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

Anglophone scholars originally developed the field of pre-1600 Japanese history in two ways. The initial perspective was elite cultural history, exemplified by the work of George Sansom. The other approach, elite political and institutional history, reached its apogee in John Hall’s Government and Local Power in Japan, 500 to 1700 (Princeton University Press, 1966). These two interests held scholarly attention through the 1970s, but since the mid-1980s, younger scholars became dissatisfied with these venerable approaches and began to explore other topics in social, economic, and cultural history.

One of the main tenets of the older perspectives was that Japan was an isolated, homogeneous society. To quote from Hall’s classic: “The drama of political change in Japan was, until recent times at least, almost completely an indigenous affair, and the roles and the motivations of its main actors were created and sustained by the conditions of the Japanese environment. To this extent Japan offers the ingredients of a closed system” (p. 6). This sense of the uniqueness and isolation of Japanese society has been slow to change: as recently as 2003 Bruce Batten essentially reaffirmed it in To the Ends of Japan (University of Hawai‘i Press).

In Confluences of Medicine in Medieval Japan: Buddhist Healing, Chinese Knowledge, Islamic Formulas, and Wounds of War, Andrew Goble has continued the long struggle to break away from these well-worn perspectives in two important ways. First, he has persuasively shown how closely Japan was connected to East Asia and indeed greater Eurasia in the twelfth to fifteenth centuries. Second, he has advanced study of the medieval period by exploring in overwhelming detail the story of medicine in Japan through an examination of the life and works of Kajiwara Shōzen (1265?–1337). While the author was much more successful in his first goal than his second, there is much to be learned from a careful reading of Goble’s monograph.

In a brief introduction, the author sets forth his theme: “the dissemination and appropriation of Song medical knowledge in thirteenth- and fourteenth-century Japan” (p. xiii). After a brief summary of the contents and discussion of his sources, Goble turns his attention to what he calls “The Kamakura Context” in chapter 1. This chapter is a tour de force in which Goble explores and describes what he calls “the second wave of Chinese influence” on Japanese society, taking place during the era 1100–1400. Here the author shows the difference between the East Asian and Eurasian worlds as seen from the basically closed society of Kyoto civil aristocrats and the wide-open commercial center that was Hakata in northern Kyushu. He also discusses in some detail what has come to be recognized as the East Asian world of horizontal ties established among members of the Buddhist community. In particular, he discusses Eisai (preferred reading Yōsai, 1141–1215) and Enni (1202–80) to flesh out his point about the East Asian scope of activities of the most well-known monks. This illuminating section is followed by more excellent material on the Ritsu sect and its social welfare work with outcastes and disease victims. The author concludes chapter 1 by discussing the development of Kamakura as a city and port. While I might quibble with the author’s characterization of Yōsai and his devotion to tea, nonetheless, the first chapter is the most illuminating, interesting, and accessible chapter of the book. It will leave most readers wishing for more.

Unfortunately for the reader, Goble then retreats into bibliophilia, as he dissects his chosen texts, Shōzen’s Ton’ishō and Man’anpō, for references to Song medical texts. To be sure, there is a short section in chapter 2 on women’s medicine, but most of chapter 2 is rarified stuff that will interest very few. Chapter 3 describes pharmaceuticals as seen...