The Acceptance of Western Medicine in Japan

The Acceptance of Western Medicine in Japan
Author(s): Ranzaburo Otori

Source: Monumenta Nipponica, Vol. 19, No. 3/4 (1964), pp. 254-274
Published by: Sophia University
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The Acceptanceof WesternMedicine

in Japan
By RanzaburoOtori,Tokyo
Introduction
Avery primitivetype of medicinewas practicedin Japanfromancient

times. Gradually,
however,
as moreadvancedtechniques
fromtheAsian
cameintoJapanthrough
wasso transformed.
mainland
Korea,thisfolkmedicine
as to be almostobliterated.
The so-calledcontinental
medicinecameto form.
of Japanesemedicalpracticeuntilwellon intothe second
the maincurrent
evenin thetermihalfofthenineteenth
century.This factwas recognized
nologyforthe word kampoigakua(Chinesemedicine)was used to designate
the "new" practices.
AlongwithChristianity,
Westernmedicinewas introducedintoJapan,
toward
themiddleofthesixteenth
Callednamban
bythePortuguese
century.
igaku,bthemedicineof the southernbarbarians(the people of the Iberian.
thisnewstyleofmedicine
withthespreadofChristianity
Peninsula),
prospered
and fellintodisfavorat a laterdate alongwithit. When Christianity
was.
obliterated
the
measures
of
almost
the government,
through coercive
thenambanigakulikewisewentintodecline,but it did notquitedie out; some
ofitlivedon intothefirst
fragments
yearsoftheEdo period. Sincemymain.
themein thispaperis the historyof Westernmedicineduringthe Edo
period,it mightseemproperto beginwiththefirst
yearsoftheera,butsomeof the nambanigaiu will helpmentionof the riseand declinein popularity
of thewayin whichWesternmedicine
us to a moreroundedunderstanding
wasreceivedin Japanin theEdo period. I wantalsoto considerhowmedical,
a Pj,)N
b MN5

255
Western Medicine
21
education,
whichin thepropersenseofthewordwas firstbegunin the early
by thepracticeof certainelementsof Western
Meiji period,was influenced
medicineduringthe Edo period.1
I. The Rise and Decline of Namban igaku
As we have mentioned
above,Japanfirstcameintodirectcontactwith
century,
shortlyafterthe
Westernmedicinein the middleof the sixteenth
of Westernculturewas made. In 1549 FrancisXavier,
firstintroduction
and his smallband,cameto Japanto teachChristianity.
a Jesuitmissionary,
Landingin Satsuma,thisgroupused all sortsof techniquesto increasethe
appeal of theirteaching,whichtheyproceededto spread withoutdelay.
forGhristianity
among
They put specialstresson winninga wide following
the people,and to thisend theyused to attendto theirphysicalailments,
seeing in this a means for spreadingtheirteaching. Jesuitmissionaries
in medicaland nursing
wentthrough
a periodoftraining
techniques,
so much
was thismatterinsistedon in theirSociety. It is reportedthatXavier,too,
kindsof Western-made
medicalmaterials
to
successfully
employeddifferent
methodswas
bringreliefto the sick. The successof the missionaries'
oneofthereasonsforthemounting
interest
ofthecommonpeoplein Western
medicine.
At the timewhenthe Jesuitsarrivedin Japanmedicalassistancewas
availableonlyfortheupperclasses,to suchan extentthatit is fairto speakof
''courtmedicine"or "medicineforthe aristocracy."The commonpeople,
deniedaccessto medicalservices,werein additionplaguedbythedistress
and
miserythatwasbroughton by waramongthefeudalprincipalities.So cruel
was theirsuffering
thatabortionand abandonment
of newbornchildrenhad
almostbecome a commonand openlyrecognizedpractice. This stateof
affairsstruckthe missionaries
with special force. On the otherhand,the
commonpeople welcomed the missionariesand receivedtheirmedical
1 On the introductionof Western medicine in Japan see T. Aoyama lind Y.
Fujikawa, "The Development of Medicine in Japan," in Shigenobu Okuma (ed.),
Fifty Years of New Japan (London 1909), II, 285-297; Hidetomi Tuge, Historical
Developmentof Science and Technologyin Japan (Tokyo 1961), pp. 33-35. In Japanese
see Fujikawa Yui &iJ?)1i, Nihon igaku shi f!
(History of Japanese Medicine; Tokyo 1904); Ebisawa Arimichi
, KirishitannoshakaiundoQvobinamban
(The Christian Social Movement and Namban
igaku J
Medicine; T6kyo 1944); Koga Jfijiro
Seiyo ijutsudenraishi
f
_ (Historyof the Introductionof WesternMedicine; T6ky6 1942).

Ranzabur6 Otori
22
256
therewereother
withpleasure. In additionto themissionaries,
treatments
mentionmust
special
them
Among
medicine.
practiced
Europeanswho
be made of Luis de Almeida(1525-1584),who came to Japanin 1555 in
BalthasarGago. Almeidawas a merchant
the companyof the missionary
fromLisbon, andhe wasalsolicensedto practicemedicine. By chancehe
BalthasarGago and his
set out for Japan on the ship thatwas carrying
intoa fervent
Duringthelongvoyagehe was converted
fellow-missionaries.
andjoinedtheworkof themissionaries.As partofhismissionary
Christian
medicalassistanceand,in addition,starteda
work he oftenadministered
home for foundlingsin Bungo Funaia (the Oitab of today). Of all his
missionaryendeavorsthose in the field of medicine were the most
remarkable.
withhis ownmoney
a homeforfoundlings
In 1556Aln*idaestablished
assistanceof Otomo S6rin,clord of Bungo.
and withthe supplementary
Two milkingcows wereprovided. A largenumberof abandonedchildren
weretakenin and caredforby Christianwet-nurses.In December1556,
and in it separate
a hospitalwas opened nextto the homeforfoundlings,
andforlepers. Almeidadirected
patients
wereprovidedforordinary
facilities
the hospitalwiththe help of severalJapaneseassistants. He specializedin
whilethevery
kindsofmedicalingredients,
treatment
usingdifferent
external
are said to have been
performed
simplesurgicaloperationshe occasionally
his
instructed
addition
to
the
actual
Almeida
In
practice,
quite successful.
assistantsin externaltechniquesas well as in certainpracticesof internal
namePaul,
includedone bearingonlytheChristian
medicine. His assistants
anotherThomas Uchida,dand some twelveothers.
In thisway,the nambanigaku,withits centerin Funai, beganto put
a prohibiafterthehospitalwas opened,however,
downroots. Veryshortly
headwas
sent
to
the
from
their
medicine
their
Jesuits
practicing
tionagainst
Luis de Almeidaleftthe establishment
quarters,and,as one consequence,
he had openedonlyone yearearlier. Since,in addition,thepressureagainst
and especiallysincethe
workgraduallygrewstronger
Christianmissionary
more
hospitalwas burneddown duringthe war,nambanigakudiminished
andinfluence.Justas theearlyJapaneseChristians,
and morein importance
so
however,maintainedtheirbeliefthroughpersecutionand martyrdom,
managedto continue.
nambanigakuand its practitioners
&g
k5
c 9kAg
d tW

257
Western Medicine
23
to practicemedicineFranciscanscame
AftertheJesuitswereforbidden
the workforlepersbegunby theirpredecessors.It
to Japan,continuing
all overJapan
can be said thatthehospitalsforleperswhichtheyestablished
role in perpetuating
nambanigaku. These leprosaria
played a significant
wereattachedin everyinstanceto a Franciscanconvent. They werequite
somebeingfoundas farnorthas the Thhokuaarea, somein the
numerous,
in southwest
Kinkibdistrict
Japan,and sevenin the cityof Nagasakiitself.
They wereall foundedafter1590. The treatment
providedin theleprosaria
was notparticularly
advanced,themainconcernofthemissionaries
centering
the patients'feelingof isolationand theirspiritual
ratheron counteracting
succor. Hence, it is not unfairto say thatthe lepersdid not themselves
ofWesternmedicinebut,on theotherhand,theleprosaria
enjoythebenefits
ofthatkindofmedicine.
roleinbuildingup thereputation
playedan influential
ofChristians,
whichextendedfromthelatter
The veryseverepersecution
untilwellintotheseventeenth
partofthesixteenth
century
century,
brought
on the interchange
betweenJapanand
withit unusuallystrongrestrictions
theWest. Japanesewereforbiddento travelabroad,whileall Westerners,
except the Dutch, were denied access to Japan. As a consequence,
nambanbunkawas replacedby komobunkac
(Dutch culture),2and thissituationcontinueduntiltheend of theEdo period. As partof thischangethe
fromthe IberianPeninsuladied out as Dutch influence
medicalinfluences
grew. Justhow thischangeoccurredis not altogether
clear,but whatwe
a
knowof thecareerof ChristovaoFerreira, Portugesewho arrivedin Japan
around1611 or 1612,sheds some lighton the matter.
was born
Ferreira,who latertookthe Japanesename Sawano Chfiand,
cametoJapanas a missionary.
in Portugalin 1580andafterbecominga Jesuit,
until1633whenhis resistance
He boreup strongly
againstthefierce
persecution
was brokenby tortureand he renouncedhis faith. Changinghis nameto
assistedtheshogunate
in itspersecuhe is saidto haveactively
SawanoChuian,
tion of the Christians.He died in Nagasakion October11, 1650.3
2 Koimo bunka literallymeans "red-hair" culture. The usual name given to

the Dutch was Komo or red-hairs,a name more intendedto suggesta demonicbeing
than to describe the actual coloring of the foreigners'hair. See Donald Keene, The
Japanese Discoveryof Europe (London 1952), pp. 21-23.
3 On Sawano see Koga Juijirot?_RJ,
"Haikyosha Sawano Chfian t
XIX (1940), 549-576.
(Sawano Chuian: The Apostate), in Shigaku t;
jR;,%"
c &ET:E JL d Nf?f;,
a 3k1L b jEI

24
RanzaburoOtori
258
in bothastronomy
Sawanowas interested
and medicine,and leftseveral
bookson nambansurgery,
suchas Nambangekahidenshoa
(The SecretTraditionofNambanSurgery),
NambanChuangekahidenshob
(The SecretTraditionof Chuian'sNambanSurgery)and Nambangeka-shz7c
(A Miscellanyon
NambanSurgery).Thoughthetitlesoftheseworksweredifferent,
thecontents
werepractically
thesame. The mainteaching
is littlemorethanthehumoral
pathologyof the Greeks. Accordingto it, all diseasesare caused by the
discordof the fourbodilyhumors. A patientsuffering
froma festering
disordershould,it was advocated,be aided eitherby earlydispersionof the
purulent
elementorbyaccelerating
theactivity
oftheelementso thatitwould
thencometoa headandbe dispelled. Sawanolistsa largenumberof various
kindsofplasterusefulforthesepurposes. He also put forwardsome of his
own ideas on curingby incisionsand, in thiscontext,
on the use of balsam
and cocoanutoils.
The books containingSawano's teachingare valuableforshowingus
whatnambanmedicineand surgeryreallywere. Amonghis studentswere
Handa Jun'an,d
all of whomworked
NishiKichibeie,
and SugimotoChuikeif
withKurisakiDakig, a nambansurgeonof a somewhatdifferent
school,to
preservethe traditionof nambanmedicine. They transmitted
theirown
of Dutch medicine.
knowledgeto the practitioners
In additionto Sawano's worksanothersourcewhichdepictsthe way
in whichthetwotraditions
is the set references
intermingled
to Inoue ChiinDaghregister
vanhetNederlandsch
kugo-no-kami
Masashigeh
comptoir.Inoue
withtheDutch,whilehis interestin Dutch medicine
servedas a negotiator
was quite deep. In the accountforJanuary31, 1654,it is statedthathe
be translated
intoPortugese.
orderedthatseveralDutch workson anatomy
thispassageas showingthatPortugese,even
It is no inistaketo understand
at thisdate,was morewidelyused thanDutch. Hence it wouldbe difficult
to maintainthatDutch medicineand surgeryreplacedthatof theIberian
Peninsulaat one stroke. The changewas surelya gradualone.
On the whole,it can be said thattheinfuenceof nambanmedicinewas
not considerable,
mainlydue to the factthatsixteenth-century
Europeans
in
medicineor surgery.
had verylittleofvalueto teacheitherin internal
a $,
T,t ,g
b
-4 qj;II

259
Western Medicine
II.
Dutch Physicians at the Dutch Factory and K5mo Surgery
25
RelationsbetweenHollandand Japanin the fieldof medicinego back

centurywhen Holland was replacing
to the earlyyearsof the seventeenth
Portugaland Spain as masterof Orientalwaters. In 1602 the Dutch East
and it proceededwithoutlongdelaysto expand
India Companywas founded,
its area of tradeprivilegesforthe homeland. From 1600,whenthe first
Dutchmanarrivedin Japan,to 1853,whenJapanwas opened,Hollandwas
withJapan.
uninterruptedly
the onlyWesterncountryto carryon relations
to theWestthatcameintoJapanwas brought
pertaining
Almostall learning
since Dutch activitywas confinedalmostexby theDutch. Furthermore,
clusivelyto Nagasaki,thatcityhas a veryunusualpositionin thehistoryof
Japan'srelationswith othercountries.
activities,.
The Dutch factory,
the focalpointof tradeand commercial
was firstestablishedin Hiradoa but later moved to Nagasaki-Dejima.b
to serve
in residenceat thefactory
werepermanently
One or twophysicians
underhim. Allmembers
andtheemployees
themedicalneedsofthedirector
withJapaneseand someacquaintancewith
of thefactory
had somerelations
Japaneseculture,but, so far as medicineis concerned,it was the Dutch
who cameto knowone another. Some
and Japaneseinterpreters
physicians
up to 1850,whenthe
rendered
theirservicesin the factory
sixtyphysicians
in one way or anotherta
lastone was dispatched. All of themcontributed
prowerestrictly
Japanesemedicine.It used to be said thatthesephysicians
hibitedfromgivinganymedicalasistanceto anyonenot connectedwiththe
Dutch factory,
but recentresearchhas establishedthat,thoughtherewere
the physiciansof the earlyperiodwere quite activein
indeedrestrictions,
it can be said thattheintermeditreatingJapanesepatients. In summary,
of medicalknowlegewerethe physiciansin the
aries in the transmission
Dutch factory.4
a physicianin the Dutch factorywho lived in
Kasper Schamburger,
varioussurgicaltechniqueswhichwere
Japanfrom1649to 1651,introduced
4 On the medical activitiesof the Dutch factorysee my article,Otori Ranzaburd
H a7t,% -~
AN, "Rankan nisshi no ishigakuteki kenkyu F
, TIOJD5E"
(Studies in Medical History Following the Diary of the Dutch Factory), in Nihon
ishigakuzasshi H Et@2,X(1962). See also Otori Ranzaburo, "17 seiki ni denrai
(WesternScientific Books
sareta seiyo gakujutsusho" t-b
XLIV (1963).
Introducedin the SeventeenthCentury),in Igaku no ayumiSt)j4,
a p~T b 0-14t.
,%

RanzaburoOtori
26
260
partofwhatcametobe calledtheKasperSchoolofSurgery. InomataDemstudiedunderKasperand laterpublishedsuhc

beiaand six otherinterpreters
ishob(The Medical Book of the Kasper School) and
booksas Kasparu-ryfi
Orandageka-shoc
(The Book ofDutch Surgery). The main teachingintroducedin thesebooksis thehumoraltheoryof Hippocratesand Galen. The
withplastersis advocatedas
originof purulenceis discussedand treatment
preparing,
and applyingplastersare
most effective.Ways of prescribing,
andpracticeofKasperdid notdiffer
greatly
enumerated.The medicaltheory
was thatthe
fromthatoftheschoolofnambanpractitioners.One difference
lattergroup,owingto circumstances
beyondtheircontrol,
had to use Chinese
of Kasperused medicinesmanufactured
in the
medicineswhilethefollowers
West. Since the Kasper schoolwas thefirstto drawon Dutch knowledge
and practice,it has historical
significance.
Amongthe Dutch physicianswho visitedJapan in the seventeenth
Daniel Buschdeservesspecialmention. He cameto Japanon three
century,
separateoccasions,in 1622, 1664, and 1665. Receivingpermissionfrom
he caredformanyJapanesein needof medical
competent
Japaneseofficials,
care and also answeredquestionson medicinewhichon variousoccasions
were proposedto him by Japanesedoctors. Busch presenteda certificate
to Arashiyama
Hoan,da physicianof the Hirado han,e
of accomplishment
to thefactthathe had mastered
thetechniques
on January
21, 1645,testifying
after
ofDutchsurgery
longyearsofstudyandthathehadusedthemeffectively.
whichis stillextant,is considered
to be thefirstof itskind,
This certificate,
whichit recordscan be attributed
to Busch's inand the accomplishment
were
fluence. It presentsclearevidenceofthefactthatJapanesephysicians
instructed
personally
by Dutch physicians.It also throwslighton theway
and on the stateof
in whichDutch medicalknowledgewas transmitted
at thattime.
development
muchof whathe learnedfromBusch in
Arashiyama
broughttogether
of the Medical
Bankokuchihoruishutekidenf
a bookentitled
(An Explanation
Practicesof ForeignCountries). The book is mainlyconcernedwiththe
of purulentwoundsand cuts. Surgical
use of plastersforthe treatment
as belonging
to "secrets"of the
operationsare nottreated,beingmentioned
ofKasper'smedicalpractices,
profession.Whencomparedwithexplanations
a
t7;,,
54:
d JW

f WPf
261
Western Medicine
27
offerslittlenew. It does, however,includemore

thisbook of Arashiyama
systematic
explanationsthan are foundin otherworks.
NarabayashiChinzana(1643-1711) studied medicine under Willem
a doctorof the Dutch factory
who was stationedin Japanfrom
Hoffmann,
wasfrequently
incontact
aninterpreter,
Narabayashi
1671to 1675. Originally
towardwhoseprofession
he cameto havea strong
withtheDutchphysicians,
inclination.Much of what he learnedfromHoffmannhe publishedin
a book entitledKoi geka sjdenb (An Explanationof Dutch Surgery). This
Kinsisho,d
Kinsochitsuboku
bookis dividedintosix parts: Shikakesho,c
zu,e
no sho,gKJyakusho.hWe cannotheredescribe
Aburano sho,fAburatoriyj
pointsmaybe ofinterest.
in detailthecontents
ofthisbook,butthefollowing
ailmentsand theircauses along with simple
Shikakesholists thirty-odd
foreach. Kinsoshocarriesfairlydetaileddescriptions
methodsof treatment
is the factthatan
of woundsand theirtreatment.Especiallynoteworthy
is included.
and oftwoor threesurgicaltechniques
explanation
oftrepanation
Koyakushoand Aburanosho containlistsof plastersand of medicinaloils
nosho explains
typesof treatment,
whileAburatoriyo
to be used in different
oils should be prepared.
how the different
The thirdpart,Kinso chitsuboku
zu, providesillustratedexplanations
ofmethodsofoperating,
surgicaltools,andtheuse ofbandages. The illustratothoseinAmbroise
resemblance
Pare's5workon surgery.
tionsshowa striking
Because of this close resemblance,
Koi geka sodenis sometimesconsidered
of Pare's bookfromDutch intoJapanese. Admittedly,
to be a retranslation
manyof the appendedchartsweretakenfromPare,but the mostadequate
seemsto be thatKoi gekasodenis based bothon Pare's writings
explanation
and on what Narabayashilearnedfromthe Dutch physicians.Whatever
workwas one
thefinalexplanation
of thesourcesof thebook,Narabayashi's
of themostunusualon WesternmedicinepublishedduringtheEdo period.
and devotedhimselfto
Narabayashieventuallyresignedas an interpreter
in his
thereafter
medicine. The practiceof medicinebecame traditional
family.
5 Ambroise Pare was a famous French surgeon whose works on surgery were
considered among the most authoritativeat that time. See Iwakuma Satoshi tR#iq,
OD
i a FAvA->:
"Geka sodento Pard gekashoto no hikakukenkyu!F1
I:39 "(Comparative Study Between Geka sodenand Pare's Surgery),in Nihon ishigaku
zasshi
i$;-:*X , No. 1295 (1941).
e
c {?JgF; d
J f iU
:
b g
a 4I4
h tjr
g iEb;LO:

RanzaburoOtori
28
262
Other interpretersfollowed the example of Narabayashi and studied

Dutch medicine. Not a few actuallypracticed medicine. Differentschools
of medicine,such as the Nishiryiaand the Yoshioryl,bwere lumped together
in common parlance and called the interpreters'schools of medicine, to
indicate their origin.
The relationshipbetween Japanese and Dutch medical practicesbecame
increasinglyclose as more and more doctors from the Netherlands came
-toserve at the Dutch factory. The influenceof these men, though limited
-inscale, was intensiveand effective. I would like to single out two individuals, in addition to those already mentioned,for special mention. They
.are Willem ten Rhijne and Engelbert Kaempfer.
Rhijne was born in 1647 at Deventer in Holland and in 1668 entered
Leyden University,whichwas thenat the heightof its academic glory. After
fiveyears of study under famous medical scholars,he was chosen to be sent
-tothe Dutch factory. He arrivedin Japan in July 1674 and resided there
-untilthe autumn of 1676. He twice visited Edo and was able both to treat
Japanesepatientsand to discuss questions of a medical naturewith Japanese
,doctors; but no writtenrecord on these mattershas come down to us.
While in Japan Rhijne studied both acupuncture and moxibustion,
techniques which were much in vogue, and published a reporton them for
European readers. He also explained how gout could be treatedwith moxa
and added chartsindicatingon what places of the body acupunctureshould
be carriedon. Later, in 1687, he published a reporton leprosyin Asia, inecludingin it an explanationof the fact that in Japan moxibustionwas used
both as a preventivemeasure againstleprosyand as one means of treatment
-forit. It was throughthese reports of Rhijne that European scholars first
came to learn of acupuncture and of moxibustion. These reports aroused
-no little interestin these practices.
EngelbertKaempferwas born in 1651 in Germany. He studied natural
science and medicine at the Universityof K6nigsberg. He was a man of
broad interestsand enjoyedthe commandof severalforeignlanguages. After
-traveling
throughseveral countries,he joined the Dutch East India Company
in 1668. In September 1690, he arrivedat Nagasaki-Dejima and remained
-in Japan until October 1692.
During his two yearsin JapanKaempferwas quite busy,as werethe other
Dutclhphysicians,in theirworkforJapanesepatientsand in theirdiscussions
a 9r
1:3

Western Medicine
263
29
withJapanesedoctors. In additionKaempfercarriedon ratherextensive

researchon variousaspectsof Japaneseculture-fromits history,
politics,
products,and tradeto its floraand fauna. The
religion,customs,manners,
resultsof his studywerepublishedin 1727. It is said thathe receivedthe
in preparing
thisbookbut,be that
cooperation
of severalJapaneseassistants
as it may,it was throughthisbookthatWesternreadersreceivedtheirfirst
systematicknowledgeof the diverseaspectsof Japaneseculture.6
knowledge
BothRhijneand Kaempferplayedan activerolein spreading
buttheywereno lessactivein introducwithinJapanaboutWestern
medicine,
ing Japanto theWest. In a senseit can be said that,thanksto theefforts
timein itshistory
appearedon theinterofthesetwomen,Japanforthefirst
nationalscene.
III.
Dutch Language and Rangaku soshia
of theeighteenth
interchange
At thebeginning
century
Dutch-Japanese
schoolsof medicalpractiwas carriedon largelyby thefamiliesof different
and thatof the
tioners,such as thatof the interpreters-turned-physicians
of the Arashiyamamethod.
who werethe chiefsupporters
Katsuragawa,b
The Nishi,Kurisaki,and Narabayashi
each of whichgaveits name
families,
fortheir
aftergeneration
to a schoolof medicine,werefamousgeneration
transmitted
work. Each of thesefamilies
orallyitsknowledgeso thatsuch
knowledgecan hardlybe said to have been of a scientific,organized
nature. The chiefobstacleto this more systematized
learningwas thelack
oftheDutchlanguage.
on thepartoftheJapaneseof adequateunderstanding
ofthe languagecould be obtained,the Japanesewere
Until some mastery
unable to reach a trulyscientific
level in medicine.
Fromthebeginning
of contactsbetweenJapaneseand Dutch thelarger
carriedon negotiations
throughDutch,
part of the Nagasakiinterpreters
of the languagelefta good bit to be desired. The
but theirunderstanding
passage of time and the expansionof relationsbetweenthe two countries
6 Kaempfer has been called the "scientificdiscovererof Japan." His extensive
notes and carefulstudies furnisheda valuable historyand descriptionof Japan. His
book The Historyof Japan, 3 vols. (Glasgow 1906), translatedfromthe Dutch manuscriptby J. G. Scheuchzer and originallypublished in 1727-1728, formany years
constitutedthe chiefEuropean work on Japan. On Kaempfer see Karl Meier-Lemgo,
EngelbertKaempfer (1651-1716), erforschtdas seltsameAsien (Hamburg 1960).
a VjPIJA b O)II

30
Ranzabur6Otori
264
led to a greaterneed forreal abilityin Dutch. The keen interestof Arai

positionwithintheshogunate,
whohappenedto holdan important
Hakuseki,a
also stimulateda desireto improvethe teachingand learningof Dutch.
to increasenationalproduction,
The policyoftheeighthshogun,Yoshimune,b
thosein thepracticalsciences
encouraged
a policyrootedin hisutilitarianism,
ofstudiesabout
in no smallmeasureto thedevelopment
and also contributed
Westernaffairs. In 1740 Aoki Kon'ya,cthenin chargeof the shogunate
were
and Noro Genj6,da physicianin theemployof the shogunate,
library,
studyof Dutch. These
to give themselvesto a scientific
commissioned
were the firsttwo men so commissioned.Noro studiedWesternbotany
from1741to 1750,usingtheoccasionoftheannualvisitoftheDutchphysiciansto Edo forthatpurpose. The resultsof his researchwerepublished
and was aided chiefly
in severalvolumes. He workedthroughinterpreters
Musculusand Everts. Between1742and 1758Aoki,
by thetwophysicians,
in turn,used his annualmeetingswiththe Dutch groupfromNagasakifor
languagestudy,on whichsubjecthe publishedmorethanten volumes.
waywas begun.
studyof Dutch in a systematic
In thiswaythe official
resultof thisstudyappearedin 1774in theformof the
The mostimportant
Kaitai shinshoe
(A New Treatiseon Anatomy).The publication
translation
to as Rangakusoshi(The Beginning
of Dutch
is referred
of thistranslation
oftheworkwhichwasin thehandsofMaenoRy6taku,f
Studies). Publication
SugitaGempakugand othersof theirgroup,was occasionedbyan eventon
March 4, 1771. On that day theywitnessedthe dissectionof the bodies
and, greatlyagitatedby what
of some criminalsexecutedat Kotsukaharah
on.
thetranslation
theywereworking
theysaw,pledgedto bringto completion
at thisperiodwas largely
ofhumananatomy
The Japaneseunderstanding
based on the Chinesetheoryof the so-calledgozo roppu.i This theoryof
in Western
fromWesternideas. As bookson anatomy
coursediffered
greatly
came to have
somethinkers
languagesbeganto trickleintoJapan,however,
doubtsaboutthevalidityof this Chineseexplanation.In 1457 Yamawaki
of a criminal
executedin Kyoto,
thedissection
T6y6,iforexample,witnessed
and in his memoiron the event,Z6shik(On Entrails),he raisedobjections
againsttheChinesetheory.7FollowingYamawaki'slead,othersbegantheir
7 Chinese medicine held the view that the human body was a small reflection
of the universe. All the human organs had their correspondencesin externalnature:
a man had fourlimbs to correspondto the fourseasons; and twelvejoints to correspond
d f;j
f -iJff%AR
c '*MM
3 e ffjET
g{
a -kWEME b =
b- h tJi,i
H:RN,X j [IjA-A,
k ro--5U

31
Western Medicine
265
own study of the internalorgans and not a few made effortsto correctthe
mistakenChinese theories. Though they used Dutch books on anatomyin
this work,theycould not profitverymuch fromthem owing to theirinability
in language.
Maeno Ry6taku, Sugita Gempaku, Nakagawa Jun'an,aand otherswere
startledat the greatsimilaritytheyfoundbetweenthe relationof organsin the
dissected bodies of the criminals and what appeared in the charts of the
Dutch anatomical book which two of them had. This prompted them to
begin the workof translationof the book, which appeared in August, 1774, as
Kaitai shinsho. As a detailed account of the work this project involved is
(The Commencementof
included in Sugita's memoirs,Rangaku kotohajimeb
Dutch Studies)8 it will not be describedhere. Maeno Ryotaku was the only
memberof the group who had some knowledgeof Dutch.
The effortsof the
group and the frustrationthey experienced during the three and one-half
years they spent on the translationdefies the imagination. Eleven times
revised,the translationfinallyappeared in fivevolumes.
The original of Kaitai shinsho was entitled OntleedkundigeTafelen
waarin het
en Aanmerkingen,
benevens de daartoe behoorendeAfbeeldingen
Samensteldes menschenlijken
lichaams,en het gebruikvan alle deszelfsDeelen
geleerdword. The Dutch work itself was a translationof the
afgebeelden
originalGerman work, AnatomischeTabellen,which was published in Danzig
in 1722 fromthe pen of the anatomist,JohanAdam Kulmus. The translation
intoDutch was made by GerradusDicten,a physicianofLeyden,and published
in 1734in Amsterdam. Kulmus' book was reallynot a verylarge work,but it
included simple explanationsabout all phases of anatomyalong witha wealth
of chartsand drawings. Kulmus himselfwas not an outstandingauthority,
but his book, designed forbeginners,was widelywelcomed and wentthrough
a number of editions.
In Japan the book was usually called Tafel Anatomia. The origin of
thistitleis uncertain. Kaitai shinsho,the translation,consistsof fivevolumes,
fourof which are text,the fifthcontainingboth the prologue and illustrations.
withthe twelvemonths.Man's heartcontainedseven holes to correspondwiththe seven
starsin the constellationUrsa Major, and his skeletoncontained360 bones to correspond
with the 360 degreesin a circle. The human body was thus relatedto the largerorder
of nature in a tidy and satisfyingmanner.
8. For an introductionto and a German translationof Rangaku kotohajimesee
Monumenta.Nipponica, V (1942), 144-166, 215-236. See also Keene, The Japanese
Discoveryof Europe, pp. 28-31.
a J[ls jt b @`

Ranzaburo
Otori
32
266
is in kambuna
as it was expectedthatthebookwouldbe read
The translation
we noticethat
withtheoriginal,
in Chinatoo. If we comparethetranslation
footnotes,
explanatory
whilethe originalconsistsof a shorttextwithlengthy
altogether.The qualityofthetranslation
omitsthefootnotes
thetranslation
reproducethe
is not alwayssuperior,sincesome passagesdo not faithfully
graspits
did not thoroughly
originaland some revealthatthe translators
in the translationare wood-prints,
meaning. Finally, the illustrations
lackingthe detailand clarityof the etchingsof the original.
thevalueofthetranslation,
mayseemto diminish
These criticalremarks
book from
of a scholarly
but thefactthatit was thefirstserioustranslation
how littleDutch
theWestcannotbe denied. We shouldratherremember
existed.
no dictionaries
was knownin Japanat thetimeand how practically
venture
Anotherpointto keep in mindis thatthisworkwas a cooperative
of physiciansand thatit turnedthe interestof numerousotherphysicians
towardthe medicalknowledgeof the West. The factthatthe leadersin
in
Dutch studiescame fromamongthis typeof scholarcan be attributed
part to the influenceof this translation. Moreover,withthe appearance
of Kaitai shinsho
it becameclearthatknowledgeof anatomyformsthe core
of scientific
medicine. So, the influenceof thisworkon the development
as greatindeed.
of modernmedicalpracticein Japanmustbe acknowledged
IV. Translations from Dutch Medical Books
of
Afterthe publicationof Kaitai shinshoit is clear thattranslations
were
If
we
all
its
in
on
medicine
books
attempted.
aspects
manyWestern
we wouldhavea listlikethefollowing.
mention
onlythosethatwerepublished,
Books on Basic Medicine
., 65XS
3h
2 volumes,1772.
translated
by MotokiRyoi **a',
by Sugita Gempaku
2. Sugishikaitaiyakuzu
IN, translated
7
5 volumes,1773.
by KumagaiGensh6
Et?;;, illustrated
1. Oranda zenku naigai bungozufu kengo fnj
9. Kulmus' workwas more properlycalled Tabulae Anatomicae. Tafel Anatomia

was probably due to Sugita's lapse of memory. In the translationSugita consulted
also Anatomia of Kasparus Bertholius and various other textbooksof anatomy.
a M- :

267
WesternMedicine
33
3. Seisetsuihan teikJshakugi S
translatedby Udagawa
Genshin
I1J)IIkA, 3 volumes, 1805.
4. Ihan teikonaishodohanzuK ,
FkI @I, translatedby Udagawa
Genshin qHBII;$,
etchingby Nagata Zenkichi 7kEO -, 1808.
5. Ensei iho meibutsu-hk i
translatedby Udagawa Genshin
WBII
,, 36 volumes,1833.
6. JulteikaitaishinshoR,
translatedby Otsuki Gentaku tkm,
, 13 volumes, 1826.
7. Kurumusukaitaifu
L
translatedby Otsuki Gentaku -kA
AN, etchingby Nakaya Isaburo rIg ^5,S, 1826.
8. Orandayakukyv5
translatedby Udagawa Genshin qIFj J
I
6 volumes,1830.
9. Orandayakuseiben
translatedby FujibayashiFuzan $f
fnVtP,,
2
1830.
[if, volumes,
10. Seisetsuigensuiyjtranslatedby Takano Choei AA5 volumes (one volume published), 1832.
11. Sei-igenbyoryaku
, translatedby Ozeki San'ei J
1832.
hoi )4q
-12. Ensei ihomeibutsuko
Yoan
E1)J[)II , 9 volumes, 1834.
J, 3
13. Byogaku tsuironr 5=, translated by Ogata K6an 7
volumes,1849.'
14. JinshinkyuriA4WGX translatedby Hirose Genkyo ,
3 volumes, 1856.
15. ChiseironTt=, translatedby Hirose Genkyo Ma
A,, 3 volumes,
1856.
16. Watoruyakusei-ron
f, translatedby Hayashi D6kai #lg,
'fflX.
18 volumes,1856.
17. Seiri hatsumo*
, translatedby Shimamura Teiho ,-4ffT,
14 volumes,1866.
]Books on Clinical Medicine
1. Seisetsu naika sen'yo
!IJ:jiM,18 volumes,1793.
translatedby Udagawa Genzui
d
translatedby Hirokawa Kai f)IIb), 1804.
,
2. Ran ryoho
translatedby Yoshida Choshuku EgU
3. Taisei netsubyoron
=,
,JI,6 volumes,1805.
4. Juiteizoho naika sen'yo
J
9
Genzui qB:fU)IIAM, edited by Udagawa Genshin EU)IItg,
volumes, 1810.
5. Taiseigekashuiko5
44tIt, translatedby OtsukiGenkan MA;,
3 volumes, 1814.
translatedby Katsuragawa
,6. Kaij5 biyo hogaishohen fi y j4,
7.
Hoshia )IIjs,
2 volumes,1815.
Ganka shinsho;f4ffj9, translatedby Sugita Ryukei ' [Aft&i, 5 vol-

34
Ranzabur6Otori
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
268;
umes, 1815.
Oranda ganka shinshof FRA#fia, translated by Sugita Ryakei.
tEIizi5gA1,6 volumes, 1815.
Yoka seisenzukai
'
translatedby Koshimura Tokumoto
2 volumes, 1820.
S; ;tt,
Yojutsu chishin
.
translatedby Otsuki Genkan RCt4;,,
3 volumes, 1823.
Kyuirigekasoku%
translatedby ShingfiRyotei i
,3144IJ,
7 volumes, 1823- 1840.
Yoishinshog
f, translatedby Otsuki Gentaku 7kV,AV, 4 vol-umes, 1825.
Zoyaku hasshi seiyo tAt1'g;,
translatedby Sasaki Chfitaku ft
a 7?fr., 3 volumes, 1826.
Yoka shinsengp-#ffiA,translatedby Sugita Ryiikei
Lt , 5 volumes, 1831.
Iho kenkiN
1831.
, translatedby Adachi Choshun ,
Taisei naika shiuseig
translatedby Ozeki San'ei J
3 volumes, 1832.
IryoseishiXE ,E translatedby Ito Gemboku
24 volumes,.
;
1835-1847.
Fushi keikenikun f J-1AI, translatedby Ogata Koan
1t)t
26 volumes, 1842-1861.
Yoyo seigi '
translatedby Horiuchi Sodo
*V_, 1845.
Sanshi sanron*t>F,
translatedby Yatabe Keiun
10
W
volumes, 1845.
Saisei sampo g-f
translatedby Sugita Seikei t3 M) yj$,3 volumes,,
1849.
Ikai t,*, translatedby Sugita Seikei 4tfRg.)A1,1849.
Fujin byorontjAJi,
translatedby Funabiki Takudo p
6 volumes, 1850.
Juisosagen
J
translatedby Otsuki Shunsai 7
1857.
Sei-i myakukan F
translatedby Hirose .Genkyo ;fl-;t,
1857.
Satsubyokikan g3R,
translatedby Aoki Kosai 3 volumes,
1857.
MyakuronRUffu,
translatedby Tsuda Junzo *
1858.
-,
Fushi shindan t
translated by Kodama Junz5 VQ,}1p&,
3 volumes, 1860.
KSoshiiso gyokukai ?;K;-lre,
translated by Kodama Junz6 t
3 volumes,1860.
IEhI1,JW,
30. Ganka shinsen

umes, 1861.
, translatedby Ema Tenk6 I
2 vol-
All oftheoriginalworksofthetranslationslistedhereare clearlyidentified.

In addition to these translations,however,there is-an even larger number

Western Medicine
269
35
'whose originalsare not known. Thus, the number of medical books transperiod after1770 is imposingindeed.
lated intoJapaneseduringthe ninety-year
At approximatelythe same time that Western medical theories were
being enthusiasticallyintroducedthroughtranslations,anothertrendbecame
discernible; namely, the increasing attentionpaid by Japanese physicians
'to experimentalworkin medicine. Such workmay well be called the foundation of modern medicine. The pioneer in this field was Yamawaki Toy6,
'whose book on human anatomy, Zoshi, has been mentioned above. The
activityin experimentalresearchthat he startedwas taken up and continued
by Kagawa Gen'etsua in obstetrics,Hanaoka Seishfibin surgery,Fuseya Sotekicin physiology,and a number who carriedon post-mortemdissections.
In 1773 Kagawa (1700-1777) published a two-volume study entitled
.Sanrond (On Obstetrics) in which he made clear his own views, rooted in
the experienceof many years, on normal and abnormal fetal positions and
on ways to rectifythe latter. The view on normal fetal'position which until
that time had been passed down from generationto generationwas that
the fetus stood upright until the tenthmonthand then turnedaround. In
opposition to this view, Sanron explained that usually afterthe fifthmonth
,of pregnancythe fetus is about the size of a cucumber,with its head always
hanging downward,its forehead situatednear the upper part of the mother's
pelvis. He added some scathingremarksabout the prevailingerroneousexplanation. Further, he devised techniques to assist mothers in abnormal
childbirthand inventedinstrumentsfor this purpose which had never been
fusedbefore.
Fuseya Soteki's physiologicalresearch,especially so far as it concerns
the production of urine, was trulyoriginal. The subject was discussed in
the sixth section of his book of 1802, Oranda iwae (Talks on Dutch
Medicine), a work which was writtenin the formof questions and answers
-ontwenty-eight
topics. Numerous experimentsled Fuseya to the conclusion
-thaturine is produced in the kidneys. His research demonstratedclearly
the falsityofthe explanationof Chinese medicinethatthatorganplays a central
role in the reproductiveprocess and that urine is produced in the intestine.
The publicationin 1774 of Kaitaishinshohad far-reaching
effectsthrough,out the country,leading to an increasingnumber of autopsies and greater
interest in Rangahu. In Ky5to and Osaka, for example, it is known that
around 1800 autopsies wereheld fromtimeto time and chartsand picturesof
a
-Ji[fk
fJKj
di i
e TH

36
Ranzabur5 Otori
270-
the discoverieswere drawn. Notable among them are the following:Heijir3g

kaibjzua
(An Anatomical Chart of Heijir5) produced in 1787 by Koishi
Genshun;b Seyakuinnantai z6 zuc (A Chart Showing the InternalOrgans of aMan in Seyakuin) produced in 1798 by Mikumo Kanzend and his associates;,
Kansei jiuninenfujin kaibjzue (An Anatomical Chart of a Woman's Body as,
Observed in 1800) produced by Oya Shasaif and his associates; KaibJ
sonshinzug(Accurate Anatomy in Charts) drawn in 1819 by Minaogaki
Neiichi.h
Oya Sh6sai's work of 1800 is a presentationof the findingsfrom an

autopsy performedon the body of a female criminalexecuted on April 25,
1800, at Yoshijima in Osaka.
Oya, as well as Fuseya Soteki and Kagami
Bunken,i have leftrecordson the experimentaldata concerningthe autopsy.

Minaogaki's work of 1819 was based on anatomical experimentsrepeatedi
more than fortytimes. A painter who drew the chartshimself,Minaogaki
has left us an especially impressivepiece of work.
The workof Hanaoka Seishui(1760-1835) in surgerydeservesmore than,
passing mention. Afterperforminga successfuloperationforbreastcancering
1805, Hanaoka had good resultswith otheroperationstoo. These operations
were somethingnovel not only in Japanbut also in Holland. Hanaoka workedY
out and successfullyused techniques of narcotherapy.10 The narcotherapy
in question led to total lack of consciousness. Hanaoka's successfuluse of
narcotheraphycame afterlong readingand numerousexperiments.
V. Philipp Franz von Siebold

Westernmedicine and medical theories,introducedthroughtranslations,
found an increasingresponsein Japan,so that theywere graduallyfeltto be
closely related to the country'sneeds. Translations alone however did not
sufficeto give the Japanese a real understanding.
10. On Hanaoka Seishui see Kure ShCiz6
: "Hanaoka Seishu sensei oyobi
(Hanaoka Seishfi and His Surgery; Tokyo 1923).
sonogekai
IjItj-5"
Hanaoka performedthe firstsurgicaloperationunder total anaesthesia using mafutgusan (an anaestheticmade from datura). This was earlier than the initial use of
ether anaesthesia by Morton. See also Uchiyama Koichi pIjt-,
Meijizen Nihon
seirigakushi
(History of Physiology in Pre-Meiji Japan; Tokyo
9fH_4tgl
1955); Ogawa Teiz5 'JJIjS , Meijizen Nihon kaib5gaku shi qJGjj H
(Hlistoryof Anatoynyin Pre-Meiji Japan; Tokyo).
c XaYJJr
b 'j'3i5c
d
e t1H
a
f
hz2i
g t04
Sh
JXr i b
f ff

37
Western Medicine
271
As Japan still lacked trainingin those disciplineswhich formedthe basis

formodern medicine,furthereffortsthan those expended in translationwork
were needed. Dutch physicianshad fromthe very beginningpassed on their
medical knowledgein fragmentsto individual Japanese, but this was still a
far cry from medical education in the strictsense of the term.
With the coming in 1823 of the physicianof the Dutch factory,Philip
Franz von Siebold,11 medical education properlyso called graduallycame
into being. The dispatchof Siebold by the Dutch authoritieswas a definite
contributionto Japan, especially in furtheringthe development of natural
science, which was then in its infant stages here.
The Japanese side,
in turn, showed a certain amount of understandingof Siebold's work,so

that the combinationof this with Siebold's own effortsmade his mission
quite successful.
Siebold studied medicine at the Universityof Wiirzburg. His interest
in various fields of science was also quite noticeable. Aftergraduating,he
entered the Dutch East India Company and left for service in the Orient.
When he arrived in Japan as a medical officerin the employ of the factory,
he was a young and energeticscientistjust twenty-sevenyears old.
Evidence of Siebold's inquiringspiritis to be found in a shortreporton
the status of natural science in Japan, which he wrote in 1824 with the
assistanceof some Japanese. Hardly had he arrivedin Japan when he made
contactwith a considerablenumberof Japaneseto-whomhe showed the latest
methods of scientificresearch currentin Europe.
In addition, he treated
Japanesepatientsin Nagasaki,allowingJapansephysiciansto observehis work.

While it cannotbe maintainedthatSiebold's workwas eitherhighlysystematic
or organized,it can be said thathe was the firstto introduceclinical medicine
to Japan.
The numberof those who studied under Siebold was fargreaterthan the
totalnumberof those who had learnedfromall his predecessorsput together.
Since, moreover, the large majoritywere themselves professionalmedical
men, theywere able to bringhome to a largenumber of people, throughtheir
words and deeds, the true value of Western medicine. Shogunate officials
too could no longerfailto pay attentionto thisnew movementin medicine.
11. On Siebold's work in Japan see Kure Shflz5

h (Dr. Siebold:
.
shogai oyobi k5gyo5 - oi A' 1
L
ploits; Tokyo 1926); Nichidoku Bunka Ky6kai H
v.-',
lf t (Studies on Siebold; To3kyo1938).
Siebold sensei: sono

His Life and Ex(ed.), Siebold kenkyFu

272
Ranzaburo -Otori
38
VI. Pompe van Meerdervoortand the Nagasaki Clinic'2

who weretrainedin Chinesemedicine(Kampoigaku)
Those physicinas
butthey
toallsortsofstrategems
totrytosuppressthenewmovement
resorted
national
isolation
The
abolished
the
shogunate
unsuccessful.
werecompletely
policyin 1854,openedJapanto theoutside,and concludeda seriesoftreaties
it changed
withothernations. In line withthisdevelopment
of friendship
to one of
its attitudetowardWesternmedicinefromone of lukewarmness
positive cooperation.
The shogunate openly showed its belief in the superiorityof Western

-medicinewhen in 1857 it inviteda Dutch physicianto serve as an instructor
at the second Naval Training Center in Nagasaki. The man selected,Pompe
van Meerdervoort,was a naval physician. He arrivedin Japan in August,
and on November 12, 1857, began his lectureson medicine at the government officein Nagasaki to speciallyselected studentsfromall the han. He
lecturedon anatomy,physiology,pharmacy,bandaging, pathology,internal
forthis purpose.
medicine, surgery,and other matters,using an interpreter
To enable all to understand,he preparednotes foreach lectureand accepted
questions on all points.
As an additional aid to his studentsPompe exerted immense effortsto
enable them to carryout experimentsand learn fromautopsies. He insisted
on the necessityof clinical lecturesand on the establishmentof hospitalsas
to convincethe authoritieson these
of primeimportance. His efforts
mnatters
points were rewarded. Imperfectand crude though they were, classes were
held in which experimentsand dissections were incorpolated. Moreover,
on September 21, 1861, a new Western-stylehospital, quite imposing for
the times, was opened. The first'such hospital in Japan, it was named the
Nagasaki Yjjgshoa (Nagasaki Clinic) and was open both to regular and to
out-patients.
The opening of the clinic changed Pornpe's daily life not a little. Visits
to patients,treatmentsfor out-patients,lectureson clinical medicine and on
other subjects,the recurringrounds of visits-this was his daly life. Students
joined him in his work,visitingpatients,changing bandages, writingup prescriptions,compounding medicines, and even preparingfoods and giving
assistancein bathing.
12. Pompe van Meerdervoort,Vif jaren in Japan:
a A - ffiT
1857-1863 (Leiden 1867).

Western Medicine
273
39
Pompe's lecturenotes,preservedforus in the translationof an interpreter,

Matsumoto Jun,a provide us with detailed informationon his teaching.
Importantas theywereforthestudentsofWesternmedicineofthatgeneration,
they are also invaluableforthe studentof Japan's medical history.
VII. Conclusion
Modern medicine in the real sense of the term began in Japan at the
beginningof the Meiji era, when the predecessorof the Medical Faculty of
T6ky6 University,the Daigaku T6k6,binvitedGerman medical instructorsto
teach medicine in an organizedway. As a consequence of this invitationthe
medical education of the time was largelyalong German lines. It may be
thought that this new type of medical education was completelydifferent
fromthe kind of Westernmedicinewhich had preceded,but in realitythe two
types had many points in common. This can be easily understoodfromthe
fact that most of the medical books translatedinto Japanese from Dutch
were themselvestranslationsfromthe originalGerman text.
Furthermore,
indispensable elements of modern medicine such as experimentationand

practical diagnosis had already been introduced by the Dutch at the end
of the Edo period and, as we have seen in the preceding section, had been
incorporated into medical education. This development was surely not
withoutrelationto the modern medical education of the early Meiji period.
'The fact that a large number of Japanese who were prominentin medicine
at the end of the Edo period played leading roles in the professionunder the
new Meiji governmentclearly supports this view.
If we go back to the periodjust priorto the Edo era, we see that namban
medicine had been introduced. This gradually changed in the early part
of the Edo era into medicine as taughtand practiced by the Dutch. This
kind of medicine, which successive generationsof Dutch physiciansof the
Dutch factorytaught, held sway until the end of the Edo era. Initially
fromnambanmedicine,but gradually it evolved into
it was not so different
a distincttype of medicine,thanksto the Dutch physicians,whose role along
was crucial. The latter,in daily contactwith
with that of theirinterpreters
Dutchmen, developed the so-called interpreters'school of medicine, which
was perpetuatedchieflythroughthe oral transmissionof the contentsof Dutch
works on medicine and on surgery. Books on medicine in other Western
a PA*J1ib zlT3;X5

40
Ranzaburo Otori
274
languageshad an increasinginfluenceon Japanesemedicalmen through

Dutch translations,
and it was throughsuch translations
that theycame
into contactwithWesternmedicinein a broadersense.
At aboutthe same timethatseriousresearchand studyon the Dutch
languagebegan,thefirst
Japanesetranslation
ofa Westernmedicalwork,Kaiiai shinsho,
appeared. Between1774,thedateofitspublication,
and theend
of the Meiji era forty-seven
different
kindsofmedicalworksweretranslated
andpublished.As a consequenceofthistranslation
work,Westernmedicine
becamemoreandmoredeeplyrootedin Japan. The introduction
ofWestern
clinicalmedicinethrough
theworkofSiebold,thepracticeofautopsyand dissectionof the humanbody,the spreadof experimentation
in medicineand
othersimilarchangesmay well be called the harbingers
of seriousand
systematic
researchin Westernmedicine.
The formalinvitation
to Pompefromthe shogunatetowardthe end of
theEdo era led to theestablishment
of a medicaltraining
centerin Nagasaki
and to the erectionof thefirstWestern-style
hospitalin Japan. Thus the
way was paved forthe spreadof Westernmedicine,in Edo firstof all, but
the country.
also throughout
With the establishment
of the Meiji government,
old systemsanct
werereplacedor changedby thecentralgovernment.In medical
regulations
educationthe model of Germanywas selected,and medicalprofessionals
wereinvitedfromGermany
toestablish
thenewsystem.The change,however,
was not a revolutionary
one, since Dutch and Germanmedicalknowledge
and practicewerecloselyrelated,as we haveseen. Hence,we can conclude
bysayingthatthemodernmedicalsystemnewlyestablished
in thefirstyears
of the Meiji era was bound by manyties to what had preceded.


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The Acceptance of Western Medicine in Japan

Author(s): Ranzaburo Otori

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