Organizer: Diana E. Wright, Western Washington University
Chair and Discussant: Peter Nosco, University of Southern California
Japanese history is replete with examples of the close relationship between medicine and politics. This panel explores aspects of the complex relationships among state, politics, and medicine in both premodern and modern Japan. Through its diagnosing of what constituted any given illness, dictation of how that illness (and the individual involved) should be treated, and, most importantly, by determining the afflicted individuals prognosis, the State intimately exerted its control over the general populous. Moreover, such involvement was supported, even actively solicited, by medical practitioners themselves; governmental interests all too often were their interests. Thus it was that the field of medicine provided yet another venue from which the Japanese State could expand its power, and at the same time also served as a means by which to validate that power. Panel presentations begin with Thorntons article, "Borrowed Tradition: Jishű Amulets and Safe Childbirth," which introduces the themes of bakufu-practitioner alliance and validation through healing. Smits paper ("The Politics of Medicine in the Ryukyu Kingdom") reveals that in the Kingdom of Ryukyu as well, the state pursued policies to change and regulate the medical practices of the masses. Wrights research ("Diagnostic Judgements: Insanity and the Edo Period Legal System") examines bakufu identification of, and methods of dealing with, the criminally-insane. Matsumura ("Kure Shuzo and the Issue of Insanity as a National Disease") concludes the presentations by examining the relationship between psychiatry and the State in early twentieth- century Japan.
A Borrowed Tradition: Jishű Amulets and Safe Childbirth
Sybil Anne Thonton, Arizona State University
During the Edo period, the Tokugawa government financially subsidized the travelling mission of the Jishű (formerly, the Yugy˘-ha). The principal responsibility of the missions head, the Yugy˘ Shonin, spiritual heir to Yugy˘-ha founder Ippen Shonin (12391289), was to distribute salvation in the form of slips of paper imprinted with the invocation of the name of Amida Buddha (nembutsu). While these amulets were an extension of meditation practices meant for strictly spiritual purposes, the material benefits of the amulets seem to have been of significant importance to the order.
One of the miracles most often reported in association with these nembutsu amulets is safe childbirth. However, the Yugy˘-ha originally had no tradition of safe childbirth talismans. The theme of safe childbirth as a result of amulets received from a famous nembutsu priest is to be found in the fifteenth-century version of the life of Joamidabutsu, founder of the Shij˘-ha (Fourth Avenue School), rival to the Yugy˘-ha. Joamidabutsu reportedly gave three nembutsu amulets to former emperor Fushimis consort, who safely delivered future emperor Kogon after consuming them. This miracle account of Joamidabutsu and the birth of emperor Kogon was very likely invented as an attempt to maintain Shij˘-ha autonomy. The attempt failed; the Edo bakufu placed the imperially-connected Shij˘-ha under the jurisdiction of the bakufu-connected Yugy˘-ha (now Jishű). It was no accident that the tradition of safe childbirth amulets was then appropriated by the Jishű, the same order which worked to legitimize Tokugawa rule.
The Politics of Medicine in the Ryukyu Kingdom
Gregory James Smits, Pennsylvania State University
This paper examines the intersection of and conflict between: (1) folk religion and medical practices; (2) spirit possession and sorcery; and (3) attempts by the state to impose "rational" forms of medical practice on Ryukyuan society.
Starting late in the seventeenth century, advocates of Confucianism became increasingly influential among Ryukyuan elites. As a result of their success in court politics, Confucianism became the de facto ideology of the Ryukyuan state by the middle of the eighteenth century. One distinguishing aspect of Ryukyuan Confucianism was an emphasis on applied science, including medicine. Another was an active, albeit largely unsuccessful, program of social engineering by the state to transform "benighted" segments of society into proper subjects of a sagely ruler. In the realm of medical practice, broadly defined, this Confucianization of Ryukyuan elites resulted in official, legal agnosticism with respect to sorcery, spirit possession, and most forms of popular divination, all central to the lives of most Ryukyuans. On the one hand, the state effectively stopped prosecuting Ryukyuans accused of malicious forms of sorcery. Simultaneously, it applied legal pressure on ordinary Ryukyuans to cease patronizing sorcerers, monks, and folk diviners when seeking cures for medical problems. Instead, the state offered physicians with formal academic training in Chinese and Japanese medical traditions. The early-modern Ryukyuan state lacked sufficient power to successfully impose its Confucianized medical view and practices on the Ryukyuan masses, but its efforts foreshadowed later, more successful state attempts to impose official medical-political doctrine and practices on its modern citizenry.
Diagnostic Judgements: Insanity and the Edo Period Legal System
Diana E. Wright, Western Washington University
After analyzing both bakufu and individual han court records, it becomes clear that each recognized that madness, particularly that of the criminally-insane, constituted a special social problem, one that could be used to the advantage of the State(s). By redefining what constituted and/or caused "insanity"; when a "crime by reason of insanity" had been committed; and what sentence/treatment was to be imposed on the perpetrator of such a crime, the State(s) were able to retain and often expand their control over the general populousespecially during times of crisis.
Besides serving as a tool of physical domination, the concept of "insanity" provided a vehicle for the dissemination of official ideologies, ideologies usually in conflict with the traditions of the non-elite. The proponents of Neo-Confucianism, in particular, availed themselves of this tool. This is evidenced by the fact that individuals who committed certain types of crimes were more often deemed "insane" than those who committed other, often more far-reaching, types. As well, an offenders gender, social status (occupation), and age appear to have been taken under consideration when authorities ruled on the offenders official categorization (i.e., rational or insane). These same factors determined both the official diagnosis as to an offenders type of insanity (e.g., insanity due to personal addictions vs. that caused by spiritual disorder) and the appropriate prescription (punishment/ treatment) for that individual. Insanity would no longer be (officially) perceived as a sign of the divine, but rather as a manifestation of imperfection.
Kure Shuzo and the Issue of Insanity as a "National" Disease
Janice Y. Matsumura, University of Regina
Inspired by studies on the political and social impact of the establishment of psychiatry in Western societies, this paper examines the symbiotic relationship between psychiatry and the Japanese State. It focuses on the writings of Kure Shuzo (18651932), who has been credited as being the "father" of Japanese psychiatry.
As a professor at the Tokyo Imperial University School of Medicine and superintendent of Sugamo Hospital, Kure trained, and influenced, an entire generation of Japanese practitioners. Eager to win greater official support for the new psychiatric profession, as well as genuinely concerned about the care of the insane, he led a campaign for government-funded mental hospitals. In response to the "Law of Confinement and Protection of the Mentally Ill" of 1900, which called upon families to incarcerate their afflicted members in their own homes, Kure challenged the state-sponsored, idealized notions about the family, arguing that the evolving Japanese family structure was unsuitable for the care of the insane and that it was often the family that was the cause of mental illness. To persuade the authorities that insanity was a public matter that could not be left to the management of private citizens, Kure wrote increasingly alarmist articles which proclaimed insanity to be a "national disease," one that threatened the countrys economic, social, political and racial well-being. This disease, he argued, was bound to increase as Japan became more "modern," i.e., more like the West.