Late imperial Chinese pharmacies often advertised their wares as manufactured “according to the methods of antiquity” (zun gu fa), whereas local practice in market towns and merchant groups differed vastly in what “methods of antiquity” stood for. During the second half of the 20th century, however, practitioners of Traditional Chinese Medicine (TCM) sought to reconstruct a standardized pharmaceutical protocol out of diverse local experiences. To what extent did the modern discourse of “traditional” pharmaceutical skills appropriate, and also divert from, the late imperial reverence towards antiquity? Furthermore, what did the discursive transition from antiquity to tradition tell us about the shifting boundaries between public and secret knowledge in Chinese medical practice? In this paper, I use the example of Zhangshu, an important medical market town located on the Gan River of Jiangxi province, as a case study in the history of pharmaceutical practice in China. Zhangshu enjoyed its heyday during the eighteenth century, when merchant groups from all over the Qing Empire traded raw medicines there in large quantities. Once a deal was made, local artisanal shops then provided services to transform raw medicines into “cooked” form ready for sale in retail pharmacies. Pharmacological texts produced during that time also reflected a confluence of learned discourse with information from the local trades. From mid-nineteenth century onwards, however, Zhangshu was devastated by repeated wars and its importance eclipsed by maritime trade based in post-Opium War treaty ports. When local authorities sought to revive Zhangshu’s fame as the “capital of medicine” during the 20th century, the embodied expertise of old pharmaceutical laborers were featured as mute symbols of tradition. Using oral histories and reports collected during the 1950s, I seek to highlight conflicting visions inherent in the effort to create a standard set of pharmaceutical procedures that were also simultaneously sanctioned by claims of loyalty to a unique local past.