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.

Enter into an Immersive World

For as long as I can remember, I’ve been going to aquariums. Anytime my family and I would take trips and vacations, we’d HAVE to go to an aquarium. I’m not even sure just how many times I’ve gone to Maritime Aquarium, in Norwalk, alone; they just never get old for me. So I want to start off this blog entry part 2 (the sequel; see here for part 1) by just saying, I’m really excited to be reading about and discussing and visiting aquariums.

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For my pre-trip presentation on aquariums, I read a chapter, “Zoological Gardens of Japan” by Ken Kawata and “Ciliated Sense” by Eva Hayward. I was a little disappointed in how little the former talked about aquariums, but it did provide me (and I think, my peers during my presentation) some history on aquariums in Japan. Pre-WWII, aquariums were pretty uncommon, but then proliferated and became very popular post-war. Kawata partially attributes this to a cultural phenomenon relating to Japan’s status as an island nation. Like Kawata, I also would’ve expected marine life and aquatic environments to have a profound influence on “language, culture, and food habits.” But the question I had, and posed to my peers, was, “Why only after WWII does this cultural phenomenon occur? It’s not like Japan suddenly became an island nation.” Perhaps a post-war liberation from wartime duties and resource devotion to a war effort? Newfound leisure money?

I’ll put it simply: “Ciliated Sense” was absolutely fascinating. To use an analogy, if I was expecting to dive into a relatively shallow pool, say maybe 9 feet in depth, I think what I got was the Marianas Trench. That is, Eva Hayward puts forth a really interesting, deep discussion of immersion and perception as they relate to aquariums, that I won’t really have time or space to go into here. I highly recommend checking it out, though.

“Ciliated Sense” details the Monterrey Bay Aquarium, so I framed my discussion of aquariums from a Western aquariums perspective; I’m looking forward to seeing how Oota-sensei and the Tokyo Sea Life Park might parallel or challenge my ideas of aquariums. Aquariums began as early as the 19th century in Europe, with “aqua vivariums.” These were geared towards the affluent and to sate intellectual curiosity and religious and biological insights. These aquariums coincided with a time when the oceans were considered a dark, cold, alien world and its inhabitants even more so. So these exhibits, then, became a way to dominate, contain, compartmentalize, and study non-human inhabitants and demonstrate biological knowledge and technological achievement. I think these early ideas really highlight and hearken back to our previous discussions on the “West as conquering nature” ideas, sad as that may sound (especially for me as a marine biologist/ecologist at heart).

Hayward argues, using the Drifters exhibit in Monterrey Bay Aquarium, that at some point modern aquariums shifted to a less binary-generating role. Instead, she suggests, using increasingly more advanced technology and optics, aquarium displays can immerse the viewer in the underwater world of the non-human inhabitants. So instead of contrasting “man-made” and “natural” in aquariums, it seems more a blurring and integration of those binaries. Aquariums such as the Monterrey Bay Aquarium as best as they can aim to recreate and simulate natural ecosystems. Hayward has two major conclusions that I think really resonate with how I also view aquariums: “Animal displays are not simply about seeing the human reflected back upon us” and “We are not only immersed in virtuality; we are immersed in deep marine techno-science worlds.”

Along with those conclusions, I’ll leave you, dear reader, with another series of questions I proposed to my peers:

  • What do you think of when you hear “aquarium”?
  • What do aquariums mean to you? Perhaps a specific aquarium?
  • Why do you go to aquariums? What do you get out of them?

Enter into the Home

I’m going to break up today’s blog entry into two discrete posts, since they’ve been getting rather long recently (which definitely speaks to the complexity of the topics and our engagement with them!). This entry is on  kanpo, or traditional (a term I use hesitantly) Japanese medicine, and genkan (entryway) etiquette. Part 2 (the sequel?) will be on my presentation on aquariums and immersion. I don’t mean to elevate my own discussion or project as separate from Valeria’s or the general group discussion, but I think kanpo and genkan etiquette actually go hand in hand, as I think you’ll see. And I don’t mean to toot my own horn, so to speak, by even writing about my own presentation, but I want to share the ideas I read about in “Ciliated Sense” because I think they’re absolutely fascinating. Apologies for the long disclosure; now for our feature presentation!

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How ironic and relevant it is, to be discussing “illness” and “disease” and medicine (Kanpo and Western), at the same time I, myself, am fighting a sore throat and cold. When, just the other day, I went into the Bowdoin Health Center for diagnosis and treatment.

Kanpo is a little hard to define without slipping into binary traps or comparing it to Western medicine and practice, since until today that’s all I really knew. From Valeria’s and Professor Selinger’s presentations and discussions today, if I understand this correctly, kanpo and “Japanese Germs” are very much about “purity vs impurity” (note: an entirely different sense from the historical/anthropological “purity” from Day 1) and treating imbalance. It contrasts the clean (pure) inside with the dirty (impure) outside or below. So for instance, and as an incredibly relevant example as you’ll see later in this post, the genkan or entryway of a Japanese home, where you take off your shoes, has a raised step. That is, what’s considered “inside and raised” is meant to be kept clean from the impurities of the “outside and below”–hence why you take off your shoes there.

I thought it was particularly interesting about how these ideas of purity and impurity evidently arose with the Kojiki, a work which contains origin and creation stories of Japan. I’ve always been really intrigued by these kinds of stories, oddly enough, despite my “scientific” disposition. In short, Izanagi’s wife died and went to the underworld. After some time, Izanagi decided to venture into the underworld to see her (I’m unclear whether this is like an Orpheus story where he wanted to return her to the world of the living or if it was just to visit). While there, Izanagi was contaminated, owing to the death, dead bodies, and illnesses of the underworld. Back on the surface, the purifying waters of a river cleansed Izanagi and from cleansing deities were born: Amaterasu, Susano-o, especially, among many others.

We continued our discussion by contrasting kanpo and Western medicine as well as pathology (study of disease-causing agents) and etiology (circumstances that led to contraction of a disease). As an example, my pathology might be whatever virus, bacteria, etc. that infected my throat and upper respiratory tract. My etiology, however, would probably be staying up late after finals were over and some friends were visiting, thereby weakening my immune system and allowing me to contract whatever my friend had. I thought it was also particularly interesting the idea of ひえしょ(hiesho) or “coldness (sensitivity).” It’s an idea common, I think, to both Western and kanpo practices, in that being cold can somehow lead to illness. While I agree that hot things are wonderful when you’re sick (trust me, I’ve been drinking copious amounts of tea and soup), I wonder if in certain sicknesses cold or cool things are also useful. When you have a fever, for instance. Or just the other day, we went to the Gelato Fiasco, and I found the cool, creamy gelato to be really soothing to my sore throat. I digress.

To summarize, we came up with a list of binaries that might accurately contrast kanpo (left) and Western (right) medicine:

  • illness vs disease
    • treating imbalance vs pathogen
      • treating chronic vs acute sickness
        • correlative vs “magic bullet” thinking
          • body as homeostatic system vs as discrete parts
            • diagnosis vs treatment
              • healing vs curing
                • healing goal: restore balance (a fluid, moving, context- and environment-specific target)
                • curing goal: rid body of specific pathogen

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Respect. Appreciation. I think they’re a bit underrated, perhaps a bit neglected terms. I don’t mean to be cynical here and I’m not trying to say everyone is necessarily disrespectful or unappreciative, but I think it’s definitely something that at the very least takes a subconscious or subtle role in our lives. In contrast, respect and appreciation are huge, I think, in Japanese culture. From my second year (二年生 = ni nensei) language studies, we learned a lot about how much respect and social norms are embedded within the language itself. Take Keigo, which I briefly talked about the other day, in which you humble yourself and honor the socially-distant or socially-superior person. Or, take a typical exchange between a host and a visitor to that home:

Visitor removes coat and rings doorbell, before waiting for host.
Visitor: ごめんください。ボウドイン大学です。

Host opens door and lets visitor into the genkan.
Visitor: 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。
Host: ああ、どうぞ、おあがりください。
Visitor: (pause) じゃあ、しつれいします/おじゃまします。

Visitor takes shoes off in genkan, being careful not to touch their socks to the lower, "outside" portion, and neatly sets shoes to the side.
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After being shown to a seat, the visitor offers a gift of appreciation.
Visitor: これ、つまらないものですが。。。
Host: ああ、いいですよ、いいですよ。
Visitor: いえ、ほんの気持ちだけですから。。。

Romaji:

Visitor removes coat and rings doorbell, before waiting for host.
Visitor: Gomenkudasai. Bowdoin daigaku desu.

Host opens door and lets visitor into the genkan.
Visitor: Honjitsu wa omaneki wo itadakimashite, arigatou gozaimasu.
Host: Ah, douzo, o-agarikudasai.
Visitor: (pause) Jaa, shitsureishimasu/ojamashimasu.

Visitor takes shoes off in genkan, being careful not to touch their socks to the lower, "outside" portion, and neatly sets shoes to the side.
~~~
After being shown to a seat, the visitor offers a gift of appreciation.
Visitor: Kore, tsumaranai mono desu ga...
Host: Ah, iidesu yo, iidesu yo.
Visitor: Ie, hon no kimochi dake desu kara...

Basically, this exchange is all about respectfully entering someone else’s home after you’ve been invited in and showing gratitude for that invitation through gift culture. This kind of social exchange is definitely super important. Time to get memorizing of these set phrases (13 hour plane ride, anyone?).

A Sense of Nature…?Nah.

The prevalent Japanese stereotype is that of an individual who reveres nature and generally has a greater appreciation of nature. Discussions from D.P. Martinez’s article “Is there a Japanese sense of Nature” led to the conclusion of there is not an innate-but rather an appreciation of nature perfected by human touch (Japanese artwork in which nature is manipulated to represent spirits or other aspects of nature).

Man-made vs Natural disaster:

Oguma Eiji poses an interesting and thought-provoking history of Tohoku and its relationship with Tokyo. Throughout the article there seems to be a theme of disregard of people in Tohoku by the policy-makers and maybe even the population as a whole of Tokyo.  The disaster at Fukushima and the whole of Tohoku was set up by the path in which it was placed my policymakers and directors in Tokyo since Japan’s rapid modernization in the late 20th century. This is not to say that a tsunami would not have happened, but rather the conditions in which Tohoku found itself at the time of the tsunami was that of a rather poor depopulated region. As modernization/industrialization was prioritized the continuous disregard of Tohoku as the periphery and the careless decisions concerning the population continued. Why was Tohoku the designated rice production? Knowing the devastating consequences of removing factories from this villages would  have, why did they do it? Many have asked the question of: Why were the Nuclear plants established in a earthquake proned area? Maybe because of the “open space” and its proximity to Tokyo and the fact that its not Tokyo but Tokyo’s “backyard?”

“Nuclear power and democracy are not compatible” How and why?

Oguma Eiji puts the disaster of March 11 under the light of justice and as an activist he demands answers and envisions a better future. Although mentioned in his article, I’d like to know more about what he thinks the odds are for the reconstruction and restoration of the Tohoku region.


Nan’s brief history and statistics on acid rain an Yokkaichi were examples of how serious pollution problems were during Japan’s rapid industrialization and modernization in the late 20th century. She mentions the power balances between the organizations who have economic power vs. health/wellness/environmental agencies, the economic view point is prioritized.

Particularly interesting from the Ethan’s presentation on the concept of Built Environments was Tokyo’s constant demolition and reconstruction as a new space with retention of the old. Ethan mentioned specific Tokyo neighborhoods that illustrate the idea of Built Spaces, particularly Shinjuku, which were our Airbnb is located. I can’t wait to actually see and experience Tokyo as an international city in which one can feel as if abroad (not in Japan).

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