Source Materials and Personalities IV. Nakatsu Municipal Museum for History and Folklore, Medical Archive Series No 11, Nakatsu City, March 2012, 108 pp.  [in Japanese]


 Murakami Gensui's Treatise on the Four Elements and Fire Absorbtion

Murakami Gensui (1781-1843), a physician serving in the feudal domain of Nakatsu during the late Edo period, was an exceptionally broad minded regional scholar with a strong interest not only in medicine and allied disciplines, but also in military studies, literature and especially in theories about the universe.

In 1814 he wrote a manuscript entitled 'On the Four Elements and the Attractive Force of Fire' (Yon gengyô kakyû no ron). While taking up the classic Western concept of Four Elements (air, water, fire, earth) als the basis of the universe, this treatise also tries to draw from the traditional Chinese concept of Five Elements (gogyô): wood, fire, earth, metal, and water.

The Four Elements are not treated equally. Air, which Murakami conceives as ki (chin. qi) serves as one of the Four Elements and at the same time as the source of life and the basic constituent of the human body. Fire is described as having the power of attracting the other three elements and thus ruling over them. Obviously he aimed at the development of an own original concept. This manuscript was the first step towards the cosmological 'Treatise on the Division of Heaven and Earth' Murakami finished six years later in 1820.


 Domain Physicians in Nakatsu as Seen in a Memorandum from 1822

The social rank of physicians and Confucian scholars employed by feudal domains in Edo period Japan is still insufficiently clarified. This study discusses a 'Memorandum on an affair concerning the Chief of the Light-Foot Soldiers' (Monogashira ikken shimatsu oboegaki ) that was put up in the year 1822. The writer, an anonymous domain official, was living in Nakatsu at the same time as the well-known physicians Murakami Gensui and Negoro Tôrin (1731-1787). While the Murakami Family was well established since generations, Negoro Tôrin, born in Kyôto as a son of the ophtamologist Negoro Tôshuku, had come to Nakatsu in 1765, where he served as domain physician. In 1772 he was also entrusted with ophtamology.

During a formal New Year's visit at the home of Kôda Sampachi, Kôda's subordinate, who was taking care of the arriving visitors, did not retreat to the annex of the reception room. This caused Negoro's considerable anger. The relation between the host Kôda, who as 'Chief of the Light-Foot Soldiers' belonged to the higher ranks among domain officials, and Negoro, a lower ranking physician was well established, but in Negoro's view this hierarchical order did not include Kôda's subordinate, a 'Light-Foot Soldier'.

Negoro's written complaint eventually found its way to the senior retainer of the domain, who judged that this affair needed be treated appropriately. The memorandum does not show his final decision, but it conveys the impression that official domain physicians did not enjoy the high social status attributed to them in modern publications on the history of medicine.


 Looking at Corpses - Negoro Tôshuku's 'True Shape of Human Bones' and its Place in Japanese Medical History

In 1732 the ophtamologist Negoro Tôshuku (1698-1755) observed the decaying corpses of two criminals who had been burned and left to rot, presumably in the outskirts of Kyôto. Nine years later Negoro reworked his sketches, made coloured drawings of the skeletal remains and added extensive comments on the bones and their function. Decades later in 1781 the noted physician and philosopher Miura Baien copied the pictures as well as the explanations during his visit to the house of Negoro Tôshuku's son Tôrin, who was living in Nakatsu since 1765 as one of the domain physicians. Miura Baien was deeply impressed by the collection of astronomical and other Jesuit books from China, that were extremely difficult to smuggle into the country. A few months later Miura incorporated his copy into the anatomical book 'Residual remarks about creation' (Zôbutsu yotan). Based on this text medical historians praised Negoro's observations as an important prelude to the epoch-making dissection of a human cadaver by Yamawaki Tôyô in 1754. Then two large scale hanging-scrolls came up during the 1970s that are nowadays displayed in the Murakami Medical Archive in Nakatsu. Two further scrolls were identified a few decades later. This study discusses the background of the Negoro family, the related source materials, and the medical and cultural background of Negoro Tôshuku's observations.

A genealogical chart kept by Mr. Negoro Masateru and an outline of the historic background of his family written by Negoro Tôshuku in 1731 show that Negoro-style ophtamology has its roots in the monastery medicine of the Negoro Temple (Wakayama prefecture) and finally in the studies of Chinese medicine conducted by the founder of Shingon Buddhism Kûkai and his followers. Like in other fields of medicine too, monks versed in the treatment of eye diseases used to treat the majority of patients throughout the middle ages. With the rise of artisans and merchants during the 16th century and the waning influence of Buddhism, eventually 'civilian' ophtamologists appeared, one among them being the ancestor of the Negoro family.

The ophtamological writings of Negoro Tôshuku reveal an independent and self-confident scholar, who had acquired a considerable expertise and developed a new theory about the nature of the cataract that secured his place in the history of ophtamology. Being keenly aware of the structure and function of the eye he stressed the importance of own observations and a critical review of traditional techings, thus taking a position quite similar to that of early modern European scholars (e.g. in the Academia de Lincei).

At present only three versions of Negoro's 'True Shape of Human Bones' have been confirmed: Miura Baien's copy in a small book format, a pair of scrolls in the Murakami Medical Archive (Nakatsu) and another pair in the Museum of Traditional Medicine (Morinomiya College of Medical Arts and Sciences). A comparison of the paper's properties, the brush writing, the depiction of bones etc. revealed that both pairs of scrolls are only copies, the latter being older than that in Nakatsu. With the exemption of a few minor writing mistakes, both scroll pairs are identical and convey the large-scale design of Negoro, but neither of them shows some important features (a bone, some lines, captions etc.), Miura had recorded in 1781.

Within the framework of the history of dissections Negoro Tôshuku deserves a prominent position, but it is still not clear why he ventured out into the field of anatomy. A broader review of related material revealed, that Negoro was not the first physician who turned his attention to human skelets. The world's oldest book on forensic medicine, the 'Washing away of unjust imputations' (Xi Yuan Lu) by Song Ci (1247), already contains a chapter on the 'Investigation of bones'. This text and similar books published on forensic medicine like Wang yu's 'Abolition of unjust imputations' (Wu Yuan Lu) eventually came to Japan too. Advertisements in Edo period Japanese books reveal, that the Wu Yuan Lu was re-printed repeatedly since the latter half of the 17th century.

Furthermore, the contributions of Edo period practitioners of osteopathic manipulative medicine (seikotsu-i) to the progress in anatomical studies have not found sufficient attention of historians yet. One of the outstanding pioneers was Kôshi Hôyoku, who, based on 17 Chinese books and his own extensive observations, layed the foundations for an autochtone tradition in the 'Therapeutical Treasures of Osteopathic Manipulation' (Honetsugi ryôji chôhôki), printed shortly after Negoro's observations and years before Yamawaki's dissection. As these therapies did not work out without an intimate knowledge of bones, articulated joints, muscles and tendons, Kôshi devoted a great part of his writings to anatomical details. His illustrations were significantly better than those in any other conteporary Japanese medical publication. Even after Western anatomical teachings had found their way into Japanese medical literature, publications such as the 'New Book of Osteopathic Manipulation' (Seikotsu shinsho) by Kagami Bunken (1755-1819) continued to demonstrate the high level of research in these circles.

Last not least, in order to liberate oneself from sensual desires, contemplations on the impurity of a decaying corpse (kuso-kan), preferably the corpse of a beautiful young woman, were part of the exercises among monks and ardent devotees since the early days of Buddhism in Japan. Graphic depictions of the nine stages of decomposition served this purpose in various formats, including hanging scrolls, handscrolls, and printed books. In addition to quotations from Buddhist textual sources, poems in classical Chinese were added to these 'Nine stage pictures' (kuso-zu).

Having grown up in a family deeply rooted in Shingon Buddhistic traditions, Negoro Tôshuku's encounter with decaying corpses inevitably must have evoked such pictures, among them one of the whole skeleton followed by one showing the disjointing. In contrast to the later dissections conducted by Yamawaki Tôyô and others, the mere observation of a naturally decaying body was still within the traditional conceptual framework. Therefore the step from contemplation to observation was comparatively small, especially for an ophtamologist believing in the power of the human eye as a mean of gaining new knowledge.


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