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[[File:Practical_Pursuits.jpg|thumbnail|left|275px|<i>[https://www.amazon.com/gp/product/0674019520/ref=as_li_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=0674019520&linkCode=as2&tag=dailyh0c-20&linkId=2dc43b0f6c68bf78b1adc96420c32a55 Practical Pursuits: Takano Chōei, Takahashi Keisuku, and Western Medicine in Nineteenth Century Japan]</i>]]During the Tokugawa period, Western medicine filtered into Japan. Ellen Nakamura argues in her book <i>[https://www.amazon.com/gp/product/0674019520/ref=as_li_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=0674019520&linkCode=as2&tag=dailyh0c-20&linkId=2dc43b0f6c68bf78b1adc96420c32a55 Practical Pursuits: Takano Chōei, Takahashi Keisuku, and Western Medicine in Nineteenth Century Japan]</i> (Harvard University Press, 2005) that western medicine was dispersed throughout Japan by Japanese physicians who believed that the practical benefits of Western medicine could improve the quality of their patients’ lives. While these physicians did not completely adopt Western medical practices, they incorporated some Western medical ideas into their own treatments. Through the writings of Takano Chōei (1804-1850), a rangaku scholar and ranpō physician, and Takahashi Keisaku (1799-1875), a rural internal medicine doctor from the province of Kōzuke, Nakamura argues that Western medicine was spread by extensive social networks to physicians throughout the country. Practicing physicians were interested in examining Western medical methods, and Nakamura shows that Western medicine spread to rural Japan even as the Bakufu increasingly limited the flow of Western ideas into Japan.
The book is presented as an account of the dispersion of Western medicine to rural Japanese physicians through social networks, but it ultimately is an analysis of a specific relationship between Chōei and group of Kōzuke physicians, including Keisaku. While at times this may prevent from Nakamura from successfully arguing her wider thesis, it is a valuable look at this specific relationship. Whether or not this relationship is a typical arrangement in the Japanese medical society is not entirely clear, but there is no doubt that these individuals’ interactions influenced each other in meaningful ways. Whether or not any broader social trends can be extrapolated from this network is difficult to say. Nakamura clearly hopes to demonstrate that the previous scholarship in this area focused too heavily on physicians in Nagasaki and in the Bakufu without examining the expanding role of Western medicine in Japanese society. Ultimately, the author succeeds in demonstrating that Western medicine was not limited to those select physicians.
While Chōei never achieved financial security or fame during his lifetime, he was well known for translating Dutch medical texts to Japanese. Chōei was born into a middle ranking samurai family, but he ultimately rejected his samurai heritage to focus on his rangaku scholarship and medical practice. As a result, he struggled for money throughout his life. Chōei studied medicine with Phillip Franz van Siebold (1796-1866), a well-known European physician in Nagasaki. The Bakufu briefly allowed Japanese students to study medicine with Siebold, because they believed that Western medicine might be useful. Even before Chōei studied with Siebold, he could translate Dutch.
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After the Siebold School was closed after a scandal involving its founder, Chōei slowly severed ties with his family and focused on his rangaku studies. It was Chōei’s translation work that interested Fukuda Sōtei, a prominent Kōzuke physician. Chōei adapted the Dutch medical texts to help Japanese physicians develop solutions for local problems. Chōei did not provide literal translations of the Dutch source materials; he interpreted the work to best serve the social needs of his physician audience. Sōtei was learning Dutch and he sought out Chōei for additional guidance because he saw the potential for practical applications of Western medicine. Sōtei and Chōei began a relationship that allowed Chōei to network with a number of rural physicians from Kōzuke. Nakamura believes that this interchange of ideas between urban and rural intellectuals created an impetus for social change in Japan that extended beyond the Tokugawa period.
Nakamura does an excellent job throughout this book demonstrating that social networks developed between local physicians and proponents of Western medicine. Nakamura’s underlying thesis in this work is that these social networks allowed for the “exchange of ideas between urban and rural intellectuals, and, eventually, for social change in the late Tokugawa period and beyond.” (p. 180.) Nakamura successfully demonstrates that these networks did exist, but she fails to show how extensive they truly were. At the end of the book, it is not clear whether or not the relationship between Chōei had with the Kōzuke physicians was a typical arrangement. Nakamura’s work would benefit from additional examples of consulting arrangements between proponents of Western medicine and Japanese physicians. Despite this minor complaint, Nakamura’s book does an excellent job elucidating the growing influence of Western medicine during the Tokugawa period.
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