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 individual’s 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 Thornton’s article, "Borrowed Tradition: Jishû 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. Wright’s 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.

Sybil Anne Thonton, Arizona State University

During the Edo period, the Tokugawa government financially subsidized the travelling mission of the Jishû (formerly, the Yugyô-ha). The principal responsibility of the missions head, the Yugyô Shonin, spiritual heir to Yugyô-ha founder Ippen Shonin (1239–1289), 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 Yugyô-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 Jo’amidabutsu, founder of the Shijô-ha (Fourth Avenue School), rival to the Yugyô-ha. Jo’amidabutsu reportedly gave three nembutsu amulets to former emperor Fushimi’s consort, who safely delivered future emperor Kogon after consuming them. This miracle account of Jo’amidabutsu and the birth of emperor Kogon was very likely invented as an attempt to maintain Shijô-ha autonomy. The attempt failed; the Edo bakufu placed the imperially-connected Shijô-ha under the jurisdiction of the bakufu-connected Yugyô-ha (now Jishû). It was no accident that the tradition of safe childbirth amulets was then appropriated by the Jishû, the same order which worked to legitimize Tokugawa rule.

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.

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 populous—especially 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 offender’s gender, social status (occupation), and age appear to have been taken under consideration when authorities ruled on the offender’s official categorization (i.e., rational or insane). These same factors determined both the official diagnosis as to an offender’s 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.

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 (1865–1932), who has been credited as being the "father" of Japanese psychiatry.