I began to study medical history, including its history of ideas, sociology, economics, ethics, and anthropology. On collecting these sub-disciplines Prof. Nakagawa invented a neologism, “medical humanities”, for which he contrasted with biomedicine. In his sense there were two cultures in the studies of medicine, medical humanities and biomedicine. He used biological medicine to refer to the “narrow” scientific medicine. These terms were like C.P. Snow’s book, The Two Cultures (1959), he used to divide two categories, the sciences and the humanities. I think Nakagawa-sensei’s idea of the dichotomy between medical humanities and biomedicine seems to be sui generis because the Japanese medical authorities used the completely different dichotomies between basic and clinical medicine, and/or between clinical and social medicine. All these dichotomies, though, belonged among just one side of scientific medicine; biomedicine or natural sciences (SEIBUTSU-IGAKU or SHIZEN-KAGAKU). We never had medical humanities as an integrated discipline. The only exception was medical historiography, e.g. the works of Yū Fijikawa (1865-1940), but I think that this academic work, budded from amateur science, was not an integrated discipline to university curriculum.

(Now I will back to Nakagawa-sensei’s personal history relating with ethos that we have shared).

Dr. Nakagawa and his disciples share a similar “ethos” (the distinctive spirit of a “sub-culture”) against “social control by medical establishment.” We thought that all the social institutions could be erroneous in their treatment of patients. We remembered that Nakagawa sensei used to say, “All types of medical treatments have attributes of experiment, e.g. having a trial & error aspect, while the object of medicine is a human being, therefore we can say that all medical treatments are human experiments.”

Dr. Nakagawa was born in Seoul of Korean peninsula, the colonial town of the Japanese Empire in 1926. He was fostered as a pro-militarism boy, he said after 60 years later. But he was shocked when that undefeated imperial army was finally defeated. After 1945, during his medical student period in Kyoto Imperial University, until 1947, then in Kyoto University he had drastically converted into something liberalist. After his graduation, he participated in a voluntary party, called “SEINEN-KAGAKUSHIKA-SHŪDAN” (Young Group of Historians of Science) in the 1960s. This was after the political movement against “NICHIBEI-ANPO” (the US-Japan military alliance)  conflict of 1960. In the period of “young radicals in campuses” during the conflicts at the end of 1960s and the beginning of 1970s, our elder colleagues among the MAOists had radical experiences as university undergraduate students. But I was one of parts of later generations fallen behind the time. So to say it simply, I was in part of the post fēstum (after the feast) generation, because I was born in 1956. As a four years old boy, I was too young to understand the politics in 1960 of the first renovation of NICHIBEI AMPO. Even 10 years later, I was still too young, as a fourteen years old kid, to participate in the “struggle” of university students in 1970. In this sense the fēstum means political disturbance. So I was in an in-between generation of two big political fēsta.

Why did a dozen of students, sharing the same ethos against “social control by establishment”, gather around prof. Nakagawa who was part of an older generation? Because there were no other social spaces where young students could talk freely about of this topic. This was true not only in Kansai (western Japan) but also throughout Japan.

There were two major academic currents for studying medical history at the beginning of 1970s: one was Thomas Kuhn’s, and the other was orthodox Marxism. His old friend, Dr. Shigeru Nakayama translated Thomas Kuhn’s book, “The Structure of Scientific Revolutions” into Japanese in 1971, nine years after of original edition published in 1962. We could not accept fundamentally the Marxist theories, especially one of the Japanese Communist Party’s localized version, because they were too dogmatic in their analysis of medical practice, which always used the framework of labor processes. But at the same time, we had a tolerance for the framework of Marxist theory, especially in the case of Western Marxism, which could be used to analyze how patients were alienated. The Kuhnian model of “revolution ”, conversely, was attractive to us because we pursued a kind of paradigm change by inventing the medical humanities as opposed to the biology-dominant medicine, “biomedicine”.

Until 1980, Dr. Nakagawa was an associate professor that had no chance of being promoted above this position. When he was finally promoted to the professorship, he was 54 years old – I am now three years older than him. He had the charisma to be our spiritual guru and best theorist for medical humanities, like our western heroes that I mentioned before. His personal character was that of a good egalitarian, unlike any other professor in the faculty of medicine. He had great tolerance and never to directed in a magisterial style when he would comment on our research presentations.

A senior student, who was a medical doctor, proposed to us his creative concept of “HIHANTEKI-IRYŌ,” the Critical Medicine . We welcomed this conception of him. It helps us develop our position that would take us away from social control by medical establishments and towards the liberation of oppressed people. We were charmed easily by this dogma of critical medicine. At that time, there were a dozen of key concepts for constructing a medical “theology for liberation” in the western medicine e.g., anti-psychiatry, illness labeling theory, a series of negative aspects of modern medicine; total institution, involuntary hospitalization, professional dominance, medicalization, iatrogenesis, victim blaming, and also, Foucauldian concepts of panopticon, anatomopolitique, and biopower, et cetera. But today I regret that we had very naïve political thinking, and believed that all medical institution would be simply oppressive. Anyway we were too idealistic to make a concrete plan to reform the “conservative” medical system.

At that time we encountered prof. Margaret Lock’s paper in Japanese, entitled “RYŌSAI-KENBO NO TEIKŌ” (Resisting against becoming good wife and wise mother) published in “KIKAN-JINRUIGAKU” (Anthropology Quarterly), Vol.15, No.1, Pp.36-60, 1984. At least for me, it was amazing article because she wrote a sophisticated argument that took a critical approach to both the grand theory of Japanese women’s somatization and the newly emerging neologism of pseudo-disease, e.g. “BOGEN-BYŌ” and “DAIDOKORO-SHŌKŌGUN.” “BOGEN-BYŌ” can be translated into “Child illness induced by deficiency of mother’s social responsibility” on one side, and “DAIDOKORO-SHŌKŌGUN” can be translated into “House wife “kitchen” syndrome,” both were very curious pseudo-disease terminologies even for Japanese. Her argument is very clear that the concept of somatization could not only be necessary to know one of universal types of psychopathology but also should be understood as a certain cultural representation of personal distress. I had just apprehended that her style of writing could be needed to create “our” medical anthropology, as HIHANTEKI-IRYŌ (critical medicine).

Unfortunately I had no time to do so because I should leave from Japan to Honduras, Central America, for volunteer work in a rural public health program, from 1984 to 87. In Honduras, during the first year I worked in a malaria prevention program, and for the final two years in a rural health program in western Honduras. After arriving in Central America under the political atmosphere of Cold War, I wanted seriously to preach the importance of medical anthropology for Honduran health workers. Needles to say that was a losing battle. Although I was serious, they felt that my ideas were bizarre because they thought that it was useless to introduce my cultural sensitive approach to a rural public health program. They were satisfied with their own work. They did not have a comparative perspective to need a better good life for rural people. They did not even care if rural people achieved good health; the public health work was only work for minimum wage (Ikeda 2001). So I abandoned my preaching and my plan to introduce medical anthropology to them. And then I started myself to do fieldwork on traditional folk medicine, commoditization of rural health, and medicalization processes, for the purpose writing academic papers. After returning to Japan, I began publishing a series of papers on medical anthropology based on my rural fieldwork experience. But it took more than 14 years before published my first book of ethnography, “JISSEN NO IRYŌ JINRUIGAKU” (Medical Anthropology of Health Practice in Rural Honduras) in 2001.

Original Paper: MMAJ-mikeda0305-RM.pdf


Source: https://www.researchgate.net/profile/Mitsuho_Ikeda2

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