It is with deep sadness that we convey the news of the passing of our International Association for the Study of Traditional Asian Medicine (IASTAM) Advisory Board member, Natalie Köhle. Our friend and colleague, Natalie fell ill in early 2024, meaning she could not make it to International Congress on Traditional Asian Medicines (ICTAM) 2024 in Taipei. We hoped she would recover, but she left us on September 9, 2024, in Sydney, Australia. She had only recently taken up her position in the School of History and Philosophy of Science at the University of Sydney as a lecturer in the history of Chinese medicine. Before her illness, she was working on two book projects. One was a global history of Chinese “phlegm,” and the other was a history of donkey hide gelatin, the Chinese drug. Natalie earned her BA (Hons) at the School of Oriental and African Studies (SOAS) University of London and her MA and PhD at Harvard University. She is gone far too early. We will miss her.

Natalie Köhle was born and grew up in Stuttgart, Germany. After graduating from SOAS, she began her doctoral studies at Harvard, where she trained with several well-known historians, including Shigehisa Kuriyama and Mark Elliott. During this time, she also spent time researching in Taiwan, where she met her future husband, Huang Bin. After obtaining her PhD in 2015, she moved to Australian National University in Canberra as a postdoc in 2016. In 2019, she became assistant professor at Hong Kong Baptist University. In 2023, she returned to Australia, taking up her new appointment at the University of Sydney.

Natalie published two significant groundbreaking articles. In “A Confluence of Humors: Āyurvedic Concepts of Digestion and the History of Chinese Phlegm” (Journal of the American Oriental Society, 2016), Natalie examines Chinese- and Sanskrit-language sources to investigate the relationship of Chinese medicine and phlegm and Indic influences. In “The Many Colors of Excrement: Galen and the History of Chinese Phlegm” (Bulletin of the History of Medicine, 2023), Natalie challenges assumptions in the field by convincingly arguing that the modern Chinese adage that “all sickness arises from phlegm” drew on the Galenic medicine concept that “all sickness arises in humors.”

Together with Shigehisa Kuriyama, her principal advisor at Harvard, Natalie coedited the online monograph, Fluid Matter(s): Flow and Transformation in the History of the Body (ANU Press, 2020). Her final contribution – an essay titled “Anatomical Images in Northern Song China” in Comparative Guts: Exploring the Inside of the Body through Time and Space (Christian-Albrechts-Universität zu Kiel, 2024) – also pushed the previous boundaries of knowledge.

In her personal life, Natalie fell in love with Australia on her first stint there as a postdoc. She was excited to get the opportunity to return in 2020 with her appointment to the University of Sydney. However, the COVID-19 pandemic meant that she and her husband Huang Bin were locked in Hong Kong until 2023. Only months after finally settling into her new job in Sydney and buying a house with Bin, she received a diagnosis of cancer. She was admitted to hospital on the day of the settlement of her house purchase. She passed away alongside her loving husband, Bin, and her loving mother, Ulla.

In addition to her academic achievements and her well-known collegiality and kindness, Natalie’s loyalty and a commitment to deeply held principles shaped her life. Firstly, her commitment to curiosity and inquiry led her to the argument that Chinese medicine borrowed more from Galenic medicine than generally understood. She agonized over the feasibility of her research finding, meaning that she often trembled with nervousness when presenting her work on phlegm in Chinese medicine. Receiving emails ardently refuting her argument on the transfer of medical ideas from West to East served to strengthen her resolve to pursue this line of research inquiry. If her argumentation aroused such fierce Chinese nationalism, she reasoned that the scholarship needed to even more go beyond the modern nation state as the primary category of analysis. In her spirit of novel conceptualization, before falling ill, she had planned a future research project in which she would articulate a new interpretation of the Chinese medical body. She had spent years reading medical texts in the hope of answering some of the questions regarding the human body that her doctoral adviser Shigehisa Kuriyama had posed in his book, The Expressiveness of the Body (1999).

Secondly, as an academic in her own right, her humility was coupled with her sense of herself as a perpetual student. Although not necessarily expressed publicly, she carried a deep debt of gratitude to her teachers, and especially Shigehisa Kuriyama. She always privately acknowledged that her intellectual development and career success would never have been possible without Hisa’s emotional support and scholarly engagement. Such a sense of her connectedness to her teachers aroused private indignation when she felt that historians of medicine had publicly mischaracterized Professor Kuriyama’s published work.

Thirdly, related to the fact that her advisor Hisa was originally an acupuncturist, Natalie was one of that minority of historians of medicine who reach out in a serious way to collaborate with Chinese medicine physicians. It is well known that there is next to no connection between historians of medicine in Australia and Chinese medicine doctors. However, upon settling into her new position as a historian of medicine at the University of Sydney, one of her first actions was to begin establishing a network in Australia linking historians of medicine with Chinese medicine doctors, as well as the medical science research community. She began by helping to facilitate a collaborative relationship linking the University of Sydney with the Australian Acupuncture and Chinese Medicine Association, and the Traditional Chinese Medicine Program at Western Sydney University. Natalie’s commitment to the broader field also led to her appointment to the Advisory Council of IASTAM.

Fourthly, and not immediately evident from Natalie’s published work, was her commitment to animal welfare. In her ongoing uncompleted project on the use of donkey hides (ejiao) in Chinese medicine, she aimed to highlight the unnecessary slaughter of so many donkeys, when other plant-based alternatives exist as substitute medicinal substances. Nevertheless, many colleagues misunderstood her research and gifted her donkey hide products. Natalie fell ill in early 2024, very nearly dying from anemia. I pointed out that donkey hide is well known as a medicine of choice for her condition. Even though unwell, in a moment of poignant irony, she jokingly surmised that perhaps the donkeys would forgive her for consuming one or two packs. Of course, she stayed committed to the welfare of donkeys by choosing not to do so.

In her final year, after recovering from her earlier anemia, Natalie admitted herself to a cancer hospital in Sydney that is well known for its reputation for integrated cancer treatment and its claim to treat the person, not the disease. Although Natalie found her principal doctor of integrative oncology to be very supportive and encouraging, the reality was that the nature of the Australian hospital system meant serious barriers to therapy through Chinese herbal medicine. Natalie did receive occasional acupuncture. However, a Chinese medicine prescription would be expected to help Natalie through her ordeals of pain and suffering. After weeks of negotiations, the team of doctors granted Natalie permission to take Chinese medicine. Regrettably, after more weeks of hospital personnel scrutinizing the ingredients of the Chinese medicine prescription, Natalie passed away. Incongruently and tragically, the doctors in an integrative medicine setting did not give permission for her to take medicine that she needed and requested. The irony of a scholar of Chinese medicine not being allowed to access Chinese medicine speaks poorly of a system geared to marginalizing forms of therapy other than biomedicine. The sad circumstances remind us that integrative medicine usually means the dominance of biomedicine and the marginalization of therapies such as Chinese herbal medicine. The readers of this journal may see that we still have much work to do to overcome the lamentable predicament where biomedicine doctors make the decisions, while we wait and hope. We need more than hope.

In her final months, Natalie’s deepest concern was for her husband, Bin, and her mother, Ulla. In those times of trial, Buddhism gave her much solace. After all, Tibetan Buddhism was her focus when she embarked on her doctoral studies at Harvard University.

Natalie was scheduled to present her research in November 2024 at a conference on Buddhism and Medicine at Dongguk University (a Buddhist university) in Seoul. Kyung Hee University, in Seoul, was also looking forward to hosting her for a day or two. Sadly, she never made it to Korea.

Apart from those difficult final months, some of my deepest memories of Natalie center on a conference on “Comparative Guts” at the University of Kiel in 2023. On long, meandering walks through the city, she laid out her own dream of a future where historians of Asian medicine made significant contributions to scholarship and to the global community. At the heart of her vision was a world where scholars in general and historians of medicine in particular practiced an active kindness and compassion to each other, that would then make an impact beyond our own narrow field. I believe that this vision is one that the readers of this journal concur with. Let’s fight for a better future. I write this for Natalie with tears in my eyes. We miss you more than you can ever imagine.

In this obituary, I have also compiled some brief tributes from some people who knew Natalie:

Liu Yan, State University of Buffalo New York: “I am deeply saddened to hear the passing of Natalie, a wonderful colleague and genuine friend. A gifted scholar with a broad vision and the courage and capacity to tackle some of the most challenging and meaningful problems in the study of Asian medicine, she had been developing a career that was set to be illustrious and impactful yet was regrettably cut too short. She is still palpably present and will be sorely missed.”

Marta Hanson, Friedrich-Alexander University Erlangen-Nürnburg: “Natalie’s first article conclusively demonstrates through the longue durée history of one of the major concepts in postclassical Chinese medicine – tan 痰 phlegm – that during the early medieval period (second to sixth century CE), Chinese translators accurately understood Āyurvedic medical concepts from Indic sources and transformed thereafter how phlegm was understood and treated in Chinese medicine. She was able to do this not only because of her gift in languages and superlative philological training but also, and as important, her training in the history of ancient Greek and Roman medicine (especially Galenic medicine), of Āyurvedic medicine, and of Chinese medicine. Her second article is even more impressive, as she successfully demonstrates that Galenic medicine entered China through the work of a relatively obscure Chinese medical scholar who wrote an otherwise little-known Yuan dynasty treatise in 1338 titled On the Art of Nourishing Life. This treatise thereafter fundamentally changed how Chinese understood the material body and the nature of disease.”

Michael Stanley-Baker, Nanyang Technological University: “While visiting Singapore for another presentation, Natalie kindly arranged to come to Nanyang Technological University to present her work. With surgical precision she unfolded the history of phlegm within Chinese medicine, laying out a meticulous argument of an undocumented transition that took place in the fourteenth century. She showed clear evidence of the influence of Galenic ideas, even though her sources mentioned no contact with any Turkic doctors from abroad. Drawing on Latin, Greek, and Sanskrit sources and a vast range of scholarship to make her case, she dared to read beyond her primary sources, triangulating across them to show a clear continuity of ideas. A rare scholar, with grit and precision, she was just getting her feet under her as an established scholar, and clearly had so much to offer us all, scholars and students alike.”

Daniel Spigelman, Natalie’s master’s student at the University of Sydney: “When I first met Natalie, I was immediately struck by not only her extraordinary intellect but also by her relentless inquisitiveness and, most of all, her humility. As a supervisor she was incredibly supportive and warmhearted. On a personal note, she helped me greatly in getting my head around many of the unspoken customs of academia and provided incredibly valuable direction in my research. I hope to help continue much of the work she started and help make her vision of the future of Chinese medicine in Australia and the world a reality. I will be forever grateful for having known her, and she will forever be in my thoughts and prayers.”

Shigehisa Kuriyama, Harvard University: “The community of students of Asian medicine mourns the recent passing of Natalie Köhle. The death of a colleague is always sad, but it is especially painful when the colleague is someone who, like Natalie, was just entering the prime of her career. Those of us who were fortunate enough to know her will remember her extraordinary mastery of languages (German, English, Chinese, Japanese, Sanskrit, Tibetan, Manchu, and perhaps others), her commitment to academic rigor, her passion for life, and above all her kindness and generosity of spirit. Less fortunate future generations will find in her articles on the history of phlegm sterling models of how detailed philological analysis can illuminate momentous developments in medical history.”

He Bian, Princeton University: “There are few people in our lives who truly anchor our being in time, and Natalie has meant that to me since we first met in 2008. Her passionate reading of the Inner Canon inspired me to take on the journey of exploring the Chinese medical tradition. As my first teacher of Manchu, she taught me to love the study of language with rigor and joy. During the cold winter of 2013, she helped me shovel snow and made delicious German meatballs in my kitchen. Through her cheerful and compassionate eyes, I have seen the world: Her Taipei apartment in the old quarters, pictures of her dog Maru, the smoky cityscape of Manchester, and the quiet dusk of Jeonju over cups of wine. Not another chance in this life, but we will ride on karma and meet each other again in the next life.”

Rest in peace, Natalie.