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December 4, 2020

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Don’t let winter get you down. Take a tonic!

The air inside the herbal workshop at Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine is particularly hot for an autumn day when I stop by for a visit.

Four long rows of red copper cauldrons steam above blue flames. Workers using bamboo stirrers blend the simmering ingredients of the molasses-colored liquid. A soothing aroma permeates the workshop, making me think, for a moment, that I am in a potion class with Harry Potter at Hogwarts.

The cauldrons are making gaofang, a traditional Chinese traditional winter tonic concocted from up to 40 different herbal medicines and sometimes animal materials like turtle shell and donkey skin. In addition, foods such as lotus seeds, dates and crystal sugar may be added to improve the taste.

The remedy is traditionally taken in winter to bolster health throughout the cold months.

Some varieties of gaofang are available ready-made, while other variations are tailored to the specific prescriptions of traditional Chinese medicine doctors.

Gaofang was first recorded in “Huangdi Neijing,” the earliest Chinese medical book, and it has been popular since the Tang Dynasty (AD 618-907).

The gaofang season usually lasts about six weeks, from lidong, the start of winter on the Chinese calendar, to the Winter Solstice on December 21.

Gaofang is mass-produced and available in Chinese pharmacies, but if you want the real McCoy, look no further than the workshop here at Yueyang Hospital which claims to be the only place in Shanghai that adheres to the traditional processing method.

Chen Weiming has been making gaofang for over 40 years. Since his apprentice days, the hospital has always used proper copper cauldrons.

“My master back then never allowed us to use steel pots,” said Chen. “According to some ancient medical tomes, some costly medicinal ingredients are best simmered in gold pots.”

Chen, now chief of the workshop, leads a team of eight doctors and some 20 other workers. The winter remedy they make is an exact art that requires dexterity, meticulousness and patience.

The team works in temperatures approaching 40 degrees Celsius, sometimes for eight hours straight.

Traditional gaofang brewing consists of seven stages — formula, dipping, extracting, concentrating, collecting, packaging and drying.

“The devil is in the details,” Chen told me.

The extraction, soaking and condensing must be done precisely, though the differences might not be obvious to the untrained eye.

Every day, Chen unties sacks containing tailor-made ingredients. Each is soaked twice in a large bucket for about three hours.

The juice is ready to simmer around 11am in the morning. After that, it is pressed and residue is removed.

“Only when the juice is cleanly filtered can the ingredients be effective for the health,” explained Chen.

The juice is then thickened into gel-like texture. Ingredients such as brown sugar, yellow wine and donkey-hide gelatin are added, along with “precious” materials, such as a fungi called cordyceps and dendrobium, a genus of orchid.

Workers ladle up the mixture periodically to test its thickness. If all goes well, not a single drop will stick to the bottom of the cauldron, said Chen.

It usually takes two and a half days to complete a ready-to-use batch of gaofang.

The hospital writes more than 20,000 prescriptions for the remedy each year. Almost all 100 cauldrons are currently operating nonstop, enough to produce 320 prescriptions of gaofang a day.

Chen said the number of prescriptions has been decreasing over the years, due to more competition in the market.

This year, amid the COVID-19 pandemic, some wondered whether this popular herbal paste might be effective in treating virus patients. That has not been proven one way or another.

Dr Chen Xianchuan has been prescribing gaofang for over 20 years. She said it is effective in strengthening the overall vitality of the body and keeping the balance between yin (cold) and yang (warm), qi (energy flow) and blood.

“It does not mean that the remedy is effective for a single cold,” said Chen. “As long as the internal organs are in balance, it can play a role in preventing colds.”

Gaofang can be adapted to doctors’ prescription specifications, based on symptoms, age, gender and underlying ailments.

“Doctors can determine if a patient’s inner organs are in balance and prescribe medicine according to the lack of yin or yang,” said Chen Xianchuan. “Therefore, the medication varies for different patients.”

She added that most of the gaofang is prescribed for elderly people for health maintenance, but an increasing number of white-collar workers in high-stress jobs and middle-aged people on health kicks are now taking the tonic.

According to Chen, younger people now account for 30 percent of those using the herbal paste. Many of them are from the post-1990s generation, who often go on business trips, stay up late or keep irregular schedules.

Symptoms such as giddiness, fatigue, dark skin spots, insomnia, anxiety and menstrual disorders can be common in people working in office buildings with poor ventilation, she says.

A patient surnamed Tan, 25, shows symptoms of anemia and suffers general body weakness. She is taking gaofang for the first time.

“A friend of mine has a family tradition of taking the tonic in the winter,” said Tan. “And she always looks more energetic than I feel.”

There are those who think gaofang is also effective in maintaining beauty, Chen said.

“If your qi and blood are smooth and balanced, it will benefit external appearance and natural rejuvenation,” she explained.

A patient surnamed Li said gaofang, like other traditional Chinese medicine remedies, takes effect after long-term conditioning.

“I’m in an unhealthy state due to my fast-paced job, just like many young people in my age,” Li said. “Some problems, like sleeping and eating disorders, cannot be diagnosed through normal health checks, but they can be treated with herbal tonics.”


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