The Origins, Rises, and Falls of Kampo Medicine in Japan
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Traditional Chinese medicine has roots in the Japanese health care system dating as far back as the fourth and fifth centuries (Lock 1980, 50). Although the historical record is incomplete, Japanese sources indicate the Japanese military were setting up military outposts in Korea by A.D. 366 (Best 2006, 48) (Lock 1980, 50). During this period, there was a significant increase of cultural flow between Japan and Korea, as many ideas, beliefs and technologies crossed national borders. In fact, even people moved across these boundaries. Before long, Korean exposure to Japan led to the introduction of “the Chinese script” and the importation of many Chinese writings – all of which had great influence on Japanese “scholars and priests” (Lock 1980, 50). A small number of Korean medical physicians extended the Korean-Chinese influence further by practicing Traditional Chinese Medicine (TCM) in Japan (Lock 1980, 50).
Japan and Chinese Influence
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Though an important part in the development of TCM in Japan, at this point, the Korean influence of Traditional Chinese Medicine had not penetrated into the core of Japanese medical ideology; many Japanese continued to practice and/or seek out indigenous Japanese medicine (Lock 1980, 50) (Long 1987, 67). However, by the sixth century, “[w]hen the Chinese were united under the Sui dynasty […] and Buddhism was officially declared acceptable,” Chinese ideologies and practices grew in popularity and swept through the country (Lock 1980, 50). “As Buddhism gained ground, imposing temples were built in [Japan in] Chinese style,” resulting in an unprecedented flow of Chinese culture throughout Japan (Benton 1976, 60). Japanese Prince Shotoku sent scholars to China to learn more about the culture of Chinese people. But these traveling scholars brought back more than just stories of culture. They returned with fanciful stories of the Chinese T’ang dynasty that led Shotoku to believe China was superior to Japan (Benton1976, 60).
The Japanese people felt threatened by this and worried their current political structure was subordinate to China’s, leaving Japan vulnerable to Chinese attack. To establish security against possible foreign invasion, the Japanese government enacted the “Taika reforms,” which provided “a system of centralized government with the emperor as absolute monarch [at] its head” (Benton 1976, 60). In 660, China tested the strength of Japan’s reformation by sending its military to Korea to overthrow the “Korean kingdom of Paekche,” a Japanese ally (Benton 1976, 60). Although Japan provided military support to Paekche, the power of the Chinese military proved itself too strong for the Japanese and Korean military to fend off, ultimately ending in the culmination of their defeat in 663 (Benton 1976, 60). Shortly after this failure, Japanese Prince Nakano Oe took over the position as emperor and began to enforce changes on the Taika reforms to “to make it more suitable to the practical needs of the state” and to provide better protection against foreign attack. In doing so, Prince Oe formulated “written codes” to serve as the basis of the Japanese political structure (ritsu-ryo). These codes, also known as the Taiho codes, were “imitation[s] of the lu-ling of T’ang China and incorporated some of its articles just as they stood” (Benton 1976, 60).
Buddhism and Politics
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Similarly to the Chinese government, the Japanese emperor was given full reign over the country’s political sphere. But, in contrast to the Chinese model, the Japanese emperor “was also [named] the traditional high priest [in charge of maintaining] peace for the land and people by paying tribute to the gods and sounding out their will” (Benton 1976, 60). This system of dual authority gave the emperor the power to enforce upon the people of Japan his particular spiritual and political ideologies. As a result, in the eighth century, Emperor Shomu “introduced strong doses of Buddhism into [the] government” (Benton 1976, 61). Shomu believed “that the Buddhist faith was a means to ensuring both the happiness of the individual and peace for the country as a whole” (Benton 1976, 61).
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The integration of Buddhist ideals with the Japanese political structure sparked change on the whole system and organization of the government. For instance, in 702, the emperor devised a new “ministry of health” made up of several health “specialists,” including a “minister of health,” physicians, doctors, and “students of medicine,” acupuncture, massage, and magic, as well as herbalists and “nonacademic staff members” (Lock 1980, 50-51). But, “[o]ne of the most important subdivisions of the ministry was devoted to the study of natural phenomena; its purpose was to help the government in making political decisions. It was called the ommyo-ryo, or the ‘Bureau of Yin Yang” (Lock 1980, 51). In East Asian Medicine in Urban Japan, medical anthropologist Margaret Lock says this subdivision of the ministry was responsible for making sense of the theories central to “Han Confucianism,” such as “the yin/yang theory, the five-phase theory, and numerology” (1980, 51). If the Japanese were going to mold their government after the Chinese, it was crucial for them to know “the philosophy that justified the system.” Such knowledge would enable Japanese elites to interpret other Chinese texts and provide the necessities to have “a satisfying, unified, and orderly system for explaining all phenomena” (Lock 1980, 51). This set the stage for Japanese officials and scholars to learn and better understand Chinese medical transcripts, eventually leading to increased usage of Traditional Chinese Medicine (Lock 1980, 51).
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In Japan, however, the practice of pure Traditional Chinese Medicine has serious, practical limitations. The Chinese medical literature asks for certain herbs and “raw materials” nonnative to Japan. Consequently, in the eighth century, much effort went into tracking down such material from neighboring lands; a fact that played privilege to Japanese elites more than anyone else. For the majority of Japanese physicians, importing raw materials was not a plausible option. Instead, many “doctors […] had to make do with mixtures of folk medicine and true kanpo,” in which they had easy access to (Lock 1980, 51). Furthermore, none of the medical literature had been translated into native tongue, placing severe barriers on potential practitioners who lacked literacy in the Chinese language (Lock 1980, 52). For the country’s non-elitists, TCM “spread [largely] through the work of Buddhist priests” who often used modified versions of Traditional Chinese Medicine, introducing a variety of style to the practice (Lock 1980, 52).
The Invasion of Foreign Influence
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Finally, in 984, Yasuyori Tanba translated the nation’s “first [Chinese] medical text [into] Japanese” (Lock 1980, 52). Tanba aimed for a translation consistent with the original meaning of the texts, and provided a comprehensive description of the different ailments and therapeutic remedies TCM has. Also, he gives a Japanese written explanation of Buddhist theory and its special elements (Lock 1980, 52). This easy-to-read translation provided the means for many Japanese to gain a deeper understanding of Chinese healing and its theoretical frameworks. Undoubtedly, this new found access sparked further growing interest in the field of Chinese medicine – up until around the twelfth century, that is (Lock 1980, 52). Due to political reasons, many of the Japanese began to distrust Buddhists and Buddhist theory. People were pouring their money into Buddhist temples, and, when “the temples gradually amassed vast wealth, […] monks acquired high political positions and began to interfere with secular affairs” (Benton 1976, 61). At the point “when it seemed to them that the evils of Buddhistic government were threatening the future of the nation, they set on the throne a new emperor, […] who had no leanings toward Buddhism” (Benton 1976, 61).
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Then, in “the Kamakura period,” between 1192 and 1333, continuing conflict pushed for more change. The emperor was unhappy with all of the foreign influences that were shaping Japan, and imposed new laws to take the country back to its traditional Japanese roots. He officially put an end to the Taiho code, and the “medicine at the court went into […] decline” (Lock 1980, 52). During this period, interest in Chinese medicine sank and it was relieved of its superior social status. From the fourteenth to sixteenth centuries, lots of doctors began practicing medicine on samurai warriors in the field. Heavy traveling called for simpler medical techniques and less equipment to travel with (Lock 1980, 52). By and large, “[t]hese doctors abandoned the classics completely and developed highly pragmatic, simple theories, which were handed down orally” (Lock 1980, 52-53). But just when Chinese medicine seemed to have lost its sway, it shot up in popularity once again “in the fifteenth and sixteenth centuries” (Long 1987, 68).
The Division of Schools
The Division of Schools
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Zhu Xi’s “Neo-Confucian medical theory and practice brought about a revitalization of Chinese-style medicine in Japan, and an elite of secular physicians emerged who served government officials, samurai, and townspeople” (Long 1987, 68). This new style focused special attention on empiricism, and used observations of the natural world to guide its practice (Kasulis 1995, 231). Though many of its practitioners were practicing under the same medical theory, few had the same interpretation of how to execute it. By the sixteenth century, Manase Dosan tried to standardize the teachings into a “systematized and formalized” practice. Eventually he did, and the goseiha school of medicine was born. But, a century later, other Japanese challenged the teachings of this new school, and argued for a refocus on the teaching’s original interpretations (Long 1987, 68). Like Dosan, this group opened their own school of medicine, kohoha, whose teachings were to stay consistent with early Chinese classics (Long 1987, 68).
Though the goal of kohoha was to follow the teachings of Chinese texts closely as possible, “lack of raw material” was still a definite problem (Lock 1980, 51). On top of that, centuries of up-and-down practice brought about a slightly simplified version of the texts, and practitioners began to place more emphasis on empirical methods (Long 1987, 68). In “Health Care Providers: Technology, Policy, and Professional Dominance,” Otsuka suggests that this division between the two schools led to a “Japanized goseiha medicine” (Long 1987, 68). But the division wasn’t truly so dichotomous. Many practitioners developed methods incorporating aspects from both schools, as well as a few of their own (Long 1987, 68). This trend continued with the introduction of Western medicine in the sixteenth and seventeenth centuries – the lines separating competing schools of thought were blurred, and practitioners utilized many different medical techniques, technologies, and practices (Long 1987, 68-69).
Western Contact
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In the sixteenth century, Spanish and Portuguese missionaries landed in Japan to spread the teachings of Christianity. This Western-Eastern contact then opened the doors for new areas of trade (Kasulis 1995, 229). Early on, the Japanese were impressed with “Western surgical technolog[ies],” and, after enough exposure, some may have even come to prefer Western healing methods (Long 1987, 69). But Japan also admired Western “military technology of rifles and canons” (Kasulis 1995, 230). With their more traditional ways, Japan was beginning to see itself on the peripheries of power, subordinate to the West (Kasulis 1995, 230). Many thought adopting certain Western technologies could help Japan gain back some of the power thought to be lacking. In the middle of all of this, Japan was in a “state of civil war,” and in need of “unification under a new military-political order” (Kasulis 1995, 230).
To aid his “rise [in] power,” military dictator Oda Nobunaga studied and mastered the new, more efficient Western military weapons, and then used them to gain control of the country (Kasulis 1995, 230). However, Nobunaga’s attempt to unify the country was not met without opposition. There were strong political and ideological conflicts between the followers of Nobunaga and Buddhist factions. Nobunaga feared these factions because they were often composed of thousands of armed militia, and could band together against him at any time (Kasulis 1995, 230). To weaken this Buddhist threat and strengthen unity, Nobunaga used his power to persuade the country to adopt Christianity. During this time, “Christianity was not only tolerated, but […] encouraged” (Kasulis 1995, 230). But, this period of strong Western influence was only short-lived (Kasulis 1995, 230).
Japan Closes Its Doors
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By the seventeenth century, the push toward the Christian faith was not seen as unifying. Japanese rulers had suspicion Japanese Christian converts “might [form] spiritual bond[s] with priests connected to the imperialist courts of Europe,” and undermine the sovereign’s right to power and ability to control his country (Kasulis 1995, 230). The efficiency and easy-to-use style of Western military weapons added further concern to the establishment of order, as Japanese elites worried “peasant[s] can be taught to fire a rifle in a few hours and kill a samurai swordsman who has spent decades perfecting his skill” (Kasulis 1995, 230). On top of all this, Japan had become well aware of European colonization trends, and paid notice to the historical correlation between arrival of Christian missionaries and development of military posts. It wasn’t long before the Japanese elites acted to enforce change and rid the country of Western influence. In fact, after outlawing Western firearms, Japan closed down its borders, cutting off contact to most of the Western world.
This closed-door policy lasted for close to 250 years, only allowing in few for the special exception of trade (Kasulis 1995, 231). For most of this period, Japanese physicians practiced the Neo-Confucian interpretation of Chinese medicine, not the Western medicine alternative. In “Sushi, Science, and Spirituality: Modern Japanese Philosophy and Its Views of Western Science,” Thomas Kasulis writes, “Neo-Confucianism framed its naturalism within a social ethic, a dimension of its system that the shogunate could use as part of its state ideology” (1995, 231). But not even closed borders could keep Western influence out of Japan. The Dutch continued to trade with the Japanese, resulting in a gradual increase of Japanese interest in Western medicine and surgical techniques (Long 1987, 69). Then, in 1774, the popularity of Western medicine rose high. Western surgical techniques impressed many Chinese-style physicians, until finally Sugita Genpaku partnered with other Japanese scholars to publish a Japanese translation of “the German anatomy book, Anatomische tabellen” (Long 1987, 69).
After Genpaku’s Japanese translation, Western medicine achieved new status, and was put on more or less equal grounds with Traditional Chinese Medicine. The impressive Western surgical displays made possible through the Japanese translation sparked interest in other aspects of Western medicine as well, such as the field of internal medicine. Eventually, this interest led to the first Japanese translation of “Western internal medicine” in 1793 (Long 1987, 70). From this point on, Western medicine became an official practice for many Japanese physicians. Western medical schools began opening, and translations of Western texts started circulating within the general public (Long 1987, 70). This gave rise to yet another category of medical practice available to the people, increasing the diversity of ideas and methods medicine had to offer. Then, in the 1840’s, the Japanese government attempted once more “to rid itself of foreign influence” (Long 1987, 71). The Ruling power sought to govern the medical field by adopting and enforcing a medical practice that was basically a combination of the goseiha and kohoha schools, called the Taki school (Long 1987, 70-71). In her article “Health Care Providers: Technology, Policy, and Professional Dominance,” anthropologist Susan Long writes, “[t]he Taki family had come to control the government’s Medical Bureau […] [serving] as personal physicians to the shogun” (Long 1987, 71).
Japan Opens Its Doors to Western Medicine
In 1853, the hope of resisting outside influence was shattered. American “Commodore [Matthew] Perry forced Japan to open its ports to trade with the West,” and Japan was unable to refuse (Kasulis 1995, 231). This time, Western influence was stronger and “Japan felt squeezed and threatened” by the recent geopolitical moves that Western countries were making to extend their power across the globe (Kasulis 1995, 231). Long says, “[t]he government was now convinced that the only way to remain sovereign was to adopt foreign technology, particularly military technology” (1987, 71). That is not to exclude, however, the technologies of Western medicine. The introduction of new Western vaccinations gave the Japanese a new and reliable way of preventing illness (Long 1987, 71). For the most part though, Western medicine and TCM were seen as equal. That is, until 1858, when Chinese medicine “failed to cure the ailing shogun” (Long 1987, 72). By the end of the century, the Japanese government started to favor Western medicine and “adopted a policy” to promote it (Long 1987, 72).
As part of the new policy, the Japanese government began to fund Western medicine schools and hospitals. In fact, the government even implemented laws forcing Chinese medicine practitioners to obtain a license in biomedicine if they wished to practice medicine the traditional way (Long 1987, 72). This regulation discouraged many physicians away from studying Kampo because obtaining a degree was costly, not to mention it added additional years of study on top of an already lengthy process (Long 1987, 72-74). In conjunction with Japan’s burning desire to modernize, these policies led to a general dismissal of Traditional Chinese Medicine and the full, official adoption of Western biomedicine.
Traditional Chinese Medicine, or Kampo, is currently staging a comeback in Japan. The harmful side effects that often accompany Western biomedicine are under scrutiny, and many are choosing to engage in less risky medicinal therapies. Public awareness rose on the potential risks associated with biomedicine when a major drug corporation in Japan, the Ciba-Geigy, introduced an unsafe drug into the market that was found to cause serious illness and death (Tsumura 1991, 30). Akira Tsumura, author of Kampo: How the Japanese Updated Traditional Herbal Medicine, says “[n]o greater fallacy exists about medicine than that a drug is like an arrow that can be shot at a particularized target. Its actual effect is more like a shower of porcupine quills” (1991, 35). This “porcupine effect” may be impossible to ascertain beforehand, and places serious risk on those patients with weak immune systems, such as children and the elderly. This is particularly important because, in the last 50 years, Japan has been experiencing a rising increase in its elderly population and “geriatric diseases such as stroke, cancer, heart disease, and dementia have become more common” (Takayanagi 1998, 503). In many such cases, patients like these are seeking out the less potent herbal remedies found in Traditional Chinese Medicine (Tsumura 1991, 30-31).
But people are not turning to Kampo only for those reasons. Western biomedicine has had little success treating chronic diseases such as cancer and diabetes. Though scientific proof may be lacking, patients and physicians agree that TCM is effective in treating such illnesses (Tsumura 1991, 31-53). They also agree that TCM is effective in treating acute diseases. Others refuse to believe that herbal remedies and practices such as acupuncture and moxibustion have healing properties, at least not until scientific evidence suggests otherwise. Nevertheless, Kampo has made itself prevalent in Japan once again. Though, its future is yet undecided (Tsumura 1991, 31-53).
The Sociocultural Framework of Japan
To appreciate the historical origins, period of public dismissal, and recent revival of Traditional Japanese Medicine (TJM) in Japan, one must contextualize the practice of TJM within Japan’s unique sociocultural framework (Lock 1980, 11). Several factors contribute to Japan’s success in adopting and adapting Traditional Chinese Medicine to fit succinctly with traditional Japanese values, spiritual beliefs, and political agendas. But, at the same time, there are factors working in opposition to such cohesion which threaten to denounce the legitimacy of TJM. Time and length constraints of this paper limit the focus to just a sample of the plethora of literature and information available on these topics. However, the goal is not to provide a comprehensive review of everything that is relevant to the matter, but rather to offer an insightful overview of important social conditions helping shape, reinforce, and challenge the Japanese conception and practice of Traditional Chinese Medicine. In this paper, areas of interest include an analyzation of the ideological similarities and differences between traditional Japanese spiritual beliefs, such as Shintoism, and TJM (or Kampo). We will also explore Japanese notions of the body and mind, the relationship of the individual to nature and society, and the social significance of health and medicine. After considering these sociocultural characteristics of Japan, it becomes clear how Kampo fits into the overall social structure and helps explain its continuing importance in society today.
Shintoism, Buddhism, and Traditional Chinese Medicine
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To begin with, in East Asian Medicine In Urban Japan, Margaret Lock says “[m]edical systems, like social systems in general, are embedded in a cultural matrix from which is derived the coherent body of ideas of which the system is composed. The practice of all medicine […] has evolved as a result of its setting in a unique cultural context” (1980, 11). In Japan, the adoption and evolution of TCM is no different. The Koreans and the Chinese brought Traditional Chinese Medicine, which is “couched in Confucian, Taoist, and Buddhist terms and presented in Chinese script,” to Japan amidst the backbone ideology of the time – Shintoism (Lock 1980, 45). But this mixing of ideas did not expunge one ideology or the other; rather, the Japanese found a way to promote their coexistence. Now, centuries after the initial adoption, these ideologies live side-by-side as dominant forces of thought. In a 1994 article in the New Perspectives Quarterly, “Descartes, Brain Death and Organ Transplants: A Japanese View,” Takeshi Umehara says “[t]he majority of Japanese today practice Shintoism and, at the same time, Buddhism [and that] these are both so deeply woven into the daily life of Japanese that they are not much noticed at the conscious level” (1994, 25-26). Nonetheless, one might wonder how this came to be.
There are several reasons why the Japanese were able to reconcile their Shinto beliefs and pre-TCM medical practices with Traditional Chinese Medicine and Buddhism. Perhaps the most convincing reason though is that these ideologies share some fundamental characteristics. Lock says that “the concept of preventive medicine is common to both traditions, and in both systems the individual [is] required to take positive steps to maintain his health” (1980, 45). Such preventative measures include maintaining a healthy diet, avoiding “dirty and potentially dangerous” areas, getting an appropriate amount of physical exercise, and having a deep awareness of one’s body and bodily functions (Lock 1980, 81-96). In TCM and TJM, these activities are thought to keep the body’s internal flow of energy (in Kampo, ki) in balance, which is important because an imbalance of ki can cause health problems such as disease and illness. Thus, a central part of both is living in harmony with one’s surroundings. But Shinto followers use these preventative measures for a different reason – to safeguard themselves not from an imbalance but from a state of “pollution” (Lock 1980).
This idea of pollution is in conflict with the TCM notion of balance because it classifies the external agents which cause disease as inherently negative regardless of the amount. Instead of understanding these agents as actors in part of an overall balancing mechanism that have value in small amounts, they are seen as toxins that must be purged from the body (Lock 1980, 45). While these “[a]ttitudes toward [the] causality” of disease may seem irreconcilable, they are compatible in at least one nontrivial regard – both belief systems attribute “disease causation” to “external agents” (Lock 1980, 45). Lock argues that “the external agents of disease causation in the Chinese system could have easily been redefined as objects causing pollution,” making the adoption of TCM less threatening to traditional Japanese beliefs (Lock 1980, 45, 88).
Beyond ideas of preventative health though, Shintoism and TCM share other principles that aid in the success of the juxtaposition of the two. For instance, both Shintoism and Buddhism, which lie at the foundation of Traditional Chinese Medicine, believe all living things to be equal, and that all forms of life “share the same essence which flows through [them] in eternal cycles.” This concept has roots stretching far back in time to the “Paleolithic Age,” where man was still at the mercy of his environment and did not yet see himself at the center of the universe (Umehara 1994, 26). This view of equality is a precursor to the idea of living in harmony with the environment and with other living things (1994, 27). Consequently, the “Buddhist-derived philosophy” of TCM which “tend[s] to emphasize unity, harmony, and balance” can be understood under the Shinto belief system that stresses the equality of all life forms (Lock 1980, 88) (Umehara 1994, 26). As a result of these similarities, the Japanese were more easily able to rationalize the introduction of Traditional Chinese Medicine and its Buddhist principles. Today, these ideologies still operate together in Japanese society and influence fundamental ideas of everyday life that are important to Kampo, such as the relation between the mind and body. This mind-body relationship is central to the Kampo practice and differs greatly from the traditional Western conception.
In America, as well as much of the Western world, the mind and body are seen as two distinct entities. The body is simply the mechanism in which the self, or the mind, resides. As such, Western science tends to study the body and mind separately. It believes “that [man’s] body is but matter, an organic machine that can be managed and manipulated through the replacement of parts” (Umehara 1994, 27). Much of the West’s anatomical knowledge is “learned through the dissection of corpses or vivisection of animals, neither of which allows access to the functions of the conscious human body” (Kasulis 1995, 240). To study a heart, one can simply remove the organ from a dead body and examine its structure and then make inferences from observation. One may also study the heart by examining its functions in a patient undergoing major surgery. But by-and-large, when one studies the heart under the methodology of Western science, one strives to do so with as little variables as possible so that one can understand its function independent of other factors.
In Western medicine, one does not study a heart by examining seemingly unrelated parts of the body, or by trying to understand the emotional state of the person. Even with recent advances of knowledge in the physiological aspects of “organs and their biochemical functions,” Western scientists tend to limit their perspective to the simplest explanation. Consequently, this view of the body bleeds over into how medical professionals interpret illness and disease. By singling out a specific area in the body where an illness manifests itself, doctors believe they can determine a cause-effect relationship that explains the presence of an illness and gives clues as to how to cure the illness (Kasulis 1995, 240). The goal of Western medicine then is to target the malfunction and fix it, with hopes that such a fix will cure the problem indefinitely. Since the goal is to fix a specific problem, a diagnosis in Western medicine need not consider the patient’s mind or parts of the body that are seemingly unrelated to the malfunction in question. But diagnosis and interpretation of illness and disease are, at least partly, dependent on how one conceives of the mind-body relationship.
Japanese philosopher Yuasa Yasuo has a tough time conceiving of how “the body can be understood independently of the mind, the physical mechanism independently of consciousness” (Kasulis 1995, 240). Umehara expands on this same idea saying “[i]n the Shinto belief which has informed Japanese thinking for millennia since the forest civilization flourished […], the spirit whose essence recycles eternally is in the body and in all living things, not just in the egotistical mind that posits ‘I think, therefore I am.’” He goes on to say, “‘We are, therefore I think’ is much closer to our way of apprehending reality […]” (Umehara 1994, 25). This reversal of the more familiar Cartesian statement puts emphasis on the body rather than the mind and, and, by using the word “we,” draws connections between one’s own consciousness and the outer world. In this line of thinking the mind, body, and the natural world are seemingly inseparable.
Similarly, in “Sushi, Science, and Spirituality: Modern Japanese Philosophy and its Views of Western Science,” Thomas Kasulis equates the study of the human body without relation to the mind to a “study of electromagnetism with the electric current turned off” (1995, 240). Clearly, electromagnetism cannot be understood by electricity or magnetism alone; instead, it requires knowledge of the interaction between both forces, and is probably better understood as its own force all together. The body and the mind are the same way – true knowledge of the body does not come from singling out its parts because in the process one loses understanding at a deeper level. Each of these accounts gives insight into the Japanese conception of the mind-body relationship and signifies the strong connection between the two. The next question is how this conception of the mind-body relationship is relevant to the practice of Kampo.
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Kampo offers an explanation that connects the mind and body through a system of interconnected meridians which serve as pathways for the flow of ki which make up the entire energy supply of the mind-body (Kasulis 1995, 241-42) (Tsumura 1991, 27-28). In contrast to Western medicine which has a standardized diagnosis method that involves pinpointing a specific malfunction and treating it, Kampo medicine views illness and disease as the physical manifestation of an imbalance of ki and as a result of a “problem [that] lies deep in the organs that are weakened, and unable to resist attacks by toxins and bacteria” (Tsumura 1991, 21-22). Therefore, illness cannot be explained simply by its physical manifestations. One must consider the dynamic relationship between all the different parts of the body and mind and even external agents outside of the body and mind. Thus, the goal is not to simply treat and cure the physical manifestation itself, but to “discover the true [source] of [the] illness” and to develop a plan to restore the body and mind back to a healthy, balanced state (1991, 31).
For example, consider the differences between the ways Western medicine and Kampo might go about treating a patient suffering a headache. Whereas a Western doctor will likely only “examine [the patient’s] head,” a Kampo physician will ask many questions about the patient such as what his or her dietary intake is like and what the patient’s social circumstances are. He will then inspect many areas of the body in an attempt to draw connections to the headache, like the patient’s heartbeat and tongue, which a Western doctor would completely ignore (Tsumura 1991, 49). Finally, the Kampo physician will diagnose the patient to a condition that is particular to him or her and then prescribe a treatment that is specific to his or her diagnosis. However, because the diagnosis and treatments consider so many factors that are particular to the patient’s unique circumstances at one moment in time, the diagnosis and treatments can and will change over time as the patient’s physical, mental and social circumstances do.
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Unlike Western medical treatment that uses universal standards of diagnosis and has a standardized method of prescribing medicinal treatment for each diagnosis, Kampo appreciates the context that is particular to each patient and strives for an understanding of the patient’s condition beyond that of which is seen in a specific physical manifestation. By treating only the specific area that is troubling the patient, the root of the problem is left unaddressed. Clearly, Kampo fits in well with the Shinto and Buddhist principles that stress holistic understandings of the body and mind and which value balance and harmony in life and nature. With this in mind, it is easy to understand the advantage Kampo has over Western medicine – it respects a collective representation of the mind and body. But in order for one to recognize this connection or to experience what harmony or balance feels like, it is necessary to be in tune with one’s body and mind. Such attunement begins at an early age for many of the Japanese and can be seen in Daniel Walsh’s “Frog Boy and the American Monkey: the Body in Japanese Early Schooling.”
Walsh’s study of children in Japanese preschools reveals a socialization process taking place that teaches young children to become in tune with their bodies and to trust their physical capabilities. To start with, Walsh identifies three “common Japanese cultural beliefs about children” that he learns in his studies. First of which is that “[c]hildren are naturally good and naturally sensible. They can be trusted to make sensible decisions.” Secondly, “[t]he ‘spirit’ formed by early experience provide the basis for later life.” And lastly, that “[c]hildren are physical beings, and their physical development and expression critical to their well-being” (2004, 104). These three assumptions influence the way many parents interact with their children and, in turn, shape how children interact with each other and their environment.
These aspects of the children’s early socialization mold them into adults with values that fall in line with those of Kampo, such as being in tune with one’s body and having an appreciation of the mind-body connection (Lock 1980, 76). Such values are imperative to have for a Kampo patient because the physician depends on the patient to provide personal, thorough descriptions of internal bodily processes. Without that, the physician will be unable to fully understand the nature of the illness, much less offer a proper diagnosis. Clearly, the practice of Traditional Japanese Medicine is well-adapted to Japan’s sociocultural framework. Japanese Shintoism and Buddhist theory reinforce many of its values, including the mind-body connection, which is of central importance to the Kampo practice. While Japan’s history of Western influence has pushed it to adopt Western practices of medicine that is grounded in science, Kampo, a traditional, nonscientific system of healing, continues to play a prevalent part in Japanese society. At this point, one can only wonder what lies in the future of Kampo.
