Category Archives: drugs

Wordcatcher Tales: hen’i kabu ‘mutant strain’

In its Japan Focus section this week, the Honolulu Star-Advertiser introduced a new term that has been much in the Japanese news lately. Their romanization as “hen ikabu (n.) mutant strain, as in COVID-19 variants” would be more accurately rendered as hen’i 変異 ‘mutation’ + 株 kabu ‘stock, strain’. Let’s break it down a little further.

hen ranges in meaning from ‘change’ to ‘accident’ to ‘strange’, as in 変名 henmei (change-name) ‘alias’, 変成 hensei (change-become) ‘metamorphosis’, 変死 henshi (accident-death) ‘accidental death’, or 変態 hentai (strange-condition/attitude) (n.) ‘metamorphosis’, (adj.) ‘abnormal, perverted’. Most foreigners resident in Japan soon learn the expression 変な外人 hen na gaijin ‘strange foreigner’.

i also means ‘strange, different, foreign’, as in 異人種 ijinshu (alien-person-type) ‘alien race’, 異見 iken (different-view) ‘objection’, 異国語 ikokugo (foreign-country-language) ‘foreign language’.

kabu ‘stock, strain’ originally meant ‘rootstock’, as in kabu ‘turnip’ (now written 蕪) but nowadays most commonly means ‘stock, share’, as in 株主 kabunushi ‘shareholder’ or 株式会社 kabushiki kaisha ‘joint stock corporation’. In Japanese corporate names, K.K. is equivalent to Corp., Inc., or Ltd.

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Hudson’s Bay Company Policies vs. Realities

From The Company: The Rise and Fall of the Hudson’s Bay Empire, by Stephen Bown (Doubleday Canada, 2020), Kindle pp. 118-121:

Spirits were in great demand as payment for hunting, in ceremonial exchanges and in payment for furs. Throughout the eighteenth century the Company made frequent attempts to restrict or regulate the dispensation of liquor, but these efforts were never uniform. The main obstacle to instituting a more consistent prohibition was that it was impossible to regulate alcohol completely within the factories for their own employees, and they feared that if denied alcohol completely the Indigenous traders would take their business to the French, in spite of the greater travelling distance and inferior trade goods. Potent alcohol was a recurring problem for all who congregated at the Company’s posts; this was a society struggling to develop the social infrastructure and accepted behaviours needed to regulate and control the actions of people under the influence of the new intoxicants. Isham later observed that a custom had evolved whereby men who planned on drinking would send away the women and children along with all the guns and knives. Most of the problems between the employees and officers at the factories also had to do with the abuse of or smuggling of liquor.

The most striking thing is that none of the decision makers on the London Committee ever visited the bay, apart from James Knight, and the yawning gap between reality and theory was also part of life at the outpost. Whether it be admonitions to grow more vegetables, to get more work done during each season, to trade for more furs by exhorting the Cree to work harder, or to get their employees to urge Indigenous peoples from farther inland to breach the Cree hegemony and trade directly at the fort, many directives had to be politely ignored. Life at the factories along the bay revolved around its own unique set of customs and activities, borrowing from Indigenous practices whenever convenient, accommodating Indigenous customs whenever possible and generally creating its own society that was derived from cultural and geographical necessity rather than rigid London imperatives.

One directive from the London Committee to John Nixon must have made his eyes roll when he read it at Fort Albany in 1680. A helpful suggestion on how to save money on food rations, it revealed just how little was appreciated in London of life along the bay: “Upon Hayes Island where our grand Factory is, you may propagate Swine without much difficulty, wch. is an excellent flesh, and the Creature is hardy and will live where some other Creatures cannot.” These types of directives were written by well-meaning dandies, upper-class financiers and aristocrats who had never been to Hudson Bay and experienced its primitive outposts, harsh climate and poor soil, but also had never worked outside the rarefied palatial offices and manors of upper-class English society—people, in short, who ought not be telling servants how to procure their food on a remote distant continent, where they were visitors in a bewildering and deadly land, perched precariously along the rim of a geographical and cultural terra incognita.

On the one hand, there was the London Committee, with its directors planning grand strategy and issuing orders that occasionally indulged in the penchant for micromanagement, and then there were the people who worked for the Company in the outposts with the geographical and climatic constraints of the Subarctic and who worked with, or were friends with or even married to, the Indigenous people of that land. The Company had official policies, but the people bayside interpreted those policies and adjusted them to reality.

RELATIONSHIPS WITH THE HOSTS OF THAT foreign land were at the heart of life and business at the posts. Not only were the local, or Home Guard, Cree often hired for jobs as labourers, hunters, guides, seamstresses, cooks and interpreters, but sexual and romantic relations between Indigenous women and Company men were common. In the earliest days of its operations in the late seventeenth century, the Company’s directors issued proclamations to its officers to prevent or obstruct these relationships. “We are very sensible that the Indian Weoman resorting to our Factories are very prejudiciall to the Companies affaires,” the committee wrote to John Nixon in 1682, “not only by being a meanes of our Servants often debauching themselves, but likewise by embeazling our goods and very much exhausting our Provisions, It is therefore our positive order that you lay your strict Commands on every Cheife of each Factory upon forfiture of Wages not to Suffer any wooman to come within any of our factories.” For obvious reasons, this directive from aristocratic directors, comfortable in their estates in London and surrounded by their families, was not only foolish but unenforceable, human nature and social needs being what they are.

There was always a difference between what London directors wrote in their letters as official policy and what chief factors enforced for themselves and their men. Money was usually at the crux of it. Workers who spent many years of their lives in what amounted to remote work camps wanted to improve their lot as much as possible, while the managers didn’t want responsibility for families. But, as Graham noted, “the Company permit no European women to be brought within their territories; and forbid any natives to be harboured in the settlements. This latter has never been obeyed.”

But the Company soon appreciated the benefit of having close ties with their Indigenous trading partners and quietly began supporting intimate liaisons. The shift in opinion was based on the realization that these relationships were not a financial drain but rather an asset. Unofficial diplomatic marriages between Indigenous women and Company employees became common, with Indigenous women seeking kinship ties for more favourable trading privileges, while single Company men sought female companionship and an introduction to the life and customs of the land. In a practical sense these were alliances for mutual aid, companionship and support, both social and economic, much like marriages today.

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Gen. Grant’s Guardian Angel

From Grant, by Ron Chernow (Penguin, 2018), Kindle pp. 148-152:

Grant needed a commanding personality to manage his office and ride herd over his staff and from the outset selected John Rawlins for a special place in his entourage. Rawlins was the pallid young lawyer with the full dark beard, saturnine aura, and enormous dark eyes who had bowled over Grant with his impassioned oratory at the Galena recruiting meeting. On August 30, Rawlins was appointed assistant adjutant general with the rank of captain, effectively making him Grant’s chief of staff. With no military background, he was startled that Grant gave him such a high appointment.

Rawlins’s family history with alcohol abuse gave him a special purchase on Grant’s drinking troubles, making it an all-consuming preoccupation. Before joining his staff, he extracted a pledge from Grant that he would not touch a drop of liquor until the war ended, and he would monitor this vow with Old Testament fervor, carrying on a lonely, one-man crusade to keep Grant sober. That Grant agreed to this deal shows his strong willingness to confront his drinking problem. The mission perfectly suited Rawlins’s zealous nature. With Grant’s consent, he laid down draconian rules to curb drinking, forbidding the open use of liquor at headquarters. In general orders that announced Rawlins’s appointment, Grant berated men who “visit together the lowest drinking and dancing saloons; quarrel, curse, drink and carouse . . . Such conduct is totally subversive of good order and Military Discipline and must be discontinued.” With Rawlins on the premises, even senior officers drank secretly in their tents. Any staff member who furnished Grant with alcohol faced the fervid wrath of Rawlins and likely dismissal. Rawlins fretted over Grant, agonizing over suspected lapses from the straight path of abstinence. He had no compunctions about chastising Grant for lapses, and his unflagging vigilance was remarkable in its forthright passion and candor.

Grant never discussed publicly his drinking pact with Rawlins, but he must have taken it to heart since Rawlins became his right-hand man and alter ego during the war. He allowed Rawlins to be the moralistic scourge and resident conscience of his staff. Later in the war, Grant wrote that Rawlins “comes the nearest being indispensable to me of any officer in the service.” In entering the army and assuming tremendous responsibilities, Grant must have feared he would be hurled back into the hard-drinking world of officers from which he fled in 1854, endangering the hard-earned sobriety of his St. Louis and Galena years. A general could not afford even occasional bouts of dissipation. In the army Grant would also lack the firm, restraining hand of his wife. Prolonged absence from Julia could easily set him up for a major relapse into the periodic degradation of his West Coast years. With some notable exceptions, Rawlins largely succeeded in his role as self-appointed watchdog. In later years, Grant’s Galena physician, Dr. Edward Kittoe, paid tribute to “Grant’s repeated efforts to overcome the desire for strong drink while he was in the army, and of his final victory through his own persistency and advice so freely given him by Rawlins.”

The ever-watchful Rawlins enjoyed special license to be frank and even scold Grant. “It was no novel thing to hear the zealous subordinate administer to his superior a stiff verbal castigation because of some act that met the former’s stern disapproval,” said the cipher operator Samuel Beckwith. “And Grant never resented any reprimand bestowed by Rawlins.” Rawlins spoke to him with a freedom that flabbergasted onlookers. Only he could slap Grant on the back or engage in familiar banter. Grant shrank from profanity, yet he tolerated with amusement the barrage of oaths that constantly poured from Rawlins’s mouth.

Because of the purity of his motives, Rawlins became Grant’s closest friend. “Gen. Grant was a man who made friends very slowly,” noted a journalist. “While he had a great many acquaintances, I think he had a very limited circle of friends—I mean men whom he trusted or whose advice he accepted.” Only Rawlins could penetrate the zone of privacy that Grant drew subtly about himself. With his single-minded devotion, Rawlins could confront him with uncomfortable truths and fiercely contest his judgment, spouting opinions in a stentorian voice. With his thoroughgoing skepticism and mistrust of people, he was the ideal foil to Grant’s excessively trusting nature. Rawlins “was always getting excited about something that had been done to Grant,” recalled Lieutenant Frank Parker. When someone showed disrespect for Grant, “he would prance around and say, ‘General, I would not stand such things’ to which Grant would say, ‘Oh, Rawlins! what’s the use in getting excited over a little thing like that; it doesn’t hurt me and it may make the other fellow feel a little good.’”

Perhaps because it contrasted vividly with his listless manner at the Galena store, Rawlins never forgot his initial glimpse of Grant at Cairo: “He had an office in a great bank there, and I was amazed at the quiet, prompt way in which he handled the multitude of letters, requisitions, and papers, sitting behind the cashier’s window-hole, with a waste basket under him, and orderlies to dispatch business as he did.” Fresh from personal calamity, Rawlins threw himself into a whirl of military activity. Before long, he worked day and night, tidying up Grant’s office, creating files, and instituting sound working procedures. Long politically active—Grant thought him the most influential young man in northern Illinois—Rawlins also assisted Grant in perfecting his relations with Washington. When Washburne boasted to Secretary of the Treasury Salmon P. Chase that Grant in Cairo was “doing wonders in bringing order out of chaos,” Rawlins surely deserved much of the credit.

Such was the influence of John Rawlins over Grant that some observers would later exaggerate or misinterpret the nature of his power, attributing to him the military acumen that properly belonged to Grant. He had excellent common sense and swiftly grasped many basic principles of warfare, especially the need to concentrate forces instead of spreading them too thinly. And he became a formidable warrior in his own right, personally signing off on every letter and plan of campaign that came from Grant’s command and never hesitating to differ with him. Nevertheless, Rawlins had no military background and lacked Grant’s general knowledge of warfare. He could never have done what Grant did. While Grant developed tremendous respect for Rawlins’s fearless judgment, it was Grant who originated the plans, Grant who improvised in the heat of battle, and Grant who possessed the more sophisticated strategic sense.

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Ice as Alternative Currency in North Korea

From The Girl with Seven Names: A North Korean Defector’s Story, by Hyeonseo Lee (William Collins, 2015), Kindle Loc. 2689-2705:

On one occasion, my mother called me with an alarming question. Normally we spoke on the weekends, but this time her call came during the day while I was at work. She sounded excited.

‘I’ve got a few kilos of ice.’

‘What?’ I sank down in my seat, out of sight of my colleagues.

She wanted to know if I had connections in China who could sell it.

Ice, or crystal methamphetamine, had long replaced heroin in North Korea as the foreign-currency earner of choice for the state. It’s a synthetic drug that is not dependent on crops, as heroin is, and can be manufactured to a high purity in state labs. Most of the addicts in China were getting high on crystal meth made in North Korea. Like the opium of the past, crystal meth, though just as illegal, had become an alternative currency in North Korea, and given as gifts and bribes.

‘Omma.’ My voice was a furious whisper. ‘Do you know what that is? It’s highly illegal.’

‘Well, lots of things are illegal.’

In her world, the law was upside down. People had to break the law to live. The prohibition on drug-dealing, a serious crime in most countries, is not viewed in the same way – as protective of society – by North Koreans. It is viewed as a risk, like unauthorized parking. If you can get away with it, where’s the harm? In North Korea the only laws that truly matter, and for which extreme penalties are imposed if they are broken, touch on loyalty to the Kim dynasty. This is well understood by all North Koreans. To my mother, the legality of the ice was a trifling matter. It was just another product to trade.

She said one of the big local traders brought it to the house because he knew I was in China and wondered if I could sell it there.

‘Give it back to him. Never get involved. There are bad people in that trade, and they won’t care if you’re caught.’

She never asked me again.

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Addiction Treatment Culture

From Hillbilly Elegy: A Memoir of a Family and Culture in Crisis, by J. D. Vance (Harper, 2016), pp. 114-117:

On designated weekdays and weekends, we visited our mother at the CAT [Center for Addiction Treatment] house. Between the hills of Kentucky, Mamaw and her guns, and Mom’s outbursts, I thought I had seen it all. but Mom’s newest problem exposed me to the underworld of American addiction. Wednesdays were always dedicated to a group activity—some type of training for the family. All of the addicts and their families sat in a large room with each family assigned to an individual table, engaged in some discussion meant to teach us about addiction and its triggers. In one session, Mom explained that she used drugs to escape the stress of paying bills and to dull the pain of Papaw’s death. In another, Lindsay and I learned that standard sibling conflict made it more difficult for Mom to resist temptation.

These sessions provoked little more than arguments and raw emotion, which I suppose was their purpose. On the nights when we sat in that giant hall with other families—all of whom were either black or Southern-accented whites like us—we heard screaming and fighting, children telling their parents that they hated them, sobbing parents begging forgiveness in one breath and then blaming their families in the next. It was there that I first heard Lindsay tell Mom how she resented having to play the caretaker in the wake of Papaw’s death instead of grieving for him, how she hated watching me grow attached to some boyfriend of Mom’s only to see him walk out on us. Perhaps it was the setting, or perhaps it was the fact that Lindsay was almost eighteen, but as my sister confronted my mother, I began to see my sister as the real adult. And our routine at home only enhanced her stature.

Mom’s rehab proceeded apace, and her condition apparently improved with time. Sundays were designated as unstructured family time. We couldn’t take Mom off-site, but we were able to eat and watch TV and talk as normal. Sundays were usually happy, though Mom did angrily chide us during one visit because our relationship with Mamaw had grown too close. “I’m your mother, not her,” she told us. I realized that Mom had begun to regret the seeds she’d sown with Lindsay and me.

When Mom came home a few months later, she brought a new vocabulary along with her. She regularly recited the Serenity Prayer, a staple of addiction circles in which the faithful ask God for the “serenity to accept the things [they] cannot change.” Drug addiction was a disease, and just as I wouldn’t judge a cancer patient for a tumor, so I shouldn’t judge a narcotics addict for her behavior. At thirteen, I found this patently absurd, and Mom and I often argued over whether her newfound wisdom was scientific truth or an excuse for people whose decisions destroyed a family. Oddly enough, it’s probably both. Research does reveal a genetic disposition to substance abuse, but those who believe their addiction is a disease show less of an inclination to resist it. Mom was telling herself the truth, but the truth was not setting her free.

I didn’t believe any of the slogans or sentiments, but I did believe she was trying. Addiction treatment seemed to give Mom a sense of purpose, and it gave us something to bond over. I read what I could on her “disease” and even made a habit of attending some of her Narcotics Anonymous meetings, which proceeded precisely as you’d expect: a depressing conference room, a dozen or so chairs, and a bunch of strangers sitting in a circle, introducing themselves as “Bob, and I’m an addict.” I thought that if I participated, she might actually get better.

At one meeting, a man walked in a few minutes late, smelling like a garbage can. His matted hair and dirty clothes evidenced a life on the streets, a truth he confirmed as soon as he opened his mouth. “My kids won’t speak to me, no one will,” he told us. “I scrounge together what money I can and spend it on smack. Tonight I couldn’t find any money or any smack, so I came in here because it looked warm.” The organizer asked if he’d be willing to try giving up the drugs for more than one night, and the man answered with admirable candor. “I could say yes, but honestly, probably not. I’ll probably be back at it tomorrow night.”

I never saw that man again. Before he left, someone did ask him where he was from. “Well, I’ve lived her in Hamilton for most of my life. But I was born down in eastern Kentucky, Owsley County.” At the time, I didn’t know enough about Kentucky geography to tell the man that he had been born no more than twenty miles from my grandparents’ childhood home.

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Gen. Kearny, Frontier Diplomat

From Blood and Thunder: The Epic Story of Kit Carson and the Conquest of the American West, by Hampton Sides (Anchor, 2007), Kindle Loc. 551-568:

Kearny perceived, with a clarity rare among frontier soldiers of his generation, that alcohol was destroying the American Indian. Everywhere he went on the prairies, in his summits with the Plains tribes, he made “firewater” one of his central themes. “You have many enemies about you but this is the greatest of them all,” he once said in council with the Sioux. “Open your ears now and listen to me. Whenever you find it in your country, spill it all upon the ground. The earth may drink it without injury but you cannot.”

Kearny’s experience with Plains Indians was vast and yet, so rare in the brutal history of the West, his encounters were happily uneventful. Among the Plains tribes he was known as Shonga Kahega Mahetonga, Horse Chief of the Long Knives. He’d dealt with the Crows, the Blackfeet, the Chippewa, the Mandan, the Pawnee, the Winnebagos, the Potawatomi, the Sac and Fox, and scores of other tribes and moieties—almost always without bloodshed. Sometimes he fought against them, but more often he tried to referee the various Plains tribes in their time-honored wars against one another—or in their newer wars against the freshly arrived Cherokees, Chickasaws, and other so-called “civilized tribes” that the United States had force-marched from the East in the 1830s to live in the immense, if vaguely defined, Permanent Indian Frontier. Not surprisingly, the tragic U.S. policy of transplanting woodland Indians with an entirely alien culture and grafting them by fiat onto the unfamiliar world of the prairie had pried open a Pandora’s box of tensions—tensions that Kearny spent the bulk of his years as a young officer trying to understand and, to the extent possible, resolve. As one historian succinctly put it, Kearny and his contemporaries in the frontier army were charged with the thankless task of “imposing a Pax Americana on the entire artificial, ill-amalgamated Indian nation which the government had created.”

A diplomat by nature and an officer possessed of a Job-like patience, Kearny was the right man for this kind of work. His career was marked by persistence, discretion, and tolerance. There was about all his actions a distinct “absence of swashbuckling,” as biographer Dwight Clarke phrased it. It was that quality, perhaps more than anything else, that kept his invasion of New Mexico in 1846 from devolving into a disaster.

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Soviet Veterans and PTSD

From Afgantsy: The Russians in Afghanistan 1979-89, by Rodric Braithwaite (Oxford U. Press, 2011), Kindle Loc. 5393-5420:

Though there was no nationwide study, individual regions, local veterans’ organisations, and local newspapers began to set up their own websites about their young men who had served in Afghanistan. The newspaper Voronezhskaya Gazeta reported there were 5,200 Afghan veterans in Voronezh. By the summer of 1996 seventy-five had died, half as a result of accidents, one-third had been struck down by illness, and one in seven had committed suicide. Twelve years later, more than five hundred had died – one-tenth of all those who had returned from the war. The paper claimed that the young men died not so much because of what they had been through in Afghanistan, but because no provision had been made for their psychological rehabilitation, because they had been unable to afford proper medical treatment, because many of them had been unable to find work or a decent place to live.

But the amount of psychological rehabilitation available for the soldiers was limited partly by the lack of resources and partly because the concept of trauma was alien. If the soldiers who fought against Hitler could survive without going to the shrink, why should the Afgantsy be different? ‘Trauma’ was an alien, perhaps an American idea.

Nevertheless, a thin but native Russian tradition did exist. The first work on soldiers suffering from psychological trauma was done in Russia after the Russo-Japanese war in 1904–5 by psychiatrists in the Academy of Military Medicine. The results were largely ignored in the Soviet period and the 40th Army took no psychiatrists with them when they went into Afghanistan. The first specialists went there in the mid-1980s. The symptoms they found among the Afgantsy were much the same as the Americans had identified after Vietnam: a sense of guilt at what they had done, a horror at what they had seen, the same self-reproach that they had survived while their comrades had died. Some specialists reckoned that as many as one in two Afghan veterans needed some sort of help. At first the symptoms were psychological: irritability, aggressiveness, insomnia, nightmares, thoughts of suicide. After five years many would be suffering from physical as well as psychological consequences: heart disease, ulcers, bronchial asthma, neurodermatitis.

The trouble was that, compared with the United States, there were nothing like the facilities available in Russia to treat the traumatised veterans. There were only six specialised rehabilitation centres for the whole of Russia, and these had to deal with people traumatised not only by Afghanistan, but by their experiences of dealing with the nuclear accident in Chernobyl in 1986, and by the fighting in Chechnya, and other places of violent conflict.

One of those who tried to explain the phenomenon scientifically was Professor Mikhail Reshetnikov, the Rector of the East European Institute for Psychoanalysis in St Petersburg. He had himself been a professional military medical officer from 1972 and was posted to Afghanistan in 1986. He sent a paper to the General Staff, based on interviews with two thousand soldiers, which set out the problems from which the 40th Army was suffering: from the inadequacy of the army’s supply system to the moral and psychological training of the soldiers. The report had no effect, and he was asked by his superiors why he had deliberately set out to gather facts which brought shame on the Soviet Army. From 1988 to 1993 he directed several programmes for the Ministry of Defence on the behaviour of people affected by local wars, and man-made and natural catastrophes. After retiring from the military he became a member of the Association of Afghan Veterans.

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The Richest People in Arctic Potalovo

From In Siberia, by Colin Thubron (HarperCollins, 2009), Kindle Loc. 2385-2397:

The richest people in Potalovo are the children. They drive tractors and bulldozers, own houses, sail ships. The fact that all these possessions are wrecked makes no difference. They are a simulacrum of the adult world. So the children keep house in burnt-out cottages, or climb into the cabins of tractors and roam the tundra on vanished wheels. Sometimes they man the bridge of the beached and derelict cargo ship, and steer for the Arctic Sea. Only when they stop being children do they realise that they are inhabiting a world in ruins.

At the age of twelve or thirteen, said Nikolai, they start to drink.

He hated the arrival of the boat-shop which plied the river. That afternoon it had opened its hold on a thin range of expensive goods–vodka, above all–and the villagers had sped out in their motor-boats to meet it. In his dim-lit clinic Nikolai looked through the window at the night and circled his arm. ‘Probably this whole settlement is drunk around us at this moment. Almost everyone.’

He dreaded the monthly arrival of pensions. ‘Single parents get an allowance for each child, so a man with five children and no wife can feel a millionaire! He’ll drink himself sick while the children starve. The women do it too. Everybody. And when the vodka gives out they’ll search for anything. There’s an American machine oil which is bought galore here. Our machines are all broken, of course, but people drink this fluid by the bottle. Within two to three hours they’re asphyxiated. If they get to the hospital I can save them, but they die in their homes or in the streets.’

Thubron’s descriptions of the drunken town-dwellers in “Potalovo” (or Potapovo) seem very different from what Werner Herzog narrates about the hardy trappers of Bakhtia depicted in The Happy People: A Year in the Taiga. Both communities are tiny outposts on the mighty Yenisei River isolated for much of each year.

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Wordcatcher Tales: Kampouyaku

From The Roads to Sata: A 2000-Mile Walk Through Japan, by Alan Booth (Weatherhill, 1985), pp. 141-142:

The city of Toyama is nationally famous for the manufacture of patent medicines, usually sold door to door by elderly enthusiasts in small wooden chests (the medicines, not the enthusiasts), and these chests become part of the household furniture. The preparation of and sale of the medicines, called kampoyaku [漢方薬 kan-pou-yaku ‘China-method-medicine’] (Chinese concoctions), bear all the signs of a small-scale cottage industry, but the entrepreneurial genius of the people of Toyama has parlayed this unlikely source of fortune into a business with an annual wholesale value of more than 190 billion yen. The city’s oldest and best-known kampoyaku manufacturer is Kokando, and I arranged to pay them a visit.

The Kokando factory—opened in 1876 and rebuilt shortly after the war—stands in the southern sector of Toyama near the old tram stop named after it. The who showed me round spoke slowly and precisely and with the solemnity of a preacher who has the undivided attention of a disarmed infidel.

“Before the war our ninety-nine medicines—the widest range of kampoyaku in Japan—were manufactured and packed entirely by hand. Nowadays, of course, we use machines, but the traditions and process remain the same, and the recipes continue to derive from thjose which were imparted to Lord Maeda in the seventeenth century.

“The botanical ingredients include Korean ginseng (a very expensive kind of carrot) and the roots of the Indian ginkgo tree. But more highly prized are the items we obtain from the internal organs of animals. There is, for example, the dried glandular fluid of the male musk deer, drawn off during the rutting season and employed in the manufacture of a powerful stimulant. Originally, in order to obtain this fluid, it was unfortunately necessary to slaughter the deer, but nowadays, thanks to the development of new methods, it can be obtained humanely through plastic tubes. Then there is the bile of the Japanese bear, a pain killer and an agent in the reduction of fevers. The secretion from the poison gland of the Chinese toad is mainly used in the treatment of heart diseases, though it, too, kills pain with remarkable efficacy. And gallstones produced in the bladders of cows are a restorative and an antidote to several toxic substances.”

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Doctors and Patients in North Korea

From Nothing to Envy: Ordinary Lives in North Korea, by Barbara Demick (Spiegel & Grau, 2009), Kindle Loc. 1672-1694:

Making one’s own medicine is an integral part of being a doctor in North Korea. Those living in warmer climates often grow cotton as well to make their own bandages. Doctors are all required to collect the herbs themselves; Dr. Kim’s work unit took off as much as a month in spring and autumn to gather herbs, during which time the doctors slept out in the open and washed only every few days. Each had a quota to fill. They had to bring their haul back to the hospital pharmacy, where it would be weighed, and if the amount was insufficient, they would be sent out again. Often, the doctors had to hike far into the mountains because the more accessible areas had already been scoured by ordinary citizens who sought to sell the herbs or use them for themselves. The most coveted was peony root, which was used as a muscle relaxant and to treat nervous disorders. Wild yam was thought to regulate menstrual cycles. Dandelion was used to stimulate digestion and ginger to prevent nausea. Atractylodes, which is also popular in Chinese medicine to strengthen immunity, was used when it was impossible to get antibiotics.

For years, North Korean hospitals had been using herbal remedies in combination with Western medicine. Instead of painkillers, the doctors used cupping, a technique in which a suction cup is applied to stimulate circulation to parts of the body. Another technique borrowed from the Chinese involved lighting sticks of mug-wort next to the afflicted area. With anesthesia in short supply, acupuncture would be used for simpler surgeries, such as appendectomies.

“When it works, it works very well,” Dr. Kim told me years later. And when it didn’t? Patients would be strapped to the operating table to prevent them from flailing about. For the most part, North Koreans were stoical about enduring pain during medical treatment. “They weren’t like South Koreans, who scream and holler about the slightest little thing,” Dr. Kim said.

For all its shortcomings, North Korea’s public health system provided the public with better care than they’d had in pre-Communist times. The right to “universal free medical service … to improve working people’s health” was in fact written into the North Korean constitution. Dr. Kim was proud to be a part of the health-care system and gratified by the service she provided her patients. But by the early 1990s, the deficiencies in the system became more pronounced. Much of the medical equipment was obsolete and broken down, with spare parts impossible to obtain since the factories in the Communist-bloc countries where they were manufactured were by now privatized. The pharmaceutical factory in Chongjin curtailed its production due to a lack of supplies and electricity. There was little money to import pharmaceuticals from abroad. The bag that Dr. Kim carried on her rounds had gotten progressively lighter until she had nothing inside but her stethoscope. All she could do for patients was write prescriptions and hope that they had a connection in China or Japan, or a stash of money to buy the drugs on the black market.

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