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It is often said that medicine in Japan is still far behind the West. This is true, unfortunately, in terms of patients’ rights advocacy, malpractice-prevention measures, the medical education system, and hospital amenities and working conditions.

However, in terms of medical technology, Japan is on a level with the West, and even as far back as the late 19th century, it had its share of world-class doctors, particularly in the field of bacteriology.

Prominent among these was Shibasaburo Kitasato (1852-1931), a native of Kumamoto who surprised the world medical community in 1890 when he discovered how to treat tetanus while studying in Germany under Robert Koch, a leading bacteriologist known for his work on tuberculosis.

Kitasato was inspired to study medicine by C. G. van Mansveldt, a Dutch doctor teaching at a Kumamoto medical school in 1871.

However, Kitasato’s career examplifies how, with the end of the Tokugawa Shogunate in 1867, Japan forsook the pioneering tradition of rangaku (Dutch learning) in medicine for the German model of modern medical practice. Indeed, according to Shizu Sakai, a visiting professor at Juntendo University in Tokyo, the first modern government of the Meiji Era (1868-1912) consciously decided on German medicine “because it was the front-runner in the world at the time.”

Hence, in 1870 Japan asked the German Embassy in Tokyo for two doctors to be brought over to teach at the newly established forerunner of the present University of Tokyo Medical School. More German doctors soon followed to teach at the school, and the Meiji government also sent the school’s brightest students to Germany so they could teach others about German medicine when they returned.

Kitasato, though, was not Japan’s only early trailblazer. Another was Ogai Mori (1862-1922), a top military doctor now better known as one of the literary giants of modern Japan. Born into a family of physicians in the service of a daimyo in Tsuwano, Iwami Province (part of present-day Shimane Prefecture), Mori — whose real name was Rintaro Mori — began lessons in Dutch when he was 7. Later, though, he switched to German, and in 1884 was sent to study in Germany for four years.

Although German medicine was pre-eminent in Japan for decades, that changed with the Axis defeat in World War ll and the rise of U.S. influence on Japan, says Sakai.

In simple terms, experts characterize the result of this as being a shift in emphasis in medical education from the German, research-based scientific approach, to a U.S. approach focused more on thorough clinical training.

However, medicine as practiced in Japan still owes much to the German model — including its long-criticized education system that has students spending far longer in lectures than with patients.

In addition, German influence continues to pervade the Japanese medical vocabulary, with patients’ records called karute, from the German word karte (card), while their rentogen (X-rays; after the German physicist Wilhelm Conrad Rontgen [1845-1923]) are displayed on a schaukasten (German for “viewing-box”) on the wall. As for Dutch influence, well, surgical scalpels are still called mes, from the Dutch word for “surgical knife.”