The First European Description of Japan, 1585 (42 page)

25
  Mrs. Hugh Fraser, A Diplomat's Wife in Japan. (London: Hutchinson & Company, 1899), 310.

26
  Paul McGreevy,
Equine Behavior: A Guide for Veterinarians and Equine Scientists
(Edinburgh: Saunders, 2004).

27
  See Hickman, “Painting,” 142.

28
  Alcock,
The Capital of the Tycoon
, 165.

29
  
Isabella Bird, Korea & Her Neighbours
, 2 Vols. (London: John Murray, 1898), I, 138–139.

30
  
Fixaqus
(
hishaku
).

31
  Frois uses the terms “kingdom” and “king” (
regno
and
rei
). In the prologue to the missing first volume of the
Historia
, “king” is the ninth of ten examples of Portuguese terms that Frois explains do not do justice to Japanese realities. Frois notes that, in Japan, it is commonly written that there are sixty-six realms, but their rulers' power is limited. Frois went on to note that, while there is only one “king” of Japan using the Europeans sense of the word, there were some exceptionally powerful rulers such as the “King of Bungo,” Ōtomo Sōrin, who was baptized by Frois in 1578 and ruled before Nobunaga conquered most of Japan.

32
  Martingales come in different forms and basically consist of a strap that is used to keep a horse from throwing his head up and back, unsettling the rider.

33
  Townsend Harris,
The Complete Journal of Townsend Harris: First American Consul General and Minister to Japan
, Ed. Mario E. Cosenza, (Garden City: Doubleday and Company, 1930), 398.

34
  Louise H. Curth, “English Almanacs and Animal Health Care in the Seventeenth Century.”
Society and Animals
8(2000):1:71–86.

35
  Harris,
The Complete Journal
, 399.

36
  Gomez A. Mendoza, “The Role of Horses in a Backward Economy: Spain in the Nineteenth Century.” In
Horses in European Economic History
, ed. F.M.L. Thompson, pp. 143–155 (Reading, UK: The British Agricultural Historical Society, 1983).

37
  Kaempfer,
The History of Japan
, II, 282.

38
  It was for this reason that Japanese racehorses broke bones at a tremendous rate in the 1980s.

39
  Kaempfer,
The History of Japan
, II, 282.

9   Diseases, doctors, and medicines

1. Among us, it is commonplace to suffer from swollen glands
,
¹
kidney stones, gout, and plague; in Japan all of these ailments are rare
.

Swollen lymph nodes (they are not actually glands), particularly in the neck, are a common symptom at the outset of a variety of illnesses. Sixteenth-century Europe was repeatedly subjected to acute and chronic infectious diseases, including bubonic plague, which refused to go away after devastating Europe in the fourteenth century.
²
Frois might also have mentioned typhus and syphilis, two diseases previously unknown in Europe that ravaged the continent during Frois' lifetime.
³
Most of us are familiar with kidney stones and gout. The Portuguese term used by Frois for the latter (podagra) is still used by doctors and often refers to gout that manifests as pain in the joint at the base of the big toe. Kidney stones and gout were a particular problem for European elites, who consumed large amounts of meat and not enough diuretics (e.g. beets, peas, artichokes, cabbage).

Japan in the sixteenth century appears to have been relatively free of acute and chronic infectious diseases, despite its large and urbanized population.
⁴
The Japanese penchant for cleanliness and Japan's physical separation from the rest of Asia and the world might help explain why Japan went unscathed (relatively speaking) by diseases that elsewhere changed the course of history.
⁵

2. We use bloodletting; the Japanese use a cauterizing iron with herbs
.

Bloodletting as “preventative maintenance”
⁶
or to restore the body's humeral balance was common medical practice in Europe. Burning
moxa
—a wool-like material ideally taken from the leaves of a species of Chrysanthemum (
Artemesia
vulgaris
)—and acupuncture, were the Chinese and Japanese way of restoring or insuring bodily health. Both were similar to European practices in that they were predicated on the idea that health presupposed a balance of vital force (
ki
in Japanese, from the Chinese
qi
).
⁷
Maintaining or restoring
ki
entailed engaging bodily energy through acupuncture (strategic placement of very thin silver or gold needles) and/or burning very small, cone-shaped
moxa
at particular sites on the body (the heat generated by the
moxa
was thought to “unblock” or accelerate the flow of
ki
). As Kaempfer wrote in his thorough chapter on moxibustion,
⁸
the
moxa
burned so slowly that “… the pain is not very considerable, and falls short of that which is occasion'd by other Causticks.” Although Japanese and Chinese physicians did not agree (and still disagree) about where to burn for various complaints, Kaempfer observed that the backs of the Japanese “… of both sexes are so full of scars and marks of former exulcerations, that one would imagine they had undergone a most severe whipping.”
⁹

Much like bloodletting, moxibustion was used to treat specific ailments (e.g. headaches, toothaches), as well as to maintain bodily health. Again, Kaempfer: “Here, these little mugwort cones [
moxa
] are to be found in most houses, and people are burned in the spring, just as in England blood-letting was formerly customary at the same season.”
¹⁰

Today, few Japanese, particularly among the younger generations, practice moxibustion, just as few Europeans embrace phlebotomy. Note, however, that there have been some impressive studies of the physiological equivalent of blood-letting, i.e. blood donation, that suggest significant increases in life expectancy. Reading about disfiguring scars caused by
moxa
and the unnecessary deaths caused by overzealous bloodletting, we laugh at our ancestors, yet our ancestors may well have the last laugh.

3. Among us, men ordinarily are bled from their arms; the Japanese use leeches or a knife to the forehead, and they bleed horses using a lancet
.
¹¹

The ordinary procedure for bloodletting in Europe was to open a vein with a lancet or fleam and to then collect and measure the blood flowing or spurting from the patient's arm (the goal was to remove “excess” blood and restore the body's humeral balance and health). Europeans also used leeches and cupping devices to remove smaller amounts of blood from severed capillaries. (Perhaps because leeches are so painless, their frequent use led to their extinction in some parts of Europe.)

The forehead bleeding mentioned here by Frois refers to a Chinese practice carried out with a “three-corner-needle” or fleam on the crown and occipital part
of the head (because the crown usually was shaven, Frois speaks of the forehead). This bleeding to remove “bad blood” was not so common a practice as venesection and probably was used for certain maladies. Thus, Valignano (and others) wrote “They never bleed a person, …”
¹²

4. We make use of enemas or syringes; under no circumstance do the Japanese use such remedies
.

For at least two-thousand years before Frois wrote this, the West made use of enemas to treat constipation and flush parasitic worms from the colon and lower intestine. Syringes of wood or carved from ivory frequently were used to propel an anti-worm drug, or vermifuge, up into the small intestine. During the sixteenth century tobacco from the New World became a popular key ingredient in vermifuges used to treat worms.

Frois' Jesuit superior, Valignano, contradicted Frois in a rare contrast not found in the
Tratado
: “… their purges are sweet-smelling and gentle—in this they certainly have an advantage over us for our purges are evil-smelling and harsh.”
¹³
Marcelo de Ribadeniera, a Franciscan who came to Japan in 1594, wrote that, aside from the various “… simple medicines and potions made by boiling roots” (taken from books written in Chinese, i.e.
kanpoyaku
), “… they also administer purges in candied pills so that they may be taken more easily.”
¹⁴

5. Among us, doctors write prescriptions to be filled by pharmacists; doctors in Japan dispense medicines from their own homes
.

By the fourteenth century the professions of physician and apothecary were distinct and proto-pharmacies could be found in many European cities, often in monasteries and religious houses (the Church of Santa Maria Novella in Florence, Italy claims to have the oldest pharmacy, dating to 1221). In sixteenth-century Portugal druggists were licensed and apothecary shops were required to have a small and specialized reference library, appropriate weights and measures, and both simple and compound medicines.
¹⁵

Doctors in sixteenth-century Japan usually were called
kuzushi
or “medicine-masters,” and true to their name, they filled their own prescriptions whenever they could (sometimes ingredients had to be ordered from a specialist). This does not mean they grew, gathered, and made it all. When Luis de Almeida (1525–1584), a merchant and surgeon turned Jesuit, took over a clinic in Bungo (Kyushu) in 1559, he quickly set up a pharmacy and put a former Buddhist monk in charge who could read Chinese and order Chinese medicines from abroad.

6. Our doctors take the pulse of both men and women first from the right arm and then from the left; the Japanese take a man's pulse first from the left, and a woman's first from the right
.

This difference, writes Okada, stems from Oriental yin-yang philosophy. The pattern was not restricted to medicine; male-left, female-right also applied to “signing” documents or making oaths using a bloody fingerprint.

7. Our doctors examine one's urine to gain greater information regarding the illness; under no circumstance do the Japanese examine this
.

It is hard to overestimate the importance of urine as a diagnostic tool for medieval and early modern Western medicine (the
mantula
, or urine flask, was the symbol of the medical profession during the Middle Ages).
¹⁶
Medical practitioners in sixteenth century Europe analyzed and described urine much as
sommeliers
today discuss wine. Urine was swirled and sniffed and visually examined to determine bouquet, color, sediments, thickness and other qualities that were thought to reflect bodily health. Okada notes that de Almeida checked the urine of the fief lord of the Goto islands (this according to de Almeida's letter of October 20, 1566
¹⁷
). Around this time, Japanese medical practitioners, led by Mansae Dosan (1507–94), re-worked Chinese neo-Confucian ideas (i.e. that disease was a consequence of an undisciplined, poor lifestyle) and popularized a four-fold approach to clinical care that emphasized visual observation of a patient's skin color, hair, feces and urine.
¹⁸
Frois apparently was unaware of this development. Today, Japanese hospitals seemingly collect urine samples for almost anything under the sun (perhaps because it occupies the patient during his/her long wait to see a doctor; there is insurance money for it; and the test is relatively innocuous).

8. Because the flesh of Europeans is so delicate, it heals very slowly; Japanese flesh is robust and recovers much better and faster from serious injury, burns, abscesses, and accidents
.

Recall Frois' very first contrast in
Chapter 1
, which cast Europeans as “well built” or robust as compared with the Japanese. A contemporary of Frois', Mexia (1540–1599), likewise wrote: “When they [the Japanese] fall sick, they recover in a very short time without taking hardly any medicine.”
¹⁹
This, together with statements by many European visitors about the light diet of the Japanese, may well be the first elaboration of the stereotypical oriental that is frugal, long-lived, and can survive on less than the Westerner.

9. Among us, wounds are sutured; the Japanese cover them with a little bit of paste-coated paper
.

The Japanese did not suture wounds, perhaps because sword wounds healed quickly owing to the sharpness of Japanese swords. A good adhesive band-aid apparently worked perfectly well. Okada wonders if the “paste” was ointment that also functioned as an adhesive.

10. All the dressings that we make using cloth, they make with paper
.

As Frois points out in the following chapter (see
#10
), the Japanese had many varieties of paper, compared to a handful in Europe. The Japanese could use paper and not cloth for treating wounds because some of their paper was as soft as gauze. It would not be surprising to learn that the paper also had the advantage of breaking down in time, i.e. that it was the equivalent of today's dissolvable stitches.

11. Among us, abscesses are treated using intense heat; the Japanese would rather die than use our harsh surgical methods
.

The European practice of using a red-hot iron to burn an abscess, or pouring scalding oil into a gun-shot wound, were sometimes effective, but always horrifying ways to treat a localized infection or trauma. Of course, the treatment also was likely to scar someone for life. It is perhaps no surprise that the Japanese referred to Europeans as “southern barbarians.”

12. When our sick have no appetite, we work hard to make them eat; the Japanese think this cruel, and a sick person who does not want to eat is allowed to die
.