
ences. Native sources suggested ritual causes for dis-
ease, such as contact with impurity or punishment
by irate deities. Evidence for these views derives
from the earliest extant Japanese texts, such as the
Kojiki (Record of ancient matters, 712) and the
Nihon shoki (Chronicle of Japan, 720), as well as from
subsequent literature, both nonfiction and fiction.
Similarly, early Japanese views of disease prescribed
religious rituals and herbal medicine as the cure for
disease. Buddhist ideas also impacted Japanese per-
spectives on the etiology of disease and the possibil-
ities for cures.
The two most important influences during the
medieval and early modern periods were Chinese
medicine and, eventually, Western medicine. For
instance, the Ishimpo (Methods at the heart of
medicine), composed in 982 by Tamba Yasuyori
(912–995), is Japan’s oldest extant medical text and
displays the influence of Chinese medicine and med-
ical treatises on Japan’s understanding of medicine.
Its influence lasted into the medieval and early mod-
ern periods. Contacts with the West starting in the
mid-16th century gradually eroded the primacy of
Chinese medical practices and introduced new,
Western ways of understanding and treating disease.
Although the Japanese embraced different med-
ical traditions, Chinese and Western medical proce-
dures were used to treat certain common and
widespread diseases. Aside from wounds resulting
from accidents and warfare, Japanese physicians
were confronted with a number of diseases. There
are difficulties, however, in determining today
exactly what these past diseases may have been. This
is due in part to the ways in which Chinese and
Western medicine understood, described, diag-
nosed, and treated these diseases. Diseases known to
have afflicted the Japanese include leprosy, smallpox,
syphilis, malaria, tuberculosis, influenza, and
measles.
BUDDHIST MEDICINE
In the Kamakura period, as Buddhism spread
throughout Japan, its perspectives on disease and
treatment had a large impact on Japanese medical
practice. Priests served as doctors, disseminating and
applying knowledge about medicinal herbs and
other remedies. In this sense, the medical arts were
viewed as an important aspect of their religious
activities. One way in which medieval Buddhists
made sense of disease was through the concept of
karmic disease (gobyo). According to this view,
immoral acts and transgressions performed in a past
life became manifest in the present life as disease.
Thus, disease was the direct outcome of negative
karmic acts.
Buddhist monks, besides ministering to the sick,
also compiled treatises on medicine. The Zen monk
Eisai (1141–1215), famous as the founder of Rinzai
Zen and a promoter of green tea drinking for
medicinal purposes, also wrote a medical book, the
Kissa yojoki (Drink tea and prolong life, 1214). The
Buddhist monk and physician Kajiwara Shozen
(1266–1337) is noted for two volumes Ton’isho
(Jottings on medicine, 1303) and Man’anpo (Pre-
scriptions for felicity, 1327) that detailed his under-
standing of Chinese medicine and anatomy. The
Ton’isho makes use of the idea that alimentary care—
proper food and nutrition—had healing properties.
A similar idea about the medicinal properties of cer-
tain foods is found in a medical text by the Zen
monk Yurin (died 1410).
Buddhists were also known for their aid to the
sick and indigent. The Buddhist priest Ninsho
(1217–1303), for instance, was noted for the assis-
tance he provided to those who were homeless and
impoverished. He founded two refuge centers dedi-
cated to ministering to the sick and poor, and
worked on behalf of lepers.
CHINESE MEDICINE
Chinese medical theory and practice (in Japanese,
kampo) was central to much of medieval and early
modern medicine. It provided models for such
things as the balance of vital force (Chinese: qi;
Japanese: ki) in the human body, the cause of dis-
ease, and the medicinal properties of plants and
other natural materials. Chinese medicine was intro-
duced to Japan as early as the sixth century, quickly
influencing Japanese medical perspectives. It was
practiced with little modification until the late
medieval period. In the Heian period, the aristo-
cratic court physician Tamba Yasuyori (912–995)
wrote the Ishimpo (Methods at the heart of medicine,
984), the oldest extant Japanese medical text that
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