Illness From a Japanese Perspective

Most of my day was spent helping my sister pack to move out of her apartment, so again I hope that my thoughts are somewhat coherent. Anyway, onto to the good stuff! Or, I guess, not-so good stuff, as this post is about illness and medicine.

The readings I will focus on are the following:

  1. Illness and Culture, Ch. 3: My very own illness: Illness in a dualistic world view by Emiko Ohnuki Tierney
  2. Illness and Culture Ch. 5 Kanpō: Traditional Japanese medicine of Chinese origin by Emiko Ohnuki Tierney

There are multiple distinctions in Japanese about different states of health or “constitutions” of one’s body. Something that I first noticed about this reading was the use of the phrase “cultural germs.” What a fascinating concept! And it makes a lot of sense. What makes something a germ is not definitive, and even the word itself implies that germs are inherently bad, which may not be the case in some cultures. For example, this author recounted an incident in which a Japanese male with high social standing was not afraid to reveal he was sick. Sickness, the author argued, was something more to be proud of than to hide in Japan. I wonder how this ties back to the concept of purity we talked about in the beginning of this week. Is there a Japanese state of being pure? What’s the distinction between physical and mental purity? How does sickness fit in? Is illness more of a way to getting to “purity” (since it is viewed as having sensitivity to your surroundings)? The author does point out the difference between an acute illness and a more chronic, life-threatening illness. The former is called jibyō, and an example is like dizziness or cramps. But there are also “constitutions” that the author defines (though the author does not define what a “constitution” is, which is why I use quotations. My guess would be the state of the body, but I am not too sure). These range from from healthy to ordinary to weak, and some symptoms of being weak include being a light sleeper or sensitive to the cold. What is the significance of these distinctions?

Kanpō reminds me of palliative care. I’m not an expert in either subject, but

The illness that you carry with you

When you feel unwell, what do you think is happening inside your body? Do you think something is happening to your body? To what extent do you attribute your environmental conditions to your illness? These are the kinds of questions raised when considering 漢方 (kanpō), traditional Japanese medicine with Chinese origins. Today we looked at illness and medical treatment in Japan. There are distinct medical practices and interactions pertaining to illness that distinguish Japan from other societies. For one, a common ailment is 持病 (jibyō) which could translate to something like “the illness I hold” and is a chronic illness that affects Japanese people throughout their lives. So then how does one cure themselves of jibyō? That’s a bit of a trick question. A main discussion point that we tossed around today dealt with the idea of “curing” versus “healing.” In fact, it can be said that in kanpō, a physician does not intend to cure a patient of their illness, say their jibyō; rather, a physician intends to correct in imbalance in the body. This is where kanpō departs from Western medicine. Western medicine doesn’t really see imbalances in the body; instead, it looks for a pathogen, a biochemical substance that is foreign to the body, and decides the best way to eliminate that pathogen. Western medicine attempts to “cure” a patient by eliminating the pathogen and kanpō attempts to heal them by correcting an imbalance.

今日、有留先生とアナさんは玄関に入ることについて発表したんです。お客さんは「ごめんください」といいます。それから、お客さんは入って、くつをぬぎます。家に入る前に、お客さんは「本日はおまねきをいただきまして、ありがとうございます」と言います。ホストは「おあがりください」と言って、お客さんは家に入ります。お客さんはおみやげを持ってきた方がいいです。お客さんはホストにおみやげをあげて、「つまらないものですが。。。」と言います。ホストはおみやげをもらわなかったら、お客さんは「いえ、ほんの気持ちだけですから」と言います。日本で、僕は、こんな話すことをよく言うといいんですが。。。がんばります。

I’m going to start writing some parts of these posts in Japanese. This bit is about etiquette when entering a Japanese home. One must be extremely polite and humble, using set phrases to express gratitude to the host. A guest always brings a gift, usually food, as a display of appreciation to the host. It is essential that a guest properly enters the home from the 玄関 (genkan), or entryway where the shoes are taken off. Although I’m anxious about getting something wrong in these settings, I feel motivated to try it out with the tools that I have learned today.

Thoughts Change

(Apologies, coming up with suitable titles has always been difficult)

As prep week is coming to an end, I have learned to consider topics in many different ways. Our research and discussions are definitely taking a humanistic, sociocultural approach to nature as well, striking my initial worries of the dominating science-oriented aspects of the trip.

Today, we started by talking about kanpo, 漢方 (Han way), defined by Wikipedia as the Japanese adaptation of Traditional Chinese Medicine. I began approaching the question in a very materialistic view, thinking about the environmental effects of the herbs and other materials used in the treatment (since most of them do come directly through foraging, harvesting, etc). I have always had a long-term interest in “traditional medicine” including wanting to pursue it as a career and doing a herb related science fair project in high school. Having grown up seeing a traditional medicine doctor monthly, I am much more familiar with the more inquiring techniques than diagnostic. Furthermore, my interest in Korean culture in middle and high school years led me to explore the development of similar practices in the peninsula. Because of my long interest, most of the information I learned today were not “surprising” or “novel.” What is interesting over the years is the resurgence of kanpo, in China as well, in multi-generational popularity. For the last two summers I spent in China, I was surrounded by long-term patients complaining about minor discomforts and praises for the treatments (and doctors) despite the high costs not covered by insurance. China has also increasingly used traditional medicine as a means to re-establish its national image and connect to the “Western” biomedical world with frequent international conferences and increasing funding for research. I am very excited to see how the practices are adopted in Japan by a doctor of Chinese origins.

The second discussion evolved around zoos and aquariums. I am surprised to hear about the history of the development of the attractions because I forgot how recently things have changed. In terms of animal viewing attractions, the sense of dominating has shifted to blurring the boundaries between humans and “the Other.” I still remain against the aquarium and zoos despite their educational and conservational values. I think I stand in the more extreme turf to say that contained studies of a species is “unnatural” (haha), since social ethics now dictate that is immoral to do to other humans. As much as I enjoy seeing roaming pandas at the conservation base in Sichuan, I do feel that by keeping them isolated from the world, they are more likely to experience unsettlement once released into the wild again. These are big questions that need very fine answers, but before anything else, I will see how my experience at a zoo and an aquarium goes.

TWO DAYS. VERY EXCITED.

 

 

Healing vs. Curing

As a future health care professional, I want to be aware of biomedicine limitations and the benefits of understanding other forms of medicine practice in this case Kanpo. Kanpo treatment is composed of many attributes, but it is in great part, herbal medicine, which I personally find quite fascinating. To think that a “cure” or aide can be found in the leaves or roots of plants! I can’t but awe at the power and completeness of nature…

Culture and Illness by Emiko Ohunuki-Tierney carefully explained the differences between Kanpo(漢方薬), Japanese Traditional Medicine (derived from Chinese medicine) and biomedicine. One of the main differences between the two is the that while biomedicine specifically focuses on the pathogen, Kanpo places a great importance to the Etiology, or the circumstances that lead to the susceptibility of the patient to contract an illness/disease, such as humoral imbalances and this includes climatic conditions in general (weather patterns, environment factors and surroundings). And this is where we can establish a direct link between Kanpo Medicine and the Environment. For example, Kaze (風)or wind (really any sort of breeze) is said to be the one of the main components of most illness, how then does the issues with Air pollution affect people’s susceptibility to illness?

We were able to establish several binaries:

illness vs. disease; treating imbalance vs. treating pathogen; chronic illness vs. acute illness; correlative thinking vs. magic-bullet thinking; body as homeostatic system vs. body as discrete parts; treatment vs. diagnosis: ==== healing vs. curing. 

Today’s discussion of Kanpo(漢方薬)cultivated my understanding of Japanese culture, especially the significance of the genkan (玄関)and the Japanese notions of purity and impurity and their relation to Japan’s creation myth, the Kojiki.

Some of the questions I’d like to ask the Kanpo sensei we are meeting SOON next week are: What are some of the questions that you ask your patients in the diagnostic process? With what kind of illness are people approaching Kanpo? Environmental?  Is there Kanpo formulas that treat environmental diseases such as Kawasaki Disease, Minamata Disease, Yokkaichi Asthma etc? Is there a reaction of health care systems, particularly Kanpo Medicine, to the environmental health problems in Japan. If there is―what sorts if initiatives have been set into motion? Is Kanpo widely used among all demographics in Japan (young/old, rural/urban citizens, etc)? Is there Kampo campaigns that promote the well-being of the environment? 


With Julian’s presentation and a brief history of Aquariums, I am anxious to see how Tokyo Sea Life Park is attempting to blur the line between the natural world, the ocean, and humans, and actually promote the marine life conservation and education of patrons.

5/25 Kanpo as a Cultural Agency

Our discussion was centered in Kanpo and then aquariums as Julian led us. In the reading of Kanpo, we explored the implications of treating illnesses and diseases and further established the defining differences between western medicine and Kanpo medicine. The fascination of Kanpo, however, is that it has cultural implications in Japan and that we can never discuss Kanpo outside of the Japanese cultural environment, and vice versa.

We started off discussion of Kanpo with Valeria’s presentation on part of Illness and Culture in Contemporary Japan by Emiko Ohnuki-Tierney. She talked about the major difference between Western medicine and Kanpo medicine by making a distinction between pathogen and etiology. While Western medicine is focused on finding the exact pathogen and fighting it out of the patient’s body, Kanpo medicine is concentrated in studying the etiology of certain illness and trying to adjust the body’s relation to the environment in order to recover health. Suggesting that etiology includes climate conditions or environmental factors, the author is able to make a common ground for Kanpo, which encapsulates the Japanese understanding of illnesses, and the culture. Then, Valeria picked an example that illustrates this common ground. The fact that Kanpo characterizes the inner environment as pure and the outer environment as dirty aligns with the cultural meaning of 玄関 as separating the dirtiness outside and the purity inside.

Then regarding the reading, Prof. Selinger proposed some binaries to consider when thinking about the relationship between Kanpo and the Western medicine: illness vs. disease, treating imbalance vs. treating pathogens, chronic illness vs. acute illness, correlational thinking vs. magic-bullet thinking, the body as homeostatic vs. the body as discrete parts, and treatment vs. diagnosis. As Prof. Selinger pointed out and observed in the reading, the binary between illness and disease is not one of nonscience and science, but one of social understanding and science. Above all the differences in the way of thinking, the fundamental uniqueness of Kanpo is that it has an incredible amount of social interactions and implications; Kanpo has gone so far that it is no longer a school of medicine, but a way of interacting with the body and interacting with the outer environment.

An example we discussed was the “contradiction” of drinking cold water at restaurants while drinking hot tea at home, even for people with 冷え性. Restaurants are places for social interactions, with a sense of openness and constant flow of people, while the home is a highly private and cultural space, where the person receives care. 冷え性, a highly cultural concept, is better looked after at a cultural space like home; meanwhile, the closeness at home also parallels the privacy of 体質 and separates the inner(cultural space, home) and outer environment (social space, e.g. workplace, restaurants) of a person.

Julian’s presentation about aquariums then inspired a lot of discussion and different opinions. An interesting question he brought up is: as a place with high technology and human effort, are aquariums trying to pass the message of human conquest of nature? Does aquariums’ effort for immersion downplay this message or contradict it?

One thing undeniable about aquariums is their display of containment of nature by the human. By having those huge tanks, whatever forms they take and however blurred the line between human and fish is, the aquariums express the idea of manipulating nature. As opposed to wrapping a rock with a paper straw in Shinto temples, containing animals in tanks and displaying them for profits are a clear establishment of power instead of connection. However, the educational purpose of aquariums cannot be erased. When the most innocent eyes of children gaze at the beautiful fish and manmade coral reefs, the aquariums are responsible for teaching them the reality of animals living in the ocean, which is different from those living in a tank, even a delicate one.