A Medicated Empire: The Pharmaceutical Industry and Modern Japan by Timothy M. Yang (review)

A Medicated Empire is a delightful book about medicine and its relationship with business and politics as examined through the largest pharmaceutical company in prewar Japan, Hoshi Pharmaceuticals, and its colorful founder, Hoshi Hajime. The book adds a welcome new dimension to a recent corpus of scholarship on addictive drugs in Japan. Behind the "moral economy" (Miriam Kingsberg) and grotesque necropolitics (Mark Driscoll) of the Japanese empire and stimulant-addicted affluent Japan (Jeffrey Alexander) the pharmaceutical industry was there selling healing medicines and addictive drugs.¹ The modern pharmaceutical industry developed alongside new imperialism, market capitalism, mass media, and world wars. Timothy M. Yang does an outstanding job of placing Hoshi Pharmaceuticals in this larger, global context while detailing Japan-specific information about nation-state/empire building and competition over raw materials overseas. Importantly, he raises a fundamental issue concerning the Janus-faced nature of the pharmaceutical industry in a capitalist economy as a pursuer of the public good and profits alike. His is a timely publication that reminds us that the current opioid epidemic in the United States is neither a uniquely American nor new problem.

Hoshi Pharmaceuticals was founded in 1906. Anyone who has flipped through the pages of magazines like King or Shufu no tomo has surely seen its ubiquitous ads for over-the-counter medicines with slogans like "Medicines Are Hoshi" and "Kindness First!" Founder Hoshi typified the credo of risshin shusse, or success in the world, as a commoner—albeit the eldest son of a well-to-do farmer—starting with nothing but establishing Japan's most capitalized pharmaceutical company by the early 1920s. His patent-medicine company was also the largest supplier of opium and cocaine for the Japanese government. This tension between healing medicine (patent medicines and quinine) and life-ruining drugs (opium, cocaine, and morphine) drives Yang's narrative. Hoshi's collusion with powerful political figures is another theme that runs through the book. Having grown up avidly reading science fiction shorts by Hoshi's son Shin'ichi, I knew the vindictive account given of the collapse of Hoshi Pharmaceuticals and the demise of the elder Hoshi in Shin'ichi's Bureaucrats Are Powerful, the People Are Weak.² Yang, however, presents more nuanced discussions of the rise and fall of the company without either victimizing or lionizing Hoshi.

Yang's book consists of an introduction, eight chapters divided into four parts, and an epilogue. The introduction lays out the three major arguments of the book. First, that the "global pharmaceutical industry developed as a statist and colonial enterprise" (p. 10), and that Hoshi Pharmaceuticals is an example of how the industry in Japan instilled "the values of a modern medicinal culture that supported Japan's national development and imperial expansion" (p. 3). Second, that Hoshi Pharmaceuticals accomplished the above by cultivating what Yang calls "a culture of self-medication"—of "rational, free-thinking consumers with the knowledge and ability to diagnose maladies and treat them on their own" (p. 11). According to Yang, the company promoted this culture and created consumer desire for its products while also making hefty profits out of drug addicts in the colonies who were unable to exercise such sovereignty over their minds. Third, the book makes "the connections between capitalism and medicine as a form of biopower—namely how the drug industry's market machinations helped mold pliant minds and produce docile bodies for the benefit (and sometimes to the detriment) of state rule" (p. 2). I find Yang's concept of "culture of self-medication" useful and quite effectively applied in the following chapters. How it supports the Foucauldian argument about "docile bodies," however, is not entirely clear, as I will discuss later.

The four parts, each consisting of two chapters, are organized chronologically. Part 1, "The Drug Industry, Entrepreneurship, and the State," locates Hoshi Pharmaceuticals in the nascent drug industry of Meiji Japan. Chapter 1 provides an...