Abstract
This chapter discusses the major epistemological shift in medicine that occurred in the mid-eighteenth century and the emergence of the Kagawa School of Obstetrics that occurred in conjunction with this shift. Physicians from relatively disadvantaged social positions developed new medical methods, leading to the establishment of the Ancient Practice tradition (Kohō and Koihō), which, contrary to its name, introduced a new set of ideas and methods. Kagawa School physicians rejected the theoretical underpinnings of the Chinese medical tradition, including yin yang and the Five Phases. Instead, they projected the body as an object demarcated and isolated from the surrounding environment by its skin and marked it with tangible bone structures and reproductive organs.
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Notes
- 1.
There are different opinions about how to define “Kohō” and “Koihō.” In this study the notion of the Ancient Medicine School encompasses both factions.
- 2.
Thomas Kuhn, The Structure of Scientific Revolutions (Chicago: The University of Chicago Press, 1962).
- 3.
Michel Foucault, The Order of Things: An Archaeology of the Human Sciences (New York: Vintage/Random House, 1973); and The Archeology of Knowledge (New York: Harper Colophon, 1972).
- 4.
Maruyama Masao, Nihon seiji shisōshi kenkyū (Tokyo: Tokyo Daigaku Shuppankai, 1952): 71–139. For an English translation of this work, see Masao Maruyama, Studies in the Intellectual History of Tokugawa Japan (Princeton, NJ: Princeton University Press, 1974).
- 5.
The author of this text is Chōki [Ch Zhang Qi, 142–220] who is also referred to as Chō Chūkei [Ch Zhang Zhongjing]. Paul U. Unschuld, Medicine in China: A History of Ideas (Berkeley, Los Angeles, and London: University of California Press, 1985): 168–169.
- 6.
Fujikawa Yū, Nihon igakushi (Tokyo: Shinrisha, 1941): 296–299; Sakai Shizu, Nihon no iryōshi (Tokyo: Tokyo Shoseki, 1982): 237–238.
- 7.
Sakai, Nihon no iryōshi, 92–93. Wada Masatsugu, “Kakumei no iketsu, Yoshimasu Tōdō,” Tōa Igaku Kyōkai, ed., Nihon no kanpō wo kizuita hitobito, Kanpō no Rinshō, Vol. 9, No. 11–12 (December 1962): 90–94.
- 8.
For the section of Yoshimasu Tōdō, Sakai, Nihon no iryōshi, 240–248; Fujikawa, Nihon igakushi, 352–355.
- 9.
The Yellow Emperor’s Inner Canon, one of the greatest medical classics of Chinese medicine was reportedly written between the third and first century BCE. This work is divided into Somon [Ch Su-wen], which discusses basic theories, and Reiku [Ch Ling-shu], which elaborates the methods of acupuncture and moxibustion. For an English translation, see Ni Maoshing, The Yellow Emperor’s Classic of Medicine: A New Translation of the Neijing Suwen with Commentary (Boston: Shambhala, 1995).
- 10.
Kyoto-fu Ishikai, ed., Kyoto no igakushi (Kyoto: Shibunkaku, 1980): 958–959; Sōda Hajime, Zusetsu nihon iryō bunkashi (Kyoto: Shibunkaku, 1989): 127, 165, 168.
- 11.
Tōyō was able to obtain permission to conduct a dissection because he was a friend and teacher to domanial physicians of the Obama domain daimyō, Sakai Tadamochi, who was the governor of Kyoto [shishodai] at the time. A request was presented to the daimyō by these physicians to the domain, and permission was granted by Tadamochi. Achiwa Gorō, Kindai nihon no igaku: seiyō igaku juyō no kiseki (Kyoto: Shibunkaku, 1982): 94–105; Sakai, Nihon no iryōshi, 241–242; Sōda, Zusetsu nihon iryō bunkashi, 159–169; Kyoto-fu Ishikai, ed., Kyoto no igakushi, 962–970; Ōtsuka Yasuo, “Yamawaki Tōyō,” Kinsei Kanpō igakusho shūsei 13: Gotō Gonzan, Yamawaki Tōyō (Tokyo: Meicho Shuppan, 1979): 18–34.
- 12.
Achiwa, Kindai nihon no igaku, 98–101. Japanese physicians’ and scholars’ curiosity in understanding the mechanism [Jp karakuri] of European-made clocks, music boxes or clockwork dolls is not unrelated to the type of intellectual interest that Tōyō and other physicians demonstrated in their desire to figure out the inner workings of the human body. This interest was not a monopoly of physicians of Dutch medicine. See Timon Screech, The Lens within the Heart: The Western Scientific Gaze and Popular Imagery in Later Edo Japan (Honolulu: University of Hawai’i Press, 2002). See, particularly, Chap. 3, “Mechanics and Motions,” 61–93.
- 13.
For an early work on this topic, see Uiriamu D. Jonsuton (William D. Johnston), “Jūhasseiki nihon no igaku ni okeru kagaku kakumei: Ranpō hatten no tame no shisō teki na zentei, Part 1 and 2,” Nihon ishigaku zasshi, Vol. 27, No. 1 (1981): 6–20; and No. 2, 131–156.
- 14.
On a development in Confucian and scientific thought that entailed the revival of the notion of ri in the late Tokugawa period, see also Albert Craig, “Science and Confucianism in Tokugawa Japan,” in Marius B. Jansen, ed., Changing Japanese Attitudes Toward Modernization (Princeton: Princeton University Press, 1965): 133–160. Ng Wai-ming presents an interesting discussion on how Chinese cosmological categories that derived from The Book of Changes [Jp Ekikyo; Ch Yijing] mediated the adoption of European scientific knowledge. See Ng Wai-min, The I Ching in Tokugawa Thought and Culture (Honolulu: Association for Asian Studies and University of Hawaii Press, 2000).
- 15.
After the death of its founder, Gen’etsu, the Kagawa School was divided into two major branches. One of the branches served a daimyō house on Shikoku island for generations. The other branch in Kyoto gained immense prestige by serving the imperial court and attracted many disciples.
- 16.
For existing works on the Kagawa School, see my discussion in the introduction. Feminist studies on the Kagawa School other than the ones I have discussed include: Sutō Mikako, “Edo jidai no shussankan, taijikan,” in Fujiwara Noboru, ed., Nihon seikatsu shishi kenkyū, Vol. 2. (Morioka: Seikatsu-shisō Kenkyū kai, 1990): 61–94; and “ ‘Umu’ shintai no kindai,” Gendai shisō 19-3 (March 1991): 220–229.
- 17.
Gen’etsu’s biography is documented in Fujikawa, Nihon igakushi, 371–373; Fujikawa Yū, Kure Shūzō, and Masuda Tomomasa, eds., Nihon sanka sōsho (Kyoto: Shibunkaku, first published in 1895, reprinted in 1971): 5–6; Ogata, Nihon sanka gaku shi (Tokyo: Maruzan, 1918, reprinted by Kagaku Shoin, 1980); 108–109.
- 18.
Fujikawa, Nihon igakushi, 372; Ogata, Nihon sanka gaku shi, 108. The Hikone domain did not allow, at the time, sons of concubines to inherit the father’s family name and status.
- 19.
Sanron is written in the kanbun style (Japanese written in the form of classical Chinese) that was customarily used in scholarly writing. This most likely helped enhance Gen’etsu’s methods’ prestige. For the significance of writing scholarly work in the kanbun style, see Sakai Shizu, “Edo jidai no seiyō igaku no juyō,” in Yoshida Tadashi, ed., Higashi ajia no kagaku (Tokyo: Keisō Shobō, 1982): 5–49.
- 20.
Gen’etsu’s stipend was about half that received by noted scholars such as Arai Hakuseki (1657–1725) while in the service of the Kōfu domain during his early career, and was comparable to that received by some middle ranking retainers serving Chōshū domain, according to information dated 1852. Kate Wildman Nakai, Shogunal Politics: Arai Hakuseki and the Premises of Tokugawa Rule (Cambridge, MA: Council on East Asian Studies, Harvard University, 1988): 29–38; Kimura Motoi, Kakyū bushi ron (Tokyo: Hanawa Shobō, 1967): 50–53, 58–76.
- 21.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku (Tokyo: Iwata Shoin, 2008): 18–19.
- 22.
Ibid.
- 23.
By “cross bones,” Gen’etsu most likely referred to a section of pubic bones. Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 72–73.
- 24.
1 sun = 3.03 centimeter = 1.193 inch; 10 bu = 1 sun.
- 25.
Gen’etsu also disapproved of the use of the birth chair after delivery, which was another custom recommended by many childbirth manuals including Fujin kotobukigusa. The cover of this book portrays this custom.
- 26.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 30–31.
- 27.
Gen’etsu remarked, “I looked at the illustrations of internal anatomy that the red-haired barbarians brought [‘kōi tsutauru tokorono naikei zu’].”
- 28.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 24–27.
- 29.
As I discuss later in this chapter, there were female obstetricians who were trained in the Kagawa School tradition.
- 30.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 26–27.
- 31.
The conception meridian was the only meridian that Gen’etsu refers to in Sanron. His discussion of this meridian, however, does not demonstrate a systemic understanding of traditional Chinese medicine.
- 32.
Modern anatomy does not recognize sexual difference in terms of the size of this “gap” that is connected by the pubic symphysis, but identifies sexual disparity in the form of the pubic arch shaped like an inverted V. The angle forming this pubic arch is more acute in the male pelvis, while the female pelvis generally pertains to a broader and rounder pubic angle. Elain N. Marieb and Jon Mallatt, Human Anatomy, Second Edition (Menlo Park, CA: Benjamin/Cummings, 1997): 173–178.
- 33.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 24–25.
- 34.
This work was a Japanese translation of a Dutch version of the anatomy text, Anatomische Tabellen (Third Edition, 1732) by the German natural scientist Johann Adam Kulmus (1689–1744). It was translated into Dutch by the physician Gerardus Dicten and was published as Ontleedkundige Tafelen in Amsterdam in 1734. Kaitai shinsho was the first Dutch medical text whose full translation was published in Japan. Nihon gakushi-in, Nihon igaku shi, Vol. 1 (1955): 152.
- 35.
Shigehisa Kuriyama, “Between Mind and Eye: Japanese Anatomy in the Eighteenth Century,” in Charles Leslie and Allan Young, eds., Paths to Asian Medical Knowledge (Berkeley, Los Angeles, and Oxford: University of California Press, 1992): 21–43.
- 36.
Ogata, Nihon sanka gaku shi, 304.
- 37.
Medical historians speculate that Gen’etsu attended Yamawaki Tōyō’s lectures at his residence in Kyoto, and saw Dutch texts in Tōyō’s possession. The historian Ogata Masakiyo suggests the possibility that Gen’etsu was inspired to invent his iron hook by viewing illustrations in a Dutch obstetrics text written by Hendrik van Deventer (1651–1724). Ogata points out, however, that the illustration of the hook was presented by Deventer to warn against its use. Ogata assumes that because Gen’etsu was unable to read the text, he thought the hook was recommended for obstetrical purposes. Ogata, Nihon sanka gaku shi, 133–135.
- 38.
Judith Walzer Leavitt, “Birthing and Anesthesia: The Debate over Twilight Sleep,” in Leavitt, ed., Women and Health in America (Madison: University of Wisconsin Press, 1984): 175–184; Richard W. Wertz and Dorothy C. Wertz, Lying-In: A History of Childbirth in America (New Heaven: Yale University Press, 1977): 116–119, 137, 178–197, 289. In Japan, the use of anesthesia was pioneered by “external medicine” (geka, surgery) physicians who had learned certain methods from Dutch physicians in Nagasaki in the late sixteenth century and early seventeenth centuries. They provided local anesthesia by means of a prescription of mandarage (thorn apple). The physician Hanaoka Seishū (1760–1835) was the first to perform general anesthesia with a formula that consisted of mandarage and aconite, which he used for mastectomy operations for treating breast cancer, beginning in 1804. Sōda, Zusetsu nihon iryō bunka shi, 227–232; Nihon Gakushi-in, Nihon Kagakushi Kankōkai, ed., Meiji-zen igaku shi, Vol. 4 (Tokyo: Nihon Gakujutu Shinkōkai, 1964): 807–808.
- 39.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 84–85.
- 40.
Ibid., 84–85.
- 41.
Modern medical statistics suggest that abnormal fetal positions are found in 3.5% of births; breech presentations account for 3% and transverse presentations for 0.5%. Nanzandō igaku daijiten (Tokyo: Nanzandō, 1966): 514, 934.
- 42.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 84–87.
- 43.
Sanka Bunken Dokushokai, ed., Heiseiban sanron, sanron-yoku, 86–87.
- 44.
Ibid., 86–89.
- 45.
One of these texts was a presentation of Gen’etsu’s oral lectures, Fujin sanzen sango fukushin shujutsu hō [Methods of Diagnosis and Operations for Women before and after Childbirth, the transcriber and hand-written year unknown], reprinted in Fujikawa et al., eds., Nihon sanka sōsho, 133–143; Oku Ressai, Kaisei kōhō hiketsu [Keys to the Use of the Hook for Restoration, publication date unknown], ibid., 764.
- 46.
Ochiai, “Edo jidai no shussan kakumei,” “Kinsei matsu ni okeru mabiki to shussan,” and “The Reproductive Revolution at the End of the Tokugawa Period”; Sutō “Edo jidai no shussankan, taijikan,” in Fujiwara Noboru, ed., Nihon seikatsu shisō kenkyū, Vol. 2 (Morioka: Seikatu-shiso Kenkyūkai, 1990): 61–94; “‘Umu’ shintai no kindai,” Gendai shisō, Vol. 19-3 (March, 1991): 220–229.
- 47.
Ogata, Nihon sanka gaku shi, 224.
- 48.
Sutō Mikako’s discussion on the major obstetric texts of the Kagawa School and others includes their organization and subject headings. See Sutō Mikako, Kagawa-ryū kaiseijutsu no kenkū: Edo jidai no shussan kan, taiji kan ni kansuru ichi kōsatsu (M. A. Thesis, Ochanomizu University, 1990): 37–126. The two texts of the school founded by Hiruta Katsumei also demonstrate that Hiruta generally followed the classification of childbirth established by Kagawa Gen’etsu. See Sanka shinron (1815) and Hiruta sensei sanjutsu kunkai (publication year unknown) in Fujikawa et al., eds., Nihon sanka sōsho, 790–843.
- 49.
In his obstetrics manual, Sanka shinron (1819, a text different from the Hiruta School), physician Tateno Ryūtei (date of birth and death unknown) remarked that eight or nine out of ten obstetricians belonged to the Kagawa School tradition. Kyoto-fu Ishikai, Kyoto no igakushi, 1103.
- 50.
Sanka kibun (the Bunka era, 1804–1814) reprinted in Fujikawa et al., eds., Nihon sanka sōsho, 213–217.
- 51.
Some research in Folklore Studies suggests that the Japanese did not consider a child under seven years of age as a human being. Some scholars refer to this concept to explain why the practice of infanticide, commonly called mabiki (the culling), was pervasive. The act of infanticide was also often referred to as “returning” [kaesu] from the world of humans to the world of gods [kami]. For the notion of the human life cycle in the Japanese folk custom, see Herman Ooms, “A Structural Analysis of Ancestral Rites and Beliefs,” in William Newell, ed., Ancestors (Chicago: Aldine, 1976): 61–90. Chiba Tokuji and Ōtsu Tadao extensively discuss the Japanese folk perception of the fetus and the child in Chiba Tokuji and Ōtsu Tadao, Mabiki to mizuko (Tokyo: Nōson gyoson bunka kyōkai, 1983). William LaFleur analyzes the perceptions of the fetus in certain Buddhist thought in both the early modern and modern periods. Some recent scholarship in history and anthropology has questioned the theory that age seven was the definitive point at which the child came to be perceived as a full human, and that infanticide was acceptable; however, most scholars still maintain that the fetus and the baby were not considered as fully human in early modern Japan. William LaFleur, Liquid Life: Abortion and Buddhism in Japan (Princeton, NJ: Princeton University Press, 1992). For a good summary of various views on this issue, see Sawayama Mikako, Shussan to shintai no kinsei (Tokyo: Keisō Shobō, 1998): 20–24. For a recent English-language work on Tokugawa practices of infanticide, see Fabian Drixler, Mabiki: Infanticide and Population Growth in Eastern Japan, 1660–1950 (Berkeley: University of California Press, 2013).
- 52.
Ogata, Nihon sanka gaku shi, 355–362, 372–374.
- 53.
Ibid., 353–359. Ogata, Nihon fujinka-gaku shi (Tokyo: Maruzen, 1914, reprinted, Tokyo: Kagaku Shoin, 1980): 275–279.
- 54.
Fujikawa et al., eds., Nihon sanka sōsho, 616–620.
- 55.
Ogata, Nihon sanka gaku shi, 279–280. The Kyoto branch of the Kagawa House, which was established by Gen’etsu’s natal son Mankyō (1734–1793) did not serve any daimyō house; however, some of its head masters received the official rank of physician for serving in the imperial court. During the Tokugawa period, in addition to the officers at the Health Ministry [Tenyaku-ryō], there were 30 hereditary medical families that provided court physicians and medical administrators, and another ten medical families that were recruited on a temporary basis due to their superior skills. The head masters from the Kyoto Kagawa House were among the ten medical houses whose services were sought after by the imperial family. Gen’etsu’s grandson, Kagawa Mantei (1772–1833) first served the court as a masseur at the age of 45 in 1815, and later gained the title of medical officer specializing in illnesses specific to women and in charge of the education of midwives and nurses serving within the court [Nyoi hakushi] with the sixth rank. Mantei’s son Mansō (1796–1864) began his career as a court physician with a very low rank in his late twenties but eventually gained the title of Nyoi hakushi and the fifth rank. Mansō’s heir Mansai (1830–1891) rose to the sixth rank by his late twenties. The ranks received by these Kagawa head masters were comparable to those granted to other medical houses that had newly obtained status as a court physician, but were, on the whole, slightly lower than the ranks that were given to the hereditary medical houses. Kyoto-fu Ishikai, ed., Kyoto no igakushi, 1245–1342; Sōda, Zusetsu nihon iryō bunka shi, 25–29; Aoyagi Seīchi, Shinryō hōshū no rekishi (Kyoto: Shibunkaku Shuppan, 1996): 116–117.
- 56.
There is virtually no record of the fees that Kagawa School physicians generally charged for assisting a delivery. It is plausible that fees varied greatly depending upon the reputation of individual physicians and the wealth of clients. Until the mid-nineteenth century, it was also common that patients remunerated physicians in the form of summer and winter gifts instead of paying for each visit.
As of 1842, a type of female physician called onna isha, who was most likely a professional midwife and abortion specialist, reportedly charged between one and two bu (a quarter ryō and half ryō) for a visit to a pregnant woman. The onna isha also very often provided in-patient care at her residence. She charged one-and-a-half ryō for a patient to stay at her house for seven days, including fees for medical services and food. These fees, however, were lowered for poor patients. Aoyagi, Shinryō hōshū no rekishi, 136–185. Kagawa School obstetricians were most likely more socially established than these female midwives, but it is not certain if their higher social position always led them to collect higher fees.
- 57.
Bunpaku’s book was based on readings of Japanese, Chinese and Dutch texts. The publication year of this text is still unclear. Although some sources indicate that it was published during the Meiwa era (1764–1771), medical historians Kaji Kanji and Fujī Naohisa think that this was unlikely because the text demonstrates an unmistakable influence of Kagawa Gen’etsu’s Sanron. They speculate that it was published during or after the Bunka era (1804–1817). Nihon Gakushi-in, Nihon Kagakushi Kankōkai, ed., Meiji-zen Nihon igaku shi, Vol. 4, 143–144.
- 58.
Fujikawa et al., eds., Nihon sanka sōsho, 136–141.
- 59.
The German physician Philipp Franz Barthazar von Siebold (1796–1866), who resided in Japan during 1823–1829 and 1859–1862, brought European style forceps, which a few of his disciples put to use. Ogata Masakiyo, Nihon sanka gaku shi (Tokyo: Maruzan, 1918, reprinted by Kagaku Shoin, 1980): 478–481. For an English-language study on Siebold and his Japanese disciples, see Ellen Gardner Nakamura, Practical Pursuits: Takano Choei, Takahashi Keisaku, and Western Medicine in Nineteenth-Century Japan (Cambridge, MA: Harvard University Asia Center, 2006).
- 60.
Ibid., 282–283. Ogata also argues that the introduction of tangan-ki led to the renewed popularity of the Kagawa School in the field of obstetrics.
- 61.
Ogata, Nihon sanka gaku shi, 156–185.
- 62.
Kyōto-fu Ishikai, ed., Kyōto no igakushi (Kyoto: Shibunkaku, 1980): 1119.
- 63.
Ogata, Nihon sanka gaku shi, 156–185.
- 64.
For the operation of various private academies of Tokugawa Japan, see Richard Rubinger, Private Academies of Tokugawa Japan (Princeton, NJ: Princeton University Press, 1982).
- 65.
100 mon. 1 gold ryō = 4000 mon = 4 kan.
- 66.
60 monme of silver was equivalent of approximately1 ryō although the exchange rate was subject to the fluctuation of the market price of gold and silver.
- 67.
The currency unit hiki was commonly used for the measurement of gifts and donations, including tuition fees for private academies. 1 hiki = 10 mon. 400 hiki = 1 ryō.
- 68.
In the earlier period, it was common at the time of entrance into the academy for students to offer their teachers gifts in the form of food and drink instead of cash payment—a practice that continued throughout the Tokugawa period in small academies or those located in rural areas. Rubinger, Private Academies of Tokugawa Japan, 70–71. This particular Kagawa academy required cash payments instead of gifts; however, cash payments were made under the pretense that they were to be used for buying food and drink. Fees for a fan generally indicate instruction fees. Rubinger notes that in some cases students from warrior families continued the practice of offering a fan to his teacher. Ibid, 70.
- 69.
The payment to their master at the time of graduation included: fees for issuance of the certificate, 100 hiki; banquet fees, 100 hik i; fan fees, 1 ryō; fees for teacakes, 1 ryō. Another instructor was to receive: banquet fees, 500 hiki; fan fees, 1 ryō; fees for teacakes, 2 monme of silver. They were also required to give 100 bronze coins to each servant.
- 70.
The total fees paid by the disciples of the Kyoto Kagawa academy seem to be more than those for most private academies of medicine and other branches of scholarship. For example, while the Dutch School physician Itō Genboku’s academy in Edo was known for its relatively expensive fees, its entrance fees included 200 hiki for sokushū, and 450 hiki for other miscellaneous fees. Confucian scholar Hirose Tansō’s academy in today’s Ōita prefecture, which attracted a large number of students, most likely set its sokushū at 100 hiki complemented by seasonal gifts, each of which would cost approximately 100 hiki. Rubinger, Private Academies of Tokugawa Japan, 70–71, 121–122, 232.
Historians Mitamura Engyo and Shinji Yoshimoto estimate that carpenters made a daily wage of 5 monme 4 bu (442 mon); however, they had to pay for all the living expenses for themselves and their families on their own. (In this currency system measured in silver, 1 monme was divided into 10 bu.) Male servants for warrior houses earned a yearly allowance of between 2 and 3 ryō 2 bu in the early nineteenth century. Female servants, on the other hand, made between 1 and 3 ryō. See Inagaki Fumio, ed., Edo seikatsu jiten (Tokyo: Seiabō, 1959): 110–113; Kodama Kōta, ed., Kinseishi handobukku (Tokyo: Kondō Shuppansha, 1972): 318–319.
- 71.
New students had to produce a reference from a guarantor to be initiated as a Kagawa School disciple. Nonetheless, this requirement did not seem to deter commoners whose families did not practice medicine from being admitted to the academy.
- 72.
Ogata, Nihon sanka gaku shi, 182.
- 73.
Ibid., 161–185. There were several renowned female physicians in the Tokugawa period. Most had been born into a physician’s family and obtained medical knowledge from their fathers and other family members, and by reading books on medicine and other branches of Chinese scholarship. Ogata Masakiyo refers to the following female obstetricians from the Tokugawa period in his Nihon sanka gaku shi: Morikawa Hoyū, who in 1823 published an obstetrics text entitled Sanka shinan written by her deceased teacher Ōmaki Shūsei; a woman physician named Ine, the daughter of Philipp Franz Barthazar von Siebold and his Japanese wife, Taki, who obtained medical training from Siebold’s Japanese disciples; Yamada Hisao, who published an obstetrics manual entitled Uka hatsumō zukai in 1852. Ogata, Nihon sanka gaku shi, 427–428, 481, 831–835.
- 74.
Miyama, “Kyūdai sanba gyō no eizoku shitaru nakaoka ke no ryakureki,” Josan no shiori 80 (January 1903): 26–29.
- 75.
See, for example, Sakurai’s brief introduction to this issue in Sakurai Yuki, “Kinsei no ninshin shussan gensetsu,” Rekishi hyōron, No. 600 (April, 2000): 33–35; and Drixler, Mabiki. Many historians have suggested that peasants in Tokugawa Japan practiced infanticide, not simply to reduce the number of children in the family, but to have a specific number of male and female children with an adequate age difference between them. Such a practice emerged from rational calculations designed to maximize benefits to their families. See, for example, T. C. Smith, Nakahara: Family Farming and Population in a Japanese Village, 1717–1830 (Stanford, CA: Stanford University Press, 1977); Sawayama, Shussan to shintai no rekishi, 20–27; Ōta Motoko, “Joron kyōdō kenkyū no kadai to hōhō oyobi tōtatsuten ni tsuite,” in Kinsei nihon mabiki kankōshi shiryō shūsei (Tokyo: Tōsui Shobō, 1997): 19–23.
For demographic studies of the Tokugawa period, see Hayami Tōru, Rekishi jinkō gaku no sekai (Tokyo: Iwanami Shoten, 1997); Laurel L. Cornell, “Infanticide in Early Modern Japan? Demography, Culture, and Population Growth,” Journal of Asian Studies 55: 1 (February 1996): 22–50; and “Retirement, Inheritance, and Inter-generational Conflict in Preindustrial Japan,” Journal of Family History 8 (Spring 1983): 55–69; L. L. Cornell and Akira Hayami, “The Shūmon Aratame Chō: Japan’s Population Registers,” Journal of Family History 11: 4 (1986): 311–328. Drixler draws on this earlier work.
- 76.
Drixler discusses this topic in Mabiki. See also Kanazu Hidemi, “‘Datai mabiki’ kō,” in Kinugasa Yasunobu, ed., Kinsei shisō shi no genzai (Kyoto: Shibunkaku, 1995): 401–421; Sawayama, Shussan to shintai no rekishi, 188–218; Yatabe Mariko, “Akago yōiku shiyōhō ni tsuite,” in Watanabe Nobuo, ed., Miyagi no kenkyū, Kinsei hen II (Osaka: Seibundō, 1983): 250–267; LaFleur, Liquid Life, 102–118.
- 77.
Sakurai, “Mabiki to datai,” 102–119; Sawayama Mikako, “ ‘Umu’ shintai to kaitai shussan torishimari,” Edo no Shisō Henshū Īnkai, ed., Edo no shisō, Vol. 6 (Tokyo: Perikansha, 1997): 7–18; and also Sawayama, Shussan to shintai no rekishi, 95–187; Takahashi, Datai mabiki no kenkyū, 153–170, 183–185, 209–223, 231–240, 245–261; Yatabe, “Akago yōiku shiyōhō ni tsuite,” 238–249.
- 78.
For example, the Tsuyama domain specified that the punishment for the mother for abortion or infanticide was a fine of 2 hyō of rice, and seven days’ confinement. (1 hyō= approximately 0.5 bushel.) On the other hand, the next-door neighbor and the five-people group were liable to five days’ confinement. In the case of failing to report a pregnancy, the woman was fined 3 hyō of rice and received seven days of confinement in manacles; the next door neighbor and the five-people group were also to pay 3 hyō of rice and confined for five days; the head of the group was fined 2 hyō of rice; the village headman was to give 1 hyō of rice as penalty. Sakurai, “Mabiki to datai,” 114–115.
- 79.
Sawayama, “‘Umu’ shintai to kaitai shussan torishimari,” 18–23; and Shussan to shintai no rekishi, 158–187.
- 80.
Ibid., 176.
- 81.
Sakurai, “Mabiki to datai,” 119–120.
- 82.
Ibid.
- 83.
See, for example, Okitsu Kaname, Edo senryū onna hyakkei (Tokyo: Jiji Tsūshin sha, 1994): 79–83.
- 84.
Sakurai, “Mabiki to datai,” 123–126.
- 85.
The six oaths included the following clauses: (1) You should not forget gratitude toward the Kagawa House which gratefully shared with you the foremost obstetrics skills. (2) At the client’s house you should strictly adhere to the Kagawa School methods and should not combine other methods with them. You should also take utmost care to provide services equally for the rich and poor. (3) You should not share with others, including your relatives and friends, the teachings and operation methods that were transmitted orally (from your Kagawa School masters). The treatment techniques should also not be demonstrated freely without deliberation. (4) The prohibition of abortion. (For the exact wording, see the main text.) (5) There are differences in competence even among those of you who have received a certificate. When you find a junior disciple with remarkable skills, you should not act condescendingly toward him or her just because you are senior, but should admire his or her expertise. (6) You are not allowed to practice until you have obtained a certificate. Those who violate this promise will be ousted from the Kagawa School. Those who practice in the name of the Kagawa School without being initiated into it should also discontinue their practice at once. Ogata, Nihon sanka gaku shi, 156–157.
- 86.
Although the practice of abortion doctors was denounced as a mercenary act, the Kagawa School’s operation itself was structured by market forces. The Kagawa head masters sought to represent their practice as enacting the Confucian tenet of jin [benevolence] by saving the life of the mother and that of the child, and not as a money-making business. It might be beneficial to think about this issue in terms of an overall historical trend toward medical practices becoming highly profitable businesses by the mid-Tokugawa period. The emphasis many physicians placed on their moral mission might have stemmed from the fact that they were so profitable.
- 87.
See Drixler, Mabiki.
- 88.
Ibid.
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Terazawa, Y. (2018). Changing Perceptions of the Female Body: The Rise of the Kagawa School of Obstetrics. In: Knowledge, Power, and Women's Reproductive Health in Japan, 1690–1945. Genders and Sexualities in History. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-73084-4_3
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