15DOI: 10.4312/as.2022.10.1.15-44
“Praying for the Cure”: Transformations  
of Japanese Medical Traditions and the  
Question of Modernity
Luka CULIBERG*
Abstract
“Science” and “magic” are not simply two opposing thought processes which have a straight-
forward relationship, first, on a presumed axis of progress—from magic to science, and second, 
within the context of a presumed cultural divide—Western “science” vs. Eastern “tradition”. The 
aim of this paper is to examine in historical perspective the introduction of so-called “Western 
medicine” in Japan and examine the idea that through this introduction “traditional” Chinese 
knowledge was simply superseded by “modern” Western science. By looking into the intellectu-
al currents within the field of medicine, specifically in eighteenth-century Japan, and compar-
ing them to those in the West, the article tries to challenge the narrative of “modernity” as a sort 
of uniquely Western achievement defined by “disenchantment”, “rationalism” and “science”.
Keywords: science, medicine, West, China, Japan, tradition, modernity, epidemic, disease, 
epistemology
»Molitev za zdravilo«: preobrazbe japonskih medicinskih tradicij in vprašanje 
modernosti
Izvleček
»Znanost« in »magija« nista zgolj dva nasprotujoča si miselna procesa v neposrednem od-
nosu, najprej na domnevni osi napredka od magije k znanosti, nato pa v okviru domnevne 
kulturne ločnice – zahodna »znanost« proti vzhodni »tradiciji«. Namen tega prispevka je v 
zgodovinski perspektivi proučiti vpeljavo tako imenovane »zahodne medicine« na Japon-
skem in razmisliti o tem, ali je s to uvedbo »moderna« zahodna znanost res preprosto 
izpodrinila »tradicionalno« kitajsko znanje. S proučevanjem intelektualnih tokov na po-
dročju medicine, zlasti na Japonskem v 18. stoletju, in z njihovo primerjavo s tistimi na 
Zahodu skuša članek spodbijati pripoved o »modernosti« kot nekakšnem edinstvenem 
zahodnem dosežku, ki ga opredeljujejo »razočaranje«, »racionalizem« in »znanost«.
Ključne besede: znanost, medicina, Zahod, Kitajska, Japonska, tradicija, sodobnost, epi-
demija, bolezen, epistemologija
* Luka CULIBERG, Assistant Professor of Japanese Studies, Faculty of 
Arts, University of Ljubljana.
 Email address: luka.culiberg@ff.uni-lj.si
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16 Luka CULIBERG: “Praying for the Cure”
Introduction
Habe nun, ach! Philosophie,  
Juristerei und Medizin,  
Und leider auch Theologie  
Durchaus studiert, mit heißem Bemühn.  
Da steh ich nun, ich armer Tor!  
Und bin so klug als wie zuvor;
Johann Wolfgang Goethe: Faust, lines 354–59
There are several major factors that can disrupt the course of human societies. They 
can be broadly categorised as geological, biological and political. Within the first 
category we can count natural disasters, such as earthquakes, volcanos, landslides, 
floods, tsunamis, etc., the second would include contagious diseases, while the 
major factor within the third category would be wars. It is difficult to assess how 
a specific factor shapes the course of history, however William McNeill (1998) 
proposed in his ground-breaking book Plagues and Peoples, originally published 
in 1977, that the international movement of disease accounts for much social and 
political upheaval and ultimately change throughout human history. A similar hy-
pothesis, namely that infectious diseases are as important to understanding soci-
etal development as economic crises, wars, revolutions, and demographic change, 
is proposed by Frank M. Snowden (2019) in his recent book Epidemics and Socie-
ty, where he considers the impact of epidemics not only on the lives of individual 
men and women, but also on religion, the arts, the rise of modern medicine and 
public health, and intellectual history (Snowden 2019, 2).
Often these factors would accompany each other or overlap. Though often exag-
gerated or misconstrued in general discourse, natural disasters can have serious 
health consequences, generally associated with population displacement, specifi-
cally the proximity of safe water and functioning latrines, the nutritional status of 
the displaced population or the level of immunity to vaccine-preventable diseases 
(Watson, Gayer and Connolly 2007, 1). Wars and epidemics likewise like to join 
hands, be it the Plague of Athens which devastated the famous city-state during 
the Peloponnesian War in 430 BC or the 1918 influenza pandemic, known as the 
Spanish Flu, which killed millions in the wake of the First World War.
However, in the decades following the Second World War, a feeling prevailed that 
humanity was finally coming out on top of contagious diseases, and pathogenic 
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17Asian Studies X (XXVI), 1 (2022), pp. 15–44
calamities such as the ravaging of the Black Death, the epidemics of smallpox, 
cholera, tuberculosis, or even Spanish Flu, were becoming a thing of the past, 
only to be read about in history books and certainly not to be experienced in to-
day’s world.1 In the preface to the 1998 edition of his book, McNeill reflects on 
the 1970s’ overly optimistic atmosphere in medical science, with the prevailing 
belief that infectious diseases had lost their power to affect human lives signif-
icantly, supposing that scientific medicine had finally won decisive victory over 
germs (McNeill 1998, 9). Indeed, newly discovered antibiotics, advanced public 
health measures and other developments in medicine made infections easy to pre-
vent and cure. After all, in late 1970s the World Health Organization succeeded 
in eliminating smallpox from the face of the Earth (ibid.). However, as McNeill 
(ibid., 10) argues, this was the high point of the WHO’s remarkably successful 
campaign to reduce human death from infections and a germ “counteroffensive” 
soon followed, most notably with the HIV virus causing AIDS:
Development of resistant strains of malaria, TB, and other familiar infec-
tions was a second, and in many ways more important, sign that twenti-
eth-century victories over the parasitic microorganisms that feed upon our 
bodies was only an unusually dramatic and drastic disturbance of the age-
old balance between human hosts and disease organisms. As the century 
comes to its close, it seems sure that infections are coming back, regaining 
some of their old importance for human life … (McNeill 1998, 1) 
These words could hardly sound more prophetic in the third year of the COV-
ID-19 pandemic that is still transforming the world. While medical science pro-
duced effective vaccines which prevent contracting or at least falling victim to a 
more severe case of COVID-19, the general attitude of the public across the globe 
1 Actually, it was in the mid-70s that Ivan Illich published his book Limits to Medicine which opens 
with the famous sentence: “The medical establishment has become a major threat to health” (Illich 
1995), arguing that the “threat which current medicine represents to the health of populations is 
analogous to the threat which the volume and intensity of traffic represent to mobility, the threat 
which education and the media represent to learning, and the threat which urbanization represents 
to competence in homemaking” (ibid., 7). Following Illich’s critique, we could also argue that this 
period was a turning point where medical industry or medicalized health surpassed other diseases 
as the obstacle to a healthy life, the idea that Illich called iatrogenics. Illich claims that “The study of 
the evolution of disease patterns provides evidence that during the last century doctors have affect-
ed epidemics no more profoundly than did priests during earlier times. Epidemics came and went, 
imprecated by both but touched by neither. They are not modified any more decisively by the rituals 
performed in medical clinics than by those customary at religious shrines” (ibid., 15). We will not 
explore the theory of iatrogenics in this paper, but in arguing the relationship between “magic” and 
“science” in the field of medicine, we will be following the line of argument in his critique on the 
“magic” of “medical science”. 
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18 Luka CULIBERG: “Praying for the Cure”
is nevertheless ambivalent, with a not insignificant percentage of people having 
a strong distrust of scientific explanations or perhaps subscribing to various con-
spiracy theories relating to the pandemic and the measures taken to prevent it.
It might seem bewildering how at the start of the third decade of the twen-
ty-first century people still hold deeply unscientific or “magic” beliefs about 
medicine, and particularly vaccines. However, “science” and “magic” are not sim-
ply two opposing thought processes which have a straightforward relationship, 
first, on a presumed axis of progress—from magic to science, and second, within 
the context of a presumed cultural divide—Western “science” vs. Eastern “tradi-
tion”. The aim of this paper is to present a historical perspective on the intro-
duction of so-called “Western medicine” in Japan and examine the idea that 
through this introduction “traditional” Chinese knowledge was simply super-
seded by “modern” Western science. 
The current situation allows us to observe daily the actual complexity of beliefs 
and attitudes toward the epidemic, vaccines, masks, drugs, homeopathic treat-
ments, etc., and these observations offer useful insights into similar historical con-
texts. For example, current attitudes toward COVID-19 vaccination cannot be 
reduced to a simple opposition between pro- and anti-vaccine movements. The 
public embraces a whole spectrum of fears and beliefs that guide their convictions 
regarding vaccination. Japan has often been described as a relatively sceptical na-
tion, but in a recent paper exploring today’s vaccine hesitancy in Japan, Andrew 
Gordon and Michael R. Reich (2021) argue that the apparent low public confi-
dence in vaccines is based on a complex history of vaccine acceptance and resist-
ance, and that while today the recommended routine vaccines are generally ac-
cepted, the cases of vaccine failures and improper official reactions to these have 
nevertheless generated significant public and official hesitancy toward some new 
vaccines in the country.
Belief in “Science”
Vaccination is indeed an unusual technology within the field of medicine. Vac-
cines are not a cure. One does not take them when sick hoping to get better. In-
stead, vaccines are administered only to healthy people with the idea that those 
who get the shot will not get sick if they are infected at some later date. And this 
is indeed strange as a concept of medication, requiring a certain leap of faith be-
cause it expects us to believe that we have not fallen ill precisely because we took 
the vaccine. And because we can never know this, we must believe it.
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19Asian Studies X (XXVI), 1 (2022), pp. 15–44
However, we should not conflate this belief with the often professed “belief in sci-
ence”. We should not gloss over the fact that “science” is a complex notion which 
warrants some caution when invoking its powers. There is a significant difference 
between understanding the scientific method as the best possible tool for the inquiry 
into the nature of things, and an approach to “science” as an object of adoration. Nev-
ertheless, we regularly come across narratives professing “belief in science”, which 
supposedly legitimizes the believer’s stance and provides them with the argument 
to crack down on “nonbelievers”. But science is not something to be believed, it is 
something to be practiced no matter how often scientific conclusions turn out to be 
false. If we profess our belief in science, then nonbelievers can (and they inevitably 
do) simply point to any of those instances when scientists got things wrong (or were 
deliberately misleading, which, naturally, happens as well), and they can justifiably 
ridicule our blind faith. Scientists use the scientific method and operate with theories, 
while believers conflate them for truths. Aside from the question of whether the re-
sults of the scientific investigation are “true” or not, science itself cannot be “true”. 
Science is instead a historical mode of thought and inquiry which can provide us 
with better and more accurate explanations of the world we live in.
By saying that science is historical rather than true, I want to emphasize that the 
application of a specific method of inquiry, which we call the scientific method, has 
its own history with its origins and historical development, which is, as we have 
long been aware, not a continuous progress toward universal truth, but rather a 
process of paradigm shifts or scientific revolutions. Our aim in this paper is not to 
follow the development of the scientific method across cultures, but to look more 
specifically into the nature of medical practice and how attitudes toward medicine 
correlate with the so-called shift to modernity. 
Have We Ever Been Modern?
We still tend to explain the world history in terms of “progress”, “enlightenment”, 
“modernity”, etc. by which we try to give meanings to various phenomena re-
garding human institutions and structures in various societies. The ideological 
background of the project of modernization requires the modernizing societies 
to be cut off from their premodern traditions. On the other hand, for the new 
modernized regime to be maintained, it is necessary to establish the legitimacy 
of the new order by relying on continuing cultural traditions2 (Shiraishi 2018, 
2 In this sense, as Andrew Horvat (2018, 190) notes, “traditional values—whether historically accu-
rate or constructed—continue to function as social norms, the benchmarks by which correct be-
haviour is judged.”
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20 Luka CULIBERG: “Praying for the Cure”
52). Contemporary sensibilities have discouraged us from the self-assured desig-
nations of the anthropology of the past, such as “primitive societies” or “societies 
without history”, and we have adopted a more relativistic approach to human di-
versity talking rather about “multiculturalism” or “cultural diversity”, but we have 
yet to rethink the attitudes or perceptions that see the world we live in as detached 
from our past by that rational enlightenment, that triumph of reason, which has 
made us modern.
Modernity is essentially understood as a specific view of human societies and 
their relation to nature, most commonly associated with the notion of “the dis-
enchantment of the world”, i.e. the historical process by which the natural world 
and all the areas of human experience become experienced and understood as 
less mysterious ( Jenkins 2000, 12). However, the narrative of a straightforward 
trajectory that took Western people from believing in spirits, myth and magic to 
modern, rational individuals has been thoroughly challenged. Josephson-Storm 
(2017) traces the genealogy of this narrative which supposes that the defining 
feature of “modernity” is the departure of the supernatural, the narrative which 
equates modernity with the rise of instrumental reason and alienation of human-
ity from nature.
This narrative is connected to another narrative that describes the history of the 
modern scientific paradigm in terms of the rise of mathematical physics and 
the construction of a model of a “clockwork universe” that no longer needed 
spirits or a deity to drive the motor of the cosmos ( Josephson-Storm 2017, 5). 
In his pursuit of this myth of Euro-American modernity and its putative rela-
tionship to rationality and nature, Josephson-Storm (2017, 5–6) explores the 
presence of magic in the very instances when disenchantment was itself being 
theorized.
Some, like Jenkins (2000, 28–29), have argued that (re)enchantment is no less 
diagnostic of modernity than disenchantment, although it might be even more 
productive to try and rethink the idea of modernity itself. We should ask our-
selves, whether modernity provided specific, modern, i.e., radically different re-
sponses in comparison to premodern ones to the above-mentioned factors of 
social disruption? Does it construct geological, biological, or political factors 
in some particularly modern and disenchanted way, compared to premodern 
societies?
The short answer would be no. “Modernity” has not eliminated warfare. It can be 
argued that modern rationalism along with technological advancement has indeed 
“rationalized” killing, be it the form of mass murders in German death camps or-
ganized in a manner of Fordist industrial production, or the “rationalization” of 
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21Asian Studies X (XXVI), 1 (2022), pp. 15–44
“collateral damage” by the application of the contemporary drone technology.3 
However, no matter how technology allowed for the “rationalization” of killing, 
be it providing solutions to how to kill either more or fewer people efficiently, the 
fact remains that survival is the self-interest of any individual and that people kill-
ing each other is, at least for those actually facing the possibility of dying, a highly 
irrational endeavour usually fuelled by emotions such as hatred or fear.
In case of geological factors, no matter how people explained causes of natural 
disasters, they attempted to protect themselves by both “rational” and “irration-
al” solutions—they were building dams, canals, and earthquake-proof buildings 
while at the same time they were praying to the gods of nature. As for human 
health, even though we tend to think that “premodern” societies relied more on 
magic than science, a look into the history of medicine reveals that people of all 
times and cultures were investing quite a lot of effort into finding cures to supple-
ment their prayers and magic. 
As natural disasters continue to afflict mankind, we try to alleviate their impact by 
means of technology, although people still resort to prayer. As we have seen, we 
make use of the advances in technology to improve our lives, while at the same time 
we use them to wage even bloodier and more lethal wars. Both aspects are charac-
teristics of modernity. In the field of disease, we continue to do what humans have 
been doing for millennia—we try to keep up with the pathogens by developing our 
medical science with the aim of preventing or curing a disease. However, as Ivan 
Illich (1995) warned us in his critique of the modern medical system, we could be 
falling victim to another “enchantment”—the magic of the medical profession.
At the beginning of this paper, I listed infectious diseases in the category of biolog-
ical factors, but we must be clear from the start that diseases, while being of course 
3 Writing about drone warfare, Gusterson (2019, S78) describes these “rationalizations” allowing 
drone operators to defer a strike until there are no or at least few civilians nearby, and then consult 
with military lawyers who can decide whether the likely civilian casualties would be deemed “pro-
portionate”, and therefore acceptable, within the frame of the laws of war. Drone operators can also 
use special software to calculate the probable damage radius (and thus the likelihood of civilian 
“collateral damage”) depending on the ordnance selected and the placement of the missile. The pro-
ponents of the so-called “technomorality” of drone warfare argue that it represents a kinder, gentler 
way of fighting (ibid., S77). George W. Bush’s CIA director, Michael Hayden, quoted in Gusterson 
(ibid.), described drone warfare as “the most targeted and effective application of firepower in the 
history of armed conflict,” and called the drone “an exquisite weapon when you want to be both ef-
fective and moral”. In a similar vein, Harold Koh, legal advisor to the State Department during the 
Obama administration, said, “because drone technology is highly precise, if properly controlled, it 
could be more lawful and more consistent with human rights and humanitarian law than the alter-
natives” (ibid.). The “rationalization” of killing can thus cut both ways: in the case of German death 
camps, it was perceived as the absolute lowest point for human beings as moral beings, while in the 
case of drone killings it is presented as the epitome of morality within warfare.
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22 Luka CULIBERG: “Praying for the Cure”
a pathological reality, are at the same time also a social construction (Hays 2009, 
1). Apart from its material manifestation, a disease is also constructed through 
various convictions about it. What concerns us here, therefore, is not the biomed-
ical “reality” of disease or scientific “rationality” in the history of medical practice, 
but rather the idea of rationality itself as manifested in the attitudes, responses 
and beliefs regarding disease and medicine. Through historical survey, I want to 
focus on the question of how societies across the cultural spectrum construct their 
convictions and attitudes toward disease or medicine in a broader sense. I want 
to question the idea of a fundamental divide between the “modern”, rational and 
scientific attitude based on the European Enlightenment and non- or premodern 
“magical” approaches. To better explore this, I next present a brief overview of the 
history of medical tradition in Europe and Japan.
European Medical Tradition
According to Hays (2009, 9), the ancient Greek attitudes and practices show that 
the border between “supernatural” and “natural” approaches could be very unclear, 
as it had been for the earlier Egyptians:
The best-known healing tradition of the early Greeks was associated 
with the cult of Asclepios, a mythic hero who emerged as a lesser god in 
the Greek pantheon of the sixth century B.C.E. The sick would repair to 
the temple of the god and perform ritual sacrifices and bathings, followed 
by a crucial “incubation sleep” in which dreams and visions appeared to 
the sufferer. Those dreams either healed directly, or gave directions (inter-
preted by the priests of the god) for an appropriate therapeutic regimen, 
which might include bathing, rest, the administration of drugs, and at-
tention to diet. (Hays 2009, 9–10)
This cult of Asclepios, according to Hays (2009, 10), gained a wide following in 
subsequent centuries, extending into the Greco-Roman world as the principal 
pagan religious response to disease. Then there was a Hippocratic tradition which 
had some of its roots in Asclepian temple medicine, but it also included both old-
er traditions of surgery and pharmacology and some newer conceptions of nature.
By assigning explanations for the phenomena of health and disease to nature and 
reason, the Hippocratic physicians rejected superstition, divination, and magic. 
They reasoned that if the world was uniform and natural, all phenomena were 
equally part of nature and if the gods were responsible for any particular phenom-
enon, they were equally responsible for all phenomena (Magner 2005, 95). This 
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23Asian Studies X (XXVI), 1 (2022), pp. 15–44
rejection of magic therefore cannot be interpreted as an intellectual shift from 
magic to reason, but rather a shift in understanding nature as both natural and 
divine. While Hippocrates ridiculed the deceptions practiced in the name of reli-
gious healing, he was not opposed to prayer and piety (ibid.).
Based on the Hippocratic tradition of understanding anatomy and medicine 
through the theory of humorism, the most famous physician and philosopher of 
European antiquity, Galen, later influenced both medieval Christians and early 
Muslims (Hays 2009, 11). Indeed, no other figure in the history of medicine has 
influenced the concepts of anatomy, physiology, therapeutics, and philosophy as 
much as Galen, the physician known as the Medical Pope of the Middle Ages and 
the mentor of Renaissance anatomists and physiologists (Magner 2005, 121). His 
explanation of human physiology was “systemic” in the sense that if disease was a 
product of the imbalance of the humors carried by the different systems, the phy-
sician should restore the balance (Hays 2009, 13). Galen, like many other physi-
cians in the Roman Empire, was Greek, because the Romans among whom Galen 
lived generally did not “practice medicine” as a profession. They rather explained 
disease as the product of the many gods who superintended each household and 
indeed each part of the body, and heads of families performed the appropriate 
rites and sacrifices to preserve family health (ibid.).
Christianity brought a radically different conception of healing which grew out of 
a religious view which, as Hays (2009, 14–15) argues, sharply contrasted with the 
ideas of the Greco-Roman culture. It combined the ideas of Judaism, which were 
shared with Mesopotamian cultures in relating disease to errant behaviour that 
angers the gods, while the other emphasis was the association of disease and the 
“unclean”. On the other hand, in contrast to the Jews, the Christians lived in the 
expectation of the imminent end of the world:
Perhaps because things of the body therefore seemed transiently insig-
nificant, perhaps because pagan learning was not to be trusted, some 
Christians scorned the orthodox healing routines of the Greeks and 
Romans. Perhaps the traditions of Hippocrates, or Asclepios, were too 
closely associated with other gods, while the elaborate purification rituals 
of the Jews represented the “law” that Jesus’s teaching had superseded. 
The Christians lived in a world entirely dominated by their god’s imma-
nence; disease and health, if they had any importance at all, acquired such 
importance as manifestations of God’s power and will. (Hays 2009, 15)
After the fall of the Roman Empire, the early centuries of the European “Middle 
Ages” were primarily based on agricultural production with little long-distance 
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24 Luka CULIBERG: “Praying for the Cure”
trade, and this profoundly rural society lacked the urban concentrations that en-
couraged airborne diseases, so major epidemics were largely absent in Europe 
until the plague returned in the fourteenth century (ibid., 19). With the later 
growth of urban centres and long-distance trade, however, medieval cities be-
came intensely crowded and very dirty. The lack of sanitation on one hand meant 
high levels of intestinal infections, such as diarrhoea, dysentery, and typhoid fever, 
while on the other hand bigger crowds meant tuberculosis, influenza, smallpox, 
measles, and of course the plague (ibid., 36).
European medical doctrine regarding contagious diseases in those times was 
based on the concept of miasma (pollution) or as it was also known—mala aria 
or “bad air”. However, though the miasma remained a predominant theory re-
garding the cause of disease up until the late nineteenth century, when the un-
derstanding of pathogens as the causes for infectious diseases replaced miasma 
theory with germ theory, the so-called “Black Death” epidemic of the fourteenth 
century had already prompted some reactions that seemed based on the idea of 
contagion (ibid., 54). So, as Hays (2009, 54–55) argues, by the fifteenth century 
the members of health boards gradually began acting on more clearly contagionist 
assumptions which led to more direct interference in the lives of both individuals 
and groups. As such, occasions that brought crowds together, like school classes, 
church services and religious processions became suspect, and were thus objects 
of regulation. 
These public health control measures that were articulated and practiced in fif-
teenth-century Italian city-states included municipal quarantine and isolation of 
the victims, and thus with a health commission’s declaration that the plague was 
present in a city, a series of administrative and political measures were implement-
ed whose goals were quarantine and isolation (ibid., 55).
The complexity of responses to disease from antiquity well into “modern” times 
certainly belies the idea that the development of a “scientific” thought process 
followed an imaginary trajectory from “magic” to “reason”. Any change should 
rather be understood as shifts in mode of thought, sort of epistemological shifts, 
that seldom completely abandon existing epistemological foundations. Scientific 
revolutions do not occur that often, and Galen remained the ultimate authority on 
anatomical and physiological questions at least until the sixteenth century (Mag-
ner 2005, 124):
Never satisfied with purely anatomical description, Galen constantly 
struggled to find ways of proceeding from structure to function, from pure 
anatomy to experimental physiology. It is rare to encounter a problem in 
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25Asian Studies X (XXVI), 1 (2022), pp. 15–44
what might be called classical physiology that Galen did not attempt 
to cope with either by experiment or speculation. By extending medical 
research from anatomy to physiology, Galen established the foundations 
of a program that would transform the Hippocratic art of medicine into 
the science of medicine. (Magner 2005, 125)
As Hays (2009, 78) writes, indistinct boundaries divided science, religion, 
magic, empirical healing, and folk custom, regardless of the role of God’s will 
as the major explanation of the origin of disease. According to Magner (2005, 
197), the Renaissance era may have ultimately transformed European cul-
ture in a profound and permanent way that led to the modern world, but it 
was also a period in which superstition, mysticism, intolerance, and epidemics 
flourished.
The development of international trade ushered in an era of exploration which, in 
its turn, set in motion the technical innovations that were based on scientific re-
search. The so-called age of scientific revolutions brought challenges on many fields 
of ancient knowledge and medicine was by no means an exception:
Important philosophers in the early seventeenth century, especially Des-
cartes and Francis Bacon (1564–1626), came to the radical conclusion 
that all past knowledge was uncertain and that the human mind must 
begin anew on different epistemological principles, whether those of de-
ductive reason and mathematics (as Descartes urged) or of the inductive 
collection of data (as Bacon argued). In either case authority—perhaps 
Aristotle’s, perhaps Galen’s, perhaps Christianity’s—must be set aside. 
(Hays 2009, 99)
This raises the question of just how far did the Enlightenment affect the prac-
tice of healing? Hays (2009) makes an interesting argument showing how deeply 
scientific conceptions were related to broader social circumstances and attitudes. 
Despite all the advances in “scientific thinking”, this scientific thought was bound 
to the wider conceptions of the rerum natura, and both medical ideas and practic-
es followed from this. For example, regarding the cause of epidemic disease, there 
remained a basic disagreement between the miasma or “bad air” doctrine and the 
idea of contagion (ibid., 109).
In fact, by the seventeenth century many states had evolved elaborate public health 
mechanisms to deal with the plague, but during the eighteenth century that ma-
chinery, and the thinking behind it, largely fell from favour, and the reason for this, 
according to Hays (2009, 110–11), is that in part the miasma theory might have 
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26 Luka CULIBERG: “Praying for the Cure”
been more sympathetically regarded by those Enlightenment thinkers who empha-
sized the rights of individuals against the coercive powers of the state. Undoubted-
ly much liberal Enlightenment opinion resisted the infringements on liberty that 
came with a contagionist doctrine, such as quarantines and health passes, which 
they considered as classic instruments of a heavy state hand. Just as those who today 
oppose the mask mandate in the name of personal liberty and argue “rationally” that 
masks cannot stop the virus, so the eighteenth-century liberals argued “rationally” 
that disease is spread not through contagion but through “bad air”.
On the other hand, contagionist arguments may also have withered because the 
plague ceased to be a major menace in the eighteenth century, which called into 
question the utility of the machinery designed to divert it. Seventeenth-century 
thinkers increasingly relied on mechanical and iatrochemical explanations for the 
causes of new diseases such as curvy, syphilis, rickets, and above all the “fevers”, 
such as typhus, malaria yellow fever, and influenza. However, older explanations, 
such as divine wrath, plutonic exhalations, unfortunate astrological conjunctions, 
etc. persisted (ibid., 109–10).
Medicine in Japan
From the fifth century on the inhabitants of the Japanese archipelago gradually 
adopted more advanced medical techniques from the Asian mainland through 
Korea, eventually called kanpō igaku4 漢方医学 or “Chinese medicine”, which 
came to form the main current of Japanese medical practice until well into the 
second half of the nineteenth century (Otori 1964, 20). In fact, practices under-
stood under the term of kanpō persist in Japan to this day, and according to data 
from the Japan Kampo Medicines Manufacturers Association ( JKMA) during 
the period from August 5, 2008 to September 12, 2008, 83.5% of 684 medical 
doctors stated that they were using kanpō (Motoo, Seki and Tsutani 2011, 85). 
Kanpō is still greatly integrated into modern medicine in Japan by being a part 
of the medical education given at all 80 medical schools in the country since 
2005 (ibid., 86).
Of course, “Chinese medicine” is just as heterogenous, diverse and complicated as 
the previously described “European tradition”. The earliest written evidence ex-
tant today on the theoretical and practical consequences of illness in China dates 
from approximately the eleventh century BC, and testifies that at the time it was 
assumed that the well-being of the living depended to a considerable extent on 
4 Also sometimes transcribed as kampō.
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27Asian Studies X (XXVI), 1 (2022), pp. 15–44
their interactions with the non-living members of the community, i.e., with their 
ancestors:
An adherence to specific norms was thought to guarantee social and 
individual health; transgressions were known to cause the wrath of the 
dead, who then had to be propitiated with sacrifices. The communication 
between the living and the nonliving that was necessary to establish the 
cause of an affliction and to identify an appropriate remedy was recorded 
on bones and turtle shells, many of which were found in the soil, espe-
cially in the province of Henan, earlier this century. Whether the belief 
in ancestral intervention was supplemented by a pragmatic application of 
drugs or other empirically valuable means of therapy was not document-
ed in written form at this early time. (Unschuld 1993, 20)
Unschuld (ibid.) writes that subsequent political changes during the first millen-
nium BC, with centuries of civil war, may have been responsible for the rise of a 
new worldview in which the emphasis switched from the belief in the effect of 
ancestral curses or blessings on the health of the living to one that understood 
health or illness predominantly as an outcome of successful protection against the 
possibility or manifestation of an onslaught of not only visible but also invisible 
enemies, like demons.
Some of these ancestral and demonological notions survived until the present 
time as important aspects of the overall system of conceptualized and practical 
health care, although this should not be interpreted as simply adhering to a “mag-
ical” approach toward disease. According to Unschuld (1993, 20), Chinese med-
icine, documented since the second century BC, developed as a system of ideas 
and practices based on insights into the laws of nature rather than on metaphysics, 
while still embodying some of the fundamental tenets of those earlier approaches 
to understanding health and healing, namely an emphasis on cause-effect rela-
tionships and a localistic-ontological notion of disease.
As early as the first century AD, various schools of medical thought had been 
founded in China and were already producing diverging ideas. These were com-
piled under the name of the mythical Yellow Emperor and have become the classic 
text and fundamental source of traditional Chinese medicine—the Huandi Nei-
jing 黃帝內經 or the Inner Canon of the Yellow Emperor (ibid.). Another impor-
tant document for understanding the history of Chinese pharmaceutical knowl-
edge is the text, dated to the third century BC, found in the archaeological site of 
Mawangdui and subsequently called Wushi'er Bingfang 五十二病方 or Recipes for 
Fifty-Two Ailments. From these and other ancient sources it is possible to deduct 
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28 Luka CULIBERG: “Praying for the Cure”
the nature of the early developmental phase of Chinese medicine. According to 
Unschuld, central to Chinese medicine is its perception of the human organism: 
… the human organism was described in Han sources as a system of 
individual functional units that stored, distributed, and processed re-
sources, which were brought into the organism from the outside or were 
developed within. The individual units were linked through a system of 
channels, thought to transport resources from one place to another and 
join the units to the outside world. The terminology used to describe 
the structure and workings of the organism is largely metaphoric and is 
based on images from the geographic, economic, and social environment 
of the Ch’in and Han dynasties in China. (Unschuld 1993, 21)
These resources that passed through the organism and represented a “vital force” 
thought to be the carrier of life were called qi 氣 in Huangdi Neijing (ibid.). For 
a long time, at least until the end of the Song dynasty in the thirteenth century, 
a dichotomy prevailed between two major currents, which Unschuld (ibid., 23–
24) relates to the basic antagonism between Confucian-legalist thinking and the 
Daoist worldview: one was the so-called medicine of systematic correspondence, 
the other was pragmatic drug therapy. Various schools emerged within the frame-
work of systematic correspondence, advocating the existence of two (yin and yang) 
or five (five phases) categories of all phenomena. It was only after the Song dynas-
ty, between the thirteenth and fifteenth centuries, in the aftermath of the rise of 
Song Neo-Confucianism, that certain Confucian-legalist and Daoist tenets were 
united for a few centuries and attempts were made to construct a pharmacology 
of systematic correspondence (ibid., 24).
We should be wary, though, of explaining too much of the medical beliefs and 
practices simply by examining traditional Chinese ideological systems. After all, si-
nologists in recent decades have discredited many times the notion that Confucian-
ism, Daoism or Buddhism were just abstract and unchanging essences that deter-
mined the shape of intellectual history (Sivin 1988, 53). Still, according to the basic 
Chinese medical philosophy, disease was primarily caused by an imbalance of yin 
and yang, resulting in a disorder of one of the five phases, expressed as a dysfunction 
of the corresponding organ and the organs controlled by it. Therefore, all therapies 
were directed toward restoration of a state of harmony (Magner 2005, 72).
If we had to forcibly juxtapose both traditions, we could say that Western anat-
omists studied the body as if dealing with an assemblage of bits and pieces be-
longing to a machine, while, in contrast, classical Chinese anatomy was more 
concerned with the dynamic interplay of functional systems rather than specific 
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29Asian Studies X (XXVI), 1 (2022), pp. 15–44
organs (ibid., 71). Despite considerable debate about various details, we should 
not simply project modern notions of “official” versus “traditional” medicine back 
in the past, and we would be at great pains to establish the difference based on the 
“scientific” vs. “magical” divide. For example, there is little argument about the fact 
that Chinese scholars accepted the relationship between the heart and the circu-
lation of the blood long before these concepts were incorporated into Western 
science and medicine by William Harvey (1578–1657) in the early seventeenth 
century (ibid., 72).
As mentioned above, Chinese medicine probably became the standard in Japan 
sometime from the fifth century onwards. From the formation of the centralised 
state the Japanese view of disease was thus primarily influenced by Chinese med-
icine. The description, diagnosis, and treatment of disease in premodern Japan 
almost always derive from Chinese texts, though Buddhist scriptures from In-
dia could also influence how disease and medicine were perceived in early Japan 
(Farris 1993, 376). According to Farris (ibid.) it is unclear how much the Japa-
nese knew about disease and its treatment before Chinese and Indian influences, 
because about the time that the Japanese government borrowed the Chinese cus-
tom of recording outbreaks of disease it also borrowed their medical theory. Some 
medical practices reported during early epidemics may well derive from native 
Japanese view that saw disease as demonic possession to be exorcised by shamans 
and witch doctors (ibid.).
It certainly seems plausible that ancient oral societies primarily resorted to mag-
ical practices in battling disease, but since we have no records of their “reasoning” 
behind those practices we can only speculate about the actual “epistemology” of 
their medical thought. However, based on other “ancient” practices, like hunting, 
for example, which regularly involve “magical” rituals, we can speculate that just 
as people involved in hunting pay no less attention to the production of suitable 
weapons, to the studying of the behaviour of animals, and so on, ancient oral soci-
eties gave no less thought to “rational” healing practices. Just as hunters knew that 
magical rituals alone would not bring dinner to their table, so healers always tried 
to combine “magic” with healing techniques.
From the time people on the Japanese archipelago introduced Chinese medical 
concepts and practices along with Chinese writing system we can follow their in-
tellectual thought processes with more certainty. By the time we reach the medie-
val and early modern periods, we can observe that Japanese medicine was already 
the site of multiple and conflicting understandings of the human body, its diseases 
and treatment:
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30 Luka CULIBERG: “Praying for the Cure”
These different perspectives—especially, Buddhist, Chinese, and West-
ern—do not reflect some inevitable movement from a less sophisticated 
understanding of medical science to a more sophisticated (Western) one. 
Rather, these different medical views often coexisted, particularly in the 
early modern period. (Deal 2006, 232)
We have already mentioned at the beginning of this chapter, that the so-called 
“traditional Chinese medicine” or kanpō still coexists with the so-called “West-
ern medicine” in Japan. Although the Japanese embraced different medical tra-
ditions, both Chinese and Western medical procedures were used to treat certain 
common and widespread diseases. There are difficulties, however, in determining 
today exactly what these past diseases may have been, which is due in part to the 
different ways in which Chinese and Western medicine understood, described, 
diagnosed, and treated these conditions. Diseases known to have afflicted the Jap-
anese include leprosy, smallpox, syphilis, malaria, tuberculosis, influenza, and mea-
sles (ibid., 233).
Chinese medicine was practiced in Japan with little modification until the early 
modern period. In the Heian period (794–1185), the aristocratic court physician 
Tanba no Yasuyori 丹波 康頼 (912–995) wrote the Ishinpō 醫心方5 (Methods at 
the Heart of Medicine, 984), the oldest extant Japanese medical text that compiled 
Chinese medical treatises into 30 volumes. Among the topics explored in the Ishin-
pō were diseases and their origins and treatments (ibid., 233–34). There is noth-
ing “magical” about the medical knowledge in this tenth-century treatise which 
covers clinical treatments drawing from the ancient Chinese traditional medicine 
and influenced by Indian medical theories found in Buddhist scriptures as well as 
Daoist references (Sugimoto and Swain 1989, 140).
From the Muromachi period (1336–1573), a medical perspective blending 
Neo-Confucianism and Chinese medicine known as the Li-Zhu School began to 
attract the interest of Japanese medical practitioners, which was partly a result of 
the interest taken by Japanese Zen monks in Chinese Neo-Confucian ideas, such 
as vital force and principle 理 (Chinese: li; Japanese: ri). The school, which derived 
its name from two Chinese physicians, Li Dongyuan 李東垣 (1180–1251) and 
Zhu Danxi 朱丹溪 (1281–1358), viewed disease as the direct consequence of a 
poor lifestyle and vital force imbalances. Treatment consisted of combinations of 
herbal medicine, acupuncture, and moxibustion (ibid., 234).
In the late Muromachi period, Manase Dōsan 曲直瀬道三 (1507–1594) es-
tablished the Li-Zhu School as an orthodox approach to medical theory and 
5 Also transcribed as Ishimpō, Ishimhō or Ishinhō.
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31Asian Studies X (XXVI), 1 (2022), pp. 15–44
practice. Dōsan, who was both a physician to the imperial family and a promi-
nent teacher, trained doctors in Li-Zhu medical theory and practice at his private 
medical school (ibid.). His influence continued well into the Tokugawa period 
(1600–1868), gaining support from high-ranking warriors and the shogunate. As 
Deal writes, one of the great contributions made by Dōsan and his followers to 
the Japanese practice of Chinese medicine was to establish standard procedures 
for diagnosing disease:
According to these procedures, there were four observations that a phy-
sician needed to make to accurately assess a patient’s disease: 1) visual 
observation, especially of such things as skin color, hair condition, feces, 
and urine; 2) auditory observation of such things as coughs and verbal re-
sponses made to pain when the patient was touched, and olfactory obser-
vation of patient odors; 3) observation of patient responses to physician 
questions concerning such things as appetite and emotional state; and 4) 
observation of pulse and abdomen through touching the body in various 
ways. (Deal 2006, 234)
It was in the Tokugawa period (1600–1868) that the most important achieve-
ments took place in medicine. Medical progress was able to build on the exist-
ing base of Chinese medicine, and physicians trained in the Chinese tradition 
later helped to introduce Western science (Bartholomew 1989, 13). The Li-Zhu 
School remained influential but there was one important competing school of 
Chinese medicine that developed starting at the end of the seventeenth century—
the School of Ancient Medicine, kohō 古方 or koihō 古医方 (Deal 2006, 234). It 
was rooted in a scholarly trend from the late seventeenth century developed by 
Confucian scholars who increasingly rejected Neo-Confucian interpretations of 
the Confucian classics in favour of a direct reading of the ancient texts.
One of the famous proponents of the School of Ancient Medicine was a Kyōto 
physician, Yamawaki Tōyō 山脇 東洋 (1706–1762), author of the famous medi-
cal text Zōshi 蔵志, a book on internal organs, published in 1759, who, according 
to Deal (ibid., 235), represents a bridge between Chinese and Western medicine 
as practiced in Japan. Although he administered Chinese medicine as an imperial 
court physician, he began to have doubts about the traditional Chinese view of the 
structure of the human anatomy:
According to this traditional anatomical view, the human body was con-
ceptualized, without any empirical or visual verification, as encompassing 
five organs and six viscera that interacted with each other and with the 
meridians, paths along the body through which vital force flowed. In 
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32 Luka CULIBERG: “Praying for the Cure”
turn, the five organs corresponded to traditional Chinese views of the five 
elements: heart/fire, lungs/metal, kidneys/water, liver/wood, and spleen/
earth. The organs themselves were not a site of treatment in tradition-
al Chinese medicine, that is, disease was not caused by malfunctioning 
organs. Rather, this anatomical view related to the idea that disease was 
caused by imbalances in and disruptions to vital force and the five ele-
ments. Toyo’s doubts about the traditional view of human anatomy came 
about in part because of an anatomical description in one of the Chinese 
classics that asserted that the body contains nine organs. To determine 
which anatomical view was correct, Toyo received permission to dissect a 
human body, which he did in 1754. In 1759, Toyo presented the results of 
his observations in a publication entitled Zoshi (Anatomical record). Al-
though Toyo’s findings contradicted the traditional view, the five organs 
and six viscera theory remained orthodox. (Deal 2006, 235)
Yamawaki Tōyō’s experiments and doubts in the orthodoxy of Chinese teach-
ings were important factors in the intellectual turn toward Western medicine. 
What needs to be pointed out here is that this turn did not happen solely because 
Western medicine was recognized as “better”, but because it appeared to be more 
in line with the intellectual shift within Confucian thought, a shift that sought 
greater emphasis on empirical observations. It was only after this epistemological 
shift that Western medicine became more interesting to the Japanese and estab-
lished itself as a new competitor to Chinese medicine.
The reason for this turn to European medicine was thus not simply its supposed-
ly inherent advantages as a medical praxis, but also an epistemological turn to the 
empiricism within the Confucian thought itself. There were many objections raised 
against Yamawaki Tōyō’s bold actions of dissecting corpses, and though some were 
opposed to it based on the conservative argument that it went against the teachings 
of the ancient saints, others were arguing against it from a more utilitarian perspec-
tive—that it did nothing useful for curing patients (Ogawa 1975, 62).
One other proponent of the epistemological turn to a supposedly “ancient Way” was 
Kagawa Shūan 香川 修庵 (1683–1755), who is responsible for the formulation of a 
system of Confucian-medical thought that viewed Confucius’ “Way of the sages” as 
being basically identical with a “Way of medicine” (Hirakawa 1998, 44). According 
to Kagawa, the sages of antiquity were staunch in their reverence for empirical fact, 
and latter-day speculative philosophers had obfuscated that emphasis (ibid.).
So, as was pointed out by Hirakawa (ibid., 43), we need to recognize the eigh teenth-
century intellectual trends to understand the rise of so-called Dutch studies and 
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33Asian Studies X (XXVI), 1 (2022), pp. 15–44
Western medicine. Seventeenth-century Japan was dominated by the Cheng-Zhu 
School (Cheng Zhu lixue 程朱理學) of Neo-Confucianism, a grand system of spec-
ulative philosophy that provided the principal current of orthodox learning during 
the Tokugawa period (ibid.). By the end of the century more and more critical voic-
es appeared and challenged the orthodoxy of the Cheng-Zhu School with an epis-
temological shift toward supposedly more original “Ancient Learning”, which, as 
we have seen, shaped new approaches within the field of medicine as well.
The Li-Zhu School of Chinese medicine, which was a form of speculative phi-
losophy that discussed human pathology in terms of yin-yang, the five elements, 
five circulations, and six qi, under the influence of “Ancient Learning” gave way to 
a paradigm shift that rejected such speculative ideas as latter-day inventions and 
attempted to return to the “Way” that medicine had supposedly been practiced 
in ancient China (ibid., 44). As such, scholars like Kagawa Shūan or Yamawaki 
Tōyō became sceptical of the traditional anatomical diagrams used by Tokugawa 
specialists of Chinese medicine, and instead of simply relying on such traditional 
guides they trusted their own experimentation. Yamawaki Tōyō, as we have noted, 
was the first to have performed an autopsy on an executed criminal in 1754 and 
recorded his observations (ibid., 45).
As Hirakawa (ibid.) points out, there was thus a clear relationship between the 
textual rigor of the School of Ancient Learning and the practical and empirical 
emphases of Dutch studies. Prior to the beginning of the Tokugawa period, inter-
est in Western medicine focused primarily on surgery and materia medica, but ac-
cording to Bartholomew (1989, 13–14) during the eighteenth century we can ob-
serve two important developments in Japanese medicine: the diffusion of Chinese 
style inoculation techniques and the founding of European anatomical studies.
New epistemological logic thus stimulated considerable interest in experimental 
medicine and led directly to the epochal publication in 1774 of the Kaitai shin-
sho 解體新書 (New Text on Anatomy) by Sugita Genpaku 杉田玄白 (1733–1817) 
and his colleagues. This was a translation with drawings of Ontleedkundige Tafelen, 
the Dutch edition of Johann Adam Kulmus’ Anatomische Tabellen, first published 
in 1722. Sugita’s translation indicates the strongly empirical approach to nature 
increasingly typical of Tokugawa science, which helped undermine the prestige of 
Chinese medicine (Bartholomew 1989, 13–14).
The publication of Kaitai shinsho inaugurated the study of Dutch medicine (ran-
pō 蘭方) in Japan, together with other Western medical and scientific disciplines 
(Deal 2006, 237). This scientific and medical knowledge that was entering Japan 
via the Dutch in Nagasaki convinced some intellectuals that European scientif-
ic methods were superior to both Chinese and Japanese ones, and led them to 
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34 Luka CULIBERG: “Praying for the Cure”
establish the movement of Dutch studies or rangaku 蘭学. The word often used by 
Dutch studies scholars to describe the superiority of Dutch to Chinese learning 
is “precision” or seimitsu 精密. They would say that Dutch learning is “precise” (sei 
精) and “accurate” (seimitsu 精密), while “Chinese” learning is “negligent” (so 疎) 
and “careless” (sorō 疎漏) (Aihara 2013, 27).
However, these judgments of superiority and inferiority were not followed by a 
complete rejection of the Confucian epistemological framework. While Sugita 
Genpaku was astounded by the effectiveness of Dutch measurement and research, 
he interpreted this from within the Confucian framework of scientific logic or 
“penetration of principle” (kyūri 窮理) (ibid.). As quoted in Aihara (ibid., 27–
28), for Genpaku the Dutch science (oranda no kyūri) was grounded in measure-
ment (jissoku 実測) and experimentation (jikken 実験), and was therefore superior 
to the “empty” Chinese science (shina no kyūri). Genpaku believed that Chinese 
medical books were based on conjectures and false analogies (憶度附会), while 
Dutch medical books relied on direct observation (今直観之).
Sugita Genpaku’s scathing criticism of Chinese science might give the impression 
that Dutch studies scholars or rangakusha 蘭学者 completely rejected Confu-
cian epistemology, however, it needs to be emphasised again that their turn to the 
Western approach happened precisely because epistemological shifts were already 
taking place within the Confucian paradigm.
To give one more example, we can take a look at another interesting eigh teenth-
century astronomer and physician, Asada Gōryū 麻田 剛立 (1734–1799). Gōryū 
was not part of the intellectual world that embraced Western science. He was not 
reading Dutch books, his knowledge of European astronomy was based on Chi-
nese books such as 暦象考成 (Li xiang kao cheng or Rekishō kōsei in Japanese), a 
Chinese calendar book of the Qing dynasty, published in 1723, describing the 
theories of Tycho Brahe and the calendar calculations based on them (Arisa-
ka 1968, 41). A son of a Confucian intellectual in the Kitsuki domain in Bungo 
province in Kyushu, Gōryū was interested in astronomy from an early age and 
studied it by himself while also studying medicine. He became a “court physi-
cian” of the domain lord until he decided to leave his domain for Osaka (ibid., 42; 
Ogawa 1956, 353). There he immersed himself in the study of the celestial calen-
dar, constantly improving measurement instruments, and by trusting only actual 
measurements and empirical verification he eventually discovered what is known 
as Kepler’s third law, namely that square of a planet’s orbital period is proportion-
al to the cube of the length of the semi-major axis of its orbit (Arisaka 1968, 42).
As for his medical studies, Gōryū belonged to the koihō or School of Ancient 
Medicine. Arisaka (ibid., 43) notes that even though he himself used to maintain 
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35Asian Studies X (XXVI), 1 (2022), pp. 15–44
that the great advancement of the koihō school can be dated to 1754 when Yamawa-
ki Tōyō performed his dissection, the real breakthrough should rather be ascribed to 
the positivistic and scientific spirit of medicine as practiced by Asada Gōryū. Asa-
da also performed dissections on various animals and his anatomy of the human 
body, compiled by his friend Nakai Riken 中井 履軒 (1732–1817) under the title 
Essorōhitsu 越俎弄筆, was published in 1793, a year before the famous text of the 
Dutch studies scholars, Kaitai shinsho (ibid.). Asada’s medical theory was thus in no 
way Western but was based on the positivistic and clinical type of the koihō school.
“How the East Was Won”
The history of “scientific” pursuit surely followed different trajectories in the var-
ious parts of the world we are considering here. By Hellenistic times in Europe 
and the Han period in China the scholarly disciplines that were henceforth to 
be regarded as learning had already settled into their respective discernible pat-
terns. In the West, it was philosophy, medicine, the dialectic and the mathematical 
sciences (including astronomy and statics) that were considered standard academ-
ic pursuits, while inquiries into chemical properties were excluded from the ranks 
of legitimate learning. In China, the study of the Confucian canon occupied the 
highest position, while astrology and calendar-making played a supporting role. 
Medicine ranked far down the list, and the status of mathematics was even lower. 
Meanwhile, technology and applied science did not find favour in either world 
(Nakayama 1984, 53).
In most parts of today’s world, it seems that the public attaches greatest scholar-
ly respect specifically to medical doctors, which can be argued also from a socio-
linguistic perspective by the fact that in many languages the word for a learned 
person or intellectual—doctor—came to be almost exclusively associated with the 
profession of physician. When people go to “see a doctor”, they never mean a 
philosopher.
On the other hand, throughout history physicians in Europe as well as in Ja-
pan were considered quite low status. So, another reason why eighteenth-centu-
ry physicians would want to identify as Confucian scholars was the respect these 
enjoyed as such in contrast to being a simple physician. Sugita Genpaku himself 
explained how doctors in Japan were equated with artisans and thus historical-
ly considered to be “lowly people”6 within the Japanese hierarchical system (Liu 
2013, 58). In the Tokugawa period, where social status was strictly hierarchical, 
6 夫医は方技の一にして，諸史には其末に加へ，賎しきものになせり 
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36 Luka CULIBERG: “Praying for the Cure”
physicians, other than those in the service of shōgun or tennō, were thus low in the 
social hierarchy and despised by the bushi or the samurai. In order to become a 
respected Confucian doctor, Kagawa Shūan, for example, advocated the idea of 
“Confucianism and Medicine as One” (儒医一本論) and thus tried to raise the 
status of doctors (ibid.).
Many Dutch studies scholars thus reinterpreted Confucianist notions and blended 
them with the study of Western natural sciences, while still considering themselves 
Confucianists. Their Confucianism was, therefore, readily accommodating the 
methodology of Western science which became a major part of Japanese percep-
tion of the West (Culiberg 2015). These rangakusha did not think that the West was 
more advanced or represented the next stage in the progress of civilization, because, 
as Watanabe (2012, 321) points out, such a historical view was still absent in those 
times. Rather, they believed that, for some reason, it was in the “national character” 
of the Western countries to assemble information, examine it in detail, investigate 
its underlying principles, and skilfully employ the knowledge thus gained.
“Science” or “learning” was understood exclusively within a Confucian frame-
work—no science existed outside this intellectual universe, and the rangakusha, 
while retaining this Confucian sensibility, merely shifted the object of their study 
from China to the West (Watanabe 2012, 321).
This admiration of Western “penetration of principle” (kyūri 窮理) eventually led 
to Japanese anxiety over Western military supremacy. Shocked by China’s defeat 
in the Opium War of 1839–1842, another famous Neo-Confucian scholar and 
rangakusha, Sakuma Shōzan 佐久間 象山 (1811–1864) had thus concluded that 
the West was engaging in the penetration of principle more correctly and effec-
tively than the countries under the sway of Neo-Confucianism (ibid., 322). In 
the field of medicine, surgery and the treatment of epidemics such as cholera and 
smallpox in the nineteenth century led to a further decline in trust with regard to 
Chinese medicine in favour of Western medicine.
The Japanese adopted Western medicine because by the nineteenth century it was 
better aligned with the epistemological currents within the Japanese intellectual 
universe. For example, by the time anatomy became increasingly important, the 
Western advantage over Chinese knowledge was already immense. Chinese “ig-
norance” of anatomy, with the scant descriptions and crude illustrations of organs 
reprinted in one medical book after another, used to be explained simply by Con-
fucian taboos against dissection. But as Sivin (1988, 59) shows, this hypothesis 
ignores the quite common practice of autopsy. It was just that the early Chinese 
understanding of health and disease was heavily weighted toward function, while 
that of Galen focused on structure. To the Chinese it mattered what the organs 
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37Asian Studies X (XXVI), 1 (2022), pp. 15–44
did, not their design and spatial relations, and thus there was nothing that a doc-
tor could accomplish by cutting into the abdomen. He was curious about the bal-
ance of body functions and the propagation of functional imbalance, and the lo-
cation of an inner lesion was of minor concern (ibid.).
Even in Europe, as we have already seen, anatomical knowledge had practically 
no clinical utility until the middle of the eighteenth century, but it was a source 
of prestige for learned doctors whose reputations did not depend on practice. In 
China the unbroken tie between doctrine and practice removed this motivation 
for the development of anatomy (ibid.).
The arrival of Western medicine in Japan was doubtlessly a paradigm changing 
event, however the switch from the Chinese to Western medical paradigm was 
not simply a story of supplanting one system with the other. It was a complex pro-
cess of weighing pros and cons, and the main point of contention remained the 
question of method. In his paper on the perception of motor disability in Tokuga-
wa period medical texts of European medicine, Kawahara (1985) looks at various 
texts of Western medicine from the late Edo period where he discusses, among 
other things, the adoption of the so-called empirical method. It was this method-
ological requirement that guided the course of Japanese medical science.
The fact that Sugita Genpaku still felt the need to critique the Huangdi Neijing 
testifies to how this basic text of Chinese medicine was still important in eigh-
teenth-century Japan. In his treatise Kyōi no gen 狂醫之言 (Words of a Mad Doc-
tor), published in 1775, Genpaku reiterates anatomical doctrine as explained in 
the Neijing, and then states: “But if we now dissect the body of the condemned 
and look at the organs, the position and appearance of the organs is different,”7 
and concludes, “since the observation of the actual thing differs, it means that it is 
a deceiving book”8 (Sugita 1976, 231; Kawahara 1985, 42; Liu 2013, 62).
Conclusion
As we have seen in the case of medicine in Europe and Japan, the “great divide” 
between “Western science” and “Chinese tradition” is not as clear as the classical 
narrative of “modernity” would have it. There was certainly no straightforward 
epistemological trajectory from “magical” thinking to “scientific” thought. Medi-
cine has always relied both on “rational” examinations as well as “magical” beliefs. 
And in this sense the “West” was no more rational than the “East”.
7 然るに、今刑死を剖りてその臓を観れば 、その位置 ・臓象はこれと異なるなり。
8 これを物に質すにこれと異なれば、すなはち、また人を欺くの書なり。
Azijske_studije_2022_1_FINAL.indd   37 12. 01. 2022   14:36:13
38 Luka CULIBERG: “Praying for the Cure”
We have argued that the intellectual framework of Japanese physicians in the 
eighteenth century remained Confucian, however, as Hays (2009, 130) observes, 
in this the era of science and enlightenment, when human reason exulted in the 
powers conferred on it by the giants of the scientific revolution, in Europe too 
continuities rather than change dominated much of its relations with disease. 
Physicians’ therapies, including for those who could receive the finest medical 
care, remained fundamentally Galenic. Even in the middle of the nineteenth cen-
tury, the miasma theory was still the leading concept of epidemic disease.
In his book The Ghost Map Steven Johnson (2006) tells the story of one of the 
founders of modern epidemiology, John Snow, who during the 1854 cholera epi-
demic in London discovered that the source of the disease was polluted water and 
not miasma, and the author claims that 
[d]espite all the technological advances of the Industrial Age, Victorian 
medicine was hardly a triumph of the scientific method. Reading through 
the newspapers and medical journals of the day, what stands out is not 
just the breadth of remedies proposed, but the breadth of people involved 
in the discussion: surgeons, nurses, patent medicine quacks, public-health 
authorities, armchair chemists, all writing the Times and the Globe (or 
buying classified advertising there) with news of the dependable cure 
they had concocted. ( Johnson 2006, 45)
As today, medical minds of that time were not in possession of the “truth” but fol-
lowed theories that they devised based on their research, and which they believed 
explained their observations most accurately. For example, the Philadelphia debates 
over yellow fever’s cause and nature illustrated many of the general themes of such 
eighteenth-century discussions. Within the general frameworks of miasma and con-
tagion, a specific “scientific” theory was proposed that electric fluids in the air were 
“invariably fatal”, and the large number of lightning rods that imperceptibly draw 
off the electric fluid from the clouds put Philadelphia in peril (Hays 2009, 131).
Such theories, which completely relied on contemporary scientific speculations, 
coexisted with more “magical” beliefs, that the yellow fever was a divine visitation 
punishing the wicked as a judgment on the sins and errors of the new nation of 
the United States, or, echoing very old theories about plague, some believed that 
fear itself might cause the fever (ibid.).
In this sense, the reactions and attitudes toward contagious disease we are wit-
nessing first-hand almost daily during the current COVID-19 pandemic do not 
differ in essence from their eighteenth-century counterparts. People all around 
the world have protested against protective measures preventing the spread of 
Azijske_studije_2022_1_FINAL.indd   38 12. 01. 2022   14:36:13
39Asian Studies X (XXVI), 1 (2022), pp. 15–44
COVID-19, such as quarantines, face-mask mandates, vaccination, etc., usually in 
the name of personal freedom. Similarly, for several centuries European city gov-
ernments struggled to control contagious diseases in the face of similar objections 
from merchants, who saw quarantines as unacceptable interference with trade. 
However, in Philadelphia in 1793 the merchant community saw the doctrine of 
miasma as a greater threat to that of contagion, for with the former it might ap-
pear to the world that fever was “native” to Philadelphia, tainting all the city’s 
products and inhabitants, and thus the state government switched to the conta-
gion theory, and imposed a quarantine on incoming goods and people (ibid.). Be-
lieving the disease was spread by “bad air” or contagion thus had to do with the 
broader social context, and the same seems to be true in the case of COVID-19.
On the other hand, the current “belief ” in “science” has taken us so far that any 
form of possibly justifiable doubt is immediately aligned with the most absurd 
conspiracy theories and addressed not as part of a valid or at least potentially le-
gitimate debate, but as a heresy. Vaccination is a powerful tool in the fight against 
viral diseases, but as already noted its use requires a bigger leap of faith than just 
taking a medicine. It is natural that from the very beginning of the use of vacci-
nation there have been mixed feelings about the procedure. The reason why many 
people accepted it in the past was probably due to their greater fear of disease. 
Such acceptance was never based purely on “rational” deliberation of the “scientific 
facts”, not in the least because scientific facts are much less straightforward than 
scientific preachers would have us believe.
When the smallpox epidemics abated substantially after the end of the eighteenth 
century, adherents and adversaries of the vaccine quarrelled about whether this 
decrease was due to the influence of vaccination. The anti-vaccinationists main-
tained that a connection between vaccination and the declining number of small-
pox deaths could not be proved, because vaccination statistics were unreliable. 
They instead ascribed the decrease in the number of smallpox deaths to improved 
hygiene conditions and better nutrition (Huerkamp 1985, 626).
Vaccination has doubtlessly accelerated the process of medicalizing the popula-
tion. However, the introduction of vaccination by no means automatically result-
ed in greater credibility for medical professionals in the eyes of the population. 
Instead, it often had the opposite effect and reinforced distrust and scepticism 
of professional medicine. The manifold forms of resistance that have been docu-
mented provide ample evidence of this, especially where vaccination was enforced 
by law (ibid., 631). And today, when with the help of vaccination we have lost 
much of the fear of deadly epidemics, anti-vaccination attitudes seem to be on 
the rise.
Azijske_studije_2022_1_FINAL.indd   39 12. 01. 2022   14:36:13
40 Luka CULIBERG: “Praying for the Cure”
Concerning disenchantment and (re)enchantment, modern societies are an array 
of opposing tendencies, themes and forces ( Jenkins 2000, 13). We tend to believe 
that our “modern” and disenchanted world is separated from the “premodern” ex-
perience in which the belief in magic was replaced by the belief in science. While 
neither “magic” nor “science” are completely straightforward ideas, it is also hard 
to draw a simple picture of how the human mind operates following one or the 
other.
As Jenkins (2000, 17) claims, such scepticism is certainly part of a wider phenom-
enon related to our understanding of the medium- to long-term consequences of 
the human impact on the environment and increasing disquiet about the damage 
that we have done.
Similarly, in medicine, triumphal upward progress, epitomized by anti-
biotics, vaccines, and advances in public health, is beginning to look in-
creasingly fragile and uncertain as bacteria acquire resistance, viruses mu-
tate, hospitals become dangerous, infective places again, and new human 
diseases appear. Apropos healing, the Western scientific model is faced 
with competitors—such as acupuncture or homeopathy, for example—
which, although they may be rooted in radically different cosmologies, 
are widely believed to “work”. (ibid.)
That puts us in a situation where it seems that a unified epistemological and ex-
planatory framework for understanding the natural world which gradually gath-
ered authority after the Enlightenment is no longer assured, and thus the “objective” 
knowledge of Western science is becoming increasingly understood as contingent 
rather than a set of permanent verities (ibid.). As Nakayama (1984, 38) writes, sci-
ence has long been identified with the quest for objective truth and meeting objec-
tive standards is, to be sure, an effective means of securing support for one’s theories. 
Yet throughout the history of science such “objective standards” have changed time 
and again. On the other hand, as Jenkins points out, there is little evidence for a de-
cline in beliefs in magic, though superficially this might seem to be the case:
Most of us, for example, no longer seek the curing powers of a wise-wom-
an or a cunning-man if we are ill. We go to our doctor. Or, at least, most 
of us go to our doctor first: the certainties of scientific medicine are rou-
tinely challenged by everyday explanatory frameworks such as fate or 
luck (institutionalized in astrology and the like), by increasing resort to 
the alternative treatments which are colonizing some of the spaces pre-
viously occupied by “conventional” medicine, or by scepticism and refusal 
deriving from a variety of sources. ( Jenkins 2000, 18) 
Azijske_studije_2022_1_FINAL.indd   40 12. 01. 2022   14:36:13
41Asian Studies X (XXVI), 1 (2022), pp. 15–44
Ever-expanding knowledge is no longer in itself believed to be enough. The 
world may actually be becoming somewhat more mysterious rather than less. This 
should not necessarily be understood as an erosion of the authority of science, but 
rather as a potential shift in its centre of gravity towards greater epistemological 
pluralism (ibid., 17). While rationalist science has, in some respects, and for the 
moment, triumphed, and secularization has been one of the dominant themes in 
modern societies over the last two centuries, the decline of magic—whether tra-
ditional or more recent—is less easy to demonstrate (ibid., 28).
As Magner (2005, 156) reminds us, many aspects of the origin, impact, and pres-
ent and future threat of modern epidemics, such as AIDS or COVID-19, are 
still unclear, just as there are many uncertainties about the historical meaning of 
leprosy and the plague. However, it is not unreasonable to hope that scientific 
knowledge concerning pathology and epidemiology, as well as historical research 
illuminating the social context in which particular diseases loomed so large, will 
eventually allow us to ask more meaningful questions about the ways in which 
people assess and respond to the threat of catastrophic disease (ibid.).
By looking into the intellectual currents within the field of medicine, specifi-
cally in eighteenth-century Japan, and comparing these to those in the West, I 
have tried to challenge the narrative of “modernity” as a sort of uniquely West-
ern achievement defined by “disenchantment”, “rationalism” and “science”. Some 
scholars have tried to explore the problem of why the “scientific revolution” oc-
curred in Europe in the seventeenth century, rather than in China or Islamic are-
as, which reached a sophisticated level in science and technology centuries earlier. 
Whether there was such thing as a European scientific revolution or not, inter-
est in astrology, alchemy, magic, religion, and related theories persisted alongside 
scientific breakthroughs. In that sense, I would argue against the idea that a “sci-
entific revolution” is a valid metaphor for the transition from a “premodern” to a 
“modern” worldview, in which science is at the very core of life and thought (ibid., 
200) as the traditional narrative would have it.
What should probably be mentioned at the end of this paper is that the applica-
tion of this new mode of thought to anatomy, physiology, and medical education 
would have been impossible without the work of the humanist scholars in Europe 
as well as Asia. We have seen how Confucian intellectuals, such as Asada Gōryū, 
Yamawaki Tōyō or Sugita Genpaku, rooted their ideas in the ancient Confucian 
learning. The greatest breakthrough in anatomy in Europe happened of course 
with Andreas Vesalius (1514–1564), who in 1543 transformed Western concepts 
of the structure of the human body by publishing his great treatise, On the Fab-
ric of the Human Body (De humani corporis fabrica), which is considered the first 
Azijske_studije_2022_1_FINAL.indd   41 12. 01. 2022   14:36:13
42 Luka CULIBERG: “Praying for the Cure”
anatomical treatise based on direct observation of the human body, and is still 
regarded as a milestone in the history of anatomy (Magner 2005, 206). Vesalius, 
too, was heir to the humanist medical tradition that had rediscovered the original 
writings of Hippocrates and Galen. Indeed, he was a member of the first genera-
tion of scholars to enjoy access to the complete works of Galen.
“Science” today seems to be increasingly separated from the “humanities” and in-
creasingly dedicated to utilitarian technological advancement. However, it was with-
in the humanist framework that the scientific mode of thought developed in Europe 
as well as in Asia, and such an interplay of epistemological shifts and philosophical 
contexts seems more productive in understanding our history of knowledge than 
relying on simple categories such as “magic”, “science”, “tradition” or “modernity”.
Acknowledgement
The research for this paper was supported by the Slovenian Research Agency 
(ARRS) in the framework of the research core funding Asian Languages and Cul-
tures (P6-0243). 
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