Other Diseases

Bubonic plague and epidemic typhus, the two most important vector-borne diseases in early modern Europe, seem not to have afflicted early modern Japan. Rather plague was first reported in Japan at the end of the nineteenth century and believed to have arrived on ships from China that carried plague-infested rats. Typhus probably arrived somewhat earlier, but typhus and typhoid were confused in Japan as they were in Europe, so it is difficult to determine which disease is being referred to in the Japanese sources. A Japanese variant of typhus, called tsutsugamushi disease, is fairly common in the Shinano River Valley. It is carried by a mite, and although the illness can be fatal, it has a much more benign history than European typhus.

The popular literature of the Tokugawa period mentions other common illnesses, but, as noted earlier, it is usually impossible to identify them within modern nosology. The kinds of diseases referred to, however, were those experienced by many early modern societies. Ailments of the eye were apparently very common, as they were featured in medical books and in general accounts of the period. Pompe van Meerdervoort, a Dutch physician who arrived in Japan in the 1850s, writes that he was struck by the number of Japanese people who were visibly afflicted, often blinded, by eye diseases. These people probably suffered from trachoma, a disease that was common in Japan in the late nineteenth century, and presumably in earlier times as well.

Other health problems frequently mentioned in contemporary literature include beriberi, toothaches, hemorrhoids, ringworm, coughing disease, kidney problems, and food poisoning. In addition to these common ailments, there are two others, which are called senki and shaku. These two terms, used in Japan as early as the tenth century, appear to refer to a host of diseases that cause stomach, intestinal, or back pain. Senki seems to refer to chronic disease, and shaku to more acute problems.

The various treatments recommended for these two illnesses suggest that they may have been caused by worms or other intestinal parasites, tumors, diseases of the stomach or gallbladder, ulcers, kidney disease, and various problems involving the lower back. In other words, these were catch-all terms that covered many of the different diseases that afflict humanity. The various manifestations of senki and shaku were featured in Tokugawa medical books, and, depending upon the symptoms, it was the task of the physician to recommend appropriate treatment.

There are few surprises in the kinds of disease described in the Tokugawa sources. Of greater interest is the failure to find evidence of certain diseases that were common in the West. Plague and epidemic typhus, already mentioned, are conspicuous by their absence. And Westerners who arrived in Japan in the late nineteenth century commented on the rarity of scarlet fever, diphtheria, tuberculosis, typhoid, cholera infantum, epidemic dysentery, and severe forms of malaria. Even tuberculosis seemed much less prevalent in Japan in the 1860s than in contemporary Europe, but tuberculosis death rates were rising sharply by the end of the century. The differences in the disease histories of Japan and the West suggest again that Japan's isolation from world trade gave the islands a measure of protection from some of the major diseases of the early modern period.

Ann Bowman Jannetta

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