Japanese traditional medicine

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Japanese moxibustion in the medical house book Banshō myōhōshū, 1853

Traditional Japanese Medicine ( TJM ) is medicine in Japan that developed in dialogue with Chinese, Korean and, since early modern times, Western medicine. It was consistently the Japanese side that took the initiative, selected from the medical schools of the neighboring countries and the West, assimilated and developed it further. The results show great independence, and in many areas Japan contributed therapeutic inventions and theoretical concepts that secured Japanese medicine its independent place within the traditional medicine of East Asia.

Relics of shamanistic practices

Comparative studies on folk medicine in East Asia, on Shinto, as well as traces of ancient healing practices suggest that people in the Japanese archipelago practiced shamanic practices and purification ceremonies before the Nara period . Some of the few herbs they used were purely symbolic. In the oldest work on history and mythology , Kojiki , written down in 712 , and the chronicle Nihon Shoki (written in 720, also called Nihongi ), a deity Ōkuninushi (also Ōnamuchi or Ōmononushi ) appears who, together with the deity Sukunabikona, heals and heals people wants to protect against dangerous animals by means of defensive magic. Diseases were the work of gods and demons, and some were caused by human error.

Organization of the basics in the Nara period (710–794) and Heian period (794–1185)

Shōsōin, the treasure house of the Tōdai Temple ( Tōdai-ji ) in Nara

At the beginning of the medical relationship with the Asian mainland there are consultation trips of Korean doctors from the realms of Silla , Paekche and Koguryō . Some of them settled in Japan. According to tradition, in the middle of the 6th century, with the arrival of the monk Zhì Cōng ( 智 聡 ), who is said to have brought 164 medical works with him, direct contacts to the Chinese Empire began. As a result, there were thirteen official Japanese embassies ( 遣 唐 使 , kentōshi ).

With the creation of state structures in the 7th and 8th centuries, Japan then oriented itself to China in medicine and the organization of the medical system (first contacts with Chinese medicine on the mainland existed since the 5th century). The division of medical disciplines and the institutions involved in them reflects Chinese role models. An imperial health department ( 典 薬 寮 , Ten'yaku-ryō ) was founded, but it was only responsible for the court and the nobility. In 787, the 'New Materia Medica' ( 新 修 本草 , Xīnxiū Běncaǒ , 659) sponsored by the Chinese imperial family became a mandatory text in the Japanese health department, but many of the 844 remedies described there were not available in Japan.

In imparting medical knowledge, monks of Buddhism, which was also adopted from China, played an important role. Many of the Chinese remedies offered by the famous Chinese priest Jiànzhēn ( 鑑 真 , Japanese reading Ganjin , 688-763) and his successors to the 'Great Buddha' ( Daibutsu ) in Nara are still today in the old treasure house ( Shōsōin ) of the Tōdai Temple ( Tōdai-ji ) guarded. Shingon School monks brought the star stitch and other therapies of Chinese ophthalmology to Japan. The native ophthalmology developed on this basis reached a remarkable level long before the arrival of the Europeans.

Since the 9th century, contact with China has lost its intensity. After 894, when the last official envoy returned, there were only occasional monks and other scholars who undertook the crossing, which was dangerous because of the unseaworthy ships.

The oldest written evidence of this reception of Chinese healing art is the script Ishimpō ( 医 心 方 , also Ishinpō ), written by the doctor Tamba no Yasuyori ( 丹波 康 頼 , 912-995) between the years 982 and 994 , which contains more than a hundred works, predominantly of the Sui Dynasty (589–618) and Tang Dynasty (618–907) uses. It is also valued today because it contains parts of Chinese texts that were lost in China.

First departure from Chinese medicine

During the Kamakura period (1192–1333), with its military structure, which was so different from the Chinese official state, the distance to China also grew in medicine. The contacts remained, however, and Buddhist monks still dominated the transfer of medical knowledge. Worth mentioning here is the Zen priest Myōan Eisai ( 明 菴 栄 西 , 1114–1215), who brought tea drinking and 'small meals' ( kissa ) to Japan and who wrote Kissa yōjōki ( 喫茶 養生 記 , ' caring for life by drinking tea') ') made a name. The Risshū direction belonging monk Ninshō ( 忍性 , 1217-1303) founded a hospital in Kuwagaya ( Kamakura ) with the support of the government, which also included a leprosy . It is said that 46,800 patients were treated here over the next two decades. Such activities, carried out by Buddhist temples, also improved the supply of the general population.

Among the writings, the works by Kajiwara Shōzen ( 梶 原性 全 , 1266-1337), 'Brief outline of medicine' ( 頓 医 抄 , Ton ishō ) and 'Safe recipes' ( 万 安 方 , Man'anpō ) stand out. The former is written in kana syllabary to promote dissemination. About the Man'anpō reached u. a. the anatomical teachings of Cúnzhēn huánzhōng tú ('Illustration of the internal organs and vessels', 存 真 環 中 図 , 1113) to Japan. At the same time, Kajiwara introduced a Japanese terminology in his treatment of leprosy . His observations on diabetes mellitus are also noteworthy .

New impulses in the 15th century

The next stronger impulse came from Tashiro Sanki ( 田 代 三 三 , 1465–1537) after a twelve year stay in China (1486–1498). There he got to know the medicine of the Jin Dynasty (also Jurchen Dynasty, 1125-1234) and the Yuan Dynasty , in which the teachings of the medical practitioners L Gǎo ( 李 杲 , alias Lǐ Dōngyuán ( 李東垣 ), 1180–1251) and Zhū Dānxī ( 朱 丹溪 , 1281–1358) dominated. The former is known for his 'treatise on the spleen and stomach' ( 脾胃 論 , Pí weì lùn , 1249). Li and Zhu advocated tonifying therapies and, in their theoretical foundation, gave the relationship between body and environment, i.e. H. the way of life, special attention. We find here also a close connection to that of Zhu Xi ( 朱熹 , from 1120 to 1200) represented Neo-Confucianism , which over the Kingdom of Korea came to Japan.

The 'school of the later age' ( Goseiha 後世 派 ) founded by Tashiro , so called because it was younger than the previously dominant song-time teachings, was further expanded by his students. Especially Manase Dōsan ( 曲直 瀬 道 三 , 1507–1594) made an outstanding contribution to his teaching facility in Kyoto . In an eight-volume collection of medical practice ( 啓迪 集 , Keitekishū , 1574), he tried to adapt the Chinese teachings to Japanese conditions. His particular merit lies in the systematization of the diagnosis (skin color, hair consistency, stool, urine, odor, cough, reaction to touch, appetite, etc.). Manase's adopted son Gensaku ( 曲直 瀬 玄 朔 ) contributed to the further development of the concepts. In addition to the remedies of Lǐ Gǎo and Zhū Dānxī, the Manase recipes also include the 'Official Recipes of the Welfare Pharmacies of the Great Peace' ( Tàipíng huìmín hé ) compiled by the Chinese court physicians Chén Shīwén ( 陳 師 文 ) and Péi Zōngyuán ( 宗 元 ) jìjú fāng 太平 惠民 和 劑 局 方 , 1110) plays an important role. Medicines include numerous animal remedies such as musk , bear bile , bezoar ( gōō 牛黄 ), which had to be imported from Southeast Asia, India and the Middle East. 'Temperaments' (cold, cool, normal, warm, hot) and flavors (sour, bitter, sweet, spicy, salty) were assigned to each remedy. When using it, the doctor also took into account the patient's social position (social indication).

In addition to Manase Dōsan, Nagata Tokuhon ( 永田 徳 本 , 1513-1630) had a lasting influence. He also broke away from the Chinese teachings and regrouped the ailments based on symptoms. Although he chose more aggressive methods than was common at the time with a number of laxatives, Nagata's therapies were aimed at supporting the forces of nature, with the consent and support of the patient playing a crucial role. Among his writings, the 'Nineteen Recipes of the Venerable Tokuhon' ( Tokuhon-ō jūkyū hō 徳 本 翁 十九 方 ) were widely used. In the 'Discourse on Medicine' ( I-no-ben 医 之 弁 , 1585) he showed contemporary doctors that the Chinese work Shānghán lùn ('Treatise on Cold Diseases') with a useful pathology and effective therapies is worth considering Alternative to Manase's teachings.

First contacts to Europe: 'Surgery in the style of the southern barbarians'

In mid-August 1549, with the landing of the Basque Jesuit missionary Francisco de Xavier in southern Kyushu, the direct and ongoing Euro-Japanese cultural exchange began. Actually, the Jesuits had no interest in medical, especially surgical, activities, because since the Council of Tours (1163) the church shied away from blood ( “Ecclesia abhorret a sanguine” ). In 1555, however, Luís de Almeida (1518–1584), a licensed surgeon and successful merchant, joined the Society of Jesus in Japan . As an ordinary brother without priestly powers, he was able to use his fortune to found a hospital with a hundred beds in Funai (today Ōita ), where, as one report says, "the body with medicines and the soul with prayers" were provided.

Many authors take this hospital as the beginning of Western medicine in Japan, but it is an institution where Eastern and Western medicine coexisted. The entire 'internal medicine' ( hondō , main path) was in the hands of converted Buddhist monk doctors, some of whom are extolled by name. The pharmaceutical industry was also pragmatic. The majority of the remedies came from the surrounding mountains, from Macau , Malacca and Cochinchina . In the letters and dictionaries of the mission, we also find numerous indications that they were engaged in acupuncture and moxibustion . In addition, the western innovations were not as revolutionary as they might seem. In a treatise from 1585 on cultural differences between Japan and Europe, the Jesuit priest Luís Fróis regretted that the Japanese did not accept uroscopy , bloodletting , enemas and cautery . Some authors refer to the treatment of the wounds caused by the arquebuses introduced by the Europeans , to the previously unknown washing out with Arrak brandy, and to the use of beef fat and olive oil. However, European doctors argued about the nature and appropriate therapy of gunshot wounds until the 17th century. With the destruction of the hospital in the course of regional power struggles and the growing persecution of missionaries and Japanese Christians, these medical contacts came to an early end. In the emerging Japanese field surgery, only faint traces of this era can be found in the form of a few remedies such as pork and beef fat, olive oil and among the instruments next to the chewing iron (not used for a long time) a ' ransetta ' (port. Lancetta ). The lasting exchange between Japanese and European medicine only came about with the arrival of the Dutch.

Beginning of the lasting engagement with the West: 'Surgery in the style of the redheads'

When the Europeans turned to the healing arts, the endeavors of the decision-makers in Edo to stabilize the situation in the country played an important role. But behind the emerging interest there are also important events. When the merchants of the Dutch East India Company, who were active in Hirado from 1609 to 1640, had to relocate their branch to Nagasaki in 1640 , the General Government in Batavia (now Jakarta ) considered it necessary to establish a permanent position of surgeon. After nearly a century of Euro-Japanese contacts, the conditions for continuous encounters between Japanese and European doctors were created for the first time. In addition, the company in the imperial Nagasaki domain was now under the control of the central government in Edo. This considerably deepened the court's knowledge of western science and technology.

In 1649 the surgeon Caspar Schamberger was sent to Nagasaki . In the entourage of the special envoy Andries Friese, he moved to Edo at the end of that year. There his skills caught the attention of high-ranking personalities. At their request, he stayed for another six months after the legation had left. He also spent several months in Edo the following year. The therapies recorded by his interpreter Inomata Dembē (also Dembyōe, 猪 股 伝 兵衛 ) and the interest of high-ranking patients stimulated a sustained preoccupation with Western surgery. The 'surgery in the style of Caspar' ( カ ス パ ル 流 外科 , Kasuparu-ryū geka ) was the first surgical 'school' of Central European characteristics in Japan. From then on, the surgeons and doctors at the Dejima (also Deshima) branch enjoyed the strong interest of Japanese colleagues, who were instructed, bought books, medicines and instruments and gradually acquired the necessary language skills so that they could finally read Western books on their own. These activities led to the 'Hollandkunde' ( rangaku ), which experienced a great boom in the 18th century, then also included other scientific disciplines and enabled the rapid modernization of Japan after the opening of the country in 1868.

With the use of new remedies, interest in replacing expensive Dutch imports with Japanese products grew at the same time, which in the first two decades according to Schambergers led to an exploration of the native flora and the publication of the work Yamato Honzō ( 大 和 本草 , 'Japanese Materia Medica ') led by Kaibara Ekiken (also Ekken) in 1709 to a first high point in the development of an independent Japanese botanical science.

'Hollandkunde' blossoming

The movements that emerged in the second half of the 17th century intensified under the eighth Shogun Tokugawa Yoshimune , who expanded domestic production of medicinal plants and in 1720 relaxed the import restrictions for foreign books. As a result, western specialist texts also came into the hands of interested people outside of the ruling circles. Up to now, the acquisition of the Dutch language has been almost exclusively restricted to the interpreters at the Dejima branch, but thanks to Yoshimune's active support, Dutch language skills have now spread to the regions. Just like the representatives of traditional Japanese surgery, the followers of western surgery ( 蘭 方 医 , rampō-i ) limited themselves to the treatment of wounds, swelling, fractures, dislocations, etc. No knowledge of western pathology was required. Japanese texts on Western anatomy can be found as early as the 17th century, but they played no role in practice. In the 18th century, however, there was a growing interest in anatomy and internal medicine. In addition, a group of scholars appears who can translate Dutch texts into Dejima on their own and independently of interpreters.

Japanese obstetrics

Pioneering in this area was the doctor Kagawa Gen'etsu ( 賀 川 玄 悦 , 1700–1777), who, stimulated by European writings, made intensive observations of his own and in 1765 published a 'treatise on obstetrics' ( Sanron ), which was published by his adopted son Kagawa Genteki was expanded and appeared as Sanron yoku ( 産 論 翼 , 'Explanations to the Tractate on Obstetrics') in 1775 . Thanks to a wealth of experience, Kagawa was more familiar with the position of the fetus during pregnancy and various complications earlier than the European doctors. By the end of the Edo period, around 2000 doctors of this school are proven.

The Japanese obstetricians developed a number of original instruments that could be used to perform extractions on the foot, as well as turns on the foot. A whalebone loop was initially used for extractions. Since head injuries could occur, Kagawa Randai replaced this sling with a silk cloth ( tentōken ), which was placed around the child's head with two whalebone sticks and tightened with a spatula. Kagawa Rankō, in turn, used a silk ribbon instead of the cloth and Tatsuno Ryūtei a silk net ( hōtōki ).

Osteopathic manipulation

Illustration in the 'New Book of Osteopathy' ( Seikotsu Shinsho ) by Kagami Bunken

In the 17th century a therapy direction called Seikotsu-Jutsu ( 整 骨 術 , osteopathy) emerged, which dealt exclusively with dislocations, contusions, dislocations and bone fractures. Particularly noteworthy here are the 'Patterns of Osteopathy' ( 整 骨 範 , Seikotsu han ) by Ninomiya Genka ( 二 宮 彦,, 1754–1827), the 'New Book of Osteopathy' ( 整 骨 新書 , Seikotsu Shinsho ) by Kagami Bunken (1755 –1819) and the 'Compendium of Osteopathy' ( 正骨 要訣 , Seikotsu Yōketsu ) by Yoshiwara Gentō ( 吉 原 元 棟 ).

The groundbreaking precision of the anatomical representations in these works is based on direct observations on corpses found at the execution sites. Many representatives of Japanese osteopathy even surpassed contemporary doctors with a western orientation in the precision of their presentation. Hoshino Ryōetsu ( 星野 良 悦 , 1754-1802) examined the human bone structure in numerous sections and in 1798 made an epoch-making wooden skeleton. Kagami Bunken ( 各 務 文献 ) had already presented images in the Seikotsu Shinsho that were only possible through intensive observation. He then also dissected the corpse of an executed woman and published the results in 1800 as a 'simple illustration of a woman's inner landscape' ( Fujin naikei no ryakuzu ). He also collected human bones and had a wooden skeleton made for him in 1819. There were also several publications in which he disseminated his treatment methods for joint damage and other diseases.

After the Meiji Reform (1868), this tradition developed into the so-called Jūdo therapy, and Japanese orthopedists with a western orientation also see this as one of their roots.

Innovations by doctors of the 'old school'

After the establishment of the Tokugawa rule, the neo-Confucianism developed in China by Zhu Xi ( 朱熹 , 1130–1200) experienced a significant upswing in a form exacerbated by Korean influences. However, there were all sorts of difficulties in applying the complex concepts encompassing man and nature, which soon led to backlash. In the so-called 'School of the Later Age' ( Goseiha , 後世 派 ), the Chinese teachings had been adapted to Japanese conditions, but the therapy proved to be too theory-laden and schematically rigid. The gaze of the critics, especially Nagoya Gen'i ( 古屋 玄 医 ) and Gotō Gonzan ( 後 藤 艮山 ), was therefore directed towards writings from earlier times, such as the Jīnkuì yàolüè asste written by Zhāng Zhong- jǐng要略 and especially to the work Shānghán lùn ( 傷寒 論 , 'Treatise on Cold Diseases'), which was more than 1500 years old at the time , which had placed febrile illnesses caused by cold under clinical observation. This renewal through recourse to the old led to the development of an independent 'old school' ( 古 医 方 派 , ko-ihōha , also kohōha ). Their recipes usually consisted of four to eight ingredients, most of which were vegetable in nature and were comparatively easy to obtain. Modern Kampō medicine has one of its most important roots here.

Japanese hammer needle / knocking needle ( uchibari ) after Mubun, 17th century
Needling with guide tubes ( kudabari ) according to Sugiyama Waichi

Since around the 16th century, Japanese doctors have shown an increasingly clear independence, rejected or changed Chinese concepts and developed their own therapies. To this day, the so-called "hammer needling" or " knocking needling " ( 打鍼 法 , dashinhō ), a therapy developed by the monk Mubun and spread by Misono Isai (( 御 薗 意 斎 )), which ignores the pathways and instead the Takes abdominal region as the place of diagnosis and therapy.

In the "tube needling " ( 管 鍼 法 , kanshinhō ), an invention of the visually impaired acupuncturist Sugiyama Waichi ( 杉山 和 一 , 1610–1694), a guide tube is used to secure the puncture site and the puncture depth. Once made of bamboo or metal, disposable sets with plastic tubes are now used worldwide.

The reactions to impulses from Western medicine were also remarkable. So the first corpse section, which actually collided with the Buddhist-Confucianist attitude towards the human body, was not initiated by a follower of Dutch studies, but by a doctor from the Sino-Japanese tradition, Yamawaki Tōyō ( 山 脇 東洋 ). Yamawaki had encountered discrepancies regarding the body organs while studying the classical scriptures and wanted to review the "nine-organs concept" of the Chinese classic Zhou-Li . The results of the one-day autopsy carried out with official approval on an executed criminal was published in 1759 under the title Zōshi ( 蔵 志 , 'organs'). In terms of content, Yamawaki was soon surpassed by imitators, but his pioneering work and the publication of his findings, which the authorities tolerated, had a great influence on contemporary doctors. There were sections in many parts of the country.

Yamawaki stood next to the body during the dissection and gave instructions on how to dismantle it. The first doctor who overcame his shyness and penetrated the inside of the body with his own hand was Kawaguchi Shinnin ( 河口 信任 , 1736–1811) from a family of doctors who had been involved with Western medicine since the time of Caspar Schamberger . He and his mentor Ogino Gengai ( 荻 野 元凱 , 1737-1806), a court doctor of the Tennō in Kyoto, were no longer looking for confirmation of older concepts. They measured organs, checked and recorded the contents of the intestines, and investigated the connection between the eye and the brain. However, Ogino feared that publication of her findings would cause confusion in the medical profession and unrest among the population, which is why Kawaguchi published the work Kaishihen ( 解 屍 編 , 'Corpse Section ') alone in 1774 .

Notwithstanding his anchoring in traditional medicine, Ogino also made contact with members of the Dutch East India Company (VOC), who stopped in Kyoto every year on their trip to Edo . One of them was the Swedish doctor Carl Peter Thunberg . The head of the Dutch trading station Isaac Titsingh presented Ogino u. a. his work on bloodletting ( Shiraku hen ), in which he combined western bloodletting with the Sino-Japanese tradition of blood puncturing ( 刺 絡 , shiraku ), and another work by his pupil Kimura Taichū. Titsingh also received an acupuncture doll , known as Tsoe bosi, along with a French translation of Kimura's writing by Jean-Baptiste Sarlandière in Europe.

Ishizaka Sōtetsu (1770–1841), a high-ranking acupuncturist at the court of the Shogun in Edo , also set out for new shores . He strove to integrate traditional medicine with western anatomy. After initial explorations with the VOC doctor Nikolaas Tullingh, in 1824 he handed over several of his writings on acupuncture and moxibustion to his successor, the pioneer of Japanese research Philipp Franz von Siebold . Siebold later included excerpts in his work NIPPON.

An international pioneering achievement was accomplished by Hanaoka Seishū ( 華 岡 br 洲 , 1760–1835), who after training with one of the leading representatives of the old school and further studies in Western surgery through a script written by Nagatomi Dokushōan ( 永富 独 嘯 庵 ) Manyū zakki ( 漫遊 雑 記 ) became aware of the problem of breast cancer . Four decades before the first western anesthesia experiments with ether by Crawford Williamson Long led Hanaoka in 1804 a mastectomy by, where he, among others, from Aconitum and Datura alba , a Stechapfelart existing anesthetic to general anesthesia (See. Anesthesia in the Middle Ages began). More mastectomies followed, which attracted a large number of students. Hanaoka belongs to the small group of those doctors whose names are now widely known through novels and television programs.

Introduction of modern western education

For a long time, the boundaries between the different medical directions of the Edo period were less clear than the labels given to them by historiography would suggest. The educated people of all classes had received training in written Chinese and important classics of Chinese philosophy, especially Confucianism, in their childhood and youth, so that adherents of the Dutch studies ( rangaku ) also saw the teachings from the West through Chinese glasses. The groundbreaking Kaitai shinsho (New Book on Anatomy), a complete translation of the anatomical tables by Johann Adam Kulmus , published by Sugita Genpaku in 1774 , is therefore written in (elegant) classical Chinese. On the other hand, people in the traditional camp, especially in the 'old school' ( kohō ha , ko-ihō-ha ), reacted to western impulses. In addition, medical training in whatever direction took place in the traditional social form of the master-student relationship until the 19th century.

The general interest in Western medicine probably got the greatest boost from the introduction of the vaccination developed by Edward Jenner (1749–1823) , which was first successful in 1849 thanks to the lymph brought to Nagasaki by Otto Gottlieb Mohnike . Now the population, which had suffered for so long from the periodic smallpox epidemics , became aware of the therapies offered by Europeans. A little later, the differences became even clearer when the Dutch VOC doctor Johannes Lijdius Catharinus Pompe van Meerdervort set up a medical training center in Nagasaki in 1857, where he taught medicine using a Western curriculum based on the natural sciences. This is considered to be the beginning of modern medicine in Japan.

Medicine based on the German model

With the opening of Japan in the middle of the 19th century, state authorities intervened more and more in the hitherto free world of medical training and practice. Shortly after the fall of the last Shogun of the Tokugawa dynasty, the new government decided in 1870 to introduce Western education and medicine, using German medicine as a model. Initially, traditional practitioners were able to continue their work due to special regulations, but from 1883 additional training in one of the medical colleges ( igakkō , 医 学校 ) and examinations in chemistry, anatomy, physiology, pathology, pharmaceuticals, internal medicine and surgery became mandatory. Attempts to put up resistance against this policy in an organized form failed as a result of internal disagreement and the demise of leading figures in the traditional camp. The attempt made in 1895 to introduce a separate licensing system for conventional medicine was also unsuccessful. During these decades, the name Kampō medicine ( 漢 方 医学 , Kampō-igaku ) came up to delimit the Sino-Japanese teachings from Western medicine. There are certain similarities to the debates in China after 1912, but in contrast to this, the traditional doctors of Japan have not been able to win the support of influential political circles.

Further development in the 20th century

One of the oldest evidence for the word Kampō (James Curtis Hepburn: A Japanese and English Dictionary; with an English and Japanese Index. London: Trübner & Co., 1867, p. 177.)

The increasingly difficult situation of traditional medicine in the second half of the 19th century improved a little at the beginning of the 20th century, as it was no longer perceived as a threat to modernization. Initially, publications such as Wada Keijūrō's "Iron Hammer in the World of Medicine" ( Ikai-no-tettsui , 1910) or Nakayama Tadanao's "New Research on Kampō Medicine" ( Kampō-igaku no shin-kenkyū , 1927) appeared. Doctors such as Ōtsuka Keisetsu , who studied Western medicine, also had a significant influence . As early as 1937, a course in Kampo medicine was set up at Takushoku University . In 1941, Takeyama Shin'ichirō published the "Theory about the revival of Kampō medicine" ( Kampō-ijutsu fukkō no riron ).

At the same time, with the introduction of modern methods in the manufacture of the remedies, the previously laborious manufacture by the doctor, who made and administered the decoctions from his stock of herbs for each individual treatment , was replaced by finished granules, etc. The company founded by Tsumura Jūsha ( 津 村 重 舎 , 1871–1941) in 1893 did pioneering work here and set up its own research institute for this purpose.

The first modern scientific work on moxibustion comes from Hara Shimetarō , who received his doctorate on this subject at the Imperial University of Kyūshū in 1929 . The doctor Fujii Hideji 藤井 秀 二 in turn received his doctorate from the Imperial University of Osaka with the first scientific work on acupuncture.

Since the second half of the twentieth century, the number of doctors who, after their license to practice medicine in Western medicine, complete additional training in kampo medicine has increased. In 1976, many Kampō products were eligible for cash register. Since 1979, departments for kampo medicine have been found at a number of state and private universities and colleges. In the country's pharmaceutical faculties, traditional remedies are being researched with regard to their active ingredients. Western pharmacies also offer one or the other Kampō preparation.

Since 1955 the practice of acupuncture, moxibustion , anma and shiatsu has been recognized as a medical profession and requires the acquisition of a state license. Training in technical colleges and universities of applied sciences includes essential areas of 'western medicine' such as anatomy.

Current situation

The bookstores are filled with books on traditional medicine and the successes in research and practice are unmistakable, but in contrast to Korea and China, the support from the state and politics is still not particularly strong, which has great effects on the international level. Meanwhile, three organizations, the Japan Society for Oriental Medicine , the Medical and Pharmaceutical Society for Wakan-Yaku and the World Health Organization (WHO) have jointly set up a Japan Liaison for Oriental Medicine (JLOM), but this is not a government organization.

In 2011, the Japan Society of Acupuncture and Moxibustion, together with the Traditional Acupuncture and Moxibustion Society, passed a "Tokyo Declaration on Japanese Acupuncture" at a joint congress, which sets out the characteristics of traditional medicine and sets out the baseline for further development. At the same time, efforts are being made to develop a binding curriculum for the training of acupuncturists, etc.

Individual therapies

Intradermal needle ( hinaishin )

acupuncture

Disposable needles with plastic guide tubes are widely used today. In addition to the procedures that are based on the concept of meridians adopted from China, there are others that completely ignore them.

Intradermal needling

When by the acupuncturist Akabane Kōbei ( 赤 羽 幸 兵衛 , 1895-1983) around the middle of the 20th Jhs. developed intradermal needling , Japanese Hinaishin ( 皮 内 鍼 ), a 0.16 to 0.2 mm thick and about 5 mm short needle is inserted obliquely into the skin, secured with a small plaster and left there for one or more days.

YNSA

Among the more recent methods, Yamamoto New Skull Acupuncture (YNSA), which the doctor Yamamoto Toshikatsu developed and published for the first time in 1973, became known. The therapist looks for the smallest changes in the muscles and tissue in areas on the head that correlate with the patient's complaints. YNSA has been shown to be helpful for pain of all forms and neurological disorders.

In addition, there is a wide range of research on non-invasive acupuncture or contact acupuncture (e.g. by Denda Mitsuhiro, Satō Akira, Hotta Harumi) and electro acupuncture ( 良 導 絡 医学 , ryōdōraku igaku ).

Shonishin

In the non-invasive children's acupuncture Shōnishin or Shōni-hari ( 小 児 鍼 , shōni = toddler, shin or hari = needle), which has been practiced in Japan since the early 20th century , usually blunt instruments with linear strokes or with pressure, Tapping and vibration techniques treated without penetrating the skin. This stimulates the indication-related reflex zones, meridian sections and acupuncture points on the trunk and extremities.

The treatment is used in babies, children and adults with susceptibility to infection, asthma and allergies, digestive problems, abnormalities in the musculoskeletal system, sleep disorders. Shonishin has also been used on babies with KiSS syndrome.

Moxibustion

traditional set with moxa from Ibuki

Direct burning

Burning with cones applied directly to the skin in the classic style is no longer too popular because of the burn marks that remain and any pain that may occur. The direct moxibusting propagated by Hara Shimetarō on the point ST36 ( Ashi no Sanri / Zusanli ) to promote the body's defenses has a certain distribution . There is also an extensive trial of prophylactic use against TB in Africa (“Moxafrica”).

Refined moxa

With traditional direct burning, a small burn, and sometimes a blister, occurs on the skin. A slight inflammation was even intended, especially during the Edo period. Sometimes the place was rubbed with slices of ginger and the like. Ä. To promote a slight suppuration. Since the 18th century a refined, high-quality moxa has been made and treated with small, pointed plugs. These go out in the lower part, so that no traces remain on the skin. The procedure is still used today by skilled therapists.

Indirect burning

Finished products sold by various companies, from finished moxa cones on a slightly sticky base to moxa cigars dominate the therapy and are often used for self-treatment.

Illustration of an abdominal diagnosis (palpation) in the style of the Wada family of doctors

cupping

Cupping , which is widespread worldwide, was carried out in Japan with 'suction horns' ( kyūkaku , 吸 角 ) or with leeches. Glass cupping heads ( suitama , literally 'suction balls') have been used since the 19th century .

Kampō

The name Kampō came up in Japan during the second half of the 19th century to delimit traditional medicine from the inflowing western medicine. Although it literally means something like 'Chinese procedures / recipes', 'Chinese direction', Japan developed numerous innovations as early as the Edo period and especially since the first half of the 20th century, which Japanese kampo medicine of of traditional Chinese medicine is clearly different. Some authors have included therapeutic procedures such as massage, acupuncture, and dietetics. In the meantime, however, the narrower version of 'Japanese phytotherapy' has established itself. When making a diagnosis, many representatives of Kampō medicine attach great importance to the abdominal diagnosis (palpation).

Japanese dietetics

The Ishimpō already contains detailed chapters on the way of life including the food taboos. During the Edo period, the Japanese teaching of the way of life, Yōjōron ( 養生 論 , 'care of life'), through writings such as Yōjōkun ( 養生 訓 ) by the neoconfucian Kaibara Ekiken experienced a great boom. Points of contact with Western writings from Hippocrates ' treatise On Air, Water and Locality to Christoph Wilhelm Hufeland's Macrobiotics or The Art of Extending Human Life (1796) were mapped out.

Towards the end of the 19th century, the military doctor Ishizuka Sagen ( 石 塚 左 玄 , 1850–1910) tried to harmonize traditional Japanese teachings with Western science in writings such as Theory of Longevity through Scientific Nutrition and General Method for Caring for Life through Nutrition (1898). The Shokuyō-kai movement ( 食 養 会 , 'Society for the Care of Life through Nutrition'), which was founded in 1907, was based on these concepts . It spoke out against Western eating habits and found strong support in politics, business and military circles.

Sakurazawa Yukikazu ( 桜 沢 如一 , 1893–1966), who was able to overcome tuberculosis in his youth by following this advice , later developed Ishizuka's concepts further as president of the Society for the Care of Life through Nutrition and made them under the name of Georges Ohsawa with the Macrobiotics adopted by Hufeland, also known in Europe and the United States .

Manual body therapies

Anma

The manual therapy anma ( 按摩 ; chin. Ànmó , dt. "Press and rub"), which came into the country since the early days of Japanese medicine, developed into an important professional field for the visually impaired during the Edo period. In China, the name Tuina ( tuīná ; Eng . " Push and grab") was introduced in 1571 on the occasion of a reorganization of the medical disciplines , in Japan the old name was retained. At the same time, the differences gradually became clearer. The anpuku ( 按 腹 ; fuku / - puku , dt. "Belly") called massage of the abdominal region was also widely used. During the reorganization of the health system in the second half of the 19th century, massage therapists were less affected, which had a lot to do with securing the livelihood of the visually impaired. However, professional training and, since the beginning of the 20th century, the acquisition of a license became mandatory.

Shiatsu

Shiatsu (指 圧 , "finger pressure") is abody therapy that emergedfrom the early modern forms of Sino-Japanese massage ( anma ). At the beginning of the 20th century, various forms of manual pressure and stretching methods were combined under this namein Japan in order to differentiatethemselves from relaxation massages and to secure a place in the western-dominated health system. Depending on the school, individual points or channels ( meridians ) are treatedwith fingers, hands, elbows, knees, and feet. In the field of veterinary medicine, Shiatsu is used particularly in the treatment of horses. Since the second half of the 20th century. There are also many derivative forms of treatment, such as water Shiatsu ( Watsu ), Seiki , Kiatsu , Ohashiatsu , Quantum Shiatsu , etc.

Sōtai

Sōtai ( 操 体 , dt. "Manipulation of the body") is a body therapy developed by the Japanese doctor Keizō Hashimoto (1897-1993) on the basis of Sino-Japanese traditions, which, combined with a special breathing technique, emphasizes the comfortable direction of movement a positive perception of the body, the sustainable release of tension and a neuromuscular restructuring aims. This reverse motion treatment was later called the sudden relaxation technique . Eventually, the name Sōtai , a reversal of the term Taisō (gymnastics), established itself .

Judo Therapy (Judo Seifuku Therapy)

The Judo therapy or judo Seifuku therapy is a martial arts and same name on the osteopathy of the Edo period declining non-invasive therapy, which was first recognized in 1920 by the Japanese Ministry of the Interior. Further legal regulations followed in 1970. It is mainly used for bruises, broken bones, dislocations, etc. The judo therapist ( 柔道 整 復 師 , Jūdō Seifukushi ) needs a license to practice, as with acupuncture. In 2001 this therapy became internationally known through a report by the World Health Organization ("Legal Status of Traditional Medicine and Complimentary / Alternative Medicine: A Worldwide Review").

Traditional Japanese Medicine Societies

There is a useful English overview by Shūichi Katai

See also

literature

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Individual evidence

  1. ↑ Fujikawa (1911), pp. 1-3; Rosner (1989), pp. 9-11.
  2. ^ Sōda (1989), pp. 6f .; Michel-Zaitsu (2017), p. 25f.
  3. ↑ Rosner (1989), p. 12ff .; Michel-Zaitsu (2017), p. 27ff.
  4. ^ Heidrun Reißenweber: Japanese Medicine. 2005, p. 689.
  5. ↑ More on the Imperial Health Department at Shinmura (2005)
  6. ↑ More on this in Mishima (2004).
  7. ↑ Rosner (1989), pp. 26-28; Michel-Zaitsu (2017), p. 37ff.
  8. ↑ Michel-Zaitsu (2017), pp. 40ff.
  9. ↑ Michel-Zaitsu (2017), p. 44ff.
  10. ↑ Rosner (1989), pp. 34-38; Goble (2001)
  11. ↑ Michel-Zaitsu (2017), p. 52ff.
  12. ↑ Michel-Zaitsu (2017), p. 52ff.
  13. ↑ Image file of the edition by Inaba Fuminori and Wakuda Yoshitora on the website of the Waseda University Library
  14. ↑ Rosner (1989), p. 48f., Michel-Zaitsu (2017), p. 56f., 101
  15. ^ W. Michel: Early western observations on acupuncture and moxibustion. Sudhoff's Archive, Vol. 77, No. 2 (Stuttgart 1993), pp. 194-222. ( Document as PDF )
  16. ↑ Michel-Zaitsu (2017), p. 61ff.
  17. ^ Sōda (1989), pp. 25f .; Michel (1999); Michel-Zaitsu (2017), p. 52f.
  18. ↑ More from Wolfgang Michel: Medicine, Remedies and Herbalism in the Euro-Japanese Cultural Exchange of the 17th Century. In: Horin - Comparative Studies on Japanese Culture. No. 16, 2009, pp. 19–34 ( Digitized in the Kyushu University Institutional Repository ( Memento of the original from October 10, 2013 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link accordingly Instructions and then remove this notice. ) @1@ 2Template: Webachiv / IABot / qir.kyushu-u.ac.jp
  19. ↑ Rosner (1989), p. 86
  20. ↑ Fujikawa (1911), pp. 79-82; Michel-Zaitsu (2017), p. 133ff.
  21. ↑ Image files in the collection of Waseda University.
  22. ↑ Tucked away at Hiroshima University today. Website of the medical faculty ( Memento of the original from October 10, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.hiroshima-u.ac.jp
  23. ↑ Fujikawa (1911), p. 66. Fujikawa's reading of the name is incorrect; Michel-Zaitsu (2017), p. 169ff.
  24. ↑ Michel (1993b)
  25. ↑ Michel-Zaitsu (2017), p. 82ff.
  26. ^ Sōda (1989), pp. 139ff .; Michel (2001)
  27. ↑ Macé (1997)
  28. ^ Sōda (1989), p. 168; Michel (2001)
  29. ↑ Michel (2008)
  30. ↑ Macé (1995)
  31. ↑ Matsuki (2011); Matsuki (2017)
  32. ^ Sōda (1989), pp. 280ff .; Jannetta (2007)
  33. ↑ Oberländer (2003)
  34. ↑ Otsuka (1976)
  35. ↑ See Tsumura (1991)
  36. ↑ Michel-Zaitsu (2017), pp. 284ff.
  37. ↑ Skull acupuncture (German version) ( Memento of the original from October 10, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. ; s. a. Zeise-Süss (2009) @1@ 2Template: Webachiv / IABot / www.schaedelakupunkt.com
  38. ↑ Yoneyama / Mori (1964), pp. 7-20; Wernicke (2014), pp. 26–28
  39. ↑ Yoneyama / Mori (1964), pp. 9-42; Tanioka (1998); Wernicke (2009), pp. 91-94; Birch (2011), pp. 29–42, Wernicke (2014), pp. 72–89
  40. ↑ Yoneyama / Mori (1964), pp. 46-60; Wernicke (2009), pp. 129-218; Birch (2011), pp. 101–245, Wernicke (2014), pp. 117–207
  41. ↑ Wernicke, Thomas: Shōnishin and KiSS syndrome - New ways in the acupuncture treatment of asymmetrical babies. German journal for acupuncture, Vol. 2, No. 56, 2013, pp. 6-11.
  42. ↑ For use in today's Japan, see Nishimura (2009).
  43. ↑ Reißenweber (2001), Oberländer (2003), Eberhard (2003), Tsumura (2003), Nishimura, Plotnikoff, Watanabe (2009)
  44. ↑ 化学 的 食 養 長寿 論 , Kagakuteki shokuyō chōju ron. Hakubunkan, Tōkyō 1896.
  45. ↑ 通俗 食物 養生 法 , Tsūsoku shokubutsu yōjō-hō. Hakubunkan, Tōkyō 1898.
  46. ↑ Nakamura, Arnoldi (2003)
  47. ↑ Masunaga, Ohashi, 2002.
  48. ^ Hashimoto, Kawakami, 1983
  49. ^ Department of Acupuncture and Moxibustion Tsukuba University of Technology: Academic Societies related to Japanese Acupuncture and Moxibustion. In: The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM). Volume 1: Special Edition: Current Japanese Acupuncture and Moxibustion. 2010, pp. 98-101. (pdf; 64 kB)