Rangaku: "Red Haired" Medicine in Shogunate Japan

In 1804, Seishū Hanaoka performed a mastectomy under general anesthesia, forty years before the West (America and England) were to adopt ether and chloroform. That single event signifies a curious, perhaps unique, pattern of knowledge diffusion—from a small Dutch trading post to an entire empire. 

 Painting by Kawahara Keiga: Arrival of a Dutch Ship. Siebold, wife and daugther.

Painting by Kawahara Keiga: Arrival of a Dutch Ship. Siebold, wife and daugther.

Rangaku

For two centuries the shogunates of Japan invoked sakoku—isolation from foreign influence. Only a single point of contact with the West was allowed. This was intended for trade, exclusively with the Dutch. These ‘red haired’ traders were confined to Dejima, an artificial island abutting Nagasaki. It was to become the injection point for Western technology, science and medicine which, for over two hundred  years, infused Japan with the knowledge and methods that would serve her well. After Commodore Perry’s visit brought, through intimidation, an end to isolation, Japan leapt onto the stage of the modern world fully rehearsed and ready to play a role.

The Japanese were not passive recipients of instruction. It was they who learned Dutch, formed schools to teach Western knowledge and mastered advanced shipbuilding using little more than sketches of the Dutch techniques. 

Chinese herbalism, moxibustion and acupuncture were prevalent in Japan. But their anatomy was primitive compared to the detailed knowledge of the Europeans. The anatomical studies of the inimitable German authority Johann Adam Kulmus’s Anatomische Tabellen (1732), were soon conveyed in the form of a Dutch textbook Ontleedkundige Tafelen (1734). Japanese doctors enthusiastically conducted dissections to confirm what they were shown, and eventually a compilation in Japanese was published as The New Text on Anatomy (1774).

 Ontleedkundige Tafelen

Ontleedkundige Tafelen

 
 The New Text on Anatomy

The New Text on Anatomy

Mafutsusan

Rangaku was a collaborative phenomenon. Hanaoka’s surgery under general anesthesia in 1804 combined a Japanese-derived anesthetic agent—Mafutsusan—about which little is known, with western operative techniques. Eventually, the baton was passed. In Osaka, on the trade route between Nagasaki and Edo (Tokyo),  Ogata Koan founded Tekijuku, a Rangaku–based school of medicine. From this were derived the programs at both Osaka and Keio Universities.

The Rangaku phenomenon was a long process, spanning from 1600 to 1868—the Tokugawa period—when members of this clan ruled from Edo Castle (Tokyo). The term Rangaku came to refer to the Western knowledge generally, not just the Dutch. Of four of the best known purveyors of medical Rangaku, three were German and one a Swede.

Red Hair Medicine

 Caspar Schamberger was a Leipzig-trained surgeon who signed up for a stint with the Dutch East India Company and arrived at Dejima in Nagasaki in 1649. He soon came to the attention of the Imperial commissioner Inoue Masashige, who had already embraced Western thought. Before long Schamberger acquired as patients a number of high ranking members of Japanese society . At the end of his two years in Japan, the governor of Nagasaki commanded a report on his methods which became the basis for the first Western practice of medicine in Japan known as Caspar-style-surgery, or kasuparu-ryû geka.

 "Dutch" & "Learning"

"Dutch" & "Learning"

 
 Dutch Microscope

Dutch Microscope

Engelbert Kaempfer was also a German physician who came to Japan via duty as a ship’s surgeon for the Dutch East India Company. He arrived in Japan in 1690, and stayed for two years, spending his time collecting local flora and learning acupuncture. Trees are alive today that were grown from Gingko seeds that he brought home. He also planted the idea in Europe that Japanese acupuncture was to be taken seriously, as he had seen cases of colic cured with needles. His travelogue of was immensely popular in Europe. It undoubtedly intrigued our next adventurer, who refreshed the genre 50 years later.

Carl Peter Thunberg. Botanist and Physician

The Swedish botanist and physician Carl Peter Thunberg, a pupil of Linnaeus, was the only European who visited and published his observations of Tokugawa Japan in the eighteenth century.

Carl Peter Thunberg was a Swede and an apostle of the great classifier Linnaeus. He himself was dubbed ‘the Japanese Linnaeus’. He too disembarked at Dejima, and was initially confined there. As head surgeon he persuaded interpreters to trade nuggets of knowledge—Western medicine for Japanese botany. His entrée into Nagasaki was the use of mercury to treat syphilis (known as the ‘Dutch disease’). In return, he was taught acupuncture. He left Japan in 1776, later to write Flora Japonica and Fauna Japonica, titles identical to later works that were based on the studies a another arrival at Dejima, one whose association with Japan became very personal.

Siebold

We refer to Philipp Franz Balthasar von Siebold,  physician, botanist and father of the first female physician in Japan. By the time Siebold arrived in 1823, the Dutch East India Company was out of business. Dejima was now operated by Holland. Within a year he had started a medical school, with instruction in Dutch. During the fourth year of his stay he fathered Kusumoto Ine, who became not only the first female physician in Japan but eventually court physician to the Empress. 

Siebold got into trouble with everyone. He was nearly recalled by the Dutch who had grown tired of his arrogance. He was put under house arrest by the Japanese as a possible spy for Russia when a secreted map of northern Japan and Korea was discovered in his possession. By the time he left, eight years in, he had collected over 1000 plants, kept in a private botanical garden. He secretly exported tea to Indonesia, Hydrangea to England and Knotweed (an invasive species) to America. Thirteen plants, two animals and a half-dozen museums bear his name. 

Smallpox

It is said that Siebold was the first to acquaint the Japanese with the concept of vaccination for smallpox. But it was not until 1849 that the government of Nagasaki asked the Dutch to import cowpox virus, which was kept at the headquarters of the Dutch East India Company in Batavia (Jakarta). This they did, and the prospect of controlling smallpox with vaccination excited all but the Chinese physicians—and the vehemently anti-Western Emperor Komei. The Emperor died from smallpox during an 1867 epidemic in Kyoto. His son however had been vaccinated ten years earlier, at the insistence of his maternal grandfather.  He survived to become Emperor Meiji. The ‘Meiji restoration’ brought capitalism and industrialization to Japan. The role of Dejima as a portal of transformation was complete.

Smallpox is now eradicated, with only two known lab stocks, one in the US and one in Russia. But the prospect of pirated smallpox as an agent of bio-terrorism is not being ignored. To this end safer vaccines have been sought, the most promising of which is the LC16m8 vaccine. It was developed in 1985 by a team of thirteen researchers at the National Institute of Infectious Disease—in Tokyo.

 Ine Kusumoto

Ine Kusumoto

 Satoshi Omura

Satoshi Omura

 

Four Japanese citizens have won the Nobel Prize in Physiology or Medicine: Sosumu Tonegawa 1987, Shiinya Yamnaka 2012, Satoshi Omura 2015, and Yoshinora Oshumi 2016. Eighteen Japanese scientists have won for Physics or Chemistry.

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Bibliography:

Rangaku Medicine As 'Outside' Knowledge in Late Tokugawa Japan:
Video of Reynolds Historical Lecture by John Van Sant.

Rangaku Medicine and Foreign Knowledge in Late Tokugawa Japan
John Van Sant Southeast Review of Asian Studies

List of Rangaku scholars: SamuraiWiki

Rangaku: Encyclopedia Britannica 

Rangaku and Westernization
Marius B. Jansen, Modern Asian Studies
Vol. 18, No. 4, Special Issue: Edo Culture and Its Modern Legacy (1984), pp. 541-553

Historical Anatomies on the Web: Kulmus
National Library of Medicine

Wikipedia links: RangakuTekijukuSchambergerKaempferThunbergSielboldKusumoto IneEmperor MeijiOkata Koan

LC16m8, a Highly Attenuated Vaccinia Virus
Journal of Virology June 2006

Seishu Hanaoka Did Not Describe His Anesthetic

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