vaginal steaming (fumigation)
The following is just a brief blog post since I have gotten a few requests for information along the lines of the question below. I have not spent days to track this information down, and this blog is by no means meant as a complete answer. It is just a band-aid until i can talk somebody else into writing a thesis, capstone paper, dissertation, or serious article on it.
Is there any ancient wisdom/texts/resources about vaginal steaming (fumigation) that you know of off hand? What is the history of vaginal or pelvic steaming in Chinese medicine, if any, and where can details be found about this practice, if there are any, in the classic texts?
Vaginal steaming is a wonderful and important East Asian treatment modality that appears to be becoming more and more popular in the West, not just in immigrant enclaves but also in the larger culture. See for example this recent article from the Huffington Post. And it makes sense that gynecologically-oriented practitioners of East Asian Medicine would ask me about its classical roots and be interested in exploring how to add this modality to their offerings. So I want to do this question justice, on the basis of my historical knowledge of classical Chinese medicine, instead of just saying “I don’t know.” To start off with, I have to say that unfortunately so far, I have never experienced one myself. But in my world, and in the damp-cold Pacific Northwest climate that I live in, anything that involves, warmth, steam, and mugwort tends to have my full endorsement.
I first came across vaginal steaming as supposedly a traditional postpartum treatment still popular in Korea. it is also a practice in completely unrelated cultural contexts from Africa to Indonesia and just makes intuitive sense to me. The first thing I should emphasize that it is NOT a practice that is described as a common postpartum treatment in classical Chinese medical sources. I have come across it in traditional medical literature only as a treatment for dreams of intercourse with ghosts and similar conditions (see the examples below). Now, absence of evidence in male-authored medical sources does not mean that the practice did not exist. It is quite possible, if not even likely, that the midwives and other female caregivers who provided standard postpartum care to women throughout the traditional period applied all sorts of treatments that were simply never considered worthy of being written down by the male authors, for the male readers, of their literature. As a critical historian, all I can contribute is what is in fact found in the written record. So let me share that material, in the hope that somebody else might dig more deeply into more recent sources, where we have a much better chance of finding a record of treatments administered by and for women as routine healthcare instead of the more strictly “medical” treatments for specific diseases that are offered in the male-authored literature.
Example One: Qiānjīnfāng (652 CE)
The first example is a formula found in the section on “miscellaneous treatments” in Volume 3 of Sūn Sīmiǎo’s 孫思邈 Bèijí qiānjīn yàofāng 備急千金要方 (Essential Formulas for Emergencies Worth a Thousand in Gold). See specifically the second note on textual variations:
[The following] prescription treats women’s sudden intercourse with ghosts.
sōngzhī (pine rosin) 2 liǎng
xiónghuáng (realgar, pulverized) 1 liǎng
Of the two ingredients above, first melt the rosin and then add the realgar. Stir it with a tiger claw until it is well-blended and the medicine is done. Take an amount the size of a chicken egg yolk and, at bedtime, burn it inside an incense burner. Make the patient inhale it up her nose, and cover her with a quilt, allowing only the head to stick out. Do not let her get overheated, but allow the Qì to drain out.
與鬼交通: This gynecological disease is described in detail in the Zhūbìng yuánhòu lùn: Explained in terms very similar to wind evil, it is caused by vacuity in the internal organs, which has weakened the hold of the spirit, allowing ghosts to invade. Its symptoms are inability to recognize others, speaking and laughing as if interacting with an invisible presence, and occasional crying and grief. It appears that “intercourse” in this context refers not necessarily to sexual intercourse, but to any sort of interaction. Contrary to cases of spirit possession, the ghost does not possess the person but remains an external presence who engages the mind of the afflicted. In a prescription for this condition in the Ishimpō, however, the interaction clearly has sexual overtones. This is evidenced both by the etiology of the illness, namely “lack of intercourse between Yīn and Yáng (陰陽不交, i.e., lack of sex), causing deep and intense desires and wants,” as well as the treatment: “Make the woman have intercourse with a man without spilling essence, day and night without stopping. If she is encumbered, do not exceed seven days. She will invariably recover.”
令病人取鼻向其上: This means that you should make her lean over the incense burner and inhale the burning medicine through her nose. This is the textual version found in the two editions. Another edition, and the version of this prescription that is cited in the Ishimpō instruct instead to “make the patient take [the incense burner?] herself and hoist herself on top of it” (令病人取自升其上).
勿令過熱及令氣得泄也: Qì could refer here either to the fumes of the medicine, meaning that the patient should allow the fumes to escape after inhaling them; or it could refer to the pathogenic substance called ghost Qì (鬼氣 ), which needs to be drained away for the woman to recover from this condition. As a third alternative, one could read the sentence in this way: “Do not allow her to get overheated or allow her Qì to drain.”
Example Two: Ishimpō
My second example comes from a tenth century Japanese collection of medieval Chinese medical texts. I refer to it frequently because it contains many citations of Chinese sources that have not been preserved anywhere else. For treating a woman who is having intercourse with ghosts, the text first advises to fumigate her Yīn lower body by burning several liǎng of sulfur, then cites the above formula by Sūn Sīmiǎo, and then offers the following treatment:
為之方：雄黃（一兩，破） 虎爪（一枚，末） 沉香（一兩，末） 青木香（一兩，末） 松脂（二兩，破）
A recipe from the Xuángǎn fūshī fāng, indicated for the condition of women suffering from bone steaming and excessive dreams of intercourse with ghost husbands:
Xiōnghuáng, 1 liǎng (realgar, broken up), one tiger claw (pulverized), chénxiāng, 1 liǎng (Aqillaria wood, pulverized), qīngmùxiāng, 1 liǎng (aristolochia, pulverized), sōngzhī, 2 liǎng (pine rosin, broken up).
Altogether, there are five ingredients. Combine them and make honey pills, the size of pellets. Place in a brazier and use it to fumigate the genitals on every other night. Excellent.
The Xuángǎn fūshī fāng is a text that is quoted altogether six times in the Ishimpō, all in contexts of what modern editor of Ishimpō, Gao Wenzhu, calls fèiláo 肺癆 (pulmonary consumption). This is a contagious disease marked by heat, night sweating, emaciation, coughing of blood, and since the Song also with worms. This text contains recipes for treating transforming corpse , bone steaming, lung wilting cough, women's blood concretions, women's emaciation and weakness, and the above-cited intercourse with ghosts. Due to citations of this text in received literature, we know that it must have been composed before the end of seventh century.
Bone Steaming is a condition caused by deep-lying internal heat due to Yīn depletion and excessive heat, symptoms overlapping somewhat with tuberculosis (in Wiseman: tidal heat effusion, night sweating, forceless panting, heart vexation and reduced sleep, heat in the palms, and yellow or reddish urine), often associated with intercourse with ghosts. In the entry on "depletion taxation with bone steaming" in the Zhūbìng yuánhòu lùn, bone steaming is one of five types of steaming: "bone steaming is rooted in the kidneys. [The symptoms are] feeling cool in the morning and hot in the evening, vexation and inability to sleep, lack of appetite, , red or yellow urine, suddenly arising vexation chaos, faint and forceless panting, waist pain, counterflow cold in the feet, and constant heat in the palms. In severe cases it damages the inside, then transforms into gān (extreme emaciation, dryness, heat, abdominal distention, often associated with parasite infestation) and consumes the person’s five organs."
Chénxiāng (aquilaria) is also called agarwood or aloewood and is a common primary ingredient for incense.
Qīngmùxiāng refers to Aristolochia debilis or A. contorta, or Vladimiria berardioides. The root of different species of Aristolochia are used world-wide medicinally (such as birthwort, A. clematitis) as abortifacients and associated with childbirth. In TCM, the root is used internally or occasionally as an external compress to move Qì, disperse swellings, resolve toxins, and treat snake bites. The wood is used in traditional incense recipes.