140 Years of Remedies: The Untold Story of How TCM Got The Back of Singapore’s Early Immigrants

Top image: Dan Wong / A Good Citizen.
In 1900s Singapore, it was not uncommon to see people drop dead on the streets.

At that time, there were no laws governing workplace health and safety. Labourers and coolies-many of them immigrants seeking a better life in Singapore-would thus work as hard and as long as possible in harsh environments. Sometimes, they worked harder and longer than they could. With no one preventing them from doing so, working to death was a frequent, and expected, end.
For instance, the typical workday of a rickshaw man in pre-independence Singapore involved ferrying two adults under 35°C heat for hours. The job’s extreme physical demands, carried out under the oppressive sun, were enough to make a puller collapse out of heat exhaustion and cardiovascular strain, and die without warning.

The historian James Francis Warren describes one-out of many others-such episode:
Kwan Moh Kia, a seemingly strong, well-fed Hockchia, had passed by a Tamil house on Bukit Timah Road going towards Kranji pulling two Macao women as fares. When he was just beyond the house, Kwan Moh Kia dropped down between the shafts, on that March afternoon in 1906, when his aorta exploded like a roadworn tyre. Taju, a Tamil woman, said he never rose up again.
As if their working environments weren’t severe enough, the homes of these early immigrant labourers were just as fatal to their health. According to a 1906 housing survey, a single shophouse in Chinatown could house up to 45 people; each occupant of the shophouse squeezed their life into a tiny cubicle. Sometimes, their “room” was just a space along the common corridor, separated from others by a row of hanging clothes.

The bomb shelters in today’s BTOs would seem cavernous to these residents.

Thus, even if they were lucky enough to survive their workday, Singapore’s early immigrants still had to return to an overcrowded home that lacked ventilation and a plumbing system, factors which encouraged the spread of diseases like cholera, malaria, and tuberculosis.

Under such conditions, anyone who celebrated their 60th birthday was considered long-lived.
Without skills or education, these coolies and labourers could not find a job more conducive to staying alive. Nor could they, on their meagre pay, move to any accommodations that did not want to murder them.
Worst of all, they could not seek medical help from hospitals. Money was an obstacle, of course, but the main reason is that medical care in 1800s Singapore was highly segregated. According to the book Caring For Our People: 50 Years of Healthcare in Singapore, the General Hospital was “the preserve of European soldiers, sepoys (Indian soldiers) and the colonial government”, while government officials and Europeans had the privilege of private house visits from hospital surgeons.

Local inhabitants and natives who have taken ill? Please writhe quietly on a street corner so you don’t disturb the peace.
The immigrant labour force of early Singapore turned to the only solution available to them-opium.

For these early immigrants, opium was not only a recreational drug but also an important medication. Because of its powerful pain-killing effects, opium was the drug of choice for coolies who regularly injured themselves while working and had to live with chronic pain.
In fact, opium was held in such high esteem by the 19th-century medical establishment that doctors worldwide prescribed it for conditions from cholera to bronchitis. Following their lead, Chinese sinsehs in the early 1900s would recommend opium as a treatment for illnesses that ravaged the immigrant communities in Singapore: tuberculosis, malaria, and venereal disease.
As a result, opium consumption in Singapore became widespread. The 1908 Opium Commission stated that 40% of coal coolies and rickshaw pullers smoked opium. But the Commission only surveyed people who “were visibly affected by the ‘disease'”, that is, opium smokers who were addicted to the drug as a form of recreation.

If we take into account non-addicts and patients who used opium as medication, Warren estimates that the proportion of opium users am…
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