Confluences of Medicine in Medieval Japan: Buddhist Healing, Chinese Knowledge, Islamic Formulas, and Wounds of War (review)

Any work dealing with the history of medicine in Japan will include a discussion of the priest-physician Kajiwara Shōzen (1265–1337) and his two monumental contributions to medieval Japanese medicine: the Ton’ishō of 1304 and the Man’anpō of 1327. The Ton’ishō was both the first medical treatise written in Japanese and the first medical treatise in Japan intended for a wide audience; the Man’anpō, written in Chinese, was the most comprehensive medical work of its day. Andrew Goble’s Confluences of Medicine in Medieval Japan: Buddhist Healing, Chinese Knowledge, Islamic Formulas, and Wounds of War is the first full-length study in any language on these two works. It is also the first volume in English to focus exclusively on medieval Japanese medicine. For these two reasons alone this book makes a valuable contribution to scholarship on premodern Japan and, more broadly, to the history of medicine and science. In one relatively compact volume—which nonetheless manages to include maps, endnotes, a glossary, a bibliography, and an index—Goble provides an overview of the historical, institutional, and intellectual context for Shōzen’s work. The bulk of the text, however, is dedicated to examining and analyzing the continental sources of Shōzen’s knowledge, his writings on various ailments, and many of the cures he recommended. Of particular significance is Goble’s treatment of Shōzen’s discussion of rai, a condition that roughly correlates with what is today known as Hansen’s disease or leprosy, and which had major religious and social implications in medieval Japan.

Goble’s main interests are twofold: to situate Shōzen’s work within a larger East Asian macro-culture (including what he refers to as the “Pharmaceutical Silk Road” connecting East Asia with the Islamic world), and to show that Shōzen, unlike many of his predecessors, did more than simply copy information gleaned from texts, but actively tested and refined the knowledge that they transmitted. Through a careful study of the extant Song- and Yuan-dynasty medical texts to which Shōzen referred, Goble is able to determine how he dealt with contradictions within and between his sources, how he struggled to arrive at standards of weight and measurement, and how he dealt with formulas containing materia medica that were either new to, or not available in, Japan. He points to numerous cases in which Shōzen relied on his own clinical experience to modify the recipes his sources offered. Through these and other examples, Goble consistently highlights Shōzen’s empiricism and pragmatism.

Since one of his central concerns is the question of how knowledge is transmitted and assimilated—in particular the effects of the Song-dynasty print revolution and the impacts of extensive trade networks linking East Asia with the Middle East—this book will be a useful reference for scholars seeking to place medieval Japan in broader East Asian contexts, as well as for those interested more generally in the study of premodern transnational economies of materials and ideas, the history of science and technology, and the history of print culture. The fact that Shōzen was a Buddhist priest working out of the major temple-hospital of Gokurakuji also makes this work relevant to scholars of premodern Japanese religion. Although Goble argues that Shōzen broke with earlier forms of so-called “Buddhist medicine,” he offers researchers interested in religion and the body much to consider.

Goble’s introduction provides a general overview of the Ton’ishō and Man’anpō, informing us of their length, the number of formulas they contain, the number of sources they quote, and providing a list of some of the topics they cover (pp. xviii–xx). Although this is a useful starting point for the analysis that follows, an appendix listing the complete tables of contents of these...