The V.O.C., Rangaku and Japan

Nagasaki Harbour, Kawahara Keiga (workshop of), c. 1833 – c. 1836.

Japan and the Dutch

Deshima, a man-made island in Nagasaki Bay, was originally a remote trade station of the Dutch East India Company (V.O.C.). A bridge linked this island to the rest of Japan. Here, Dutch sailors and traders were essentially shut off from the rest of the world. They were among the few Westerners permitted to remain in Japan. The Japanese first came into touch with Western scientific literature via this fan-shaped island known as Deshima. This scientific material, which was delivered by the V.O.C., guaranteed that many innovative Western ideas still reached Japanese shores.

However, some historians, such as Huibert Paul (unknown), argue that the Dutch East India Company had a minor and insignificant impact on medical and scientific fields..[1] Paul’s vision is not the only one on the issue. Other historians claim that the Dutch presence in Deshima was significant, and that the Netherlands was critical to Japan’s scientific growth. Grant K. Goodman (1924), for example, talks extensively on what those specific discoveries were in his works The Dutch Impact on Japan[2] and Japan: The Dutch Experience.[3]

Several historians argue that “Rangaku,” or the study and translation of Western writings that arrived in Japan via the Dutch trade station on Deshima, was critical to Japan’s growth. This assertion is made by the following writers and their books: Leonard Blussé (1946), Willem Remmelink (unknown), and Ivo Smit’s (unknown) book Eventful Relations: 400 Years of the Netherlands-Japan[4] and Ciska Gomperts-Spanjaard (unknown), Nobuko Karthaus-Tanaka (unknown), Annemarie Geleijnse (unknown) and Takako Reinhardt-Shibayama (unknown) titled 400 years of Dutch-Japanese relations: a past with a future.[5] In these works it appears that Dutch scientific books were translated with pain and difficulty by the Japanese and applied to Japanese society.

According to historical records, the Dutch lingered on Deshima as traders. They were just there to commerce and not, like the Portuguese, to preach their beliefs. The Dutch impact was thus mostly felt indirectly, because through this commerce, books containing scientific knowledge arrived in Japan. However, because these books were written in Dutch, the Japanese were required to translate them. Sugita Genpaku Shôzô (1733-1817), a doctor and interpreter, was one of these translators. This is significant because the foundation for contemporary Japanese medicine is built throughout his lifetime and he is also recognized as one of the most important rangaku pioneers and proponents.[6]

As a result, this essay focuses on Sugita’s work. The major issue addressed in this article is, ‘What were the consequences of Sugita’s medical discoveries for traditional Japanese medicine in the 18th and 19th centuries?’ This question will be answered by looking at the following sub-questions: ‘How did Sugita proceed in studying an important and accurate anatomical text from the 18th century called the Anatomical Tablets?’, ‘What medical results did Sugita observe?’ and ‘Where did Sugita’s results contrast with conventional Japanese medical teachings?’ The answers to these questions will reveal why Sugita’s work has been important to the progress of Japanese medicine.

The opening paragraph of this article will discuss Sugita’s progress and the nature of his work. The second paragraph will go into what traditional Japanese medicine was and why it contrasted with Sugita’s discoveries. And, in order to answer this question, the essay will consult scholarly papers and books such as Japan: The Dutch Experience and Eventful Relations.

The work of Sugita Genpaku Shôzô

In 1720, Shogun Tokugawa Yoshimune (1684-1751) removed a restriction on importing Western literary publications. For the first time in decades, it was now legal to acquire and import Western scientific books. During this period, the Japanese imported numerous Western works through the Dutch. One of these works was a book authored by Johann Adam Kulmus (1689-1745). This book, known as the Anatomical Tablets, made its way to Edo, Japan’s capital, in the spring of 1771, via the port of Nagasaki.[7] Because literature were not yet being translated by formal schools during this time period, Rangaku scholars, or those who studied books from the Netherlands, had to rely on themselves. These were specifically physicians. They made enough money to be able to go to school on their own. Sugita was one of those doctors, and he possessed a copy of Kulmus’ book in Dutch.[8]

Sugita dissected the body of Aochababa, an executed lady in her 50s, alongside two other prominent medical practitioners in 1771. The dissected corpse was then thoroughly examined. At the time, they were mostly interested in the dissected body’s anatomical layout. They compared it to the Anatomical Tablets‘ drawings. Sugita and the physicians were astounded by the Anatomical Tablets‘ precision. Unlike conventional Chinese medical literature, it had shown exactly what they had seen. Sugita, along with the other medical professionals in attendance, understood the significance of their results. This is why they chose to translate Kulmus’s work into Japanese.[9]

The book was translated over a two-year period, and while dissections had previously occurred, translating and publicizing this work represented a new milestone. The validity of the European anatomical idea was demonstrated to the public for the first time through the printed word. This book encountered no impediments throughout its dissemination and can even be considered the start of Rangaku. As a result, the emergence of a Japanese translation of a Dutch anatomy book can be seen as the conclusion of an acceptance process but not of an assimilation process.[10] Both traditional Japanese and Western medicine coexisted. This was due to neither side displaying a clear advantage over the other.[11]

The translated version of Kulmus’ work, however, contains mistakes as a result of the Japanese medical practitioners who worked on it not having had Western medical training. This did not, however, lessen the significance of this study among the Japanese scientific community. The translators of the Anatomical Tables rely on reliable information to show the correctness of the anatomical maps. As a consequence, the foundations for scientific medicine were built, and the Japanese intelligentsia embraced a more scientific viewpoint. In 1793, the government medical school, Igakkan, authorized Western surgery as a topic. Rangaku’s impact in Japan grew as a result of the discovery of Sugita.[12] Sugita’s work may be traced back as a probable source of rangaku’s extensive effect. This was owing in part to the fact that one of his partners, Ryõtaku Maeno (1723-1803), was a high-ranking bureaucrat.[13]

Japanese physician and scholar Sugita Genpaku Shôzô.

Created by Ishikawa Tairō (石川大浪), ca. late 18th century

Traditional Japanese medicine

The Chinese medical system served as the foundation for traditional Japanese medicine. As a result, the term Kampō comes from the Han method, which alludes to the Chinese Han dynasty or the Han race. Over the years, this technique has undergone significant change. As a result, it has evolved into a distinct medical technique in its own right. Plant and veterinary medicines, acupuncture, and moxibustion, a therapy that involves channeling heat energy to an acupoint, are the major medicinal treatments in this system. This type of treatment made it unusual to actually open up the body.[14]

Traditional Japanese medicine prioritized illness treatment by establishing diagnoses based on the medicines prescribed. This medical school was likewise devoted to the materialistic-tinged illness theory, which held that sickness was caused by a disturbance in the circulation of qi, or spiritual force. As a result, pathogenic causes led qi to accumulate in certain areas of the body. Aside from conventional diagnoses, identifying qi stagnation by palpation and studying an illness through sensation were also highly valued.[15]

The idea underlying the above-mentioned information is based on Confucian concept of a harmonious cosmos and revolves around preserving harmony in the body. Physical harmony was linked to the balance of yin and yang, the Chinese concept of two opposing or complementary concepts or energies. The five natural elements are also essential. There was a popular belief that there were five yin intestines and six yang intestines. Furthermore, the parallels between human features and the natural order, such as four limbs and four seasons, were highlighted.[16]

The Body

As previously stated, the Japanese view of the human body was mainly centered on the ‘five yin organs and six yang intestines.’ Western medical writings became recognized in Japan in the 18th century, and Eastern concepts were contrasted with western depictions. Sugita and colleagues decided that Western medical research was more precise and thorough after observing numerous notions and facts, such as organs not found in traditional Chinese medical literature. The viewing of pictures from the Anatomical Tablets, on the other hand, did not supply the observers with the theory underlying it. This was only available after the book’s translation, when the western theories and reasoning behind the text were also translated..[17]

Thus, the Western reasoning underlying the discoveries was introduced with the publishing of Kaitai Shinsho, a Japanese translation of Anatomical Tablets. Prior to the publication, practically no one in Japan was aware of the reasoning and motivations underlying Western medical science, let alone that they differed dramatically from those of the Kampō..[18]

The Rangaku academics stumbled upon a variety of difficulties when translating this book. Kulmus’ book, for example, had a plethora of new ideas. The functions and presence of various intestines were either unknown to the Japanese or differed significantly from traditional Chinese medical knowledge. As a result of the translation of this work, a number of new words, such as shinkei, which signified nerve and looks, and nankotsu, which meant cartilage, were added..[19] In response to these discoveries, Kampō medical practitioners stated that dead organs had no function and that organ shape was irrelevant. Only live qi, according to Kampō medical practitioners, had meaning..[20]

The advancement of medical research made possible by the translation of scientific material meant that acquiring Western knowledge might be extremely beneficial. Furthermore, there was a rise of cynicism about China and Confucianism as a result. However, this was only happening to a subset of the population.[21] This was due to the Japanese government’s efforts to repress public opinion in order to maintain the population’s obedient and traditional nature.[22]

Kaitai shinsho, page 10/11, “Courtesy of the U.S. National Library of Medicine”


In the end, Japanese traditional Kampõ medicine was still practiced, therefore the two currents coexisted. However, after much research and dissections, it was shown that Confucian medicine was neither accurate nor adequate. Western scientific publications, on the other hand, were detailed and exact enough. This was determined when Sugita performed a dissection and compared the results to Kulmus’ book. Sugita’s dissections and the resulting translation of Kulmus’ anatomical book provided fresh insights into the function of organs and organ systems. This is in contrast to traditional Chinese based Kampõ medicine. Because, according to that idea, there were only five yin organs and six yang intestines.

The precision of the anatomical maps established the groundwork for modern medicine and instilled a more scientific mindset in parts of Japan’s intellectuals. The book Kaitai Shinsho also made proven scientific evidence more available to Japanese readers. Demonstrable proof could not be provided for the Kampõ since it could only be found in live people.

Thus, with the publication of his work Kaitai Shinsho, Sugita marked the beginning of a new period of rigorous study of Western science. However, the growth of a scientific mindset did not come at the price of traditional doctrine. This was due to the fact that Japan had a highly controlling government that ensured that the residents would not grow too critical, and therefore it remained an elite movement. Neither had the Japanese been educated in the same manner that Western medical practitioners had.

As a consequence, the Japanese were able to grasp the images, but they were unaware of the ideas underlying Western medical methods. Sugita’s work guaranteed that Western surgery finally became an approved topic at the official medical school, even if they did not comprehend the philosophy underlying it. This implies that they intentionally ignored the body’s harmony and inviolability, which is essential to traditional Confucian medicine.

There is lots of room for more investigation. Sugita’s contributions may be seen in a variety of historical works. His partners, on the other hand, were high-ranking authorities. As a result, a follow-up inquiry might look into the relationship between the Rangaku academics and the relaxation of the isolation policy, also known as Sakoku or other Western technologies.

[1] Huibert Paul, Dutch in Japan, 1600-1854: The VOC On Dejima (Weesp 1984) 7-8.

[2] Grant K. Goodman, The Dutch impact on Japan. (London 1967) VII-VIII.

[3] Grant K. Goodman, Japan: The Dutch Experience (London 1986) 1-2.

[4] Leonard Blussé, Willem Remmelink and Ivo Smits, Eventful Relations: 400 Years of the Netherlands-Japan (Hilversum 2000) 89-110.

[5] Ciska Gomperts-Spanjaard, a.o., 400 years of Dutch-Japanese relations: a past with a future = Nichiran kōRyū no yonhyaku-nen : rekishi no tobira wo mirai e mukete (Leiden and Den Haag 2000) 5-11.

[6] Ann Bowman Jannetta, The vaccinators: smallpox, medical knowledge, and the “opening” of Japan (California 2007) 96; Matsushita Shinya, a.o., Rangaku: Hollandkunde in Japan: Catalogue At An Exhibition of Paintings And Books From The Collection Of The Library Of Waseda University, Tokyo, in The Leiden University Library, 18 July-6 August 2000 (Leiden 2000) 21.

[7] Jayant S. Joshi and Rajesh Kumar, ‘The Dutch physicians at Dejima or Deshima and the rise of Western medicine in Japan’, Proceedings of the Indian History Congress 63 (2002), 1062-1072, there 1064.

[8] Blussé, Remmelink and Smits, Eventful Relations, 91.

[9] Goodman, The Dutch impact on Japan, 93-95; Blussé, Remmelink and Smits, Eventful Relations, 109-110.

[10] Ibid.

[1q]Jacques Proust, Europe through the Prism of Japan: Sixteenth to Eighteenth Centuries (United States 2002) 190.

[12] Goodman, Japan: The Dutch Experience, 83-85.

[13] Goodman, The Dutch impact on Japan, 95-96.

[14] Emiko Ohnuki-Tierney, Kanpō: Traditional Japanese Medicine of Chinese Origin (Cambridge 1984) 91-92.

[15] Blussé, Remmelink and Smits. Eventful Relations, 107-108.

[16] Goodman, Japan: The Dutch Experience, 74-75.

[17] Blussé, Remmelink and Smits. Eventful Relations, 110.

[18] Ibid., 110.

[19] Goodman, Japan: The Dutch Experience, 77.

[20] Ibid., 77.

[21] Goodman, The Dutch impact on Japan, 196.

[22] Ibid., 212-213.

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