Pioneering medical journals of Japan

INTRODUCTION

The earlier articles in this series have dealt with medical journals published in the English language from countries where English is the predominantly spoken language (England¹, USA², Scotland³, Australia⁴) or those previously under the control of an English-speaking nation (India⁵, under British rule). Interestingly, it appears that India’s first medical journal, despite being a land replete with languages, was in English rather than in the vernacular. Sen’s exhaustive research on scientific periodicals in India clearly mentions Transactions of the Medical and Physical Society of Calcutta as the first Indian medical journal.^6,7

However, Japan offers a unique situation, and indeed, is quite a contrast to the British Indian trend. We assert that more than a single journal could vie for the rank of ‘first Japanese medical journal,’ depending on how one defines it or the source that one has access to!

To comprehend this issue better, we need to delve into the situation of post-1500 C.E. Japan. Specific facts are relevant to the initial development of medical journals in this nation. Table 1^8-12 provides a parallel history of selected historical events of political-cultural nature and the origin of pioneering medical journals in Japan in the 19th century. We adhere to the standard dictionary definition of ‘pioneer’ as ‘initiator of enterprise, original explorer, settler, etc.’

SYNOPSIS OF POST-1500 PERIOD HISTORY

In 1542 or 1543, a Portuguese ship lost course and was wrecked at Tanegashima in South-West Japan.^13–16 This led to the ‘discovery of Japan’ by the West (Europe). Over the next century, there were cultural exchanges between Japan and the West.

Japan was ruled by the Tokugawa Shogunate from 1603 to 1868. The growing popularity of Christianity and other western imports resulted in the emperor feeling threatened and ultimately expelling the Portuguese from the country in 1639. It is commonly believed that Japan was totally secluded from the West, and hence this period is called ‘Period of isolation’ or Sakoku (closed country). However, this is not entirely true.¹⁷

Quite a few Dutch traders were permitted to remain in the Nagasaki region, and their activity of importing Dutch goods and scientific thought influenced the otherwise-isolated Japanese minds. Thus, although the principle of Sakoku was adhered to de jure, important exceptions were permitted de facto. This led to the origin of rangaku, or Dutch learning.^17–21 based on the word Ranga Kusha, which means Dutch scholar.²²

An influential individual who contributed to intellectual exchange between Japan and Europe during the second decade of the 19th century was Philipp Franz von Siebold (1796–1866), a physician from Bavaria.^14,15,21 He landed at Deshima, the Dutch base at Nagasaki, in August 1823. Descriptions of his activities and achievements have been provided by Henkes,²² Whitney,⁸ and Chamberlain.²³

In 1853, Commodore Matthew Perry from the USA sailed into Nagasaki harbour with his ‘black ships’ and re-established contact between the West and Japan.^14,17 By now, the West comprised not only Europe, but also the newly established USA. Over the next 15 years, cultural exchanges took place, and the change in thinking and approach to everyday life by the Japanese culminated in the collapse of the Shogunate rule and the establishment of the Meiji rule (i.e. Meiji restoration in 1868).⁹ Edo was renamed Tokyo. The re-established contact with the West changed Japan in multiple directions. The prevailing medical traditions based on Chinese medicine were subjected to influences of Dutch, German, British, and American versions of western medicine.

Two articles contributed by Akihito, a specialist in ichthyology (then Emperor of Japan and currently Emperor Emeritus), also offer a good overview of the growth of science in early Meiji Japan.^14,21

WESTERN MEDICAL TEXTBOOKS IN JAPAN

The Dutch East India Company’s trading post was in Dejima, near Nagasaki. In association with the trading of goods and knowledge, erotic books were also imported into Japan. As Screech¹⁸ had noted in brief.

‘As much imported material and especially that from Europe, was medical in nature, it fell with ease into the embrace of sexual parody. Many imported books were invasively anatomical and gave rise to a whole school of Japanese Western-style physicians (ran’i). 1774 saw the first complete European book translated in Japan, the New Anatomical Atlas (Kaitai Shinsho), taken from a German text. The Japanese version was prudish (it omits the section on the penis) …’

The description by Screech ‘taken from a German text’ is rather inappropriate and deserves a factual calibration. The German original Anatomische Tabellen was authored by Johann Adam Kulmus of Danzig University in 1722. It was translated into Dutch by Gerardus Dieten, a Leiden surgeon, in 1734, and titled Ontleekundige Tafelen (Anatomical Tables). Genpaku Sugita (1733–1817), the Edo physician and Rangaku scholar, was the lead translator of the Dutch version of Kulmus’ work. In 1959, this textbook of anatomy was honoured with a memorial statue in Tokyo,¹⁶ and must be one of the few, or perhaps the only, books in the world to be honoured in such a manner.

THE FIRST MEDICAL JOURNAL IN JAPAN: Taisei-mei-i-ikô AND ITS EDITOR, MITSUKURI GENPO

Undoubtedly, Taisei-mei-i-ikô (A Compendium of Articles by Renowned Western Doctors) (Fig. 1), edited by Mitsukuri Genpo (1799–1863), was the first medical journal published in Japan (Fig. 2). It comprised reprinted articles from journals published abroad.^24,25 Janetta and Nakamura²⁴ have documented the history of this journal elegantly; this section of our review borrows considerably (but not entirely) from their work. Readers would benefit vastly by reading their contributions to the literature on this fascinating subject.

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FIG 1.

Cover page of Taisei-mei-i-ikô, volume 1, 1836. The left vertical column shows the editor Mitsukuri Genpo’s name, and the right vertical column indicates the journal name (from the public domain)

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FIG 2.

Mituskuri Genpo (1799–1863; from the public domain)

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There were eight volumes of the journal released in total: three in 1836, three in 1837, and two in 1842. The first six volumes were in Japanese, while the last was in Chinese script. Janetta and Nakamura²⁴ suggest that the delay in the release of the last volumes, as well as the change in script, was for purely political reasons; civil unrest as well as the dominance of a Chinese system of medicine. All papers in the journals were curated by Genpo, and he translated most of them as well. His colleagues and students translated the others.

Much of the translated material was from the Dutch medical literature, but there were sufficient instances where the Dutch articles themselves were translations of papers from the German and English journals. Many of the articles were from one specific Dutch journal—the Practisch tijdschrift voor de geneeskunde al haren omvang (A Practical Journal for All Aspects of Medicine), the subject material in the articles invariably dealt with practical aspects of medicine. This fitted in well with Genpo’s philosophy of classification of medical literature into two types: one with classics and what has been known for aeons (and hence, were in the textbooks), while the other with new findings, which needed to be evaluated further and were hence in the journals.

While many papers were on surgery and obstetrics, Nakamura emphasizes that even a paper on psychiatry was published in the journal, indicating that the journal was indeed practical as well as up-to-date with current happenings in the world of medicine.²⁵

Genpo was undoubtedly a Renaissance individual, a respected physician, translator, and Rangaku scholar of the Edo period.^24–26 He wrote the first structured history of Europe, the Taisei Shinju.²⁶ He was responsible for the first Japanese language atlas of the USA: The Renpo Shiryaku (Brief account of the United States) in two volumes, based on Da Mei lian bang zhi lue, by Elijah Coleman Bridgman.^27,28 Japan’s first steamboat was built based on Genpo’s translation of a western publication on steam engines.¹⁷

He was one of the translators at the Bureau of Translation, which had been established at the Observatory in Otsuki Gentaku in 1811.²⁶ When the Bureau was made an independent organization in 1855, he was one of the first Professors at the newly established Bureau²⁵, named Bansho Torishirabesho (Office for the Study of Barbarian Books), which later morphed into Kaiseijo.¹⁷ Subsequent to the publication of the last volume of Taisei mei-i ikô in 1842, Mituskuri’s work was largely restricted to government business and international affairs.⁹

In 1847, Genpo published revised editions of the Bangosen with the titles Kaisei zôho Bangosen (‘Revised and Enlarged Bangosen’) and, later, in 1850, the Kaisei Bangosen (‘Revised Bangosen’).¹⁷ Bangosen was a book with Dutch words and their explanations, published in 1798 under the title of Ruiju orandago yaku (‘A Categorised Collection of Translated Dutch Words’), but was soon changed to Bangosen.

Genpo’s home in Tsuyama has now been transformed into a museum.

JOURNALS PUBLISHED IN THE MEIJI RESTORATION PERIOD

After the pioneering communication by Genpo during the Sakoku, medical journals saw a quiescent period in Japan. We cannot state with absolute certainty which of the truly first Japanese medical journals published articles by researchers based in Japan.^10,29

Whitney states that Kin-Sei-I-setsu in 1872 was ‘among the first of the journals...’¹⁷. However, we also recognize the existence of earlier journals. Nikko Kibun (Records of Daily Lectures) was published first in 1869 by William Willis. Subsequently, in December 1869, another journal with the same title, Nikko Kibun, was published by Antoniuis Bauduin. In 1873, Bun-enZasshi appeared.^10,29

The Juntendo Iji Zasshi (now named Juntendo Medical Journal), which prides itself as the ‘oldest medical journal in Japan,’ was first published in 1875.^30,31 It contained manuscripts purely from Japanese authors. In the list of early medical journals compiled by Onodera,¹⁰ this journal appears in the 8th place. Despite its claim to be the oldest Japanese medical journal, it is more likely that Juntendo Medical Journal is the oldest medical journal of the 19th century that is still being published currently (despite some breaks in publication, over the years).

The articles by Ogawa³⁰ and Nagaoka³¹ discuss the history of this journal, which began as a 60-page issue on Octavo Japanese paper.¹⁰

Nikko Kibun AND WILLIAM WILLIS

In 1869, William Willis (1837–1894; Fig. 3) began to publish Nikko Kibun (Records of Daily Lectures). All we know about this journal is that, as the name suggests, it contained summaries of his lectures at the Tokyo Medical School.¹⁰ However, we do know more about the career of Willis in Japan, due to a biography by Sir Hugh Cortazzi, the former British Ambassador to Japan.^32–34 Willis, born in County Fermanagh, Northern Ireland, acquired an MD from Edinburgh, Scotland, and then worked in London prior to his move to Edo in Japan in May 1862. In Japan, he was responsible for establishing the Tokyo Medical School (later named the Medical School of Tokyo University) before relocating to Kagoshima. He established the department of medicine and worked in Kagoshima from 1870 until 1882, and then returned to Wales, UK.²⁹

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FIG 3.

William Willis (1837–1894; from the public domain)

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Willis is credited with performing the first iridectomy for glaucoma in Japan, practicing obstetrics and surgery, and trying to improve public health.^13,34 Though not a ‘medical innovator or a great researcher,’ he was indeed ‘a practical surgeon and physician’ and physically, was a ‘mountain of a man.’³⁴ During the Japanese civil war in 1868, despite being a foreigner, Willis operated on soldiers and simultaneously taught surgery to Japanese doctors. In fact, he treated wounded soldiers from both sides, upholding the highest Hippocratic ideals.³³

Nikko Kibun AND ANTONIUS BAUDUIN

From December 1869 to 1870, Antonius F. Bauduin (1822–1885) (Fig. 4) published 11 monthly issues of a journal, which he also titled Nikko Kibun. The periodical, of 54 pages, was published on double-folded Hanshi-size paper (Japanese calligraphy paper, 9.5×13 inches). Once again, we have practically no information about the journal itself. Presumably, judging from the title, this journal contained the transcripts of lectures delivered by Bauduin.

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FIG 4.

Antonius Bauduin (1822–1885; from the public domain)

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Bauduin himself was a Dutch physician and lived in Nagasaki from 1862 to 1865, where he taught at the earlier version of the Nagasaki University Medical School.¹⁰ He introduced physics and chemistry to the medical curriculum.²³ In Nagasaki, Bauduin introduced the ophthalmoscope in Japan in 1861 and was also the first surgeon in Japan to operate for strabismus and perform plastic surgery of the eyelids.²³ He translated Richard Leibreich’s Atlas of Ophthalmology, which was the first atlas on the topic and had just been published in 1863.³⁵ Bauduin was the first foreigner employed by the Japanese government.²⁶

In 1868, Bauduin returned to Japan and taught at Osaka Medical School until 1870, which later developed into the University of Tokyo Faculty of Medicine.^10,29 Bauduin was also an enthusiastic photographer and chronicler of his times.²³ Many of his precious photographs still exist and are in collections in libraries and museums.

Kin-sei-i-setsu (JOURNAL OF MODERN MEDICINE) AND STUART ELDRIDGE

In 1872, Stuart Eldridge (1843–1901; Fig. 5), an American, and another fascinating individual of his era, published Kin-sei-isetsu (Journal of Modern Medicine), the first Japanese medical journal that published articles by researchers based in Japan. Eldridge was the first librarian affiliated with the Department of Agriculture. He simultaneously trained in medicine and was then appointed Secretary to the Capron mission. This mission to Japan in 1871 was headed by Horace Capron, former Commissioner of Agriculture, USA, and was established to help with the ‘colonization’ of Hokkaido, the northernmost island of the country. Eldridge did much more than his brief as a government-designated ‘Japanese Government Surgeon-General of the kaitakushi’.^36,37

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FIG 5.

Stuart Eldridge (1843–1901; from the public domain)

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Eldridge established a medical school in Hakodate in August 1872 and subsequently moved to Yokohama in 1875, where he worked as a physician for the rest of his life. The Emperor of Japan conferred on him the Fourth Order of Merit in 1897 and, in 1901, the Third Order of Merit, for his services to medicine.³⁷

In Onodera’s compilation of medical journals of the Meiji period,¹⁰ Kin-sei-i-Setsu’s journal was not included. We infer that this was an inadvertent omission, probably due to the inappropriate search methodology used in 1958. The fact that Whitney’s 1885 review⁸ had included Kin-sei-i-Setsu journal does confirm the labour of Eldridge’s medical knowledge promotion in the then remote Hokkaido region.

Besides founding this short-lived journal, Eldridge had published papers on various medical themes, including aneurysms, beri-beri, and echinococci.³⁷ However, the human skull collection activity (a culturally insensitive fad practised by the natural scientists of the Victorian era) by Eldridge appears to be of current interest. On 14 March 1877, Eldridge read a paper, ‘Notes on the crania of the Botans of Formosa,’ at the Asiatic Society of Japan. This was subsequently published in the Transactions of the Asiatic Society of Japan. The papers describe, with their anatomic measurements, four skulls of the Botans or Motans, ‘one of the so-called aboriginal and savage tribes of southern Formosa.’³⁸ Eldridge had procured the skulls from James Wasson of the US military and had then passed them on to Dr John Anderson, a zoologist who eventually donated them to the University of Edinburgh. Wasson himself had been serving in the Japanese army and had collected the skulls after Japanese soldiers had decapitated soldiers from the Paiwan tribe in a battle at Mudan.^39,40 In November 2021, the Council of Indigenous peoples of Taiwan made a formal request to the University of Edinburgh for the repatriation of these remains of the Paiwanese ancestors. The university agreed, and in November 2023, these remains were returned to the Paiwan tribe.⁴¹

Bun-en-Zasshi AND MOTONORI TASHIRO

Finally, we come across the first medical journal published in Japan, by a Japanese individual: Bun-en-Zasshi (Journal of Literary Bower). We suggest that the last word ‘Bower’ in the English title is a printer’s spelling error for the word ‘Power,’ which went unnoticed. The Japanese kanji characters of the journal’s title split into ‘bun’ and ‘Nen;’ ‘Bun’ relates to culture and ‘Nen’ relates to ‘deep thought.’ Zasshi means ‘Journal.’ Thus, in English translation, Bun-en-Zasshi probably meant Journal of Culture and Thought.

This was a medium octavo (15×24 cm) journal and contained 50 pages per issue. The first issue was in June 1873, and there were five in total. Despite our efforts, we are unable to locate any more details about this journal. However, we do know that the fifth issue had a supplement, named Kanbyo Kokoropegusa (Notes on experiences with Nursing), which was the first translated nursing text of the Meiji era. It was a translation of Directions for Nurses, the 49th chapter of the book written in 1852, A treatise on anatomy, physiology and hygiene, by Calvin Cutter. A copy of this issue is available in the National Diet Library.⁴²

Motonori Tashiro (1840–1897) had served as the editor of this journal. Subsequently, he was also the Principal of the Army Medical School established in December 1888, and wrote a book, Setsudan Yoho (Methods of Amputation).⁴³

STATUS IN 1885 AND READERSHIP

An informative review written in 1885 by Norton Whitney (1855–1918)⁸ provides a summary of quantitative data (then gathered by the Department of Education) on the circulation of medical journals, the contents, regulations, and needed requirements for publication. We reproduce three such pertinent paragraphs below.

‘According to a list furnished by the Department of Education, there are ten periodicals devoted to medicine, pharmacy and public health, which have a total circulation of about 4,000 copies. Of those devoted to medicine, the Tokiyo I-ji Shinshi, or Tokiyo Medical Journal, the I-ji Shimbun or Medical News, the Sei-IKuwai Geppo, or Monthly Journal of the Sei-I-Kuwai, and the Chiu-gai I-ji Shimbun, or Japanese and Foreign Medical News, have the largest circulation; that of the I-ji-Shinshi being 1,800 weekly, and the Chiugai I-ji Shinshi, 2,600 bi-weekly. The Sei-I-Kuwai-Geppo has a monthly circulation of nearly 700 copies and has an English supplement of 12 pages.

These journals are all ably edited, and contain government notifications, original articles, translations from foreign journals, and reports of bureaux, hospitals and schools. They are printed on good paper, with movable type; they are usually post 8vo in size, and contain from thirty to sixty pages of printed matter, with occasional engravings. Advertisements seem to occupy a rather smaller proportion of space than is usually devoted to them in foreign journals. The price averages 10 sen per copy.

Of the remaining journals above mentioned, three are devoted to pharmacy, and one, the Journal of the Sanitary Bureau, to sanitary affairs. The press laws of Japan require the registration of all periodicals, and with certain exceptions, the deposit of security to the extent of over 500 yen. The exception has been made in favour of purely scientific journals. It is perhaps worthy of note that every work, whether medical or of other character, must receive government authorization before being published, and if a translation, the name of the author must appear on the title page.’

Again, we depend on Whitney’s study to estimate the readership population to whom these medical journals cater. To cite Whitney⁸ ‘a special report of the Sanitary Bureau, shows the relative numbers of individuals connected with the practice of medicine in Japan: Total number of physicians and surgeons, 38 600; of which 2,488 have passed the government examination, and a number have yet to pass. Of the remainder, 31 766 were in practice before 1876 and have received licenses without examination. Besides these, there are 646 oculists and 119, whose speciality is the diseases of the mouth.’

WHY SUCH A PROLIFERATION OF JOURNALS?

According to a journal count provided by Onodera,¹⁰ between 1873 and 1879, 27 medical periodicals made their entry. Then, between 1880 and 1889, another 42 medical periodicals entered the market. Onodera also provides the interesting information that 23 among the 69 journals folded within a year of their origin. Our conjecture is that, in Japan, it remains a fashion or fad from the Meiji period to begin something or adopt some trend from overseas, whether it be ballroom dancing, photography, stamp collecting or Schopenhauer’s philosophy of ‘denial of the will to live’. Chamberlain⁸ had provided a list of such ‘fashionable crazes’ that were prevalent from 1873 to 1904.

However, we must note that the USA too had as many as 249 new medical journals between 1797 and 1850, most of which folded up soon.⁵

What we find rather interesting was recorded by Chamberlain more than 120 years ago. To quote, ‘If small people may be allowed to criticise giants, we would here note…surely it is not enough to get at the Japanese sources. The Japanese sources must themselves be subjected to rigorous scrutiny,’ in his observations on von Siebold’s activities.²³

There is no doubt that the Meiji restoration was beneficial to health and medicine in Japan. There were other unexpected changes, too. It had been a common practice for diseases to be labelled and linked with specific places in Asia. This was in large part because of the lack of understanding of disease and aetiology. However, with the advent of modern medical journals, the Japanese decided to eliminate geographic, pejorative terms and use more scientific names, indicating progress from an uncivilized society with arcane illnesses to a progressive one. That this phase also coincided with the birth of microbiology must have contributed to the newer nomenclatures.⁴⁴ Almost a century and a half later, in 2007, the WHO also decided to eliminate places from the names of diseases because of the negative connotations.⁴⁵ In this way, Japanese medical journals, even when fledgling, were way ahead of their times.