My friend’s grandfather, a 60-something man from central China’s Hubei province, has rheumatism in his leg and is in constant pain. Recently, he caught wind of a supposedly effective folk treatment for the debilitating condition. He followed the recipe to the letter, buying natural ingredients from a local traditional Chinese medicine (TCM) pharmacy and soaking them in baijiu, a throat-scorching sorghum liquor, for several days. Though he never drank alcohol, he downed two big gulps of the mixture and had soon fallen to the ground in a drunken stupor. Fearing that he’d had a stroke, his family rushed him to the hospital. Luckily, he was unhurt — although he had the mother of all hangovers the next day.

Traditional Chinese medicine stresses that dietary changes can prevent or cure certain diseases. Medicinal liquors are also a common prescription in Chinese food therapy, which draws on both TCM and folk beliefs and frequently blurs the line between food and medicine. Recently, the well-known brand Hong Mao Medicated Wine, an over-the-counter medication containing ingredients with unclear toxicity levels, sparked an uproar when a doctor who questioned its efficacy was arrested and charged with libel.

Many Chinese health care items are marketed as supplements for things that the body lacks. This ties in with another TCM precept, namely to balance the opposing forces of yin and yang within the body. As the body ages and undergoes inevitable wear and tear, these imbalances leave it more susceptible to disease.

Many Chinese also see food as more familiar, more natural, and safer than medicine. Some TCM adherents believe that all medicines are to some extent toxic. Medicine can only treat specific symptoms at specific times, they claim, whereas food therapy is a holistic way to promote balance throughout the whole body.

China’s bestselling health supplements make money from the TCM-derived notion that the best medicines treat those who are not yet ill. Specifically, they target people who complain of suboptimal health — a gray area between health and disease where a person might experience discomfort or pain but fail to test positive for any diagnosable illnesses.

For instance, products purported to nourish the kidneys have always been highly marketable among men because in TCM, kidney health is essential for male virility and sexual prowess. Of course, Viagra and other synthetic medicines can treat male sexual dysfunction, too, but many Chinese men see purchasing Western medicine as equivalent to admitting to sexual disease — something emasculating and shameful — whereas TCM treatments help overcome temporary shortcomings in otherwise sexually healthy people. So some men turn to products like Hui Ren Shen Bao for renal nourishment. (The herbal formula’s once-ubiquitous TV ads featured the wife of a man coyly looking into the camera and saying: “If he’s feeling good, then I’m feeling good.”)

Health care companies market supplements based on vague notions that are hard to scientifically prove. I believe that most such products in China are placebos that enjoy popularity thanks to widely held but unfounded faith in their medical efficacy.

Since the end of the Mao era and the start of China’s economic and social reforms, most people have enjoyed greater economic prosperity and seen their hard, collectivistic lives transform into opportunities for individual fulfillment. Consequently, people nowadays take more care when it comes to their health and well-being.

In light of this trend, businesses started creating low-cost health care items based on hard-to-authenticate combinations of Chinese and Western medicine and nutrition. An onslaught of commercials created a veneer of scientific credibility while simultaneously taking advantage of a lack of medical knowledge among the general populace.

In the early 1990s, a team of female Chinese distance runners, coached by a former high school track coach named Ma Junren, won the hearts of the nation when they stormed to success in several global athletics championships. Ma’s unorthodox training methods included health tonics drawn from TCM and food therapy — and soon after, he became the face of a health supplement called Zhong Hua Bie Jing, supposedly derived from a species of Chinese turtle. The supplement became extremely popular, not least because it allowed consumers to share in some of the stardust generated by the emerging heroes of a resurgent homeland.

Today, however, the reputations of nearly everyone involved are in tatters. The supplement was revealed to be nothing more than synthetic saccharin — a common sweetener — and Ma and several of his runners became embroiled in a high-profile doping scandal. Yet despite the revelations of potentially crooked sportspeople selling snake oil supplements to the country’s consumers, Chinese people continue to buy huge amounts of health care products today. Instead of endorsements from elite athletes, contemporary ads feature male professionals taking clients out to a boozy dinner and perking up after taking a liver supplement, middle-aged wives who fear that their husbands are no longer attracted to them, and children who want to show respect to their grandparents yet don’t know what to give them.

In many cases, consumers know that they are buying placeboes, but they go along with it all the same. Another friend once bought caterpillar fungus — thought to ease the symptoms of chronic disease — and gave it to his parents. He knew it was a load of baloney but justified it with a standard refrain: “It doesn’t matter if it works or not — as long as they eat two stalks of it every day, that’ll make me feel like I’ve done my part.” The caterpillar fungus is above all a gift that conveys his concern, expresses his filial devotion, and solidifies his relationship with them.

Unperturbed by controversy over the unclear side effects of TCM, middle-aged and elderly Chinese consumers still flock to products like medicinal liquors and food supplements. Meanwhile, young, middle-class urbanites prefer imported multivitamins, cod liver oil, and probiotics in an effort to furnish their lifestyles with the middle-class trappings of health and well-being. Yet both groups are guilty of buying into ill-founded superstitions about their health, padding the pockets of snake-oil salesmen while fretting about their own tenuous mortality.

Translator: Katherine Tse; editors: Zhang Bo and Matthew Walsh.

(Header image: An elderly man mixes medicinal liquor at his home in Guilin, Guangxi Zhuang Autonomous Region, Aug. 12, 2018. Tang Qingfu/VCG)