed from Panyu, Guangdong, operated a dim sum café in Kuala Kangsar. Ho was sent to his ancestral hometown, Panyu, in 1918 to further his education, returning to Malaya in 1924 (Ho Yan Hor Museum 2025). His early exposure to traditional learning and subsequent experience working at a Chinese medical hall nurtured his lifelong interest in Chinese medicine. Inspired by his passion for Chinese Medicine, Ho pursued further studies at the Ganton Wah Lam National Physician’s School in Hong Kong, from which he graduated in 1940, obtaining professional training in Chinese medicine (Fig. 1).

Ho began his career as a Chinese physician in 1941, but ceased due to the Japanese occupation. Following the war, miners in Perak began rehabilitating their mines and sought workers to resume operations. Ho Kai Cheong realized that many Chinese colliers suffered from colds, runny noses, and fevers due to body heat. This rekindled his passion for Chinese medicine, and he developed a flu remedy based on a carefully formulated blend of Chinese herbs, including those for dispelling body heat and Eight Formula sugar cane extract, which helps to dispel exogenous influences.

With an initial modest capital of $4, Ho Kai Cheong established his first tea stall on Teacher Street, offering the herbal remedy as a natural solution to alleviate these conditions (Fig. 2). Timing his sales to coincide with the return of coolies and workers in the afternoon and into the night, he was surprised when the herbal tea sold out at 5 cents a glass within less than an hour. His tea went on to eventually gain widespread popularity in the community.

Typically, Chinese herbal preparations involve processing dried herbs into powdered, coarsely ground, sliced, or fragmented forms, while fresh herbs are sliced or torn to maximize their surface area (Wu et al. 2018). In 1947, Ho Kai Cheong introduced an innovative concept: packaging Ho Yan Hor Herbal Tea for sale in coffee shops and Chinese medical halls (Fig. 3). Priced at ten cents per pack, the tea became a popular remedy among the local residents. Ho soon became known publicly as the “King of Herbal Tea.”

As indicated in Table 1, Ho Yan Hor herbal tea is formulated with a combination of various herbs traditionally used in Chinese medicine. Unlike common herbal cooling teas in Guangdong, such as Wong Lo Kat and the popular “Twenty-Four Flavors,” which mainly include herbs like chrysanthemum, honeysuckle, prunella vulgaris, and licorice, the Ho Yan Hor formula features a broader array of potent medicinal ingredients (Guo 2024). The formula incorporates potent heat-clearing and detoxifying agents, such as scrophularia, gardenia, and rhubarb, as well as herbs that dispel wind and dampness to alleviate symptoms of external colds and body aches. Additionally, it contains ingredients like atractylodes lancea, which dries dampness and supports the spleen, and licorice root to harmonize the potent medicinal properties. This creates a balanced remedy that maintains wellness by addressing both acute external symptoms and chronic internal imbalances. In times when aspirin and antibiotics were not readily available, it served as a highly effective treatment for such ailments (Ho 2009, 691).

Table 1. Ho Yan You Herbal Tea Formula in the 1940s.

Commercialization and Globalization

Building on the success of Ho Yan Hor herbal tea, the Ho Yan Hor Medical Hall was officially established in 1948. Several signature Chinese medicine products had been developed, including Ho Yan Hor Oil (何人可油), Ching Tim Kam Jik San (清甜疳積散), and Ko Kou Tan (可口丹). The continual growth reflected the local demand for traditional remedies.

In 1957, the Asian Flu spread rapidly across the globe (Honigsbaum 2020). During this time, Ho Yan Hor herbal tea gained popularity as an alternative remedy to Western medicine, valued for its perceived effectiveness in relieving symptoms such as fever and dizziness, promoting self-healing, and providing accessible household relief from influenza. The Ho Yan Hor factory, established in 1954, employed workers in the manufacturing process, marking the beginning of its modern commercialization. Recognizing the importance of marketing, Ho utilized innovative strategies, such as equipping his distribution vehicle (a Fordson van) with loudspeakers to advertise the benefits of his products across neighborhoods.

In the 1960s, Ipoh was home to numerous herbal tea vendors, many of whom hired young women known as “herbal tea ladies” (leong char mooi) to attract customers. Large Ho Yan Hor tea stalls also sprouted across the country. Leveraging his strong connections with Hong Kong, Ho Kai Cheong capitalized on the widespread popularity of Guangdongese opera and Hong Kong cinema among Chinese communities in the 1950s and 1960s. Famous performers from Hong Kong, including actress Tang Pik Wan (鄧碧雲) and TVB actor Cheng Gwan-Yin (鄭君綿), were invited to visit Ipoh for promotional events. Ho Yan Hor has consistently produced a series of advertisements in major newspapers across the country, with small-sized ads that consistently convey a continuous message to reinforce consumers’ brand recognition (Vijayan 2022). It registered its trademark and officially established its first overseas brand in 1960. By the 1970s, the brand had expanded its sales to include other countries such as the United States, the United Kingdom, and New Zealand (Fig. 4).

Since the 1980s, the depletion of Perak’s tin reserves and the global downturn in natural rubber demand have ushered in a period of economic transition. In response, the state government pursued diversification by promoting manufacturing as a new growth engine, supported by expanded infrastructure and industrial development. Industrial estates were progressively established across Perak (Perak Investment Management Centre 2025). Ho Yan Hor has responded by introducing new herbal varieties tailored to specific health needs, modernizing packaging, and rebranding to attract younger consumers while maintaining its heritage.

The original recipe has since undergone systematic refinement and expansion to include 31 herbs to maximize the therapeutic value and health benefits of the herbal tea (Table 2). The new formula is crafted to clear heat, dispel dampness, regulate qi, and alleviate pain. It is conveniently packaged in aluminum cans. Additionally, the introduction of these new products and packaging has reinforced the brand’s message of promoting herbal wellness among all Malaysians.

Table 2. Ho Yan Hor Herbal Tea New Formula

The Malaysian herbal tea market has experienced significant growth in recent years, fueled by consumers’ increasing preference for natural, health-promoting alternatives to caffeinated drinks. The market showcases innovations in herbal blends, sustainable packaging, and convenient wellness products (Mobility Foresights 2025). Amidst growing competition and changing consumer lifestyles, Ho Yan Hor has adapted by introducing functional teas such as Gold Tea, Night Tea, and the Everyday Series, thereby maintaining its position as Malaysia’s leading brand with the most diverse range of herbal teas, the evolution of its manufacturing and packaging not only demonstrates the brand’s progression through different historical stages but also reflects Malaysia’s broader industrialization and shifting consumer market trends.

Cultural Heritage and Medical Transition

Malaysia, with its rich biodiversity and multicultural traditions, fosters the development of a dynamic Chinese herbal tea and medicine sector. Remedies based on local flora are still prevalent in households and present significant potential for the creation of new herbal products. After the war, Perak experienced significant political and economic transformations that facilitated modernization and rapid development. The ascent of Ho Yan Hor, established in Perak during the 1940s and later expanding nationwide, coincided with these broader economic and industrial changes. The increasing popularity mirrored robust local demand for healthcare and the adaptation of traditional remedies to evolving social contexts. Despite the creation of Western health institutions, traditional medical practitioners maintained a dominant role within local communities (Mohd Sukri 2020). By 2024, the number of Chinese medicine practitioners had continued to grow, with 402 Chinese medicine halls and 482 registered physicians, though the actual figures are likely even higher (FCPMDAM, 2016).

Herbal tea remains highly popular in Malaysia, reflecting both enduring cultural traditions and increasing health awareness among consumers. Market analyses project that Malaysia’s herbal tea industry will expand from USD 1.2 billion in 2025 to USD 2.7 billion by 2031, registering a compound annual growth rate of 14.3% (Mobility Foresights 2025). Rich in bioactive compounds, herbal teas possess antioxidant, anti-inflammatory, antiviral, and hepatoprotective properties, and are traditionally valued for their ability to clear heat, reduce fever, soothe the throat, and relieve coughs (Lin, Li, and Huang, 2024).

Notably, significant ethnic differences exist in the knowledge and consumption of Chinese herbal tea across Malaysia. A survey in Kedah, northern Malaysia, found that many Chinese consumers maintain this practice as a cultural tradition, motivated by its perceived safety and health benefits (Teh, Jaafar, and Asma 2020). Over the past century, herbal tea has become not only a cultural emblem but also a prosperous business sector. Chinese entrepreneurship has been pivotal in shaping Malaysia’s societal and economic development. Perak has rapidly evolved from its traditional economic foundation of tin mining and related industries to a diversified array of manufacturing and service sectors, ranking as the seventh-largest by economic size and contributing 5.5% to the national GDP in 2020 (Zafri and Morhalim 2022). As of 2020, the Chinese community in Perak numbered 643,627, constituting 27.22% of the state’s population, with the highest concentration in Ipoh (Jiao and Singh 2024).

Since the 1980s, the narrative of Ho Yan Hor has embarked on a new chapter, characterized by a shift from traditional remedies to modern pharmaceutical manufacturing. Following the succession from Ho Kai Cheong to his son, David Ho, the family business evolved into a research-driven pharmaceutical enterprise. Upon his return in 1980, equipped with professional training in pharmacy, David Ho established Hovid Berhad, bringing innovation, scientific production, and modern management practices. By the 1990s, Ho Yan Hor had evolved from a traditional herbal brand into a GMP-certified and Halal-accredited pharmaceutical manufacturer with an expanding international presence. Importantly, while numerous traditional herbal products exist, few have successfully transitioned from folk remedies to high-value modern biomedical brands. Thus, the case of Ho Yan Hor and Hovid presents a particularly significant and insightful example of this evolution.

Conclusion

The historical trajectory of Ho Yan Hor embodies the post-war evolution of Chinese herbal tea cultural heritage in Malaysia within the socio-economic transformation of Perak. This traditional herbal beverage adapted to processes of industrialization and commercialization, reflecting the broader modernization of traditional Chinese medicine in the country. The sustained success of Ho Yan Hor demonstrates how traditional Chinese medical knowledge can be reinterpreted and institutionalized within modern pharmaceutical frameworks. By fusing heritage-based practices with Western scientific production, marketing strategies, and regulatory standards, the company has evolved from a local family enterprise into a modern pharmaceutical corporation of both national and global relevance, serving as a model of cultural continuity amid technological and economic change.

As one of Malaysia’s most prominent functional herbal teas, Ho Yan Hor’s legacy extends far beyond being “just a cup of tea”; it is a testament to the enduring value of Chinese herbal medicine and its seamless integration with modern consumption advancements. Its evolutionary journey reflects how traditional remedies can evolve through innovation while retaining their cultural essence. This synthesis not only strengthens the brand’s position in the industry but also serves as an inspiring model for the broader healthcare sector, offering insights into how traditional and modern medicine can work in harmony to meet evolving health needs.

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Jiao, Y., and M. K. Mehar Singh. 2024. “Chinese in the Linguistic Landscape of Chinese Communities in Malaysia: A Tale of Three Cities.” International Journal of English Linguistics 14, no. 5.

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Lin Xingmei, Li Huiping, Huang Baokang. 2024. “Chemical constituents, health-promoting effects, potential risks and future prospective of Chinese herbal tea: A review.” Journal of Functional Foods 121 (October 1): 106438. https://doi.org/10.1016/j.jff.2024.106438.

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Authors

Corresponding author: Dr. Su Qiuyang, mysunnysu@gmail.com

Su Qiuyang (https://orcid.org/0009-0005-4541-0681; BA, Sun Yat-sen University; MBA, Peking University; PhD Candidate, University of Malaya) has worked in the healthcare sector for many years as a senior manager and has authored a series of articles, interviews, and in-depth reports on culture and healthcare reform. Her current doctoral research at the University of Malaya focuses on the history of traditional Chinese medicine and its development among Overseas Chinese communities in Malaysia.

Prof. Danny Wong Tze Ken (https://orcid.org/0000-0002-4357-7753) is Professor of History at the Department of History, Faculty of Arts and Social Sciences, Universiti Malaya where he teaches history of Southeast Asia and History of China. His research interests include the Chinese in Malaysia, China’s relations with Southeast Asia and History of Sabah. He is currently Dean of the Faculty of Arts and Social Sciences, Universiti Malaya. He was Director of Global Planning & Strategy Centre, Universiti Malaya and former Director of the Institute of China Studies and former Head of the Malaysian Chinese Research Centre at the same university.

Dr. Tan Miau Ing (https://orcid.org/0000-0001-9129-6641; PhD Saharan Cina Malaysia, Universiti Malaya; M.Econ and B. Econ, Universiti Kebangsaan Malaysia) is Senior Lecturer of Department of History, Faculty of Arts and Social Sciences, University of Malaya. She is also the Head of Malaysian Chinese Research Center (MCRC) of UM.

What happens when we use the same English term to translate ideas from different Asian medical traditions? Conflating concepts coming from different medical and cultural contexts can lead to confusion that severely compromises our understanding and appreciation of the differences between medical systems.

One pernicious example of this is how common it is even among seasoned Chinese medicine practitioners in the West to say that their theory is based on the “five elements.” This phrase is using a term from the European cultural context to fundamentally misrepresent the basic worldview of Chinese medicine.

Let’s pick this apart together in order to see why this mistranslation matters. . .

Our starting point is to understand that, in the ancient period, traditions of medicine originated in relative isolation from one another on opposite sides of the Eurasian landmass. Historical texts dating from the last few centuries BCE show us that the Chinese medical tradition that had taken form at one end and the Indo-European medical tradition at the other were based on fundamentally different ideas.

On the eastern side, foundational medical texts written in Chinese such as the Inner Canon of the Yellow Emperor (Huangdi neijing 黃帝內經) talked about Wood, Fire, Earth, Metal, Water being “five phases” (wuxing 五行). The key character 行 is based on a pictogram that originally depicted a crossroads or footsteps, and its core meaning is the noun “steps” or the verb “to walk.” It is associated with movement, directionality, and change over time.

On the other side of Eurasia, the Ancient Greek Hippocratic corpus that formed the basis of Greek and Roman medicine named Earth, Water, Air, and Fire the “four elements” (στοιχεῖα, stoicheia). Philosophers often added Void (αἰθήρ, aithḗr) to this list when signifying the absence of the other elements. There are also descriptions of these same elements (in India called mahābhūta) in Buddhist texts, such as the Great Elephant Footprint Simile (Maha-hatthipadopama-sutta), orally transmitted in the Pāli language since the last centuries BCE. They also appear in Sanskrit medical texts, such as the Āyurvedic classics Caraka’s Compendium and Śusruta’s Compendium (Caraka-saṃhitā and Śusruta-saṃhitā), that can be dated to roughly the same period. Whether these elements originated in India or Greece has been debated, but the fact that the elemental schema was shared between Europe and India is not disputed.^⁠1

In most schools of early Indo-European thought, the material elements of Earth, Water, Fire, and Wind are considered to be ontologically real substances that arise within the Void. They are the four fundamental building blocks of all material reality. This stands in marked contrast to Chinese cosmology, where everything that exists (i.e., the ”ten thousand things,” wanwu 萬物) are composed of the unitary substance of qi. In Chinese thought, the five phases thus are not separate ontologically existing things, but rather processes, patterns of change and transformation in how qi manifests in time.^⁠2

These philosophical and cosmological distinctions provide different starting points for East Asian and Indo-European forms of medicine. In Chinese medicine, where the human body, like all physical material, is composed of qi, the default state of the human being is one of wholeness, health, and harmony. It is only through error, or deviating from the Dao, that one deteriorates into sickness. Indo-European texts, in positing four primordial building blocks instead of one, present a less harmonious picture. The elements are not only distinct, they are often mutually incompatible, which is a persistent source of suffering for humans. Buddhist discourses on the body, for example, say that the relationship between the elements is like four venomous snakes trapped in the same basket. Their mutual antagonisms and perturbations cause disease, and inevitably in old age, they finally fall apart completely.^⁠3

If these differences between the Chinese phases and the Indo-European elements are so clear, then why do we find slippage between them today? Western-language translations equating phases and elements can be traced as far back as Matteo Ricci (1552-1610), the Jesuit envoy to the Chinese empire who first translated between European and Chinese philosophical and religious ideas. Ricci and other writers of his time were cognizant of the differences between elements and phases, defining the elements as “structural” (ti 體, yuan 源) and the phases as “processual” (yong 用, liu 流).^⁠4 Nevertheless, Ricci’s decision to translate the Greco-Roman elements as “the four phases” (sixing 四行) allowed later practitioners to elide these important distinctions and make simplistic equations between elements and phases.

Fast forward to the 1970s, when a modern style of practice called “Five Element Acupuncture” became central to the popularization of Chinese medicine in the English-speaking world. This system was primarily developed and promoted by the British physiotherapist and acupuncturist J.R. Worsley (1923–2003), and many acupuncture practitioners active in Europe and North America today trace their lineage to him.

Ricci’s and Worsley’s equation of phases and elements promoted the widespread misunderstanding that the wuxing can be thought of as ontologically existent “things,” but they are not. The phases should be understood as qualities rather than essences. They are adverbs or adjectives rather than nouns. Rather than thinking in terms of Wood, Fire, Earth, Metal, Water per se, we should think in terms of Wood-like, Fire-like, Earth-like, Metal-like, or Water-like qi. The noun is always qi because in Chinese thought that’s the only substance there ever is.

Clarifying these concepts has clinical implications, but is also important because of how metaphors structure our experience of ourselves and the world we inhabit.^⁠5 It’s one thing to live in a fractured body in a universe where competing substances vie for primacy. It quite another to be embedded in a unified whole where body and cosmos are composed of the same primordial stuff. It’s one thing for one’s idea of health and illness to be organized around the inevitability of disintegration, and quite another for it to be based on an assumption of harmonious oneness.

The stakes of this mistranslation extend far beyond academic pedantry. When we impose the language of “elements” onto Chinese medical concepts, we inadvertently import a Western metaphysical framework that is fundamentally at odds with the Chinese worldview. We lose sight of the dynamic, processual nature of the phases and replace it with an ontology that belongs to a different tradition entirely. Better historical understanding helps us to resist the temptation of false equivalences and to preserve the conceptual integrity of the traditions we study.

¹ Filliozat, J. (1964). The Classical Doctrine of Indian Medicine: Its Origins and Its Greek Parallels. Delhi: Munshiram Manoharlal; McEvilley, T. (2002). The Shape of Ancient Thought: Comparative Studies in Greek and Indian Philosophies. New York: Allworth Press, 300–309.

² Jones, CB. (2016). Creation and Causality in Chinese-Jesuit Polemical Literature. Philosophy East and West 66(4), 1251-1272. https://dx.doi.org/10.1353/pew.2016.0090.

³ Salguero, CP. (2018). “This Fathom-Long Body”: Bodily Materiality & Ascetic Ideology in Medieval Chinese Buddhist Scriptures, Bulletin of the History of Medicine 92.2: 237–60. https://muse.jhu.edu/pub/1/article/698172.

⁴ Hsu KT. (1997). “The Transmission of Western Four Elements Theory in Late Ming China.” Tsing Hua Journal of Chinese Studies n.s. 27.3: 347-380. https://thjcs.site.nthu.edu.tw/p/406-1452-41461,r2974.php

⁵ Lakoff, G, and M Johnson. (2003 [1980]). Metaphors We Live By. Chicago: University of Chicago Press.

If you want to hear scholars and practitioners engaging in deep conversations about the dark side of Asian religions and medicines, then subscribe to Black Beryl wherever you get your podcasts. Also check out our members-only benefits on Substack.com to see what our guests have shared with you. Enjoy the show!

Resources mentioned in this episode:

* Leo’s chapter on Chinese physicians will appear in Pierce’s forthcoming book, Meditation Sickness: An Anthology on the Dangers of Meditation Practice. (Get notified when this is published.)

* Pierce discusses medieval Chinese approaches to meditation sickness, including Zhiyi’s advice for meditators, in an open access article in Journal of Buddhist Ethics.

* See Leo’s recommended YouTube instructional video on the six healing breaths.

* Leo’s new website is under construction

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Herbal drugs have long been valued not just for their effects, but where they come from. The origins of drugs are thought to be important indicators of their quality and their efficacy, and scholars and pharmacists around the world have paid attention to this for centuries. It is thus rare to find new data that allows us to rethink the early tradition in fundamental ways. An article of mine titled Mapping the Bencao, recently won an academic prize, so I thought I would write a brief summary of the article and its implications.

The study uses Digital Humanities to produce new data that challenges long-held assumptions about the origins and geography of Chinese materia medica. By digitally tagging a critical edition of an early Chinese pharmacological text, I was able to analyze its contents in new ways. In particular, by tagging it with historical GIS points, and rendering them in open-access platforms, I was able to produce maps of the locations where drugs were produced in early imperial China.

The practice of reading maps is very different from the way we encounter drug locations in a text. When reading a text, names pop up that may sound familiar or jog the memory, but for the most part, they fall into the background. You don’t get a sense of where they’re from, just the significance of the name of the place. The digital map however, reveals the geographic distribution of Chinese drug cultures in a way never before seen. It brings the drug locations into relationship with one another, and also in relationship to the local landscape. In particular, it showed a surprising fact—that almost all sites of production described in the texts were located on rivers or lakes, not on mountains, as imagined in the tradition.

At the heart of this study is the bencao 本草 tradition — China’s vast pharmacopoeia literature — and its multiple textual layers, especially the Materia Medica of the Divine Farmer, the Supplementary Records by Famous Physicians, and Tao Hongjing’s 陶弘景 Collated Annotations. Together with a team of colleagues, students and research associates, at the Max Planck Institute for the History of Science, National Taiwan University, Dharma Drum Institute of Liberal Arts and Nanyang Technological University, we created a digital, searchable edition of this layered text with the MARKUS and DocuSky platforms. Each entry is tagged for properties like taste, temperature, toxicity, preparation, and—crucially—place of origin. These tags were then matched to historical maps and GIS data from Academia Sinica, allowing researchers to visualise where drugs were sourced over time.

The resulting images tell a story that textual readings alone cannot. While scholars like Yamada Keiji had previously identified the loess plateau as the origin of Chinese drug lore, this map reveals a dense corridor of medicinal activity stretching along the Yellow River from the Bohai Sea through Chang’an (modern Xi’an), and into the Sichuan basin. This “Yellow River Corridor” turns out to be a riverine highway of drug trade and knowledge, connecting regions once thought peripheral to the canonical centers of Chinese medicine.

This view allowed me to rethink early drug lore not as a product of isolated Daoist mountain sages, but as a vibrant, decentralised network of drug production and exchange along rivers, mountains, and trade corridors. Because these sites were locations of trade rather than fixed points of botanical origin, the paper reimagines these locations as “drug production” sites — nodes of social-technological activity where wildcrafting, preparation, and trading translated these “wild objects”, or raw materials, into culturally legible medicinal products. Some places, like Taishan and Songshan, have long been famous in Daoist or medical traditions, but others — such as Hanzhong and Jianping — emerge in this study as waypoints in the drug trade. These places acted as bottlenecks or crossroads, showing that pharmacological knowledge flowed along human routes of exchange rather than solely sprouting from mountain hermitages or elite academies.

One particularly important case study is the recently excavated medical texts from Laoguanshan 老官山, near Chengdu in southwestern China. Though geographically distant from the central plains, the herbal repertoire of this tomb text is particularly concentrated in east and northeast China, especially Shandong province. This challenges assumptions about regional isolation and suggests that even in the 2nd century BCE, medical knowledge travelled widely. By comparing drug names in the Laoguanshan text with those found in the digitised bencao corpus, the paper argues that the Laoguanshan text reflects an eastern herbal vocabulary, perhaps preserved through trans-regional networks that may have navigated along the Yellow River.

One takeaway is that digital tools can radically transform how we understand traditional medical knowledge. Not only do they allow for granular philological tracking of drug names and their changes over time, but they also help visualise sociotechnical systems of exchange. I argue for moving beyond elite literary imaginations that saw drug knowledge as flowing from Confucian doctors or Daoist adepts. Instead, I encourage readers to see pickers, traders, sellers, and users — actors often marginalised by Confucian social mores —as part of a complex polyglot system where knowledge was dynamic, negotiated, and deeply embedded in place.

I also argue that this open-source data could be used for other kinds of research. For example, to look again at concentrations of regional trade, or to geo-locate literature, like poems or strange tales, that favour drugs from particular regions.

This work also speaks to present-day concerns in ethnopharmacology, bioprospecting, and data equity. Just as ancient Chinese physicians debated drug authenticity, modern researchers must wrestle with how traditional knowledge is extracted, named, and validated — often by those with the most institutional power. Through careful data stewardship and open-access publication, we can provide a more ethical and inclusive way to explore and share historical medical data.

Ultimately, Mapping the Bencao is more than a historical study. It’s a compelling case for how digital humanities can not only preserve the past but reconfigure our understanding of it. The rivers and roads that once carried herbs and recipes are now mirrored by data pathways and linked ontologies — but the questions remain the same: who knows what, where does knowledge live, and how do we value it?

This is an excerpt of The Spirituality Gap: Searching for Meaning in a Secular Age by Abi Millar. It has been slightly edited for AMZ, removing references to information found elsewhere in the book or inserting a few words in brackets to give needed context.

‘It’s an often overlooked fact that mindfulness, the way that it’s taught in all of these apps, is a practice that derives originally from Buddhism,’ says C. Pierce Salguero, transdisciplinary scholar of health humanities at Abington College, Penn State University, when we talk.[1] ‘But it has also undergone a pretty thorough transformation, to be turned from a more religious or spiritual practice into a secularised medical or mental health practice.’

As an expert in Buddhism and medicine (although, interestingly, not a Buddhist himself), Salguero has a lot to say about how mindfulness-for-health fits into its historical context. In his book Buddhish: A Guide to the 20 Most Important Buddhist Ideas for the Curious and Skeptical (2022), he explains how Buddhism itself has been reimagined in the West, laying the groundwork for the present mindfulness boom. Historically speaking, Buddhism has involved a rich tapestry of traditions, some of which are flagrantly religious or magical in hue. By contrast, the Buddhism many of us in the West recognise, in which the Buddha was something like an ancient psychologist, designing an empirical ‘science of mind’, emerged little more than a century ago.

‘At the time, European discourse was talking about how backward the Asians were, and Buddhism was held up by colonial authorities as a prime example of superstition,’ says Salguero, echoing what Shreena Gandhi told me about yoga. ‘Buddhist authorities all over Asia engaged in a project of reimagining Buddhism in a more secular and scientific way, moving away from magical practices and rituals and emphasising the practice of meditation as a psychology and a philosophy.’

European and North American intellectuals, drawn to this rejigged form of Buddhism, started promoting meditative practices at home. Meditation became widespread, and with it, the perception of Buddhism as somehow more objective or empirical than other religions. When [Jon Kabat-Zinn, founder of the modern MBSR mindfulness protocol] set to work on making mindfulness ‘commonsensical’, the earlier colonial push to secularise Buddhism surely helped him along the way.

It isn’t clear, though, that the endgame of a Buddhist mindfulness practice is quite the same as the endgame for MBSR. As Salguero explains in his book: ‘Buddhist trainings that emphasize concentration often focus on generating what in the Pali language is called jhana, advanced states of absorption in which you become so concentrated on the object of meditation that the rest of the world melts away … Trainings emphasizing insight, on the other hand, focus on perceiving your chosen object of meditation as a manifestation of suffering, impermanence, and non-self.’[2] In either case, the idea is to deconstruct our usual habits of mind and see ‘reality as it is’, as opposed to reducing anxiety or fostering calm.

‘In general, the idea that Buddhist meditation is going to lead to inner peace is a misunderstanding,’ says Salguero. ‘What it does give you is the tools to be able to deal with a whole range of different kinds of experiences in a more detached and neutral way.’

At the bare minimum, he adds, you’re going to experience sore knees and a sore back. People might also experience latent traumas and other kinds of negative emotions. ‘If there’s any inner peace to be had, it takes the form of your being able to sit there with equanimity while the emotional and physical pain pass through your body and mind.’

Salguero’s description resonated with me, and even felt somewhat validating. Unlike the other routine self-care practices I am somehow not too busy for (exercise, taking a bath, brushing my teeth), meditation strikes me as an unknown quantity, and that’s why I’m often reluctant to go there. For me at least, the benefits have never emerged in anything like a linear, predictable way.

Sure, sometimes it’s relaxing, as the apps would have it. Sometimes I can see that it’s helping train my concentration and focus, as any corporate mindfulness programme would have it. Other times, though, the experience is more complicated and confronting. I may find myself crying. I may find myself racked with existential confusion. I may find old issues resurfacing or new aggravations arising, or I may just sit there feeling frustrated and bored.

I’ve had powerful meditations too, in which new insights have bubbled up prolifically, or long-buried emotions have found release. On one occasion, I was trying to ‘be present’ with an overwhelming feeling of rage. Rather than getting lost in my thoughts about the rage, I tried to pay attention to the original feeling and how it hunkered in my body. I noticed my heartbeat, more emphatic than normal, and the coiled spring of my muscles primed for action. The feeling in its distilled form was not purely negative. It was powerful. It reminded me of fire — raw, amoral, magnificent, full of destructive potential. Afterwards, I felt something toxic had left my system for good.

Experiences of this nature have left me in a conflicted place. On one hand, I’m intrigued by meditation. I’ve tasted some of the possibilities on offer. I like a challenge, and there’s a swashbuckling part of me that’s fully on board with a quest through the gnarlier regions of the mind. On the other hand, if I’ve got ten minutes to spare for mental and spiritual maintenance, I’m going to default to something that reliably makes me feel safe or calm or connected. If you’ve ever tried meditating and felt less than beatific, it’s easy to conclude that you’re failing at it, or that the concept has been mis-sold.

‘Maybe some strategic misinformation is being promoted about mindfulness, that it’s just going to make you happy,’ says Salguero. ‘But if you practice mindfulness seriously, it’s going to make you experience all your suffering in a way that is much rawer. You’ll develop a lot more equanimity, maybe more bravery, because you’re not fighting those forms of suffering as they come up. But it’s certainly not going to make those kinds of things go away.’

In more recent years, the ‘underbelly of the mindfulness movement’, as Salguero described it to me, has attracted more attention. One powerful critique comes from Ronald Purser, an ordained Buddhist teacher and management professor at San Francisco State University. In his book McMindfulness: How Mindfulness Became the New Capitalist Spirituality(2019), he makes the case that mindfulness has been hijacked by consumerist culture. It has been reduced, he thinks, to an individual coping mechanism, engendering a passive acceptance of the systems that have caused our stress in the first place. This is particularly the case when corporations get involved, offering up mindfulness to their workers as opposed to improving their working conditions. For instance, Starbucks attracted ire in 2020 when it gifted its overstretched employees a Headspace subscription.[3]

As for the ways that mindfulness has taken off in Silicon Valley, there is clearly a stark contradiction in executives using a Buddhist-derived practice to get ahead in business. In Purser’s view, practices like MSBR are being used to uphold the neoliberal status quo, masking the revolutionary potential of Buddhist teachings.

‘Mindfulness has been oversold and commodified, reduced to a technique for just about any instrumental purpose,’ he writes. ‘It can give inner-city kids a calming time-out, or hedge fund tracers a mental edge, or reduce the stress of military drone pilots. Void of a moral compass or ethical commitments, unmoored from a vision of the social good, the commodification of mindfulness keeps it anchored in the ethos of the market.’[4]

Purser’s tone is trenchant. After attending an MBSR programme, he does concede that ‘MBSR is a saving grace for many people … The course was accomplishing exactly what it was intended to do: teach people how to reduce their stress and anxiety, cope with pain, and live a more mindful life.’[5] But nevertheless, he contends, mindfulness stands to make us ‘better adjusted cogs’, docile in the face of exploitation.

His book is a bracing read and I found myself nodding along in places. That said, I sensed he didn’t give the average Western meditator enough credit. Sure, meditating tech bros are a thing — microdosing, biohacking and breath-working their way towards corporate dominance. At the same time, there are many people whose inner explorations will lead them far off the beaten path of capitalism. To my mind, just sitting and being and doing ‘nothing’ is an inherently anti-capitalist practice, the antidote to our obsession with chasing future rewards. It is very likely to bleed into something spiritual too, even if that isn’t always the terminology the practitioner would choose.

‘Ron is articulating one response that Buddhists have had to the mindfulness movement, but the Asian Buddhist communities that I’ve been involved with have actually had a different response to Ron’s,’ Salguero says. ‘The one I’ve heard most frequently is: the more people who practice mindfulness, the more wellbeing we’ll have on the planet. The more people who practice mindfulness, the less suffering there will be across humanity. And moreover, the more people who practise mindfulness, the more people might be exposed to Buddhist ideas. For me, I think there’s truth in both these responses.’

Jiva Masheder goes further, remarking that Purser has fundamentally misunderstood MBSR. As she sees it, his mistake is to conflate acceptance with resignation, which mindfulness teachers have never promoted. If there’s any truth in his argument, she thinks it lies in his observation that mindfulness has been reduced to an individual coping mechanism. Traditionally, Buddhism would have been practised in a community setting (the Sangha) with a teacher, and MBSR courses are based on the same model. She thinks you’re unlikely to get the full measure of mindfulness if you’re doing it at home on your own.

A different kind of critique comes from Willoughby Britton, who made a splash in 2017 with a paper on the potential negative effects of meditation. Britton, who is a clinical psychologist and a professor of psychiatry and human behaviour at Brown University, was interested in experiences that could be ‘described as challenging, difficult, distressing, functionally impairing, and/or requiring additional support’. Her team interviewed ninety-two Western Buddhist meditators who had reported these kinds of outcomes.

The resulting study, called The Varieties of Contemplative Experience, identified fifty-nine categories of negative experience, ranging from ‘loss of the basic sense of self’ to ‘changes in motivation’, ‘the re-experiencing of traumatic memories’ and even ‘gastrointestinal distress’. A whopping 88 per cent of the meditators said their challenging experiences had spilled over into their everyday life. Shockingly, 17 per cent had felt suicidal and another 17 per cent had required inpatient hospitalisation. [6]

As the paper explains, many Buddhist traditions ‘acknowledge periods of challenge or difficulty associated with the practice of meditation’. It adds that: ‘Given that some of these effects might even run counter to the dominant paradigm of health and well-being, it is critical that the range of effects associated with Buddhist meditation be investigated in the modern Western context.’

For sure, these study participants aren’t representative of the average person who downloads the Calm app. They were serious meditators, who had been selected for the study precisely because they’d had a tough time. Such experiences might be extraordinarily rare — the functionally impaired exception that proves the happy, healthy rule. But for researchers like Britton, they’re too important to be ignored. Today, she offers trauma-informed mindfulness trainings called ‘First Do No Harm’, and provides support services to people who’ve run into meditation-related difficulties. As she remarked in a 2014 Atlantic article: ‘As much as I want to investigate and promote contemplative practices and contribute to the well-being of humanity through that, I feel a deeper commitment to what’s actually true.’[7]

Britton is not the only researcher to probe the dark side of meditation practice. As I have argued, there is a tension between mindfulness as a spiritual practice, and mindfulness as a tool for personal thriving. According to Salguero, this very tension can sometimes cause people harm.

‘A small minority of people are interested in meditation for health and wellbeing purposes, who do some intensive practice or go on a retreat,’ he says. ‘They don’t know about the Buddhist concept of non-self and they don’t know that this is a practice designed to trigger those kinds of realisations. So, when they experience some of these effects, they don’t have the context to understand what they’re experiencing.’

It seems there are documented cases of people who have practised secular meditation and inadvertently ‘cracked open the fiction of self’. We’re talking about the kind of ego death experience we explored with the neuroscientist, Dr James Cooke, earlier in this book. For Cooke, this was a positive occurrence, but others are more panicked or perturbed by it. In some cases, they might call on a mental health professional, who is no more schooled in Buddhist frameworks than they are.

‘They’re diagnosed in many cases with serious psychiatric diagnoses like depersonalisation and derealisation,’ Salguero remarks. ‘If you read the symptoms, this sounds exactly like what Buddhists are going for with loss of self.’

Back to that Trojan horse: might someone who innocently downloads a meditation app independently reach some Buddhist realisations? After all, these apps have been stripped bare of any theoretical underpinnings. They don’t purport to explain why you’re calm, why you’re relaxed (or as the case may be, why you’ve wound up re-evaluating your basic concept of personal identity). Any explanations you might find will likely be couched in physiological terms: you are calm because meditation calms your nervous system, not because you’ve happened across a truthful and spiritual insight.

Buddhist meditations, by contrast, are meant to guide you towards a particular way of seeing the world. It is intriguing to consider that the practical techniques adopted by MBSR might succeed in doing the same thing, even minus the supporting philosophy.

For that reason, Salguero thinks that meditators, however secular their inclinations, should be aware of the possible outcomes. In common with Britton, who came up with the idea, he thinks meditation ought to ‘carry a warning label’.

‘You can take the practice out of the temple, and you can secularise it, reinterpret it and put it into the hospital setting,’ he says. ‘But the practice was designed to produce these kinds of experiences. If you don’t know anything about emptiness or non-self, then these experiences can be really disorienting.’

[1] Interview with C. Pierce Salguero, conducted by author — Over Zoom, 8 May 2023

[2] Salguero, C. Pierce, Buddhish (Beacon Press, Boston, 2022), p. 64. Kindle Edition.

[3] Kaori Gurley, Lauren, ‘Starbucks Workers Want More Hours. Instead They Got a Meditation App’, Vice (8 January 2020), https://www.vice.com/en/article/z3bxn3/starbucks-workers-want-more-hours-instead-they-got-a-meditation-app.

[4] Purser, Ronald E., McMindfulness: How Mindfulness Became the New Capitalist Spirituality (Watkins Media, London, 2019), p. 17. Kindle Edition.

[5] Ibid p104

[6] Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLOS ONE, 12(5), e0176239.

[7] Rocha, Tomas, ‘The Dark Knight of the Soul’, The Atlantic (25 June 2014), https://www.theatlantic.com/health/archive/2014/06/the-dark-knight-of-the-souls/372766/.

The following is part of a series of experiments using A.I. for a range of academic tasks. In this case, I have used Claude 3 Opus (set to “formal” style) to summarize a recent publication of mine. Unlike in other instances where I found A.I. to be incapable of performing basic humanities research tasks, I think that Claude did a decent job of summarizing various specialized academic texts I gave to it. Its outputs never capture the author’s tone or style, but they do usually convey the main ideas or major take-aways of the content accurately.

Given its strengths in this area, I think one helpful application might be for academic authors to use Claude to summarize academic content that is published in venues that are prohibitively expensive for non-academic readers to access, and/or that is written in extremely inaccesible ways due to the use of field-specific jargon and dense academic writing style. I have looked into the copyright status of doing this, and believe that summaries such as this one are covered by the doctrine of “fair use.” The piece below is substantially different than the original. I have not included the statistical details presented in the original, ensuring that any scholar who uses this research in their work will need to access the original and thus avoiding competition with the original work.

Readers who are interested in chasing down citations or gaining more precise information about the study can access the published paper here: C. Pierce Salguero, 2024, “American Buddhism and Healthcare.” In Scott Mitchell and Ann Gleig (eds.), Oxford Handbook of American Buddhism, pp. 318–34. New York: Oxford University Press.

(Energy usage disclosure: According to Claude.ai’s own reporting, generating this summary used as much electricity as conducting 15 standard web searches.)

A.I. Summary of “American Buddhism and Healthcare”

This article examines the current state of American Buddhist healing based on ethnographic interviews with 36 practitioners across the US. I map out the key demographics, practices, and contexts shaping how Buddhism is used for health and well-being in the U.S. today. My central argument is that the landscape of American Buddhist healing is far more diverse than is typically recognized, extending well beyond the medicalization of meditation practices such as mindfulness that receives the most attention in the media and from scholars. By identifying four distinct "positionalities" or overarching approaches taken by contemporary Buddhist healers, the article provides a framework for understanding this diversity and points to promising directions for further research. In shedding light on the many ways American Buddhists pursue health and healing outside the mainstream medical context, this article makes the case for a more expansive and nuanced discourse around Buddhism's role in the U.S. healthcare ecosystem.

Historical Background & Previous Literature

An interest in the relationship between mind, body, and liberation has been central to Buddhism since its very origins. Early Buddhist texts contained extensive teachings related to health and prescribed specific practices for preventing and treating illness, including meditation, moderation in diet and lifestyle, ritual chanting, and other religious observances.

As Buddhism spread throughout Asia in the premodern period, these practices were adapted to local cultural contexts. For example, Buddhist healers in China tended to frame their work in terms of indigenous concepts like qi, while those in Tibet developed a unique synthesis of Indian, Chinese, and local medical ideas known as Sowa Rigpa. This points to a consistent pattern of "domestication" whereby Buddhist notions of health were reinterpreted and recontextualized in light of the prevailing cultural worldviews and medical theories of each culture Buddhism encountered.

This cross-cultural exchange was not merely a one-way process of Buddhist ideas being modified by their new environments. Rather, the encounter with Buddhism also thoroughly transformed and revitalized many local healing traditions, with Buddhist philosophy and cosmology coming to serve as the foundation for the development of new medical systems in regions as diverse as Sri Lanka, Myanmar, Thailand, Tibet, and Mongolia. Many of these Buddhist-influenced healing traditions remain widely practiced in Asia and around the globe today.

The modern integration of Buddhist practices, especially meditation, into healthcare in the contemporary Western context has involved an ongoing dialogue and mutual influence between Buddhism and science. Buddhist concepts of mind and mental training have influenced research in fields like psychology and neuroscience while also undergoing medicalization and secularization to fit modern clinical frameworks. Ultimately, the current landscape of American Buddhist healing must be understood as a continuation of Buddhism's longstanding pattern of medical integration and innovation across cultural boundaries. This is not a modern anomaly, but rather a defining feature of Buddhism's long history of promoting health and well-being globally.

At the same time, a detailed examination of how this cross-pollination is unfolding in the context of the modern American healthcare ecosystem has yet to be thoroughly examined. There is limited existing scholarship on connections between Buddhism and healthcare in the United States. In one key study, Wu Hongyu (2002) found that 100% of the 19 respondents believed Buddhism was beneficial to health. Another important study is Paul Numrich's 2005 research involving interviews with 30 American Buddhists. Numrich found marked disinctions between “culture Buddhists" and “convert Buddhists” in terms of their use of “folk healing,” complementary and alternative medicine (CAM) practices, and biomedicine.

While Wu and Numrich paint generalized pictures of Buddhist communities, much more robust individual detail is provided by Kin Cheung's research on the practices of a Cantonese-speaking community healer in Brooklyn, NY, who uses an eclectic mix of Buddhist, Daoist, medical and folk practices. My own previous work has included a comprehensive ethnographic study conducted from 2015-2020 on the lived experience of 45 Buddhist organizations in the area. I also recently published results of a survey of American Buddhists from various backgrounds about their attitudes toward health and healing. The main findings in both of these studies is that Buddhism is playing a larger than recognized role in shaping American healthcare attitudes in contemporary times, and I argued that the full breadth of practices deserves further study.

Overall, the existing literature demonstrates that while research on Buddhism and health in the U.S. remains limited, existing scholarship consistently points to the importance of Buddhism in shaping American healthcare in ways that go beyond the typical focus on meditation alone. The studies span different communities and methodologies but converge in suggesting many American Buddhists view diverse Buddhist practices as legitimate, effective means of promoting well-being. The full scope of American Buddhist healing merits expanded academic attention.

Survey of American Buddhist Healers

My research assistants and I conducted a survey between 2015 and 2019 involving extensive interviews with 36 American Buddhist healers. The sample included a mix of races, genders, ages, geographic locations, sectarian affiliations, and cultural origins in an effort to capture a representative cross-section. All interviewees were long-term Buddhist practitioners involved in healing others or teaching self-healing using Buddhist techniques.

The survey of American Buddhist healers (n=36) included a diverse sample across dimensions of race, age, gender, geography, immigrant status, Buddhist sect, cultural lineage, and primary practitioner role. However, the sample overrepresented certain groups, such as white (55.5%), Generation X (58%), and female practitioners (56%). The most common primary occupations were professional healers (31%), monastics (19%), and priests (19%). While not a perfectly representative sample, the diversity of participants provides insight into the breadth of the American Buddhist healing landscape and the variety of ways Buddhism is being integrated into health and wellness-related work. (For more specific data, see Table 1 in the published piece.)

The survey found large majorities were in favor of the statement that Buddhism has a connection with mental health (89%) and physical health (76%). Respondents identified “meditation” as the practice most commonly associated with mental and physical health (86% and 73% respectively). Other practices frequently mentioned as health-promoting included “participation in Buddhist groups, cultural activities, or social gatherings,” “chanting,” “attending specific healing rituals, classes, or activities,” “visualization,” and “vegetarianism.” (For more specific data, see Table 2 in the published piece.)

With regard to specific reasons or mechanisms whereby Buddhism promotes health, an analysis of the open-ended responses showed a number of common themes mentioned across the interviews. Among these, the most frequently mentioned were “emotion regulation (e.g., management of stress, anger, etc.)” (61%), “mind-body connection or body awareness” (52%), and “social connection” (51%). (For more specific data, see Table 3 in the published piece.)

These findings notwithstanding, I argue that the most meaningful patterns discovered in the study were not demographic but rather based on the "positionality" of each healer - their role and approach to integrating Buddhism with healing. The paper identifies four distinct positionalities:

1. Incorporating Buddhism into mainstream healthcare

2. Integrating Buddhism with traditional Asian medicine

3. Optimizing Dharma teachings for health outcomes

4. Eclectically mixing religion, spirituality and healing

Each of these positionalities involves distinct professional settings, practitioner backgrounds, and target populations. This taxonomy cuts across demographic categories, capturing shared perspectives and practices based on the healers' roles and community contexts.

Incorporating Buddhism into Mainstream Healthcare

This group included chaplains serving in hospitals, hospices, and similar settings, as well as a leader of a Buddhist charity providing free medical clinics. Although their chaplaincy training discouraged overt religious content, they all reported drawing on Buddhist practices for patients' and their own well-being.

Key characteristics of this positionality:

• Emphasized values like equanimity, generosity, and forbearance as inherently healing for patients and protective for healthcare workers

• Downplayed need for complex ritual, instead stressing simplicity and seamless integration of basic practices (breath awareness, simple chanting/mantras, metta) into healthcare settings

• Prioritized non-judgmental presence as the essence of their work

Integrating Buddhism with Traditional Asian Medicine

Composed of practitioners of various Asian medical modalities (e.g. acupuncture, Sowa Rigpa, Thai massage, yoga therapy), this group actively integrated Buddhist practices with their therapeutic work and self-care routines.

Key characteristics of this positionality:

• Emphasized traditional training and lineage authenticity for both Buddhist and medical learning; saw both as complex lifelong paths

• Offered treatments combining physical and spiritual elements, e.g. bodywork with blessings, herbs empowered by mantras

• Used Buddhist practices for their own protection and well-being in clinical work

Optimizing Dharma Teachings for Health Outcomes

This group consisted of Buddhist clerics and community leaders who, while not primarily identifying as healers, reported regularly teaching their communities how to modify Buddhist practices to improve health.

Key characteristics of this positionality:

• Emphasized the preventive and curative potential of dedicated, long-term lay Buddhist practice; many discussed advanced meditation attainments

• Commonly taught specific chants, prayers, and rituals for healing, especially related to Bhaiṣajyaguru (i.e., the Medicine Buddha) and Avalokiteśvara (i.e., Guanyin)

• Also focused on benefits of practice for social and communal well-being

Eclectically Mixing Religion, Spirituality, and Healing

A group of Buddhist-inspired healers who offered unique blends of therapies drawing from multiple traditions, often in private practice settings.

Key characteristics of this positionality:

• Emphasized the healer's individual attainments and special abilities to perceive and manipulate subtle energies for diagnosis and treatment

• Employed eclectic and idiosyncratic methods including channeling deities, crystal healing, and Buddhist-derived rituals

• Conceived of disease and treatment in spiritual/energetic rather than biomedical terms

Conclusion

In summary, the positionalities identified in this article provide a bird’s-eye-view map the complex ways American Buddhist healers are integrating Buddhist practices and principles with other therapeutic modalities and applying them in different community settings. By identifying overarching orientations cutting across individual demographics, this framework provides a nuanced view of how Buddhist healing takes shape "on the ground." The diversity of approaches points to the need for further research exploring how American Buddhist healing extends beyond the medical mainstream. Please see the published article for more details.

I first traveled to Southeast Asia in 1990 to serve as a Peace Corps volunteer in Thailand. While studying Traditional Thai Massage or Nuad Boran at Wat Po Temple in Bangkok, I saw the Reusi Dat Ton (Traditional Thai Yoga) statues on the two Rishis’ Mountains on the temple grounds and became fascinated with this practice. I have now been a student of Thai Reusi Dat Ton and Indian Hatha Yoga for over 30 years.

During that time, I have traveled throughout Thailand, mainland Southeast Asia, and South Asia researching and studying yoga with dozens of teachers at various temples, ashrams, schools and institutes. In addition, I have visited numerous universities, libraries, museums, temples, caves and ancient archaeological sites on a quest for historical evidence of yoga poses in traditional texts, iconography, and artwork across Southeast Asia. In this article, I will share with you the best of what I have discovered.

Early Yoga Poses in SEA Art & Architecture

The earliest artistic depiction of a yoga pose I have found to date is at Sambor Prei Kuk in Kampong Thom, Cambodia, dated to about 600 AD. Sambor Prei Kuk was a capital city of the pre-Angkorian Chenla Empire and is one of the oldest surviving temple complexes in Cambodia. On an outside wall of the Yogi’s Tower or Prasat Asram in Sambor Prei Kuk, one can still discern a yogi in what is known in India as sopāśrayāsana pose, i.e., squatting while tying the back and the two legs with a piece of cloth. I found similar figures at Yasodharapura, an early capital of the Khmer Empire, in Roluos, Cambodia. Here, yogis in sopāśrayāsana pose can also be seen on the outside walls of the Lolei Temple, dated to about 893.

During my journeys across Southeast Asia, I have found images of yogis and gods in various yoga poses carved into stone at several ancient temples dedicated to Siva. In Southern Laos, in Champasak Province at the base of Lingaparvata Mountain, is the vast Vat Phu temple complex, dated to about 500-1100. Also known as the “Mountain Temple,” Vat Phu has traditionally been a special site for asceticism since ancient times. It was originally occupied by the Chams, then the Chenla and finally the Khmer who all continued the traditional worship of Siva at the site (Albanese p 283).

Outside and behind the central shrine carved into a rock face at the base of a cliff are the three gods of the Hindu trimurti, one of whom is performing a seated twisting pose similar to techniques practiced today in Reusi Dat Ton. In addition, numerous yogis in squatting poses, including sopāśrayāsana, are carved into stone on the base colonettes of doorways of numerous buildings throughout the Vat Phu temple complex.

In Northeast Thailand, in Buriram Province, atop an extinct volcano sits Prasat Phanom Rung “Big Mountain Temple,” constructed around 1100. Prasat Phanom Rung is a classical Khmer Temple that represents Siva’s home on Mount Kailasa. The temple is dedicated to the Pasupata sect of Hinduism and its concept of “formless yoga” (Srisuchat, 148). At base of the Principal Tower at Prasat Phanom Rung, carved into two stone colonettes at the bases of doorways are images of yogis practicing poses including utkutikasana, “the tight squatting pose” (Srisuchat, 154). These poses are also similar to techniques still practiced today in Thai Reusi Dat Ton.

Last but not least, I include a statue from Vietnam. While I found this one in a museum, not a temple, it’s one of my favorite early images of yogic postures because of how well it is preserved. The Museum of Cham Sculpture in Danang, Vietnam, houses a fabulous collection of stone sculptures recovered from various ancient Cham archaeological sites in southern and central Vietnam. One of the highlights of the museums collection is a sculpture of an apsara, a mythological celestial dancer in the “graceful three-bends posture (tribhanga)” (Museum of Cham Sculpture in Danang, Vietnam). This pose is nearly identical to a technique in Reusi Dat Ton known as “Gazing at the Stars.” This statue, dated around 1000, was originally from Tra Kieu, Simhapura, the first capital of the Hindu Cham Kingdom.

Nineteenth Century Examples

While the earliest artistic depictions of yoga techniques I was able to find in mainland Southeast Asia are primarily squatting, in later centuries, there appear a increasing number of more complex poses. This trend culminates in the 19th century with a sudden and vast proliferation in the sculpture and murals depicting yogic poses and exercises closely related to the Thai practice of Ruesi Dat Ton. In this section, I will give you some of my favorite examples from this era.

Advanced yoga practitioners are said to be able to develop various supernatural powers known as siddhi in Sanskrit and iddhi in Pāli. Among these powers are laghima, the ability to become weightless and fly. An example of artwork depicting this can be seen in Siam Reap, Cambodia, at the Buddhist Temple, Wat Bo. Inside the central shrine room high up on the inside walls are murals painted approximately 1800, depicting scenes from the Indian epic the Ramayana, known in Cambodia as the Reamker. One scene depicts four Yogis flying thru the sky. The abbot of the temple told me that the pose these Yogis are using is a special pose specifically used for flying. Indeed, during my travels throughout South and Southeast Asia, when I saw flying beings depicted in traditional artwork, they were almost invariably in an identical or very similar pose. This pose also appears in Ruesi Dat Ton practice.

In 1836, the Thai king Rama III commissioned the creation of 80 statues depicting some of the techniques of Reusi Dat Ton. About 20 of the original statues have survived and can be seen on the two Hermit’s Mountains or Khao Mor, at Wat Phra Chetupon (“Wat Po”) in Bangkok. Inscriptions describe the statues as “postures of yogic exercise invented by siddhas for remedy of illness… due to the malfunctioning of internal air or wind” (Srisuchat, 172). Along with each statue, there was also an accompanying tablet upon which was etched a poem describing the technique and its therapeutic effect.

In the Southern Thai provincial capital of Songkhla, there is a temple known as Wat Machimawat. On the temple grounds is the Reusi Dat Ton Pavilion, Sala Reusi Dat Ton. High up on the inside walls of the pavilion are two murals originally painted in 1863, depicting 40 different Reusi Dat Ton techniques along with the accompanying poems that describe the therapeutic benefit of each technique. I had seen photos of this mural in an old book in the National Library in Bangkok. In the book, the mural looked to be considerably damaged and many of the images were fading. When I arrived at the temple, the abbot informed me that my timing was excellent as just the week before a team from the Thai Fine Arts Department had finished repairing and touching up sections of the murals. I was able to borrow a ladder and spent the next day photographing the two newly restored Reusi Dat Don murals.

In Reusi Dat Ton, there is a series of six poses based upon the temple guardians, known as yakshas. One of these poses, known as the “Giant Holding up the Roof” can be seen at the base of the Phra Suvarnachedi tower on the grounds of the Temple of the Emerald Buddha, Wat Phra Kaew, in Bangkok, Thailand. The temple was constructed circa 1783 and the guardian giants were added sometime during the Reign of King Rama V (1868-1919) A similar pose is also found in Indian Hatha Yoga where it is known as “the Goddess.”

References and Further Reading

Albanese, Marilia (Author,) A.B.A.-Milan (Translation.) 2006. Angkor, Splendors of The Khmer Civilization. Bangkok: Asia Books.

Bassoul, Aziz. 2006. Human and Divine: The Hindu and Buddhist Iconography of Southeast Asian Art from the Claire and Aziz Bassoul Collection. Beirut: Cedar of Lebanon Editions Publisher.

Bunker, Emma C. 2003. Tantric Hinduism in Khmer Culture. Asian Department, Denver Art Museum. Published in www.asianart.com/articles/bunker/index.html.

Chandler David P. 1983. A History of Cambodia. Boulder: Westview Press.

Conti, Pia Tantric Buddhism in Phimai: A New Reading of its Iconographic Message. https://angkordatabase.asia/publications/tantric-buddhism-in-phimai-a-new-reading-of-its-iconographic-message.

Griswold, A.B. 1965. The Rishis of Wat Po. In Felicitation Volumes of Southeast Asian Studies. Presented to His Highness Prince Dhaninivat Kromamun Bidyalabh Brindhyakorn. Bangkok: Siam Society.

Matics, Kathleen Isabelle. 1978. An Historical Analysis of the Fine Arts at Wat Phra Chetuphon: A Repository of Ratanakosin Artistic Heritage, PhD Dissertation, New York University, New York.

Matics, K.I. 1977. Medical Arts at Wat Pha Chetuphon: Various Rishi Statues. Journal of the Siam Society, 65:2: 2: 145-152.

Museum of Cham Sculpture, Visitor Information Display at The Museum of Cham Sculpture in Danang, Vietnam.

Powell, Seth. 2018. The Ancient Yoga Strap: A Brief History Of The Yogapatta. Published in TheLuminescent.blogspot.com16 June 2018 (v2).

Srisuchat, Amara. 2004. Yoga Philosophy in Secondary Thought: Tracing Back to Yoga in Thailand’s Past. PhD Dissertation, Department of Oriental Languages, Silpakorn University, Bangkok.

Suebsantiwongse, Saran. 2023. The Thai Body: Understanding the Principles of Medicine, Physiology, and the Massage Tradition through Inscriptions, Texts, and the Material Culture of Wat Phō. in Part 4 of The Rutledge Handbook of Religion and the Body. Edited by Yudit Kornberg Greenberg and George Pati. London: Taylor & Francis Publishing.

Trà̂n, Kỳ Phương, Văn Thắng Võ and Peter D. Sharrock. 2018. Vibrancy in Stone: Masterpieces of the Đà Nẵng Museum of Cham Sculpture. New York: River Books.

Wells, David. 2012. “Reusi Dat Ton: The Thai Hermit’s Exercises” Yoga Mimamsa, Volume 44, No. 1: 1-18.

Wells, David. 2016. Self-Massage and Joint Mobilization of Traditional Thai Yoga: Reusi Dat Ton Part 1 Handbook. North Charleston: CreateSpace Independent Publishing Platform.

David Wells, E-RYT500, YACEP, C-IAYT, CAS, works as a yoga therapist in an interdisciplinary pain management clinic and conducts continuing education workshops for yoga teachers, yoga therapists, and massage therapists. He received advanced yoga certifications from the Kaivalyadhama Yoga Institute, the Sivananda Yoga Center, and the Yoga Institute in Mumbai in India. He served three years in Peace Corps Thailand and received Thai Massage and Reusi Dat Ton certifications from the Wat Po School of Thai Traditional Medicine and the Thai Ministry of Education. He also studied with Reusi Tevijjo and the late Ajhan Pisit Benjamongkonwaree in Thailand. He is also a graduate of the California College of Ayurveda. Contact: david@wellsyoga.com and www.wellsyoga.com.

* Pierce Salguero, A Lamp Unto Yourself.

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This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com

Resources mentioned in this episode:

* Volker’s website

* Volker Scheid, Chinese Medicine in Contemporary China: Plurality and Synthesis (2002)

* Volker Scheid, Currents of Tradition in Chinese Medicine 1626-2006 (2007)

* Paul Unschuld, Chinese Medicine: A History of Ideas (2010)

* Annemarie Mol, The Body Multiple: Ontology in Medical Practice (2003)

* Pierce Salguero, “A Polyperspectival Asian Medicine Practice” (2020)

* Slavoj Žižek, “From Western Marxism to Western Buddhism” (2001)

* Volker’s blog

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com

The twenty-minute film Traditional Medicine in Southern Laos: A Documentary tells the stories of traditional medicine practitioners in the lowlands of Champasak Province in the far south of Laos, mainly through their own words. It features the places and people where I conducted ethnographic fieldwork during 2015–16 as part of my PhD in anthropology.^[1] Since then, I have regularly visited, shooting this video footage in 2019 and eventually completing the documentary in 2023.

The three elderly men featured in the film are at the center of both the research and the film—as teachers, guides, and collaborators. While staying in their homes or the nearby village or health facility, I learned about their medical practices, recorded herbal prescriptions, collected plants during trips to the forest and in their gardens, observed them create medicines, interact with patients, and conduct rituals—and had long talks about their approach to work and life.

All are from the same generation, born before the revolution when Laos was still in the process of gaining independence from French colonial rule. Po Nueang and Ajan Vilaysack^[2] describe themselves as traditional healers (mo ya phuen mueang), while Dr. Outhai is a retired medical doctor who previously managed the small traditional medicine department in the provincial hospital. The film highlights the similarities and differences in how they approach and think about traditional medicine and examines several intersecting issues through their words and practices. These include the role of traditional medicine for people seeking care, the various methods of creating medicines, formulating treatments and transmitting knowledge, approaches to medicinal plant conservation, the incorporation of magical or spiritual principles into treatment, and the urgent need for more research and documentation.

The first scene, shot at the home of Po Nueang, features a young girl who is receiving treatment for a sprained ankle and has also taken medicine for diarrhea. Po Nueang explains that the girl and her mother had traveled from several villages away and had already tried going to the hospital to receive injections and intravenous fluids (popular forms of allopathic medicine). However, it had not helped, so she had come to consult him. This story is representative of the often complex treatment-seeking routes taken by people and their families to deal with illness, where they may use multiple medical modalities to deal with uncertainty.^[3]

Indeed, although traditional medicine has long been used as primary healthcare for simple ailments in Laos, it is now more commonly turned to in cases of chronic illness. Later in the film, Ajan Vilaysack describes his journey as a traditional medicine practitioner, explaining that “in the past, we didn’t have enough medicine or doctors—people lived in the forest and had to help themselves.” But these days, he mainly sees patients with illnesses such as liver disease (a common problem due to high rates of hepatitis and alcohol and raw pork consumption), thyroid, digestive and skin disorders, weakness, and paralysis. He argues that he can treat these conditions more effectively and cheaply than the hospital, which sometimes even sends him patients.

While healthcare integration is government policy, this shows how, in reality, integration still happens primarily at an individual, informal level. In Laos, traditional medicine was, as in neighboring revolutionary nations, promoted as an inexpensive, low-tech, and culturally appropriate medicine.^[4] In the context of an under-resourced state biomedical system and given the weak influence of colonial healthcare, there was perhaps less impetus to create a national medicine, and so locally practiced medical forms in Laos have undergone little transformation or standardization, with no centralized knowledge source and few official treatment facilities or training courses.^[5] In the far south of Laos, traditional medicine may incorporate Tai, Buddhist, Ayurvedic, Khmer, and even Chinese influences.^[6] Southern medical practices are closely linked to those in culturally similar areas of northeastern Thailand and northern Cambodia.^[7]

These influences are shown in the healers’ use of medicines. The combination of plant parts shown by Po Nueang, including roots, woods, barks, and other woody parts, together with some shells and animal horns, make up the ingredients of ya fon, a common medical practice of southern Laos that may be linked to ancient Khmer influence.^[8] This is a technique in which a root, bark, mineral or animal product is ground against a smooth stone (hin sa) into cool water, creating a thick brown liquid that is drunk without boiling. As Po Nueang describes, it is considered a cooling medicine and is thus especially useful for fever, an ever-present condition in the heat of the southern lowlands. He demonstrates how he combines these medicines into recipes for different symptom patterns, including fever types such as chronic intermittent fever (khai sam huea), shivering cold fever leading to convulsions (khai nao san), fevers with gastrointestinal issues such as vomiting and diarrhea, those described as malaria that descends to the intestines (khai nyung long lamsai), and fever with yellow skin (khai piu lueang nang lueang). Po Nueang describes these as being forms of “the disease we now call malaria,” showing how he incorporates both traditional and biomedical explanations of disease and reflecting the variable symptom patterns of malaria that have been endemic during his lifespan, including when he was a military health worker in the 1970s.^[9]

Collecting and formulating personalized prescriptions is crucial to treating illness successfully. However, while healers may follow similar principles, Lao traditional medicine knowledge is highly heterogeneous; even the oldest textual sources, such as palm-leaf manuscripts (bailan), contain discrete sets of information.^[10] Po Nueang shows a book of herbal recipes (tamla) that belonged to one of his teachers and describes the learning process. Traditionally, this involves apprenticing to one or more older healers and learning certain spiritual practices to maximize the efficacy of the medicine. Ajan Vilaysack explains, “This is our secret—we use medicine and also magic to treat patients.” He demonstrates the technique of blowing (pao) to treat a man with a headache, who describes the effect afterward as “I feel cool, and I have more strength.” When blowing, the healer also mouths a healing mantra (mon).^[11] In the southern lowlands, these incantations are usually spoken in Pali and, if written, inscribed in tham script. Still, they may also include Sanskrit, Khmer, and Lao words, reflecting the multidimensional origins of healing power and the layered religious history of the south of Laos, including the expansion of the Khmer empire and the relatively late arrival of Theravada Buddhism and its absorption of Hindu/Brahmanical and indigenous spiritual practices.^[12]

Another distinguishing characteristic of traditional medicine in Laos is its reliance on wild harvested plant materials. Laos is highly diverse, with an estimated 8000–11,000 plant species, of which ethnobotanical studies have identified a significant number showing promising actions against disease^[13] and with no previous medicinal uses recorded.^[14] While Po Nueang uses mainly small pieces of roots or bark to make ya fon, Ajan Vilaysack’s medicine store contains large quantities of plant materials used for making decoctions or steam sauna, some of which he has harvested in high altitude areas; an apprentice healer “must love to go to the forest,” but it is not easy. He explains that it is very important for this medicine to be used when fresh (no more than a month old) for maximum potency, which presents a challenge because of the difficulties involved in sourcing materials. However, while walking around his land, he also observes that “everything here is a medicine,” pointing out the many uses of each herb, demonstrating how using plants as medicine is also flexible and circumstantial. This ability to recognize plants is the first step in learning traditional medicine. Po Nueang says, “If I have an apprentice, I must take him to dig up the plants first; he must collect and sort all kinds of plants.”

Traditional principles prohibit the overexploitation of plants; as Po Nueang explains, it is very important never to cut the main root so the tree does not die and can continue growing—and based on astrological principles, only one part of the plant can be harvested at a time. This approach is related to a wider “grammar of healing”^[15] in which astrology is applied to diagnosis and treatment, and an ethical framework based on local cosmologies that governs how the healers interact with patients and medicines. Ajan Vilaysack says, “You must avoid destroying or selling plants without a good reason.” This refers to the rule that the healers cannot directly charge money for their services and must rely on donations given according to Buddhist principles, in comparison to medicine sellers (mo khai ya), who they regard as inferior, and non-Buddhist practitioners, who are not subject to the same restrictions.^[16] The healers explain that adherence to these rules is essential for their medicine to be effective and for them to practice safely.

However, factors outside the healers’ control, such as deforestation and illegal exports, have led to a loss of plant biodiversity, a matter of great concern for them as it is becoming increasingly difficult to find the materials they need. Dr. Outhai recommends creating medicinal plant gardens and teaching students how to cultivate and use them. Some conservation efforts are in place; the Institute of Traditional Medicine oversees a network of medicinal plant preserves across the country, although lack of funding and protection makes these difficult to maintain.^[17] Ajan Vilaysack has dedicated part of his land to cultivating medicinal plants, but the difficulty of ensuring water sources limits it. He has also created a small house for people with chronic illnesses to stay free of charge. Despite being in high demand by his patients, he also farms rice, coffee, and cassava with his family and has responsibilities as the village head; like most healers, he cannot depend on practicing traditional medicine to make a living.^[18]

These combined challenges mean that transmission of medicinal knowledge through apprenticeship is now very low, and as these are likely the last generation of traditional healers in Laos, new forms of learning and practice will need to emerge for the future. Dr. Outhai describes his education on medicinal plants during his time at medical college “using books and a system,” which he says is a more sustainable learning method than the long process of memorization required by apprentice healers. Lao government institutions such as the Institute of Traditional Medicine and the Faculty of Pharmacy are making efforts to research, document, and create training programs, but there is much more to be done. These institutionalizing processes will inevitably alter the forms in which Lao medicine is taught and practiced; for example, the influence of staff trained in China, Thailand, or Vietnam and the emphasis on pharmaceutical evaluation and production. However, perhaps contrary to stories of resistance against state power, the healers are not against government regulation but instead frequently express the desire for their medicine and work to be recognized and documented.^[19] Ajan Vilaysack advocates for a scientific approach to discover the full potential of Lao medicine; “I would like Lao medicine to be recognized internationally and researched so that we know what each part of the plant is good for . . . how many diseases can one tree treat?” He concludes with his hopes for the future: “This is my idea of how to preserve medicines for the rest of my life.”

Bibliography

Alvesson, Helle M., Magnus Lindelow, Bouasavanh Khanthaphat, and Lucie Laflamme. 2013. “Coping with Uncertainty during Healthcare-Seeking in Lao PDR.” BMC International Health and Human Rights 13, no. 1: 28. https://doi.org/10.1186/1472-698X-13-28.

Brun, Viggo, and Trond Schumacher. 1994. Traditional Herbal Medicine in Northern Thailand. Bangkok: White Lotus.

Coderey, Céline. 2017. “The Buddhist Grammar of Healing: Building Efficacy in the Pluralistic Therapeutic Context of Rakhine, Myanmar.” Asian Medicine 12, nos. 1–2: 233–64. https://doi.org/10.1163/15734218-12341394.

Dubost, Jean Marc, Chiobouaphong Phakeovilay, Chithdavone Her, Audrey Bochaton, Elizabeth Elliott, Eric Deharo, Mouachan Xayvue, Somsanith Bouamanivong, and Geneviève Bourdy. 2019. “Hmong Herbal Medicine and Herbalists in Lao PDR: Pharmacopeia and Knowledge Transmission.” Journal of Ethnobiology and Ethnomedicine 15, no. 1: 27. https://doi.org/10.1186/s13002-019-0307-2.

Elkington, Bethany G., Kongmany Sydara, John F. Hartmann, Bounhong Southavong, and D. Doel Soejarto. 2013. “Folk Epidemiology Recorded in Palm Leaf Manuscripts of Laos.” Journal of Lao Studies 3, no. 1: 1–14.

Elliott, Elizabeth M. 2021. “Potent Plants, Cool Hearts: A Landscape of Healing in Laos.” PhD thesis, University College London, UK.

Elliott, Elizabeth M. 2024. “Protecting the Body, Living the Good Life: Negotiating Health in Rural Lowland Laos.” In “The Good Life in Late Socialist Asia: Aspirations, Politics And Possibilities,” edited by Minh T. N. Nguyen, Phill Wilcox, and Jake Lin. Special issue, positions: asia critique 32, no. 1: 151–70.

Elliott, Elizabeth, François Chassagne, Agnès Aubouy, Eric Deharo, Outhay Souvanasy, Phaiboun Sythamala, Kongmany Sydara, et al. 2020. “Forest Fevers: Traditional Treatment of Malaria in the Southern Lowlands of Laos.” Journal of Ethnopharmacology 249 (March): 112–87. https://doi.org/10.1016/j.jep.2019.112187.

Finot, Louis. 1917. “Recherches sur la littérature laotienne.” Bulletin de l’École française d’Extrême-Orient 17, no. 1: 1–218. https://doi.org/10.3406/befeo.1917.5323.

Grabowsky, Volker. 2007. “Buddhism, Power, and Political Order in Pre-Twentieth Century Laos.” In Buddhism, Power and Political Order, edited by Ian Harris, 121–42. London: Routledge.

Libman, Amey, S. Bouamanivong, B. Southavong, K. Sydara, and Djaja Djendoel Soejarto. 2006. “Medicinal Plants: An Important Asset to Health Care in a Region of Central Laos.” Journal of Ethnopharmacology 106, no. 3: 303–11. https://doi.org/10.1016/j.jep.2005.11.034.

Monnais, Laurence, C. Michele Thompson, and Ayo Wahlberg. 2011. Southern Medicine for Southern People: Vietnamese Medicine in the Making. Newcastle upon Tyne: Cambridge Scholars Publishing.

Pottier, Richard. 2007. Yû dî mî hèng. Etre bien avoir de la force : essai sur les pratiques thérapeutiques lao. Monographies 192. Paris: Ecole française d’Extrême Orient.

Salguero, C. Pierce. 2016. Traditional Thai Medicine: Buddhism, Animism, Yoga, Ayurveda. 2nd rev. ed. Bangkok: White Lotus Press.

Soejarto, Djaja Djendoel, C. Gyllenhaal, M. R. Kadushin, B. Southavong, K. Sydara, S. Bouamanivong, M. Xaiveu, et al. 2012. “An Ethnobotanical Survey of Medicinal Plants of Laos toward the Discovery of Bioactive Compounds as Potential Candidates for Pharmaceutical Development.” Pharmaceutical Biology 50, no. 1: 42–60. https://doi.org/10.3109/13880209.2011.619700.

Soejarto, Djaja Djendoel, Kongmany Sydara, Bethany G. Elkington, Bounleuane Douangdeuane, Onevilay Souliya, and Mouachan Xayvue. 2023. “Conservation of Medicinal Plants of Laos.” In Medicinal Plants of Laos, edited by Djaja Djendoel Soejarto, Bethany G. Elkington, and Kongmany Sydara, 52–71. Boca Raton: CRC Press.

Sweet, Kathryn Dawn. 2015. “Limited Doses: Health and Development in Laos, 1893–2000.” PhD thesis, National University of Singapore.

Thompson, C. Michele. 2015. Vietnamese Traditional Medicine: A Social History. Singapore: National University of Singapore Press.

Vidal, Jules. 1958. “La thérapeutique par les plantes au Laos.” Journal d’agriculture et de Botanique Appliquée 5, no. 10: 601–16.

Acknowledgments

The author would like to acknowledge the assistance of the Faculty of Pharmacy at the University of Health Sciences, the Institute of Traditional Medicine, and Champasak Regional Hospital for administrative support during fieldwork. The Asia Research Institute of the National University of Singapore provided financial support to edit the documentary, and the Institut de Recherche pour le Développement in Laos provided videomaking equipment. This documentary was funded by the Global Traditional Medicine Grant (Award 73578).

^[1] Elliott 2021.

^[2] Po and Ajan are titles meaning “Father” and “Teacher/Scholar,” respectively.

^[3] Alvesson et al. 2013.

^[4] Monnais, Thompson, and Wahlberg 2011; Thompson 2015.

^[5] Sweet 2015.

^[6] Salguero 2016.

^[7] Brun and Schumacher 1994.

^[8] Vidal 1958.

^[9] An analysis of the plants used in these recipes showed a high use correlation with species used cross-culturally to treat malaria, several of which have shown promising results in pharmacological studies such as Amorphophallus paeniifolius (Dennst.) Nicolson and Alocasia macrorrhizos (L.) G. Don. See Elliott et al. 2020.

^[10] Elkington et al. 2013; Finot 1917.

^[11] Pottier 2007.

^[12] Grabowsky 2007.

^[13] Soejarto et al. 2012.

^[14] Libman et al. 2006.

^[15] Coderey 2017.

^[16] For example, ethnically Hmong medicine sellers (Dubost et al. 2019).

^[17] Soejarto et al. 2023.

^[18] Elliott 2024.

^[19] This is likely also to reflect their status as Buddhist, lowland, male practitioners; this may be different for other healers from non-Buddhist minority groups.

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Resources mentioned in this episode:

* Lan’s website

* Lan Li, “The Vital Other: Integrative Medicine and India” (2012)

* Lan Li, “Acupuntura e Moxabustão” (2023)

* Lan Li and Pierce Salguero, Jivaka Project Philadelphia (2015-2020)

* Pierce’s blogs on Ugly Truths about Grad School, Metamodernism, Metamodern Asian Medicine, and Polyperspectivalism

* Lan Li, Body Maps: Improvising Meridians and Nerves in Global Chinese Medicine (2025)

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More than many other places in the world, Covid-19 vaccines and other mitigation efforts were notably controversial in the United States, deepening political divisions across American society. During the 2020–2023 period, practitioners of Asian medicine in the US became fractured by these controversies. Rancorous arguments festered on social media platforms and divided Asian medicine classrooms and clinics around the country. At the time of this writing, the authors are unaware of any study that has attempted to systematically gauge attitudes toward Covid-19 prevention, treatments, or vaccines among this community. This paper reports on a survey of US-based practitioners of Asian medicine conducted in late 2022 to early 2023 at the height of the controversy over vaccines in the US. The study questions were designed to explore divisions over these issues and the underlying causes of those divisions. We had hypothesized that differences between practitioners’ attitudes — and, in particular, their opinions about vaccines — would be connected with epistemological factors related to Asian medicine methodology and body concepts. However, after analyzing our data for a number of epistemological, demographic, and social correlations, we concluded that the main influences underlying the divisions in the Asian medicine field in the US ultimately have to do with political affiliation. 

Literature Review 

As far as we are aware, at the time of this writing in April 2023, there is no previous scholarship specifically measuring attitudes toward Covid-19 vaccines among US practitioners of Asian medicine. Nevertheless, the present study intersects with several related topics that have been previously investigated by scholars, some highlights of which can be mentioned in brief.

The first is Covid-19 vaccine hesitancy in the US more generally. Studies on this topic have found that demographic factors play a role in shaping attitudes toward vaccines. In a national survey conducted in the first half of 2021, for example, Kricorian et al. (2021) noted that those who doubted the Covid-19 vaccine was safe were on average “less educated, lower income, and more rural than people who believed the vaccine is safe.” Later that year, a survey by Hamel et al. (2021) looked at race, education level, age, health insurance status, and political affiliation. One of their major takeaways was that political “partisanship and vaccination status continue to loom large as factors in how the public views both the U.S. vaccination effort and the government’s response to the pandemic in general.” Shortly afterwards, a survey by Frisco et al. (2022) examined racial and ethnic factors underlying vaccine hesitancy. They found that “U.S.-born Black adults are more vaccine hesitant than U.S.-born White adults,” that “U.S.-born Hispanic adults are less vaccine hesitant than U.S.-born White adults,” and that “there were not significant differences between foreign-born Hispanic and U.S.-born White adults in vaccine hesitancy.” 

A second area of relevant scholarship is vaccine hesitancy among practitioners prior to the pandemic. While not specifically focusing on traditional Asian medicine, Wardle et al. (2016) provides a critical review of 39 studies conducted between 2000–2015 measuring vaccine hesitancy among practitioners and users of “complementary medicine.” These authors found that the use of childhood vaccines was less prevalent among this population; however, respondents’ attitudes “may be confounded by other factors,” including “higher income, higher education or distrust of the medical system.”

A third related area is the attitude toward traditional Asian medicine for both prevention and treatment of Covid-19 among specialists and the general public. A number of qualitative studies on this topic have been conducted outside of the US, most notably in China. Pu et al. (2021), for example, surveyed about 400 medical professionals in Sichuan and found that over half agreed that Traditional Chinese Medicine (TCM) “can be used for the prevention and treatment of Covid-19.” Nguyen et al. (2021) surveyed members of the general public in Vietnam and found that “the use of herbal medicine during the Covid-19 pandemic was a common practice among Vietnamese people.” D’Arqom et al. (2022) found that, among Indonesian mothers with school-age children, 65.6% consumed a mix of “medications, vitamins/minerals, and herbs/natural products” to ward off the virus. In Western countries, Bourqui et al. (2022) surveyed 320 practitioners of TCM in Switzerland about the traditional medicine treatments they administered to Covid patients. Additionally, Kong et al. (2021) surveyed over 750 Chinese immigrants in Canada about their attitudes, finding that “TCM was widely believed by Chinese immigrants in Canada to be an effective means of preventing Covid-19 and many also stated they would use it if they were experiencing symptoms of Covid-19.” 

A final area of previous research that may be interesting to readers of the current paper is detailed historical and ethnographic studies of traditional medicine practice in the US. These studies have largely focused on Chinese medicine, including works by Wu (2013), Pritzker (2014), and Phan (2017). While produced in the pre-Covid era, this scholarship can give us a sense of the cultural and social dynamics among communities of Asian medicine practitioners in the US, which can help to contextualize the findings in our own survey. Lastly, while comprehensive demographic data is not available for all types of traditional Asian medicine in the US, some professional organizations maintain statistics that may be useful to compare to the data from our survey. These include studies from the National Certification Commission for Acupuncture and Oriental Medicine (Ward-Cook 2017) and Yoga Alliance (2016). 

All of the mentioned publications notwithstanding, the overall point is that previous research has not directly attempted to measure attitudes toward Covid-19 vaccines among American practitioners of Asian medicine as we are attempting to do in this study.

Our Survey and Respondents

Asian medicine practitioners were invited to participate in our survey through announcements we made in three large international English-language Facebook groups dedicated to Asian medicine. These groups had a notably apolitical stance on Covid-19, and our invitation to participate in the survey did not reveal that we would be asking about potentially contentious issues. 

The survey (see Appendix below) included multiple choice, multiple selection, and open-ended questions. It was made available to participants via Qualtrics from December 2022 to January 2023. We received a total of 145 responses, the largest cohort of which (n=81) were those based in the United States. We had initially intended to conduct a comparative international survey; however, as we did not receive enough responses from any other country to make meaningful comparisons, only responses from the US have been considered in this report.

Our survey results are reported in full in the appendix. To summarize some of the key points here, the respondents were diverse in terms of race, religion, location within the US, and their chosen field of Asian medicine practice. The majority was female (representing 63% of all responses), white (77%), native speakers of English (99%), and well-educated (69% had a master’s or doctoral degree of some kind), and most commonly identified themselves as practitioners of some kind of “Chinese medicine or TCM” (72%). Level of experience in the practice of Asian medicine was generally high, with 51% having a graduate degree in Asian medicine and 58% having spent more than 10 years working in the field. A majority of the respondents (52%) were full-time practitioners, 28% were teachers, and 73% identified Asian medicine as their primary source of income. Given these patterns, we feel that the survey likely is not representative of the practitioner community in the US. In particular, our survey is lacking any respondents under 25 and has very few non-native English speakers. Thus, it fails to capture the opinions of the youngest generation of practitioners, the large number of immigrants working in the massage industry or as community healers in Asian American neighborhoods, and other important populations of practitioners in the US. These omissions notwithstanding, we nevertheless believe that the survey results can be useful to better understand a segment of the Asian medicine community’s attitudes and opinions.

In addition to demographic questions and questions about their practice of Asian medicine, we had respondents rate a list of words in terms of their relevance for prevention and treatment of Covid-19. In an effort to include the widest possible range of interventions that are meaningful to our practitioner population, these interventions included conventional public health practices, Asian medical approaches, lifestyle choices, as well as what might be characterized as more spiritual or religious practices. The most highly rated (8 out of 10) interventions were sleep, personal hygiene, and herbal medicines. The lowest (5 out of 10) were prayer and luck/fate/karma. Interventions such as masking, social distancing, and vaccines fell in-between.

We also asked respondents to rate a list of words that could describe Covid-19 vaccines in positive or negative ways, ranging from “important” and “beneficial” to “toxic” and “dangerous.” Salient data from this portion of the survey that caught our attention included the fact that only 7% of respondents said that Covid vaccines are incompatible with Asian medicine. However, 26% of respondents said that vaccination is ineffective, and 33% of respondents said that the vaccines are dangerous. These beliefs about the vaccine correlated with behavior: 24% reported being completely unvaccinated, in contrast with the 63% of respondents who had received 3 or more doses at the time of the survey. 

Our survey included open-ended questions to elicit more detailed opinions about prevention and treatment. Respondents in the unvaccinated cohort responded to these questions with dismissive comments about the severity of Covid-19, calling it “a type of common cold” with a “low death rate” that “mostly affects the elderly.” They denigrated vaccines, saying that they are “highly problematic,” that there is “no difference in transmission rates or severity of symptoms,” and that getting a shot results in “a range of health concerns and death.” On the other side of the fence, one respondent wrote that “acupuncturists being anti-vax and Covid conspiracy theorists is an embarrassment to the profession, and I am ashamed to be associated with them.” Numerous other respondents wrote in support of vaccines as being effective in preventing serious illness and as important tools for community or public health.

On this basis, we concluded that our anecdotal observations were true: there were indeed divisions within the community in terms of attitudes toward Covid prevention and treatment, including strong divergences in opinions about vaccination. Having established this fact, we then turned to try to discover the likely source of these divisions. 

Are Epistemic Strategies to Blame for Polarization?

David G. Robertson has written that “the dominant forms of epistemic capital in the contemporary world are scientific, tradition, experience, channeled, and synthetic knowledge” (2021: 29; Robertson & Amarasingam 2022). These “epistemic strategies” struck us as being potentially quite relevant for understanding differences between practitioners of Asian medicine. We hypothesized that the epistemological commitments and assumptions of practitioners of various kinds of Asian medicine would exert a major influence upon their ideas about Covid-19.  In order to test this hypothesis, we asked our respondents to score each of these strategies from 1 (“completely irrelevant”) to 10 (“absolutely fundamental”) based on their “importance in your practice of Asian medicine when diagnosing/assessing patients.” The survey described these epistemic strategies as follows, in an attempt to explain Robertson’s categories in terms that would be accessible to our respondents:

1. Scientific (methods based on clinical trials, using evidence-based research)

2. Traditional (methods based on established norms that are common to a particular lineage of practice)

3. Individual experience (methods using “felt sense,” intuition, or personal experience as primary criteria)

4. External powers (methods such as divination; channeling or engaging with deities, spirits, ancestors, or any other external entities)

5. Synthetic (putting together clues and evidence in a unique or novel way that doesn’t privilege any of the abovementioned methodologies)

The five different approaches were rated by our respondents in the following order: “traditional” (average score 8 out of 10), “individual experience” (7), “scientific” and “synthetic” (tied at 6 each), and “external powers” (4). This general pattern of preferences held surprisingly steady across the majority of respondents with only slight variances.

We noticed that enthusiasm for each of these epistemic strategies correlated with certain demographic features. Practitioners who rated their enthusiasm for “scientific methodologies” at 7 or above were twice as likely on average to vote for the Libertarian party and three times as likely to identify as politically conservative. Those who rated methodologies related to “individual experience” highly had considerably less experience as practitioners. Those who favored methodologies related to “external powers” were far less likely than the average respondent to have completed a graduate degree and were much more likely to currently be a student. These respondents were much more likely to be Asian, to vote Democrat, and to report have recently tilted in a more liberal or progressive direction. Finally, those who thought favorably of “synthesis” had much more training in Asian medicine than the norm but much less experience working in the field, and much more likely to have earned a graduate degree in science. 

What about the hypothesis that practitioners’ strategic preferences would correlate with their attitudes toward prevention and treatment of Covid-19 as well as their vaccination behavior? We had expected, for example, that respondents who subscribed to scientific methods would be much more likely to endorse vaccines and conventional public health measures than those who subscribed to traditional strategies. In sorting through the data, we did indeed find that those who favored “scientific” methodologies were somewhat more likely to be vaccinated. In addition, those expressing enthusiasm for “external powers” expressed much more enthusiasm for energy practices, meditation, prayer, and luck/fate/karma than the others. However, while such findings are interesting and perhaps warrant further research, we felt that these correlations were not strong enough for us to conclude that epistemic strategies were strongly predictive of attitudes toward Covid-19 vaccination.

Are Body Concepts to Blame?

When designing the study, we had also hypothesized that the different conceptions of the body that are taught in different Asian medical systems may be another important distinction between Asian medicine practitioners. We developed the following list of body concepts that are prevalent in different Asian medicine traditions as well as in the religions that inform various types of Asian healing, and asked respondents to rate each one on a scale from 1 (completely irrelevant) to 10 (absolutely fundamental) based on “their importance in your clinical practice of Asian medicine”:

1. The body is a material structure.

2. The body is explainable through the fields of modern scientific anatomy, physiology, and biochemistry.

3. The body is a web of energy.

4. The body is constantly being affected by the energies of the natural world, such as the seasons, the stars, animal, and plant life.

5. The body is inhabited by divine powers or entities.

6. The body is itself a manifestation of the divine or cosmic reality.

7. The body is empty, insubstantial, immaterial, or mirage-like.

8. The body is an illusion that appears only in one's thoughts.

9. The body and mind are completely intertwined with one another, or are not even separate entities.

10. The body is multilayered or like “nested dolls,” with all of the above qualities being paradoxically true at the same time.

The overall respondent pool strongly approved of seven of these options (score ≥7), giving a mid-range score for “divine powers/entities” and low scores for “the body is empty” and “an illusion.” Again, we noted correlations between body concepts and certain demographic features. Asians were more enthusiastic than other racial groups about the notion that “the body is empty.” The 26-35 age group was more likely to endorse the statement that the body is “inhabited by divine powers or entities,” as were respondents who identified as Christian. Atheists predictably were the least likely to say that the body is a “manifestation of divine or cosmic realities”; however, the more education a respondent had, the more likely they were to rate that concept highly.

Such differences notwithstanding, there turned out to be no statistically coherent pattern between body concept preference and attitudes toward Covid-19 prevention, treatment, or vaccines. While we had theorized that a practitioner’s understanding of the body would play a major role in influencing their approaches to Covid, we concluded that this hypothesis was false. 

What else might be a factor? 

Having disproven our hypotheses that epistemological factors were to blame for practitioners’ polarization over Covid vaccines, we then began to look for patterns in the data related to field of specialization, position in the industry, demography, and other social factors. Education did not play any role in vaccination behavior: respondents with a doctorate degree were as likely to be unvaccinated as they were to have received 4 or more doses, and it made no difference if their graduate degree was in a science field. Nor did the location where practitioners had trained make any difference. Years of experience, whether or not Asian medicine represented the main source of income, and status in the field (teacher, student, full-time, part-time, etc.) were all statistically insignificant. 

We did note some demographic correlations of minor magnitude. Although the numbers were tiny (n=6), all of the Black and Hispanic/Latinx respondents in our data pool had received 3 or more doses at the time of the survey. Christians were likely to have had more vaccines than the other religions. On average, women had received slightly more vaccines than men. Nevertheless, as the magnitude of these differences was small, we again found such patterns to be insufficient to explain the strong polarization of Asian medicine practitioners’ attitudes and behaviors.

While drilling down to examine the unvaccinated cohort more closely, we were interested to find that some of the open comments from this group framed resistance to vaccines and other public health measures in terms of a defense of science. For example, one respondent lamented the “eroding of public trust in science” caused by the US government’s response to the pandemic. Rather than appeal to historical Asian medicine epistemologies or doctrines, these respondents equated Asian medicine with contemporary science, calling their own treatment plans “scientifically based schematics,” “process science,” and “evidence-based medicine.” This attitude seems to suggest that at least some of this cohort believed that Asian medicine approaches to Covid prevention are superior to biomedical approaches not because they are less scientific, but because they are more so. While this was the opinion of a small minority of practitioners, it may be a phenomenon that warrants more research.   

All of the above is interesting but does not clearly explain the strong divisions in the Asian medicine field. However, during this phase of our data analysis we did find one correlation that jumped out to us as a strongly predictive factor of Asian medicine practitioners’ attitudes toward Covid prevention and treatment, including their opinions about vaccines. That correlation was political party affiliation.

Politicization

When we zoomed in to look at participants’ political affiliations, we discovered two very different kinds of practitioner, which we might call “left-leaning” vs “right-leaning.” The left-leaning group, by far the larger of the two, was made up of Democrat and Green Party voters (n=49, i.e., 61% of the whole). These respondents were older, more female, and whiter than the overall pool. They had slightly more experience in the field but were more likely to be working part-time rather than full-time as an Asian Medicine practitioner. 

The smaller right-leaning group of Republican and Libertarian voters (n=11, i.e. 14% of the whole), on the other hand, were much younger and much less wealthy. They were also more likely to be female than the overall respondent pool. In the aggregate, they were less educated, with less chance of having completed a doctorate or master’s degree, and they had much less exposure to science (40% chance of never having taken a university course on any scientific subject). Right-leaning practitioners were likely to have less experience in the field than the overall respondent, and less likely to be a teacher. While the vast majority of left-leaning respondents reported not having shifted their voting patterns in recent years, the right-leaning ones were more likely to have shifted more conservative in recent years, and to identify the U.S. government’s Covid-19 policies as the reason for that shift. In terms of preventing and treating Covid-19, they had far less enthusiasm for masking, social distancing, vaccination, and ventilation machines than the overall average. 

Upon analysis, practitioners’ left- or right-leaning political affiliation turned out to be the single most significant correlation with attitudes toward vaccination. In the word association question, those on the left showed more support for positive descriptions of vaccines (i.e., natural, safe, beneficial, important) than the overall respondents and less support for negative words (i.e., ineffective, artificial, unsafe). Those on the right were the mirror opposites, exhibiting more support for negative descriptions of vaccines and less support for positive words. These attitudes also translated into actions. Left-leaning practitioners were 84% likely to have gotten 3 or more doses of the Covid vaccine with only an 11% chance of being unvaccinated, while those identifying as right-leaning were only 11% likely to have gotten three doses with a 67% chance of being unvaccinated. 

Conclusion

While the number of right-leaning practitioners is dwarfed by the left-leaning ones, the differences in attitudes between these two groups could not be starker. In the words of one of our respondents, such polarization made the issue of vaccination “confusing and difficult to discuss” among the community. The vast majority of our respondent pool signaled that they felt this way. When one of our word association questions asked them to rate a list of words that could be used to describe Covid vaccines, by far the top choice across all demographic and social groups was “politicized.” On this one point, it seems, everyone can agree.

Perhaps these findings should not have surprised us. We have known about the politicization of American attitudes toward Covid vaccines since soon after they first became available (e.g., Hamel et al. 2021). However, our research team had expected that the specific type of Asian medicine one practiced, differences in these traditions’ epistemological strategies and body concepts, or other professional or demographic factors would account for some of the differences in attitudes and behavior toward Covid-19 among practitioners. After exhaustively searching for these other factors, however, we were forced to conclude that the single most influential explanation of practitioners’ attitudes and behaviors was voting patterns. Sometimes, it just comes down to politics. 

References 

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Appendix: Asian Medicine & Covid-19 Survey

Part 1. General Demographic Information

Select the types of Asian healing practices that you engage in [check all that apply] (n=81)

• ·    Ayurveda, 7%

• ·    Chinese Medicine/TCM, 72%      

• ·    East Asian Medicine, 39%  

• ·    Mindfulness or Meditation of an Asian lineage, 26%

• ·    Qigong, 34%

• ·    Reiki, 18%

• ·    Shiatsu, 7%

• ·    Sowa Rigpa, 1%

• ·    Taiji/Tai Chi, 21%

• ·    Thai Massage/Medicine, 32%

• ·    Yoga/Yoga Therapy, 21%

• ·    Other Asian or Asian inspired body work, 13%

• ·    Other Asian or Asian inspired energy work, 7%

• ·    Other Asian or Asian inspired martial arts for therapeutic effect, 7%

• ·    Other Asian or Asian inspired spiritual healing practices, 9%

• ·    Other practices not listed above, 9%

Sex/Gender (n=76)

• ·    Male, 33%

• ·    Female 63%

• ·    Non-binary/Other 4%

Age (n=76)

• ·    26-35, 13%

• ·    36-49, 42%

• ·    50-69, 42%

• ·    70+, 3%

Race/Ethnicity [check all that apply] (n=78)

• ·    Asian/Pacific Islander, 8%

• ·    Black, 4%

• ·    Hispanic/Latino, 4%

• ·    Native American/Indigenous, 1%

• ·    White, 77%

• ·    Other, 11%

Zip code range (n=65)

• ·    Northeast, 31%

• ·    West coast, 31%,

• ·    Midwest, 12% 

• ·    Rockies and Southwest, 3% 

• ·    Southeast, 23%

Primary language (n=76)

• ·    English, 99%

• ·    Other, 1%

Individual income (n=75)

• ·    Less than $25,000 per year, 8%

• ·    $25,000 – $50,000 per year, 27%

• ·    $50,000 - $75,000 per year, 31%

• ·    More than $75,000 per year, 35%

Religion [check all that apply] (n=79)

• ·    Buddhist, 25%

• ·    Christian, 18%

• ·    Hindu, 0%

• ·    Jewish, 10%

• ·    Muslim, 0%

• ·    Spiritual/Non-religious, 40%

• ·    None/Atheist, 8%

• ·    Other, 22%

Highest level of education completed (n=75)

• ·    Highschool, 8%

• ·    2-year college, 7%

• ·    4-year university, 15%

• ·    Master’s Degree, 33%

• ·    Doctorate Degree or equivalent, 36%

• ·    None of the Above, 1%

Political party you tend to vote for most often (n=72)

• ·    Democrat, 63%

• ·    Republican, 7%

• ·    Green, 3%

• ·    Libertarian, 8%

• ·    Independent, 13%

• ·    Other, 7%

Political self-assessment 

• ·    Very conservative, 4%

• ·    Conservative, 3%

• ·    Moderate, 31%

• ·    Liberal/Progressive, 31%

• ·    Very liberal or very progressive, 17%

• ·    Other, 15%

Have you changed the political party you vote for or your political orientation since 2020?

• ·    Yes, I moved in the direction of more conservative, 14%

• ·    Yes, I moved in the direction of more liberal/progressive, 4%

• ·    No, I stayed about the same, 82%

Was this change due to the government’s Covid-19 policies?

• ·    Yes, 21%

• ·    No, 79%

Part 2. Asian Medicine Practice

What is your level of training in your primary Asian medicine practice [check all that apply]? (n=85)

• ·    Doctorate, 24%

• ·    Master’s degree, 27%

• ·    Professional Training, 29%

• ·    Apprenticeship, Informal, or Family-based Training, 11%

• ·    Self-Study, 9%

Where did you study your primary healing practice? (n=80)

• ·    Asia, 19%

• ·    Canada, 1%

• ·    UK, 1%

• ·    US, 73%

• ·    Other, 6%

How many years have you been practicing your primary healing practice? (n=67)

• ·    Under 5, 24%

• ·    5 – 10, 18%

• ·    10 – 20, 22%

• ·    Over 20, 36%

What level of training do you have in biology, chemistry, biomedicine, or any other modern scientific disciplines? (n=66)

• ·    Never took a university class, 15%

• ·    Took some classes in university, 55%

• ·    Majored in a science field in a university, 17%

• ·    Completed a graduate degree in a science field, 13%

Is Asian Medicine your main source of income?

• ·    No, 27%

• ·    Yes, 73%

What best describes your role in Asian Medicine [check all that apply] (n=80)

• ·    Hobbyist, 7%

• ·    Student, 12%

• ·    Part-time practitioner, 34%

• ·    Full-time practitioner, 52%

• ·    Teacher, 28%

• ·    Retired, 3%

Please give each of the following methodologies a score based on their importance in your practice of Asian medicine when diagnosing/assessing patients? Rate each item rated on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=66)

• ·    Scientific (methods based on clinical trials, using evidence-based research), average rating 5

• ·    Traditional (methods based on established norms that are common to a particular lineage of practice), 8

• ·    Individual experience (methods using “felt sense,” intuition, or personal experience as primary criteria), 7

• ·    External powers (methods such as divination; channeling or engaging with deities, spirits, ancestors, or any other external entities), 4

• ·    Synthetic (putting together clues and evidence in a unique or novel way that doesn’t privilege any of the abovementioned methodologies), 6

Please give any additional details or clarifications you wish about your response to the previous question.

[Open responses]

Please give each of the following views of the human body a score based on their importance in your clinical practice of Asian medicine. Rate each item rated on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=65)

• ·    The body is a material structure, average rating 8

• ·    The body is explainable through the fields of modern scientific anatomy, physiology, and biochemistry, 7

• ·    The body is a web of energy, 8

• ·    The body is constantly being affected by the energies of the natural world, such as the seasons, the stars, animal, and plant life, 8

• ·    The body is inhabited by divine powers or entities, 5

• ·    The body is itself a manifestation of the divine or cosmic reality, 7

• ·    The body is empty, insubstantial, immaterial, or mirage-like, 3

• ·    The body is an illusion that appears only in one's thoughts, 2

• ·    The body and mind are completely intertwined with one another, or are not even separate entities, 8

• ·    The body is multilayered or like “nested dolls,” with all of the above qualities being paradoxically true at the same time, 7

• ·    Other, 6

Please give any additional details you wish to about your response to the previous question. (Open response)

Part 3. Asian Medicine and Covid-19

Please score the following when it comes to the prevention of Covid-19. Rate each item on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=63)

• ·    Masking, average rating 7

• ·    Social Distancing, 6

• ·    Vaccines, 6

• ·    Diet, 7

• ·    Exercise, 7

• ·    Sleep, 8

• ·    Personal hygiene, 8

• ·    Herbal medicines, 8

• ·    Energy practices, 6

• ·    Meditation, 6

• ·    Prayer, 5

• ·    Luck, fate, and/or karma, 5

Please score the following in the order of importance when it comes to the treatment of Covid-19. Rate each item on a scale of 1 (completely irrelevant) to 10 (absolutely fundamental). (n=61)

• ·    Pharmaceutical drugs, average rating 6

• ·    Ventilation machines, 7

• ·    Diet, 7.

• ·    Exercise, 7

• ·    Sleep, 8

• ·    Personal hygiene, 8 

• ·    Herbal medicines, 8

• ·    Energy practices, 6

• ·    Meditation, 6

• ·    Prayer, 5

• ·    Luck, fate, and/or karma, 4

Which of the following words do you associate with Covid-19 vaccines? [check all that apply] (n=61)

• ·    Natural, 7%

• ·    Artificial, 36%

• ·    Organic, 0%

• ·    Chemical, 28%

• ·    Safe, 31%

• ·    Dangerous, 33%

• ·    Effective, 56%

• ·    Ineffective, 26%

• ·    Unsafe, 33%

• ·    Beneficial, 51%

• ·    Toxic, 23%

• ·    Important, 51%

• ·    Waste of resources, 16%

• ·    Politicized, 72%

• ·    Incompatible with Asian medicine, 7%

• ·    Compatible with/complementary to Asian Medicine, 54%

How many Covid-19 vaccinations and/or boosters have you received personally? (n=62)

• ·    0, 24%

• ·    1, 5%

• ·    2, 8%

• ·    3, 26%

• ·    4, 34%

• ·    More, 3%

What other vaccines do you remember receiving? [check all that apply] (n=56) 

• ·    Annual flu shot, 48%

• ·    Chicken pox/shingles, 27%

• ·    Diphtheria (DTaP), 55%

• ·    Hepatitis, 66%

• ·    HPV, 5%

• ·    Measles, Mumps, and Rubella (MMR), 84%

• ·    Polio, 68%

• ·    Pneumonia, 13%

• ·    Tetanus, 93%

• ·    Tuberculosis (TB), 46%

• ·    Other, 9%

We are interested in how practitioners of Asian medicine think about the prevention and treatment of Covid-19. Please share your thoughts with us and provide as much information as you would like to on this topic. The more information you share, the more you will help our study. (Open response)

* Preliminary published results from Ruth’s research

* Mallinson and Szántó, The Amṛtasiddhi and Amṛtasiddhimūla (2021).

* Jason Birch, The Amaraugha and Amaraughaprabodha of Gorakṣanātha (2023).

* Elena Valussi, “The Physiology of Transcendence for Women” (2009)

* BBP episode with Dominic Steavu

* Hatha Yoga Project

* Articles on guru abuse by Pattabhi Jois: Anneke Lucas, Karen Rain, Amanda Lucia

* Inform Project

* Video footage of Ruth doing historical āsanas

* Ruth’s website and email newsletter, Facebook page, Instagram

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com

Enjoy! and subscribe to Blue Beryl for monthly episodes.

Resources mentioned in this episode:

* Theodora Wildcroft, Post Lineage Yoga: From Guru to #MeToo (2020)

* Theo Wildcroft & Harriet Mcatee, The Yoga Teacher’s Survival Guide: Social Justice, Science, Politics, and Power (2024)

* Barbora Sojkova & Theodora Wildcroft, Yoga Studies in 5 Minutes (2025)

* Theo’s website:

https://theowildcroft.com

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com

Remember, if you want to hear from more experts on Buddhism, Asian medicine, and embodied spirituality, subscribe to Blue Beryl for monthly episodes. Please enjoy!

Resources mentioned in the episode:

* Brandt’s Patreon

* Brandt’s personal website

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com

Remember, if you want to hear from more experts on Buddhism, Asian medicine, and embodied spirituality, subscribe to Blue Beryl for monthly episodes. Please enjoy!

Resources mentioned in the episode:

* Naomi’s website

* Naomi’s publications on Academia.edu

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit blueberylpodcast.substack.com