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History of Medicine
36 (
2
); 117-123
doi:
10.25259/NMJI_389_22

Suicides of elite Japanese writers: The case of Ryunosuke Akutagawa

2-2-8 Toyotama Kita, Nerima ku, Tokyo-176-0012, Japan;
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

[To cite: Sri Kantha S. Suicides of elite Japanese writers: The case of Ryunosuke Akutagawa. Natl Med J India 2023;36:117–23. DOI: 10.25259/NMJI_389_22]

Abstract

Background

. To mark the 130th birth anniversary of Japanese writer Ryunosuke Akutagawa (1892–1927), I revisit his suicide (as recorded by his hand) in comparison to that of his junior contemporaries, who also chose a similar mode of death.

Data sources

. Two works of Akutagawa, namely Tenkibo (1926: Death Register) and Aru Ahono Issho (1927: The Life of a Stupid Man) in English translation of Jay Rubin were used as the main sources, in addition to published literature about his creativity.

Results

. In his final work, The Life of a Stupid Man, completed in the penultimate month before suicide, 7 among the 51 brief descriptions, Akutagawa had described his thoughts on illness and death, in addition to visiting his biological mother in a lunatic asylum, and studying a cadaver for his famous short story ‘Rashomon’. These descriptions offer a fascinating perspective on Akutagawa’s state of mind, before his suicide. Akutagawa’s suicide is also compared with the suicides of five other renowned Japanese writers (Osamu Dazai, Yasunari Kawabata, Misuzu Kaneko, Yukio Mishima and Juzo Itami).

Conclusion

. Before his suicide, doctors offered Akutagawa various diagnoses: ‘insomnia, gastric hyperacidity, gastric atony, dry pleurisy, neurasthenia, chronic conjunctivitis, brain fatigue’. Though it is uncertain, what percentage of hereditary factor(s) played a role, why the practitioners of the medical profession in 1920s Japan failed to save the life of this creative individual still remains a question.

INTRODUCTION

Japanese writer Ryunosuke Akutagawa (1892–1927) ranks among one of the elite writers of 20th century literature (Fig. 1). He also belongs to another elite group of writers who had committed suicide. While Post1 had omitted Akutagawa in his study sample of 291 famous creative men with psychopathology (due to his specific selection criteria for the study of the ‘availability of sufficiently adequate biographies’), Pretti and Miottto2 included him among a sample of 3093 eminent ‘artists’ who had committed suicide. Though 95 years had passed since Akutagawa’s suicide, a distinct lack of medical literature on his creative life remains as a handicap to non-Japanese students and admirers of Akutagawa’s creativity.

FIG 1.
Ryunosuke Akutagawa (source: Wikimedia Commons, photographer unknown. Lapsed copyright)

The New York Times, in its brief obituary of Akutagawa noted: ‘…He was a humorous, popular and successful writer, was happy in his home life, with a large circle of admirers, and apparently died simply because he was weary of life, which had been made a burden by a prolonged nervous depression.

‘His wife and children left him Saturday night writing as usual. Sunday morning his wife awoke to find him dying. He was thirty-six years old and leaves three sons.

‘Akutagawa left three “testaments”. The first was addressed to his wife, bidding her not to attempt to revive him if he was a long time dying, and containing directions about the children’s education and the disposal of his property. The second was addressed to another novelist, Kan Kikuchi. The third was addressed to various old friends and stated that he had meditated on death for the past two years, and while he had a duty to write honestly, he saw no need to explain his motives….’3

In published literature, the suicide of Akutagawa’s junior contemporary writer Yukio Mishima (1925–70) had received more attention49 than that of Akutagawa. Two possible reasons include the flamboyant-narcissist image of Mishima, and the macabre mode of seppuku suicide committed by him. Nevertheless, in a survey of 111 sophomore students conducted at the Gifu Pharmaceutical University in 2010, among the suicides committed by newsworthy Japanese in the 20th century, I had reported previously10 that 19.8% of the men and women students recognized Akutagawa’s suicide as number one of their interest. As a sequel to this study, to mark the 130th birth anniversary of Akutagawa, I revisit his troubled life and suicide, as recorded by his hand.

METHOD

Two short works of Akutagawa, namely Tenkibo (1926: Death Register) and Aru Ahono Issho (1927: The Life of a Stupid Man, Fig. 2) in English translations of Jay Rubin were used as the primary sources,11 in addition to the published literature about his life.1218

FIG 2.
Book cover for The Life of a Stupid Man (1926) by Akutagawa, consisting of 51 short fragments, translated by Jay Rubin

RESULTS

Notable life events of Akutagawa are given in Table I. As is evident, Ryunosuke had a deprived childhood, when his biological mother Fuku lapsed into a schizophrenic state from which she never recovered,12 a few months after Ryunosuke was born. Since his biological mother Fuku became incapable in looking after Hisa (second elder sister) and Ryunosuke, the latter was passed to Fuku’s elder brother Michiaki Akutagawa and his wife Tomo, who were childless. Thus, in addition to his biological mother, Akutagawa also had two aunts—one as a legal mother Tomo and the second one as a foster mother Fuki, who lived with Akutagawas.15

TABLE I. Notable life events of Ryunosuke Akutagawa
Date Life event
1892 Mar 1 Birth as the third child of Toshizo Niihara (born in 1851) and his wife Fuku (born in 1859). Eldest sister Hatsuko died
suddenly before the birth of Ryunosuke, on 5 April 1891. Second sister Hisa was born 4 years before Ryunosuke.
1892 Biological mother Fuku began to suffer from schizophrenia, few months after Ryunosuke’s birth; he was brought up by
Fuku’s elder brother Michiaki Akutagawa and his wife Tomo (legal mother of Ryunosuke). Biological mother’s unmarried
elder sister Fuki (who lived in the household of Akutagawa) became Ryunosuke’s foster mother. Father Niihara had married
biological mother’s younger sister Fuyu, as his second wife.
~1901 Ryunosuke came to suffer from convulsions.
1902 Nov 28 Biological mother Fuku died.
1905 Entered Third Metropolitan Junior high school, delayed by a year, due to his ill health.
1910 Sep Graduated from Junior high school.
1913 Jul Graduated from High school, at the age of 21, second in a class of 27.
1913 Sep Entered the Department of English literature, Tokyo Imperial University.
1915 Two stories Hyottoko and Rashomon, published in the periodical Teikoku Bungaku.
1915 Dec Met novelist Natsume Soseki.
1916 Jul Graduated from Tokyo Imperial University, second in a class of 20.
1916 Dec Part-time teacher at the Naval Academy, Yokosuka.
1917 Aug Proposed marriage to Tsukamoto Fumi (1900–68), aged 16. Her father, a naval officer was killed during the Russo-Japanese war.
1918 Feb 2 Married Fumi.
1918 Mar Received a contract as a writer for Osaka Mainichi Shimpun.
1919 Mar Became full-time employee at Osaka Mainichi Shimpun, at a salary of 130 yen per month. Biological father died, aged 69.
1920 Mar First son Hiroshi born; later, he became a film actor.
1921 Mar–Jul Spent time in China, as a reporter/overseas observer for Osaka Mainichi Shimpun; on arrival at Shanghai, Ryunosuke had to spend 3 weeks in a hospital, suffering from pleurisy (lung inflammation). Later in Beijing, he was treated for diarrhoea.
1921 Aug Deterioration of physical and mental health; suffered from weight loss, haemorrhoids, stomach pains, insomnia.
1922 Nov Second son Takashi born; he was killed in Burma in 1945. Ryunosuke suffered further deterioration in health, stomach cramps, heart palpitations.
1924 Had an entanglement/affair with a woman Hiroko Katayama, described by him as one ‘he could grapple with intellectually’.
1925 Apr–May Spent time at Shuzenji temple for water cure. Third son Yasushi born; later he became a musical conductor.
1926 Jan–Feb Spent time at Yugawara health resort; suffered from insomnia, and was in fear of ‘going mad’. Symptoms of schizophrenia
increased, with delusions of persecution and violent headache.
1926 Oct Publication of Death Register, in which his mother’s insanity was publicly revealed. Surrendered to medications and opium for relief.
1927 Jan Sister Hisa’s house burned down, and brother in law Yutaka Nishikawa was suspected of arson. Then, Nishikawa committed suicide by throwing himself in front of a train. These incidents left a financial burden on Ryunosuke that needed settlement.
1927 Feb Wrote Kappa novel in two weeks, published in the March issue of Kaizo magazine.
1927 April Proposed ‘platonic double suicide’ to Masuko Hiramatsu (1898–1953), a sickly, unmarried friend of his wife Fumi. Forced by artist-friend Oana Ryuichi to give up this idea.
1927 May-June Worried about mental collapse of writer-friend Koji Uno (1891–1961), and arranged for his involuntary hospitalization.
1927 Jun 20 Completed writing The Life of a Stupid Man with a message to his friend Masao Kume (1891–1952), ‘I leave it to you to
decide when and where to publish this manuscript – or whether to publish it at all.’ Left a suicide note to Kume Aru Kyûyû e Okuru Shuki [A Note to a certain Old Friend], indicating a ‘vague sense of anxiety’.
1927 Jul 24 Committed suicide with a fatal overdose of barbiturates (Veronal).

Source: Healy,12 Rubin36

In his 1926 reminiscence Death Register, Akutagawa had described the health of his biological mother Fuku, as follows: ‘My mother was a madwoman. I never did feel close to her, as a son should feel toward his mother. Hair held in place by a comb, she would sit alone all day puffing on a long, skinny pipe in the house of my birth family in Tokyo’s Shiba Ward…I never had the experience of a mother’s care. I do seem to recall that one time, when my adoptive mother made a point of taking me upstairs to see her, she suddenly conked me on the head with her pipe. In general, though, she was a quiet lunatic… My mother died in the autumn of my eleventh year, not so much from illness, I think, as from simply wasting away. I have a fairly clear memory of the events surrounding her death.’

In the Death Register, Akutagawa also recorded the deaths of his eldest sister Hatsuko (before his own birth) who died of meningitis in 1891 and his biological father, when he was 28 from influenza, in 1919. Describing the last night he spent with his dying father, Akutagawa wrote, ‘…I found my father eagerly awaiting my return [from a geisha entertained dinner]. He sent everyone else outside the two-panel folding screen by the bed, and, gripping and caressing my hand, he began to talk about long-ago matters that I had never known – things from the time when he married my mother. They were inconsequential things – how he and she had gone to shop for a storage chest, or how they had eaten home-delivered sushi – but before I knew it my eyelids were growing hot inside, and down with my father’s wasted cheeks, too, tears were flowing. My father died the next morning without a great deal of suffering…’

Multiple reasons have been suggested for Akutagawa’s suicide. First was that he suffered from hallucinations of inheriting the schizophrenia traits of his biological mother. Second, the financial burdens left by his brother-in-law’s suicide, in January 1927, left Akutagawa in a desperate situation. Third, a medically pertinent possibility was insomnia, for which Akutagawa had been tinkering with prescribed sleep inducing medicine, Veronal, and potassium cyanide. Fourth, according to Healy,12 mental collapse of his novelist friend Koji Uno (1891– 1961) in May 1927 might have precipitated the suicide.

DISCUSSION

It is a proven fact that Akutagawa had a fetish about his own death. In a little story entitled ‘Shiso’ (The Shadow of Death),19 he wrote probably when he was 18 or 19 years old (either in his last year of junior high school or in the first year of high school, in 1909 or 1910), Akutagawa wrote about an old fortune teller who had scrutinized his customer’s face and predicted an ‘early death’ based on a shadow between his customer’s eyebrows. The customer was the writer of the story himself. Kurachi15 had listed nine later works of Akutagawa where the theme of death symptoms dominates.

In his final work, The Life of a Stupid Man, completed in the penultimate month before suicide, 7 among the 51 brief descriptions (tagged as ‘scraps and fragments’ by reviewer Cozy20) Akutagawa had described his thoughts on illness and death, in addition to visiting his birth mother in a lunatic asylum, and studying a cadaver for his famous short story ‘Rashomon’. These descriptions offer a fascinating angle on Akutagawa’s prevailing state of mind, before his suicide.

Excerpts from Akutagawa’s specific descriptions11 follow:

About his biological mother (fragment #2):

All the lunatics had been dressed in the same gray clothing, which seemed to give the large room an even more depressing look. One of them sat at an organ, playing a hymn over and over with great intensity. Another was dancing—or, rather, leaping about—in the very centre of the room.

He stood watching this spectacle with a doctor of notably healthy complexion. Ten years earlier, his mother had been in no way different from these lunatics. In no way. And in fact in their smell he caught a whiff of his own mother’s smell.

‘Shall we go, then?’ The doctor led him down a corridor to another room. In a corner there were several brains soaking in large jars of alcohol. On one of the brains he noticed something faintly white, almost like a dollop of egg white. As he stood there chatting with the doctor, he thought again of his mother…

About cadavers (fragment #9):

A tag on a wire dangled from the big toe of each cadaver. The tags were inscribed with names, ages and such. His friend bent over one corpse, peeling back the skin of its face with a deftly wielded scalpel. An expanse of beautiful yellow fat lay beneath the skin.

He studied the cadaver. He needed to do this to finish writing a story—a piece set against a Heian Period background––but he hated the stink of the corpses, which was like the smell of rotting apricots. Meanwhile, with wrinkled brow, his friend went on working his scalpel…

This fragment relates to Akutagawa’s famous story of ‘Rashomon’, published in 1915 (Fig. 3), which gained international recognition, after Akira Kurosawa directed, an award-winning film by the same name in 1950.

FIG 3.
Book cover Rashomon and Other Stories by Akutagawa, translated by Takashi Kojima

On illness (fragment #41):

He suffered an onslaught of insomnia. His physical strength began to fade as well. The doctors gave him various diagnoses—gastric hyperacidity, gastric atony, dry pleurisy, neurasthenia, chronic conjunctivitis, brain fatigue… (dots, as in the original) But he knew well enough what was wrong with him: he was ashamed of himself and afraid of them [italics, as in the original]—afraid of the society he so despised….

This fragment indicates Akutagawa’s dissatisfaction with the diagnoses delivered by his doctors for his ailments.

On Death (fragment #44):

Taking advantage of his sleeping alone, he tried to hang himself with a sash tied over the window lattice. When he slipped his head into the sash, however, he suddenly became afraid of death. Not that he feared the suffering he would have to experience at the moment of dying. He decided to try it again, using his pocket watch to see how long it would take. This time, everything began to cloud over after a short interval of pain. He was sure that once he got past that, he would enter death. Checking the hands of his watch, he discovered that the pain lasted one minute and twenty-some seconds…

On Death (fragment #48):

He did not die with her, but he took a certain satisfaction in his never having touched her. She often spoke with him as though their dialogue had never happened. She did once give him a bottle of cyanide with the remark, ‘As long as we have this, it will give us both strength.

And it did indeed give him strength. Sitting in a rattan chair, observing the new growth of a shii tree, he often thought of the peace that death would give him.

A title ‘Stuffed swan’ (fragment #49):

With the last of his strength, he tried to write his autobiography, but it did not come together as easily as he had hoped…His own works were unlikely to appeal to people who were not like him and had not lived a life like his—this was another feeling that worked upon him…

Once he had finished writing The Life of a Stupid Man, he happened to see a stuffed swan in a secondhand shop. It stood with its head held high, but its wings were yellowed and moth-eaten. As he thought about his life, he felt both tears and mockery welling up inside him. All that lay before him was madness or suicide…

On Defeat (final fragment #51):

The hand with the pen began to tremble, and before long he was even drooling. The only time his head ever cleared was after a sleep induced by eight-tenths of a gram of Veronal, and even then it never lasted more than thirty minutes or an hour. He barely made it through each day in the gloom, leaning as it were upon a chipped and narrow sword.

It was subsequently revealed in 2008, that Akutagawa had left six suicide notes. Among the four notes which turned up at his grandchild’s house, two were addressed to his wife, one was to his children and the fourth one was to his literary friend Kikuchi Kan. The suicide note to his children, carried the admonition: ‘Don’t forget that life is a battle.’ It showed an addition made later by the writer, which modified the word ‘battle’ by adding the phrase ‘that leads to death’.21

Though Akutagawa’s mortal remains vanished in 1927, one of his creations ‘Rashomon’ (that focuses on the relativity of truth and the unreliability of human memory) has gained global immortality in scientific lexicon now,2226 via Akira Kurosawa’s 1950 film by the same name. Who among his contemporaries can lay claim to such creativity?

A COMPARISON OF SUICIDES OF RENOWNED JAPANESE WRITERS

Beginning from Durkheim,27,28 Freud29,30 and Shneidman,31 typologies proposed for suicides are aplenty. Each have their merits and demerits, based on gathered empirical data collected during different time periods that incorporated war, pestilence and individual perceptions of proposing authors, from varying cultural backgrounds. In a review of the numerous typologies proposed for suicide, Martin32 had identified 7 distinct categories pertaining to sociological, psychoanalytic, behavioural, relational, psychosocial, needs/motivation and empirical components.

Attempting to fit a small sample of elite writer suicides (in this case, from Japanese culture with distinct forms of suicide33 such as seppuku or disembowelment, shinju or love suicide and minage or drowning by women) into the proposed suicide typologies of western authorities2732 is rather inconvenient. In addition, anthropologist Ruth Benedict34 had pointed out, ‘American condemnation of suicide makes self-destruction only a desperate submission to despair, but the Japanese respect for it allows it to be an honourable and purposeful act.’; thus, cultural difference of condemnation (in Christian belief) and respect (in Shinto-Buddhist belief) is an issue to be tackled for using the proposed suicide typology slots of Durkheim, Freud and Shneidman (all three belonging to Jewish faith). As such, the four categories typology of suicide proposed by Pridmore and McArthur,35 based on the presence/absence of predicament is useful in this regard.

For comparative purposes, in Table II, details of the suicides of five renowned Japanese writers of the 20th century which followed Akutagawa’s suicide are provided. How the suicides of Akutagawa and the other five Japanese writers fit into the Pridmore and McArthur categories typology is presented in Table III.

TABLE II. Suicide methods and suggested motives of six elite Japanese writers arranged chronologically
Year Writer Method of suicide Suggested motive
1927 R. Akutagawa35 Overdose of somnolence-inducing medication Insomnia, depression and fear of going insane
1930 M. Kaneko26 Overdose of sedative (Calmotin) Physical and mental torture from husband, custody fight with
him for their 3-year-old daughter
1948 O. Dazai38 Drowning Personality disorder, suffering from tuberculosis, chest ailment,
addiction to morphine
1970 Y. Mishima45 Self-disembowelment (seppuku) Shizoidal personality, borderline narcissistic personality disorder
1972 Y. Kawabata72 Gas inhalation at workplace kitchen Depression due to death of protégé Mishima*
1997 J. Itami64 Jumping from a high building Shame on being exposed for an extramarital affair*
differing opinions prevail; whereas Kawabata’s suicide had been disputed as an accident,47 Itami’s suicide had been suggested as a ‘cryptic homicide’53,58
TABLE III. Four categories of suicide typologies
Type* Parameters* Suicide examples in Japan†
MDP-PVCD Mental disorder present and is the major driver of suicide. Predicament is very clearly the Ryunosuke Akutagawa
driver of the suicide. Osamu Dazai
MDP-PLCD Mental disorder present and is the major driver of suicide; but before suicide, it was Yukio Mishima
unrecognized/untreated. Predicament is less clearly the driver of the suicide.
MDA-PVCD Mental disorder absent, and external factors are the major drivers of the suicide. Yasunari Kawabata
Predicament very clearly the driver of the suicide. Misuzu Kaneko
MDA- PLCD Mental disorder absent; neither is there a known (to others) distressing event, or at least one recognized by others assufficiently distressing to ‘justify’ suicide. Predicament less clearly the driver of the suicide. Juzo Itami
Pridmore and McArthur35
Sri Kantha’s guesses, based only on public records and perception but NOT on medical diagnosis of named individuals. Serious limitation being, war time destruction of records; thus, it is difficult to collect personal medical records of deaths that happened before 1950. Among those cited here, only Juzo Itami’s death was as recent as 1997.

Type 1

MDP-PVCD: e.g. Akutagawa and Osamu Dazai (1909– 1948).3639 Similarities in the lives of both these writers deserve recognition: (i) Thanatophilic thoughts abound in their writings; (ii) both engaged in multiple affairs with women; (iii) both had attempted double suicide with women, who were not their own wives; and (iv) both suffered from medically recognized maladies. After his marriage to Fumi in 1918, Akutagawa’s predicaments (failed affairs) with two other women—poet Shigeko Hide in 1919 and Hiroko Katayama in 1924 also deserve notice. Then, three months before his successful suicide, Akutagawa had recorded proposing a ‘platonic double suicide’ to Masuko Hiramatsu, a sickly, unmarried, life-long friend of his wife Fumi.36 He had written, he ‘was fond of her, but did not love her, nor had he ever laid a finger on her’. Dazai attempted suicide twice, before he reached 20 years. In 1935, after his stories gained attention, he made a third suicide attempt. His fourth attempt was in 1936, jointly with a woman with whom he was living for the previous 6 years. That woman died, but Dazai survived. He succeeded in suicide, in his fifth attempt, jointly with another woman (not his wife) in June 1948.37

Type 2

MDP-PLCD: e.g. Yukio Mishima (1925–1970). Born as Kimitake Hiraoka, thanatophilic thoughts have been described vividly in his works. According to his biographers John Nathan40 and Henry Scott Stokes,41 Mishima’s paternal grandmother Natsu Hiraoka suffered from fits of hysteria and she ‘held baby Kimitake virtually as a prisoner from the second month of his birth until 12 years’. At the age of 16, in 1941, Kimitake published his first literary composition, with the pen name Yukio Mishima. Under this assumed name, he promoted himself as a novelist, playwright, Japanese martial art aficionado, film actor, leading contender for the Nobel literature prize, and as a ‘general of his own army Tate no Kai (Shield Society)’. Though the blurb of Nathan’s biography mentions that Mishima’s family had cooperated and the biographer had ‘access to a wealth of private, unpublicized papers’, the mental health profile of Mishima is distinctly missing in both biographies.40,41 Sociologist Mamoru Iga42 was one of the first to recognize that in Mishima’s life, narcissistic craving for attention and alienated self-concept were two personal traits that motivated his suicide. Piven43,44 had commented that ‘Mishima was not schizophrenic. However, he did display markedly borderline states of narcissism and aggression, replete with primitive defenses such as splitting and projective identification’. Not only Mishima died of ritual self-disembowelment on 25 November 1970, he influenced one of his followers—25-year-old Masakatsu Morita, then a student at the Waseda University, who accompanied him into the GSDF Eastern Army Headquarters, Ichigaya district, Tokyo, to commit the same ritual self-disembowelment on that day.45

Type 3

MDA-PVCD: e.g. Yasunari Kawabata (1899–1972) and Misuzu Kaneko (1903–1930). In 1968, at the age of 69 years, Kawabata became Japan’s first Nobel laureate in literature. His suicide had been analysed previously by Iga.46 While some present a case that Kawabata’s death due to gas inhalation was accidental, one suggested factor for Kawabata’s suicide was the emotional deterioration he suffered after Mishima’s seppuku suicide in November 1970.47 Having lost her biological father when she was 3, Misuzu Kaneko (a children poet), became a victim of an ill-fated marriage arranged by her uncle, when she was 22 years of age. Her husband Keiki Miyamoto’s physical torture (passing the venereal disease he had received from prostitutes to Misuzu) and mental torture (in the custodial conflict of her 3-year-old daughter), that led Misuzu to suicide, at the age of 26 years.48,49

Type 4

MDA-PLCD: e.g. Juzo Itami (1933–1997). Though he later gained fame and international recognition as a film director as a specialist on social satire,5052 Itami was originally well known as an essayist and a film actor.53 Itami also had a pedigree, because his father Mansaku Itami (1900–1946) was also a screen writer-cum-film director, who died of tuberculosis. Juzo Itami’s brother-in-law is Kenzaburo Oe, the 1994 Nobelist in literature, who had novelized Itami’s death in 2000 with the title Torikaeko (The Changeling).53 While some hold the view that Itami’s death was a ‘cryptic’ homicide not recognized in the police records, the promoted reason for the suicide was an extramarital affair with a young woman, about to be exposed by the print media.5459

Limitations

The primary limitation of this study is the non-availability of medical and autopsy records of Akutagawa and the other five writers. In addition, the caveat of Pridmore and McArthur35 that the suggested predicament categories are not exclusive, and they ‘can, and probably frequently do, occur’ has to be taken into account.

CONCLUSION

Before his suicide, consulted doctors gave Akutagawa various diagnoses—‘insomnia, gastric hyperacidity, gastric atony, dry pleurisy, neurasthenia, chronic conjunctivitis, brain fatigue’. Though it is uncertain what percentage of hereditary factor(s) played a role, why the practitioners of medical profession in 1920s Japan failed to save the life of this creative individual still remains a question.

Conflicts of interest.

None declared

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