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The traditional herbal remedies of Hainan’s Li people are both mysterious and completely unique. Passed down from one generation to the next over millennia, this jungle medicine distills the deep understanding of the natural world, hard-won by the Li people through ages of living in close contact with the area’s plants and animals, allowing them a special insight into how to cure illness and treat injuries through judicious use of local island medicines.
Is Hainan Herbal Medicine Effective?
“Is Hainan herbal medicine effective?” Yang Lina is frequently asked this question. She has opened the island province’s first Li medicine clinic in Wuzhishan City, located in central Hainan. Inside, there is a rather old-fashioned examination table, and Yang’s Li herbal medicine, which pre-dates even the archaic table.
Yang grew up in a Li village in Wuzhishan. “The Li people spend most of their lives deep in the mountains, and often suffer snake bites, broken bones, and other medical problems, so we Li all have at least some ability to identify and use the local herbs for basic issues, but whenever we run into bigger problems we don’t know how to fix, we get help from a Li doctor,” said Yang. The Li people often refer to these physicians as “Medicine Kings”.
Li doctor Yang Lina gathers herbs on the mountain. (Photo provided to Hainan Daily)
Yang’s grandmother was also a well-regarded Li doctor. When she was just nine, Yang would go up the mountain with her grandmother to gather herbs and learn how to use them to treat those in need. “After I got used to it, I didn’t think there was anything too strange about Li medicine.” In order to get out of the mountains, Yang studied diligently, and was admitted to medical school, where she studied medicine in a systematic way.
After graduation, Yang returned to practice medicine in Hainan. When she encounters patients with unusual ailments or impoverished circumstances, she naturally turns to Li herbal medicine. These simple, effective, and cheap treatments have won Yang an excellent reputation with quite a few patients, although she’s found that Li medicine is relatively unknown in other parts of China and the world.
In the year 2000, Yang, concerned about the future development of Li medicine, resigned from the hospital where she was working and returned to her hometown. She began once more to study traditional Li herbal treatments at her grandmother’s elbow, and inherited her mantle as a “Medicine King”. In 2005, Yang opened the Li clinic where she still sees patients today.
“I’ve used Li medicine to treat patients for over 20 years. As to whether or not it’s effective, take a look at the banners on the wall behind me,” Yang said proudly.
In contrast with Yang, who has been well acquainted with Li medicine since she was small, Zhong Jiedong, who is working as a specialist at the Li outpatient clinic of the Hainan Traditional Chinese Medicine Hospital, only got into Li herbal medicine later in life.
“I always heard adults talking about Li herbal medicine when I was a kid, and always thought it was interesting.” In 1994, Zhong came home to Hainan and began working as a doctor in the Wuzhishan area. He found that many of the local plants had medicinal uses. He began traveling around all the area villages, visiting hundreds of older Li doctors and studying the properties and effective uses of Li medicines. In this way, he has been able to research and preserve thousands of Li herbal remedies.
“Don’t underestimate Millettia Vine (Spatholobus Suberectus). It’s useful for enriching the blood. It’s highly effective and doesn’t cost much at all. Also the Hairy Fig (Ficus hirta), which is excellent at raising vital energy levels.” There are several herbal medicines in Zhong’s clinical consulting room, and he picks one up after the other and speaks enthusiastically about their effects.
Li herbal medicine embodies the accumulated wisdom of thousands of years of experience of the Li people. It differs from Traditional Chinese Medicine, or TCM, in how the medicine is made and used, and in how illness is treated. The Li medicine tradition makes use of more fresh herbs and ingredients sourced from animals as well as single-dose medicines for internal and external use. The ‘Yazhou Records’, published during the Qing era, note that the Li people of Hainan at that time had a fairly complete understanding of the form, function, properties, effects, harvesting, processing, and classification of local medicinal herbs.
Research shows that traditional Li medicine practitioners have plenty of experience diagnosing and treating a wide variety of illnesses, including urinary, gynecological, orthopedic, dermatological, and rheumatic diseases, and are especially adept at dealing with snake bites, contusions, rheumatic bone pain, broken bones, poisoning, and malaria. In fact, the Li treatments for bone injuries and snake bites are officially listed as part of Hainan’s intangible cultural heritage.
Lin Tiandong, a master of Traditional Chinese Medicine, stated that “Li medicine has been passed down for thousands of years, and consists of a disease prevention and treatment system that can still be used to this day, proving the effectiveness of Li herbal medicine.”
“A giant step forward in the clinical application of Li Medicine”
On August 6, 2020, the Li outpatient clinic of the Hainan Traditional Chinese Medicine Hospital officially opened. This was China’s first outpatient clinic entirely dedicated to the use of Li herbal medicine in the diagnosis and treatment of patients at a tertiary public hospital, and offers fairly comprehensive clinical services.
The opening of this outpatient clinic signified a giant step forward in the clinical application of Li herbal medicine.
However, when the clinic first opened, there were only two or three patients each day. “At that time, people didn’t know much about Li medicine,” admitted Zhong Jiedong. In order to help patients get over their misgivings, Zhong decided to begin by giving more basic explanations of Li medicine through a series of lectures, tv programs, and short videos, creating more ways for people to become familiar with the topic. This was highly effective. At the same time, word began to spread about the effective treatments provided by the Li outpatient clinic.
The clearest sign that the campaign is working is the increase in patient visits. “Now I see an average of 30 patients a day,” said Zhong. Those patients are not only from Hainan. Some of them travel for thousands of miles to visit the clinic. People from out of town now account for one-third of patients at the Li outpatient clinic.
These days, in addition to the clinic at the Hainan Traditional Chinese Medicine Hospital, there is also a Li and Miao medicine outpatient clinic at the Tunchang Hospital of Traditional Chinese Medicine, and the Dongfang Traditional Chinese Medicine Hospital has set up a Li medicine experience area. More and more people are taking note of Li herbal medicine, and the number of patients choosing Li treatments is also on the rise.
In addition, Hainan is encouraging the establishment of more Li medicine experience areas, and is offering guidance on setting them up in all parts of the province. The Hainan Province Healthcare Security Administration has also begun covering local Li and Miao medicines under the island’s official medical insurance plans.
A Double Dilemma
Li herbal medicine, which goes back thousands of years and is a treasured part of local culture, is also facing a number of development difficulties.
The first dilemma is the low number of Li doctors. According to a survey by the Hainan Administration of Traditional Chinese Medicine, there are currently just over 300 Li doctors in the province. This is partially due to the traditional training methodology for these medical practitioners.
Traditional Li medicine combines medicine procurement, diagnosis, treatment, and nursing. “Medicine Kings” usually begin their training in childhood, when they begin learning the basics and going up into the mountains to collect herbs. They are formally assessed and selected as Li medicine doctors upon reaching adulthood.
Another issue is that as the Li people do not have a written language, their medical knowledge is passed on orally. That means that some traditional treatments are only mastered by a small group of people, making it difficult to ensure their continuance.
“Currently, there are no Li doctors under 50 years of age,” Zhong Jiedong lamented. There are now four physicians working in the Li outpatient clinic at the Hainan Traditional Chinese Medicine Hospital, but that is far from enough, and the number of young people interested in learning the art is low.
“Even some current Li doctor’s own children are unwilling to study. We worry that we may be the last generation of Li doctors,” said 60-year-old Yang Lina regretfully. She is now trying to teach what she knows to her son.
There are other problems, too, such as the unreliability of Li medicinal source materials. The area where the Li people reside in Hainan is a lush tropical rainforest, giving rise to a large number of medicinal plants, and some well-known medicines also make use of the same ingredients as Li treatments.
However, aside from a few herbs that are being cultivated on an industrial scale, many of the wild plants used in Li medicine are growing scarce.
For decades, Yang has been committed to protecting and passing Li herbal medicine down to the next generation. She has found that there are 40-50 plants used in Li medicine treatment that are already quite difficult to source. “We used to be able to pick these herbs right on our doorsteps, but later we began to have to go further and further into the wilds of the mountains and ancient forests to find them. I’m worried about the environmental conditions where the Li medicinal herbs grow,” said Yang sadly.
Since most Li medicines only use small amounts of each herb, it is difficult to cultivate these plants on a large scale. Most Li medicinal ingredients are still collected in the wild, making it impossible to guarantee their quality, safety, and supply. These issues all limit the future development of Li medicine.
Innovative Developments
When facing difficulties like these, it’s important to innovate.
In Qiongzhong’s Hongling Village, there is a Medicinal Fat-head Tree (Ramulus Naucleae) plantation covering an area of over 33 hectares. It is part of the over 253 hectare-large Medicinal Fat-head Tree agricultural base belonging to the Hainan Senqi Pharmaceutical Company.
Medicinal Fat-head Tree wood (Photo by Chen Ruolong / Hainan Daily)
Medicinal Fat-head Tree wood is a common Li medicinal ingredient, and is used for reducing heat, detoxifying, reducing swelling, and relieving pain, giving it a reputation as a “plant antibiotic”. It has long been used by the Li people of Hainan to fight all kinds of inflammation.
“We are optimistic about the effectiveness of treatments with Medicinal Fat-head Tree wood, and have used it to create a medication.” Zeng Jikai, Chairman of the Senqi Board, said that the product has done well on the market since it debuted in 2017. In 2022, the company sold around 7.8 million bottles of the medication, bringing in 280 million yuan.
This gave Zeng confidence, and he set a goal of discovering new ways to use Medicinal Fat-head Tree wood, and other diseases that it might provide effective treatment for. Over the past few years, the company has worked with a number of domestic research institutions to look into the antibacterial and antiviral properties of Medicinal Fat-head Tree wood, and at the same time to develop more patented Chinese medicines and chemical products from the wood.
Medicinal Li Medicinal Fat-head Tree wood products under development (Photo: Chen Ruolong / Hainan Daily)
In addition to exploring corporate applications, Hainan also plans to search out, classify, research, protect, and develop local minority medicines such as those of the Li and Miao peoples. The province will increase research and development of the active ingredients of Li herbal medicine, southern TCM, and aromatherapy medicines. Li medicine is classified as a key technological research area for the biomedical industry.
In order to ensure that Li medical knowledge is not lost, a representative of the Hainan Administration of Traditional Chinese Medicine said that Hainan is working to identify all Li medical practitioners in the province, conducting trainings, promoting the use of Li medical technologies, and encouraging Hainan’s institutes of higher learning to offer elective courses on the subject.
Li Medicine Cultural Inheritage Representative Wang Yongji shows his students how to identify local herbs. (Photo provided to Hainan Daily)
As part of the new generation of “Medicine Kings”, Yang Lina abandoned the tradition of keeping Li herbal medicine knowledge a secret quite early on. Since 2001, she has been researching and systematizing Li herbal medicine prescriptions at her own expense, and has collected over 300 popular folk remedies, saving them from being lost to time. “As long as people are willing to learn, I’m very happy to teach them about Li herbal medicine. The most important thing is that we cannot allow this knowledge to die out.”
海南国际传播中心出品
Hainan International Media Center Presents
Translator: Nicki Johnson
Editor: Li Xiang
翻译：谢敏（美国）
编辑：李想
