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Illness we share with our ancestors. Diagnosis and remedies set us and them apart.

Imagine yourself a Kyoto noble 1,000-odd years ago. You’re feeling unwell. “One of two things,” you muse to yourself, “either my yin-yang balance is upset, or …” The second possibility makes you shudder: “Am I possessed by an evil spirit?”

Yin and yang were the elemental components of the universe: dark, moist, female yin; bright, dry, male yang. A yin-yang imbalance caused natural disasters and political upheaval in the world, disease in the body. A physician could deal with the latter. He was a sage, a learned man — learned, however, not in what we today call science but in ancient Chinese literary classics that defined health as it defined morality — a matter of being in tune with the forces of the universe. With acupuncture, moxibustion and herbal medicines he labored to restore the ailing body to its rightful universal alignment.

How effective was he? The centuries and centuries it took for doubts to creep in may testify to the slowness of human intellectual progress — or it may constitute a partial rebuttal to modern medical practitioners who dismiss ancient wisdom as rubbish.

When the physician failed, he made way, more or less graciously, for the exorcist.

The 11th-century novel “The Tale of Genji” shows us an exorcist at work. Genji’s wife, Murasaki, is dying, possessed by the vengeful spirit of one of Genji’s past loves. At last the exorcist’s prayers prove too much for it. Subdued, the spirit cries, “You have plagued me mercilessly during all these months with your prayers and spells … and so at last I have manifested myself.” The medium, a young girl, shrieks and curses — but she’ll get over it and be fine. And Murasaki recovers, though a relapse not long afterward proves fatal.

Seven hundred years later, exorcism was alive and well in the bustling new capital Edo (present-day Tokyo). A persistent blot on the Buddhist respect for life that somehow survived centuries of civil war is the casual ease with which parents aborted or murdered unwanted children. The first Europeans to visit Japan — 16th-century Christian missionaries — were shocked by it. The current euphemisms were kaesu and modosu — “sending back.” Children under 7, it was held, had yet to acquire a soul. You can justify anything, it seems, with a little philosophy and religion.

A popular exorcist of the early 18th century was a monk named Yuten, whose clientele ranged the social spectrum from the merest commoners all the way up to the mother of the shogun. Historian Beatrice Bodart-Bailey explains:

“In his most famous cases young women are haunted by the women and children their fathers had murdered or caused to be aborted, crimes that went unacknowledged (and) unpunished. The women fall ill and are deemed possessed on reaching the age where they might well experience the same cruelties their fathers had inflicted upon other women. … The priest Yuten was exceptional in going beyond the religious conventions of his times, recognizing the trauma caused to women by the violence inflicted on their bodies and their children. … The person deemed possessed returns to normal health once the crime is acknowledged and atoned for” through ritual and prayer.

To heal the human body you have to know the human body. That seems a truism, and yet, in Japan as in the West, it had to be fought for; its acceptance marks the birth of modern medicine.

Dissections of criminals and rebels occurred fitfully in ancient China. The primitive anatomical charts that resulted were brought to Japan in the 14th century by a monk-physician named Kajiwara Shozen.

But it was an ugly business, with grim theological overtones. Buddhism in Japan, like Christianity in the West, saw in it a violation of life’s sacredness. Texts, venerable and revered, were the preferred sources of knowledge — Confucian in Japan, ancient Greek and Roman in Europe. Blood and guts were for the lowly, not for scholars.

In Japan, the lowly who handled the blood and guts were the eta, the despised outcasts of old Japan. They did society’s filthiest work. They were butchers, tanners, executioners — and dissectionists. Medical students had to see some viscera, after all. They watched while, for their benefit, the eta cut open the bodies of executed criminals.

In 1771, a budding physician named Sugita Gempaku happened upon a Western book on anatomy in Nagasaki, a Dutch translation of a German text written in 1731.

“I couldn’t read a word, of course,” Sugita later wrote, “but the drawings of the viscera, bones and muscles were quite unlike anything I had seen before, and I realized that they must have been drawn from life.” This itself was a major leap forward.

Later Sugita attended a dissection. The dissectionist was a 90-year-old eta who had been doing this sort of thing all his life. He “would point to a certain part he had exposed,” Sugita wrote, “and inform the spectators that it was the lungs or that another organ was the kidneys.”

“Since of course,” he comments sarcastically, “the name of the organ was not written on it, the spectator would have to content himself with whatever the eta told him.”

Sugita at that point did something simple and marvelous. He compared the exposed viscera to the diagrams in his newly procured book — and discovered “that everything was exactly as depicted.” Classical Chinese medicine had received a blow from which it never recovered.

An amazing man, Sugita. Not knowing a word of Dutch, he and his friends made up their minds to translate the book into Japanese. It took years, but they did it.

A generation later a disciple assessed the achievement: “For long years we have been imitating (China), senselessly delighting in their ways without thinking of anything else. This has led to our excessive stupidity … and to a limitation to the knowledge we have gained with our eyes and ears.”

Michael Hoffman is the author of “In the Land of the Kami: A Journey into the Hearts of Japan.”

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