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Japanese Anesthetics and Experiments in The Doctor's Wife
MEDICAL HUMANITIES PERSPECTIVES Helle Mathiasen, Cand Mag, PhD, Section Editor
Japanese Anesthetics and Experiments in The Doctor’s Wife Helle Mathiasen, Cand Mag, PhD University of Arizona College of Medicine, Tucson.
Tsusensan is the Japanese word for an oral anesthetic made from herbs that was developed by the famous Japanese surgeon Seishu Hanaoka (1760-1835). Seishu studied the work of the legendary Chinese doctor Houa T’o (died 208). His discovery of the first Chinese anesthetic inspired Seishu to develop his own mixture of Chinese and Japanese herbs, which he would boil in water and alcohol and administer to his surgical patients. Seishu succeeded in discovering an anesthetic some 40 years before Western surgeons began to operate on patients who had been anesthetized through oral inhalation of nitrous oxide, carbon dioxide, ether, and chloroform.1 Several medical researchers have written about Seishu Hanaoka’s pioneering work in medicine. In this article, I will discuss the experimental work of Seishu, as well as a novel by Sawako Ariyoshi titled The Doctor’s Wife (1978).2 Based on meticulous research, Ariyoshi goes behind the scenes, presenting, through dialogue and description, daily life in Seishu’s household, and the actions of the doctor himself, his mother, and his wife. Ariyoshi illuminates family structure during the feudal period of Tokugawa Yoshimune (shogun 1716-1745); the women serve the men whose success glorifies the family name. Japan had been isolated from the West, and consequently also from Western medicine, but Tokugawa Yoshimune allowed some works of Dutch medicine to be translated into Japanese. Ariyoshi writes about how Seishu, the son of a doctor, experiments and finally succeeds in combining Chinese herbal medicine with Dutch surgical advances. In fact, when Seishu returns from 3 years’ medical studies in Kyoto, he brings with him a large collection of Dutch-designed instruments, including: syringes, surgical knives, scissors, a spatula made of whale bone, needles, a clamp, a curved saw, probe, mirror, spray, hot iron, and catheter tubes.2 Though from a modest background, Seishu is already destined to Funding: None. Conflict of Interest: None. Authorship: The author is solely responsible for writing the manuscript. Requests for reprints should be addressed to Helle Mathiasen, Cand Mag, PhD. E-mail address: [email protected]
0002-9343/$ -see front matter © 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.amjmed.2009.03.039
become a divinely inspired doctor; he is able to study and furnish his practice because of the self-sacrificing labor of his courageous mother, wife, and sisters. Houa T’o had used datura stramonium blended with alcohol; Seishu learns from that invention, creating his tsusensan from datura alba Nees, which grows wild around his house, as well as from Chinese herbs, and alcohol. In true empirical fashion, Dr. Seishu first experiments on dogs and cats to learn what balance of ingredients will best serve his purpose. Ariyoshi describes how Seishu’s wife, Kae, identifies with these animals because they get the best food as she does also, because of her pregnancy. She watches as her husband performs the animal experiments: “There was a cat named Miru. Holding it by the neck, Seishu was pushing its face over and over into a bowl filled with liquor until the unfortunate animal became wild, mewed frantically, and started to choke from the strong alcohol.”2 He then inserts a probe into the body of the cat to judge whether the anesthetic has had the desired effect. It becomes clear that he needs to try the drug on humans; Kae and her mother-in-law, Otsugi, compete to offer themselves. Seishu, however, chooses to give his mother what amounts to a strong alcoholic drink, while Kae imbibes a much stronger draught. To prevent involuntary movement during the sedation, she ties her knees and ankles together with the samurai knot she has learned from her grandmother.2 She sinks into a coma for 3 days, but recovers after 2 weeks. However, she loses her sight. Following a second experiment on Kae, Dr. Seishu successfully operates on a 60-year-old woman with breast cancer. Cancer surgery becomes his specialty; he achieves prosperity, fame, and many honors, becoming a sought-after teacher and physician during the shogunate of Tokugawa Harutomi. Because of her quiet dignity and sacrifice, Kae, too, becomes a hero.
References 1. Nakayama DK. Seishu Hanaoka, surgery, and anesthesia in feudal Japan. Pharos Alpha Omega Alpha Honor Med Soc. Winter 2009:35-40. 2. Ariyoshi S, trans. Hironaka W, Kostant AS. The Doctor’s Wife. Tokyo, Japan: Kodansha; 1978.
Japanese Anesthetics and Experiments in The Doctor’s Wife Helle Mathiasen, Cand Mag, PhD University of Arizona College of Medicine, Tucson.
Tsusensan is the Japanese word for an oral anesthetic made from herbs that was developed by the famous Japanese surgeon Seishu Hanaoka (1760-1835). Seishu studied the work of the legendary Chinese doctor Houa T’o (died 208). His discovery of the first Chinese anesthetic inspired Seishu to develop his own mixture of Chinese and Japanese herbs, which he would boil in water and alcohol and administer to his surgical patients. Seishu succeeded in discovering an anesthetic some 40 years before Western surgeons began to operate on patients who had been anesthetized through oral inhalation of nitrous oxide, carbon dioxide, ether, and chloroform.1 Several medical researchers have written about Seishu Hanaoka’s pioneering work in medicine. In this article, I will discuss the experimental work of Seishu, as well as a novel by Sawako Ariyoshi titled The Doctor’s Wife (1978).2 Based on meticulous research, Ariyoshi goes behind the scenes, presenting, through dialogue and description, daily life in Seishu’s household, and the actions of the doctor himself, his mother, and his wife. Ariyoshi illuminates family structure during the feudal period of Tokugawa Yoshimune (shogun 1716-1745); the women serve the men whose success glorifies the family name. Japan had been isolated from the West, and consequently also from Western medicine, but Tokugawa Yoshimune allowed some works of Dutch medicine to be translated into Japanese. Ariyoshi writes about how Seishu, the son of a doctor, experiments and finally succeeds in combining Chinese herbal medicine with Dutch surgical advances. In fact, when Seishu returns from 3 years’ medical studies in Kyoto, he brings with him a large collection of Dutch-designed instruments, including: syringes, surgical knives, scissors, a spatula made of whale bone, needles, a clamp, a curved saw, probe, mirror, spray, hot iron, and catheter tubes.2 Though from a modest background, Seishu is already destined to Funding: None. Conflict of Interest: None. Authorship: The author is solely responsible for writing the manuscript. Requests for reprints should be addressed to Helle Mathiasen, Cand Mag, PhD. E-mail address: [email protected]
0002-9343/$ -see front matter © 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.amjmed.2009.03.039
become a divinely inspired doctor; he is able to study and furnish his practice because of the self-sacrificing labor of his courageous mother, wife, and sisters. Houa T’o had used datura stramonium blended with alcohol; Seishu learns from that invention, creating his tsusensan from datura alba Nees, which grows wild around his house, as well as from Chinese herbs, and alcohol. In true empirical fashion, Dr. Seishu first experiments on dogs and cats to learn what balance of ingredients will best serve his purpose. Ariyoshi describes how Seishu’s wife, Kae, identifies with these animals because they get the best food as she does also, because of her pregnancy. She watches as her husband performs the animal experiments: “There was a cat named Miru. Holding it by the neck, Seishu was pushing its face over and over into a bowl filled with liquor until the unfortunate animal became wild, mewed frantically, and started to choke from the strong alcohol.”2 He then inserts a probe into the body of the cat to judge whether the anesthetic has had the desired effect. It becomes clear that he needs to try the drug on humans; Kae and her mother-in-law, Otsugi, compete to offer themselves. Seishu, however, chooses to give his mother what amounts to a strong alcoholic drink, while Kae imbibes a much stronger draught. To prevent involuntary movement during the sedation, she ties her knees and ankles together with the samurai knot she has learned from her grandmother.2 She sinks into a coma for 3 days, but recovers after 2 weeks. However, she loses her sight. Following a second experiment on Kae, Dr. Seishu successfully operates on a 60-year-old woman with breast cancer. Cancer surgery becomes his specialty; he achieves prosperity, fame, and many honors, becoming a sought-after teacher and physician during the shogunate of Tokugawa Harutomi. Because of her quiet dignity and sacrifice, Kae, too, becomes a hero.
References 1. Nakayama DK. Seishu Hanaoka, surgery, and anesthesia in feudal Japan. Pharos Alpha Omega Alpha Honor Med Soc. Winter 2009:35-40. 2. Ariyoshi S, trans. Hironaka W, Kostant AS. The Doctor’s Wife. Tokyo, Japan: Kodansha; 1978.