Writing, Authority and Practice in Tokugawa Medicine, 1650-1850

Abstract

This dissertation examines the history of medical knowledge in Tokugawa Japan through a study of the relationships between medical texts, social institutions and clinical practices. It situates the history of Japanese medicine during this period within its regional and global contexts, analysing Japanese doctors' engagement with ideas and practices drawn from medical cultures in China, Korea, and Europe and showing how these ideas and practices became integrated into the medical cultures of Japan itself.

Part One focuses on the written representations of medical knowledge. From the seventeenth century onwards, the medical literature available within Japan came to include more widely accessible texts published in Japanese (kana) as well as texts in classical Chinese (kanbun), but classical Chinese writings remained authoritative. The close philological study of classical Chinese texts became a central problem for practitioners of "Ancient Formulas" medicine, and philological forms of evidential argument provided a model for new ways of using the empirical evidence of medical practice.

Part Two focuses on the different types of personal interaction involved in the creation and dissemination of medical knowledge. Records of encounters between Japanese and Korean doctors in the context of diplomatic embassies during the eighteenth century illustrate the benefits and the shortcomings of cross- cultural interaction, while the history of the Ikeda lineage of smallpox doctors shows how the personal transmission of medical knowledge within Japan was linked to the desire of medical lineages to maintain the secrecy of the knowledge they possessed.

Part Three focuses on the question of how novel medical practices were integrated into Japanese medical culture. New practices such as therapeutic vomiting, bloodletting, mercurial drugs for syphilis, and the cowpox vaccine were based on Japanese doctors' reading of Chinese as well as European sources; regardless of the geographical and cultural origins of new medical techniques, adoption of such techniques often required similar processes of adaptation to the prevailing practical and cultural conditions within Japan.