A History of Hansen’s Disease in Japan: the Isolation Policy as a Violation of Human Rights

leprosybannerSome months ago, I wrote a paper for Culture and Disability, an elective course in my Anthropology program. I took this course because, as you all know, I am very interested in the history of medicine (and in medical anthropology as a whole), in particular in the Japanese history of psychiatry and its relation to culture. One series that I publish here regularly is the history of mental health stigma in Japan (see part 1, 2, 3, 4, 5). While researching this topic, I noticed that it bears many similarities with how Hansen’s Disease (leprosy) patients were treated throughout Japanese history: some sources on mental health I read perceived both types of patients as similar victims of medical injustice. In this post, I will focus on the Isolation Policy, a law that prescribed the forced segregation of Hansen’s Disease patients in Japan and was only recently abolished. I selected the parts from my paper that I believe could be of interest to you and skipped my theoretical analysis, so this post is only a very general introduction to the topic of leprosy in Japan.

In May 2016, an extraordinary thing happened: the Japanese Supreme Court Chief Justice apologized for the discriminatory practices towards leprosy patients the court had engaged in (Japan Times, 2016). The apology was a reaction to the findings of an investigation, requested by former leprosy patients in 2014. Between 1948 and 1972, special courts were established at facilities for leprosy patients, based on the wrong assumption that Hansen’s disease is highly contagious. In trying leprosy patients outside of standard courtrooms, the Constitution’s principle of equality was violated and discrimination was fostered. The fact that news on leprosy in Japan is still featured on a regular basis, points toward the significant role played by policy stipulating the treatment of Hansen’s disease patients. But what exactly is Hansen’s disease or leprosy?


Leprosy is a chronic, infectious disease caused by the bacilli Mycobacterium leprae. Also named ‘Hansen’s disease’ after the Norwegian doctor Gerhard Armauer Hansen who discovered and identified this specific bacterium as the cause of leprosy in 1873, both the terms ‘leprosy’ (raibyō 癩病[1] ) and ‘Hansen’s disease’ (hansenbyō ハンセン病) have been used in Japan, although the latter is strongly preferred in today’s discourse because of its neutrality[2]. In the long term, Hansen’s disease results in the formation of granulomas, or collections of immune cells, called macrophages. This is manifested in the growth and expansion of nodules, or lumps, and patches, or macules, on the skin and eyes, and eventually weakness, deformities and paralysis. The bacterium further affects internal functions such as the respiratory tracts and peripheral nerves. Patients experience a loss of sensation due to the weakening of the nervous system, and may damage their limbs.

leprosy who

From World Health Organisation, Global Leprosy Strategy
2016–2020 (p. 3)

One of the misconceptions concerning leprosy is that the disease itself causes the loss of body parts, while it is actually the result of lacking the necessary motor functions and the sensation of pain, due to which the patient fails to notice injuries or infections (lepra.org.uk, 2014). Another, more serious common misunderstanding of the disease concerns the need for the isolation of the patient once he or she is diagnosed. Contrary to popular belief, a historical remain that was disproved by scientific discoveries in the twentieth century but is still prevalent today, leprosy is not highly contagious and relatively easy to cure with free multidrug therapy. Hence, isolation is in fact not necessary. Since the year 2000 globally, and in most countries from 2005, Hansen’s disease is no longer considered a public health problem. Yearly, thousands of patients have been treated back to health and over the past twenty years, this number has exceeded sixteen million around the world (WHO, 2016). Japan counts around 1,500 institutionalized patients and this figure continues to decrease (Ministry of Health, Labor and Welfare, 2016).


A wife and her leprose husband

Not much is known about how leprosy first came to Japan, but the disease appears to have been around since the eighth century. Already then, leprosy was regarded as “transmittable to those nearby (Kikuchi, 1997:629)” [3]. During the middle ages, ‘lepers’ were forced to live outside the community, sometimes creating their own leprosy colonies (Sato & Narita, 2003), and to beg for food at places of worship. This was morally justified by a common perception of hereditary ‘impurity (kegare穢れ)’ (Encyclopedia Nipponica, 2001). Leprosy was also regarded as a punishment in the next life for those who did not respect Buddhist sutras. Christian missionaries from Europe took an interest in leprosy patients, pitying their neglected and discriminated position as ‘discarded people’ in society, but were soon suppressed by the Edo government after it had banned Christianity in 1620. Hansen’s disease patients were even sentenced to death because of their religious affiliation with their benefactors (Yamamoto, 1993).

At the beginning of the Meiji period (1868-1912) there were more than 30,000 leprosy patients in Japan. Statistical surveys published numbers going between 23,660 leprosy patients in 1897 to 30,359 patients in 1900 (Goto, 2011: 99), although these numbers are probably underestimated since statistical methodology was still in its infancy at that time (Kikuchi, 1997). A 1898 report on the situation in Japan, written by the United States Consulate, further specifies: “We learn that it is almost universally recognized by the medical authorities that leprosy is a contagious disease, and that the terrible disease is most prevalent where fish is most freely used as an article of food (Gowey, 1898:211)”. Ascribing the overconsumption of fish as a cause, on the one hand, is related to the belief that eating too much would result in leprosy. According to Burns (2012), “[a]lmost every text on leprosy included a lengthy list of foods to be avoided (p. 302)”. The presumed contagiousness of leprosy, on the other hand, corresponded with the ‘resolutions’ of the First International Conference about Leprosy, held in Berlin in 1897 (Pandya, 2003). This encouraged the Japanese attendees to pursue a segregation policy.

First Steps towards an Institutionalization of Leprosy Patients

leprosy hannah riddell

Patients at the hospital established by Hannah Riddell. Picture from Anglican History

Around the end of the nineteenth century, European missionaries, motivated by the same Christian values as their predecessors, began to establish facilities for leprosy patients in Japan. Father Testevuide from France was the first to open a relief center for Hansen’s disease patients in 1889, which he transformed three years later into Japan’s first leprosarium. Significant for Japan’s leprosy history is Hannah Riddell, an English missionary who established a hospital for Hansen’s disease patients in 1895. Yet, the movement towards institutionalized treatment was not limited to the endeavors of foreign missionaries. Leprosy had become a topic of medical discussions in eighteenth and nineteenth-century Japan, informed by western medicine. Already in 1874, esteemed doctor Gotō Masafumi had petitioned for the public funding of future leprosaria (Burns, 2012). Gotō claimed that the water therapy he had discovered was the best cure for leprosy. He founded a private hospital in 1872 to perform his leprosy treatment, but inspired by European examples (he suggested that European states had eradicated leprosy by establishing public leprosaria), he aimed for a similar system on a national scale. Eventually, Gotō received funding and his hospital in Tokyo officially became a ‘leprosy ward’.

This is surprising, since the doctor could not show much evidence of the effectiveness of his treatment. It is, however, explicable with the Japanese political situation in mind: after more than two centuries of isolation from mainstream society, the Meiji revolution marked the beginning of a new era. Being forced to open up its borders by the western powerful states and to sign unequal treaties, Japan was desperate to present itself as a modern, strong and civilized nation and prove to the world that it had left its ‘barbarian’ past behind. To succeed in this, it promoted western knowledge, including medicine[4], and European policies, such as the establishment of leprosy hospitals[5]. Additionally, the Japanese press responded to the desire for progress and compassion by painting Gotō as a heroic Samaritan. Hence, to solve the problem of Hansen’s disease, ‘a national shame’ in comparison to an almost leprosy-free West, the government only became actively involved in the treatment, or rather containment, of the disease when it believed its future prospects were being threatened by leprosy patients and other ‘dangers’: “Public health and medical policy, it was argued, by linking individual health to the economic well-being and political security of the nation valorized the vitality and productivity of the citizenry and rendered the poor, the weak, and the sick as dangerous “others” who threatened the Japanese nation and empire (Burns, 2012: 298)”.

The Leprosy Prevention Law

In other words, the Japanese government at first did not show much interest in tackling leprosy between 1868, when Japan opened up its borders and underwent a process of modernization, and 1902. Due to a convergence of interests of both the Japanese government and certain physicians, the 1907 law concerning the prevention of leprosy (rai yobō ni kansuru ken癩予防ニ関スル件) was passed that ordered the creation of five publicly funded leprosaria to confine the ‘lepers’ starting from 1909. It must be noted, however, that it targeted especially leprosy patients roaming the streets and the poor, thus not those who were cared for at home, and whose supervision was the task of the police (Hirokawa in Wittner & Brown, 2015). Public safety was still prioritized over welfare: around the leprosaria were walls and gates, and two of the leprosaria were built on small islands. Pictures below show the leprosaria Tamazenshoen in Tokyo and Aiseien in Nagasaki (many more interesting pictures of Hansen’s disease hospitals today on leprosy.jp).

From the 1930s on, scientists started to doubt the necessity of compulsory segregation, since the mortality rate, infectiousness and chance of a sudden outbreak turned out to be lower than estimated. Nevertheless, the Japanese government strengthened its approach of isolation in legal terms: the Leprosy Prevention Law (rai yobō hō 癩予防法) of 1931 stipulated the forced segregation of leprosy patients. Between 1929 and 1934, a movement called ‘No Leprosy in our Prefecture’ (muraiken undō無癩県運動) and funded by the government, aimed to collect money for the establishment of leprosaria in each prefecture. This movement had laid the foundations for the 1931 law. The Hygienic Bureau of the Ministry of Home Affairs wrote in 1930 in a pamphlet titled Measure for the Eradication of Leprosy that “Japanese citizens are exposed to the extreme danger of leprosy infection” to justify their policy of absolute segregation. This time, the law was applicable to all patients, regardless of their financial status (Goto, 2011). Consequently, people who had previously been nursed at home, were now forced to move into a designated leprosarium.

While abroad isolation policies quickly came to be questioned due to scientific developments such as chemotherapy in the 1940s and epidemiological studies, Japan maintained its policy of strict segregation for decades (Sato, 2002). During the occupation of the Korean peninsula (1910-1945), the Japanese also enforced this policy among the occupied population (Sase e.a., 2004). The Leprosy Prevention Law was revised in 1953, but maintained its policy on leprosy: mandatory segregation, prohibition to leave the institution and punishment – often imprisonment – for those who disturbed the peace (Yamamoto, 1997).

Maintaining Forced Segregation

Why did Japan persist in its policy of segregation, even when it became openly criticized during international conventions from the 1950s on? It has been suggested that since the number of leprosy patients in Japan and its colonies was relatively small (compared to the one million tuberculosis patients at that time), obligatory confinement was introduced simply because it was possible (Goto, 2011). It was maintained, then, to avoid policy changes. Since more than 90 percent of leprosy patients was hospitalized without the possibility for rehabilitation by the 1960s, the switch towards outpatient services was deemed too difficult and had low priority (Sato & Narita, 2003). The revision of the Leprosy Prevention Law in 1953 was based on the expert advice of three leprosarium directors, who – unsurprisingly, and despite patients’ protest – attested in favor of compulsory isolation (Sato, 2002).

leprosy promin

Promin medicine – Picture from Ehime Prefecture site

Moreover, segregation from healthy Japanese people was still prioritized over the well-being of the patients in question: mainly poor people such as farmers on the countryside suffered from Hansen’s disease, and they could not afford treatment at the few university hospitals located in the big cities (Goto, 2011). The spread of leprosy medicine, especially Promin at that time, was also lagging behind in Japan. Furthermore, patients who had been hospitalized for most of their lives ended up as depending on their institutionalization, since they had nowhere to go outside of the leprosarium: outpatient treatment or other services were very scarce to informal – not to mention the stigmatization patients would experience from the Japanese people they had been hidden from. In short, because Hansen’s disease patients had been rendered invisible for many years, there was no need and much reluctance to change or undo the established isolation policies.

The Abolition of the Isolation Policy

In the years after the revision of the Leprosy Prevention Law, the strict rules of the isolation policy were slightly loosened[6], but the law remained in force until its abolition in 1996. In the process towards an abolition of the law that had forcibly separated them for decades, leprosy patients, united in the Federation of National Leprosarium Patients (zenkoku kokuritsu rairyōyōjo kanja kyōgikai 全国国立ライ療養所患者協議会), played an important role. The federation requested a revision of the law, based on the scientific knowledge that Hansen’s disease did not require compulsory segregation, which was a violation of their human rights and fostered stigmatization in Japanese society.


A Hansen’s Disease patient reads braille with his tongue due to a lost sense of touch in the fingertips – Book with Pictures called “90 Years of Segregation” by Tada Junichi

Nevertheless, Sato (2002) points out that the patients’ voices were divided over the existence of the Leprosy Prevention Law: on the one hand they perceived themselves as victims of the law, on the other hand they did not want to lose the care and housing the government was legally bound to provide them with due to that same law. Hence, the federation decided to lobby in favor of an improvement, not an abolition. The leprosarium directors as well as the Ministry of Health and Welfare were reluctant to put an abrupt end to the law because of the reasons mentioned above: the directors feared for their hospitals, and the ministry saw the transformation of leprosaria into rehabilitation centers as financially unfeasible.

One central figure in the abolition of the Leprosy Prevention law was Fujio Ōtani, chairman of the Tofu Society (Tōfū  Kyōkai藤楓協会[7]). In 1990, he started the establishment of a National Hansen’s Disease Museum, which was completed by 1993  and organized public symposia that attracted media attention. With the abolition of the law in mind, Ōtani also created a study committee and started to meet patients. He took their wish to continue living at the leprosaria into consideration. Based on the committee’s report, it was publicly acknowledged in 1995 by the Japanese Leprosy Association, the Federation of National Leprosarium Patients and the Federation of Leprosarium Directors that leprosy did not request compulsory segregation and that the law fostered stigma. One year later, the law was terminated, without endangering the existing services leprosaria offered. Patients could stay as long as they wished[8]. The minister of Health, Labor and Welfare officially apologized for the delayed abolishment. The same year, the Federation of National Leprosarium Patients changed its name to the Federation of National Hansen Disease Sanatorium Patients, since it was argued that the term for leprosy (rai) triggered social stigma.

leprosy 5

“We won the lawsuit” – the isolation policy was abolished in 1996

After thirteen patients had sued the government for its unconstitutional policy in 1998, a law was introduced in 2001 that made it possible for Hansen’s disease patients to receive compensation for their suffering. In that same year, the prime minister apologized for the continued violation of leprosy patients’ human rights. The most recent legislation on Hansen’s disease dates back from 2008:  the Law for the Acceleration of a Solution of the Hansen’s Disease Problem (Hansenbyō mondai no kaiketsu no sokushin ni kansuru hōritsu ハンセン病問題の解決の促進に関する法律) stipulated that national leprosaria a) could not discharge patients against their will b) should provide the necessary treatment and facilities and c) should share the use of their land, buildings and services with the local community. Moreover, the state should take measures to restore the honor of leprosy patients, establish and maintain the national Hansen’s Disease Museum and historical buildings, and promote the spread of correct knowledge on Hansen’s disease and Japan’s policy history in order to honor deceased patients.


In 1952, Hansen’s disease patient Matsuo Fujimoto was charged with murder and sentenced to death in a ‘special court’, since it was believed to be too dangerous to bring leprosy patients into a non-isolated court. Fujimoto’s arrest and trial was by many perceived as unfair and unconstitutional: it was one of the many forms of discrimination that patients experienced due to the long-standing isolation policy and social stigma. During the same period, leprosy patients held demonstrations against the revision of the Leprosy Prevention Law that still prescribed forced segregation. In July and August 1953, Hansen’s disease patients protested in every national leprosarium, in front of the Senate and in the corridors of the Ministry of Health, Labor and Welfare. Led by the Federation of National Leprosarium Patients, voices protested against compulsory isolation, the prohibition to leave the leprosarium, disciplinary restraint, eugenic surgery, the lack of privacy, the impossibility to start or maintain a family, and the continued use of the discriminatory term ‘leprosy’ (Inaba, 2011).

leprosy special court

A special court for Leprosy patients – picture from Mainichi Shimbun

Discrimination inside the leprosaria

During the 1940s, patients were forced to work due to a shortage of staff, food and other resources (Aoyama, 2010). Residents engaged in farming, agriculture and other forms of production to supply all leprosarium patients and were also actively involved in administrative matters[9]. Before the end of the war, male and female patients had to live apart, regardless of their marital status. Later, sexual intercourse was allowed, but couples experienced a complete lack of privacy on that account. The first houses for couples were built from the 1950s on (Kikuchi, 1997). Since children from leprosy patients were perceived as a ‘burden’ to the hospital[10], birth control was implemented. Male patients often underwent a vasectomy, and abortion was exceptionally allowed by the state in case of leprosy. No permission from the patient was needed.

leprosy nurse

staff treating a patients

Human right infringements also included a lack of medical treatment: not the employees of the leprosaria but the patients themselves had to take care of each other, despite the fact that the many blind and physically impaired residents were in high need of professional assistance. It was only in 1963 that leprosaria started to employ nurses. In 1954, the Federation of National Leprosarium Patients protested heavily against this problem, abandoning their tasks at the leprosarium, demonstrating on the streets and occupying the ministry of Health, Labor and Welfare for five days. This nationwide movement eventually led to the slow transition of replacing patients’ nursing tasks by duties for personnel. Taking the aspects of life at the leprosarium mentioned here into account, it is clear that Japan’s Leprosy Prevention Law resulted in a serious infringement of the patient’s human rights.


One of the discriminatory practices Hansen’s disease patients had to endure for decades, was the application of eugenic measure, most prominent in its form as institutionalized sterilization and abortions: not only in Japan, but worldwide, “[p]erceived and ascribed disabilities of body and mind were one of the core sets of eugenics traits that provided the basis for institutionalized sterilization on eugenic grounds for the first 75 years of the twentieth-century (Wilson & St. Pierre in Devlieger e.a., 2016: 93)”. As mentioned before, forced vasectomy for male patients and abortion for female patients was the standard procedure at leprosaria. In Japan, eugenic policies became popular in the twentieth century, especially from the 1930s on, an era characterized by imperialism and national pride (Otsubo & Bartholomew, 1998).

leprosy eugenics

Japan followed the example of Germany in pursuing a eugenic policy during WWII

At first, eugenic activity targeted the racially ‘impure’, but was soon redirected towards people with mental illness, hereditary and infectious diseases. In March 1940, the National Eugenics Law (kokumin yūsei hō 国民優生法) was passed. The law encompassed both positive eugenics (encouraging healthy citizens to procreate) and negative eugenics (preventing ‘unhealthy’ people to procreate). In 1948, the National Eugenics Law was replaced by the Eugenic Protection Law (yūsei hogo hō優生保護法), which allowed abortion in certain cases, such as leprosy. This law was eventually discontinued in 1996.

Right-based activism

leprosy protest

Protest march against the discriminatory medical treatment of Hansen’s Disease patients

These forms of institutionalized discrimination sparked right-based activism in 1970s Japan (Hayashi & Okuhiro in Addlakha, 2009). The lawsuits against the government filed as a direct result of the movement in the 1990s, was clearly inspired by the early campaigns in the 1950s. Arrington (2014) indicates that this activism for the rights of (ex-)leprosy patients in Japan inspired similar right-based movements in South-Korea and Taiwan. By 2001, the number of plaintiffs in Japan had risen to almost thousand, and a network of hundred lawyers represented them. Reminiscent of the patients’ stance in the process towards an abolishment of the Leprosy Prevention Law, some patients opposed the lawsuits since they were afraid to lose the care and housing benefits provided by the state. Nevertheless, until this day, (ex-)patients and their families, with the support of thousands of Japanese people, are fighting against the human rights infringement they suffered.

Today, most patients with Hansen Disease are over eighty years old and the number of newly diagnosed patients is negligible. It is most likely that leprosy will cease to occur in Japan in the near future. Yet, attempts in the past to eradicate the existence of leprosy patients has now been reversed: the law of 2008 clearly states that the history of leprosy patients and the discriminatory policies they were subjected to, should be remembered and passed onto future generations. The establishment of the National Hansen’s Disease Museum, for example, is an indication of this objective. Another way to honor the memory of mistreated Hansen’s Disease patients is through a revaluation of leprosy literature in Japan: many patients produced literature (mostly poetry) inside the leprosarium and, doing so, created a whole new genre. But that’s something I will write about another time!


[1] Already described in Japan’s oldest history books, rai refers to a collection of skin diseases. (Weiner, 2009: 10) [2] Both terms will be used interchangeably here with no distinction between nuances. [3] Apparently, this was the first document worldwide to claim so. [4] It should be noted that western medicine was not simply copied but rather integrated into traditional Sino-Japanese medicine. Gotō, for example, subscribed to the ‘traditional’ school but his work and writings were informed by western discourse while he maintained a Sino-Japanese approach in therapy and etiology. [5] A similar case is the promulgation of institutionalization laws for mental health patients, which was based on the same impetus to show legal maturity towards the West (Suzuki, 2003: 199). [6] For example, patients were now more free to leave the institution. [7] Established in 1952, the Tofu Society was a reformation of the Leprosy Prevention Association, founded by Empress Teimei. [8] The importance of this decision is illustrated by the fact that only six patients left their leprosaria in the next two years after the abolition (Koh, 1999). [9] Aoyama (2010) argues that because patients were part of the organizational and administrative structure of the facility, they could strengthen their position in negotiations and slightly improve their living circumstances. [10] Children of leprosy patients also experienced stigmatization: In 1954, patient’s children, although not affected by Hansen’s disease, were denied schooling by the parent-teacher association.

Reference list here

Mad Monks & Medieval Medicine

 20160623_193100This blog post covers another part of my thesis, the fifth post already in this series of “mental health in Japan”. For those who have missed the previous posts, it is not too late to catch up: an introduction to the topic focussing on mental health stigma can be found here, and posts dedicated to ancient records of “madness” in Japan here and here. Today, we go back to medieval times to discover how “madness” was perceived in a Buddhist context, as well as in relation to the newly developing study of medicine.

Buddhist Notions of “Madness”

During the Kamakura and Muromachi period, Buddhism played a prominent role, which is reflected in the literature of that time[1]. One representative example is An Account of My Hut (Hōjōki方丈記, 1212) by Kamo no Chōmei. The essence of this short story, “the world is a hard place to live”, corresponds with the Buddhist concept of impermanence. The following two fragments contain a reference to “madness”.

Yes, take it for all in all, this world is a hard place to live, and both we and our dwellings are fragile and impermanent, as these events reveal. And besides, there are the countless occasions when situation or circumstance cause us anguish. (…) Dependence on others puts you in their power, while care for others will snare you in the worldly attachments of affection. Follow the social rules, and they hem you in; fail to do so, and you are thought as good as crazy.[2]

“Chomei, (…) while trying to become a pure monk, your heart remains tainted by impurity. By living in a ten-foot hut in imitation of the Jomyo Buddhist layman Yuima, even if you are given the benefit of the doubt, you have not realized the practice of Shuri Handoku. When you perhaps do by chance, doesn’t your karma’s punishment worry you? Or again, by reckless judgment, not becoming more intelligent you grow worse by this, grow crazy. What do you think?”[3]


Kamo no Chomei

“To be(come) crazy” is a translation of the verb kyō suru 狂する. It should not surprise that the Chinese reading of 狂 is employed here, as Buddhism was imported from China via Korea. Although this “new” religion differentiated from the traditional folk belief and Shintoism primordially present in Japan, we can discern a pattern of hare and ke here (for a concise explanation of these concepts, see this post).

Living in this world brings many hardships. For example, if you did not follow the conventions, you were believed to be “mad”. In other words, behaving abnormally on days this was not allowed (ke days) was perceived as “madness”. On the other hand, eccentricity was also thought to be a suiting characteristic of a monk in seclusion: Chōmei strives towards reaching a state of nirvana by isolating himself in a tiny hut in the mountains, following in the footsteps of other Buddhist monks. To break all ties with society is an unconventional decision indeed, but this Buddhist practice (the hare element) was regarded as a way to reach spiritual awakening in medieval Japan. The result for Chōmei, however, turns out differently. He fails to attain enlightenment, and the only state achieved is one of mental derangement, or “madness”.

Comparable to talented artists, monks or other religiously engaged people had a special status connected with hare and were, therefore, permitted to express a certain degree of “madness”. This privilege allowed them to manipulate the actions of others. For example, the Buddhist scholar Zōga-hijiri 増賀聖 could not stand the secularism of his sect and escaped the monastery unpunished by pretending he was insane[4]. Another problem that urged for fabricated madness was the immense popularity famous monks enjoyed. It was strictly forbidden in Buddhism to express any form of arrogance or pride based on an elevated status, learning or wealth[5], which forced some distinguished monks to act like madmen in order to keep the many admirers away.



A famous example from the Nara period is Gyōki 行基, who, according to various sources, “appears as a wandering shamanic figure who used his superhuman powers to instruct peasants and unlicensed monks” but displayed “suspicious behavior”[6]. As feigning madness appears to have been an effective means to isolate oneself, a state of mental derangement was perhaps tolerated among monks, but others were certainly not exempt from certain forms of stigmatization.

The impact of Buddhism on the treatment of individuals with a mental disorder was not limited to written suggestions alone. Omata Waichirō points out that during the medieval period, a handful of religious institutions, Buddhist temples as well Shintoist shrines, offered provisions for the mentally disordered, such as Chinese herbal medicines treatment and moxibustion in the former, and incantations and exorcism sessions in the latter[7]. As a result, people with a mental disorder undertook pilgrimages to “places of healing” such as Iwakura (see pictures below) that provided specialized treatment. Nevertheless, Hashimoto argues that such provisions were still exceptional in medieval Japan, and that most temples and shrines started to develop facilities for the mentally ill only late in the Edo period or at the beginning of the Meiji period[8]. Important here is that people with a mental disorder were, just like those afflicted with physical illness, gradually being regarded as subjects of treatment. Moreover, it appears that religion and the first attempts towards psychiatric care are significantly entangled, as will be explained in the part below.

Footnotes and references

[1] Sekiguchi, Tadao 関口忠男. “The Tale of the Heike and Buddhist Thought”平家物語と仏教思想 (Heike Monogatari to bukkyō shisō), Records of Lectures on Buddhist Culture 仏教文化講演会記 (Bukkyō bunka kōenkai ki), Ryūkoku University, Kyoto (2007):287-301, p. 287 [2] McKinney, Meredith, Kenkō Yoshida, and Chōmei Kamo. Essays in Idleness and Hōjōki, 2013.  [3] Washburn University.  [4] Hori, Ichirō, Joseph M. Kitagawa, and Alan L. Miller. Folk Religion in Japan: Continuity and Change. Paperback ed., 4. Haskell Lectures on History of Religions, N.S., 1. Chicago: Univ. of Chicago Press, 19, p. 103. [5] Arrogance, or Sanskr.: Māna慢, is mentioned as one of the “ten modes of contemplation” in Mahayana Practice of Cessation and Contemplation (Makashikan摩訶止観), a Buddhist work on meditation compiled in China around 594 that influenced Buddhism in Japan immensely. [6] Augustine, Jonathan Morris. Buddhist Hagiography in Early Japan: Images of Compassion in the Gyoki Tradition. Routledge Studies in Asian Religion. London: Routledge, 2012, p. 3 and 11. [7] In 1278, a corner of the Gokurakuji temple 極楽寺 in Kamakura was reserved for lepers, next to a general sanatorium. In 1394, treatment focusing on those suffering from mental disorders was started at the main temple of the Jōdoshin sect, the Kōmeisanjuninji 光明山順因寺 in Okazaki. The oldest therapy recorded is the waterfall treatment at Daiunji temple 大雲寺 in Iwakura, Kyoto during the Heian period. From the Kamakura period on, treatment as practiced in Iwakura lost its magical and supernatural character and was mainly concerned with natural therapy. Omata, Waichirō 小俣和一郎. The History of Psychiatry 精神医学の歴史 (Seishin igaku no rekishi). Tokyo: Daisan Bunmeisha, 2005, p. 82-83. [8] Hashimoto, Akira橋本明. “The History of Psychiatric Care in Places of Treatment – From ‘Places of Healing’ towards ‘Generalized Places’”治療の場をめぐる精神医療史―「癒しの場」から「普遍化された場」へ」(Chiryō no ba wo meguru seishin iryōshi – ‘iyashi no ba’ kara ‘fuhenka sareta ba’ he) in “Madness” the Time Produces時代がつくる「狂気」(Jidai ga tsukuru “kyōki”), edited by Serizawa, Kazuya芹沢一也. Psychiatric Care and Society series no. 825, 49-84. Tokyo: Asahi Shimbun Publishing Co., 2007,  p. 55.

A Change in “Madness” Perception Due to Secularization

Although a religious interpretation remained the major driving force behind daily life, the secularization of the Japanese medieval society was imminent. This secularization was further enhanced by the appearance of medicine studies[9]. It is too early to speak of a medical science, since medical treatment for mental disorders as was first developed in Japan was either based on Chinese herbal medicine or yin yang theories.


Mono no ke of Lady Aoi in The Tale of Genji

Remarkable is the fact that traditional phenomena such as mono no ke and spirit possessions continued to exist under the form of monotsuki 物憑きand were integrated in practical medicine. Among the various categories of monotsuki, possession by a fox spirit (kitsunetsuki 狐憑き)[10] became by far the prevailing explanation for deviant behavior of commoners from the Edo period on. Hyōdō illustrates the co-existence of medicine and traditional notions of “madness” by giving examples of doctors and yin yang masters who were arrested on grounds of their alleged manipulation of fox spirits to possess others[11]. She argues that all those who studied medicine were believed to hold the power to exorcise evil spirits as well, and were, therefore, also thought capable of having people possessed. Consequently, medical disorders, regarded as “diseases” caused by spiritual forces, were now treated with herbal medicines.



An early work illustrating that “madness” in its new form of fox possession was no longer evidently regarded as a sacred and ritual phenomenon, is Jottings of a Fool (Gukanshō愚管抄, 1220). The writer, Buddhist priest Jien, argues that the wife of servant Nakakuni is not possessed by the spirit of the deceased Go-Shirakawa but by an evil fox[12]:

Certainly there have been many such cases [of shrines being built to pacify a vengeful soul]. But has Go-Shirakawa’s soul become vengeful because of something done by Retired Emperor Go-Toba? And should the deceased Go-Shirakawa’s soul be considered a manifestation of the Great Hachiman Bodhisattva and honored as an ancestral Kami of the Imperial House? Have there been signs of miraculous power? Have not such things occurred because people have believed what persons-possessed only by foxes (yakan) and demons (tengu)-have said? (…) If Nakakuni and his wife have said what was in their own hearts without being at all possessed by foxes and badgers, they should of course be punished, even with exile. But we should not conclude that they have done this simply because they are strange. [13]

Jien further advocates that “the wife of Nakakuni has attuned herself to the words of mad people such as miko, mediums, dancers, sarugaku players, even coppersmiths and the fellow,” and that, since she was simply ill, the couple should “not be listened to and should be put in isolation to drive out the fox spirit”[14]. Jien attributes the wife’s “madness” to fox or badger possession (tanukitsuki 狸憑き) but denies its connection with hare, as opposed to the eccentricity of those called “the mad”, people involved with spirituality and arts[15]. Nakakuni and his wife are not explicitly punished due to the acknowledged mental condition, but a rejection of their “madness” as an expression of hare contributes to a stigmatizing attitude of isolation, as is visible in Jien’s suggestions.

As the field of medicine in Japan was substantially based on an already established tradition of Chinese medicine, new terminology and perceptions of “madness” emerging in Japan were heavily influenced by theoretical literature on medicine imported from the Chinese mainland. The Chinese vision on mental disorders is reflected in Japan’s first medical book, Ishinpō 医心方 (984) by Tamba Yasuyori 丹波康頼. In chapter three, Tamba theorizes about mental disorders, referring to them as chūfūtenbyō 中風癲病. A mental disorder is defined as an illness transmitted by a cold (chūfū 中風) causing a corruption of either yin or yang in the body[16]. The same theory is presented in Dongui Bogam 東医宝鑑 (1613), an influential Korean work[17] by Heo Jun, which proves that chūfūtenbyō remained the dominant theory until well into the 17th century. Significant for research on stigmatization is the fact that the early medical explanation for mental disorders bears striking similarities with the traditional notion of possession, in the sense that both interpretations consider the cause of the disorder to be external.



Chūfū or Fubyō 風病 is somewhere else exemplified by “the Man with a Cold” (Fubyō no otoko 風病の男) on the Scroll of Illnesses (Yamai no Sōshi 病草紙, 12th century). The scroll contains drawings of various diseases and anomalies, accompanied by a description or entertaining anecdote. This particular painting depicts a man who is playing go with two ladies, but suddenly catches a “cold” (fubyō), upon which his eyeballs and limbs start to shake. His face is contorted, he is not able to sit properly and appears not capable to articulate properly, which is an amusing sight for the two ladies[18]. A suggestion is that the man suffers from cerebral apoplexy.

Left: Anonymous, “The Man with a Cold” in The Scroll of Illnesses, 26.0 x 30.9 cm, 12th century, Kyoto National Museum. Right: detail of the same work. – source: “Yamai No Soshi (Diseases and Deformities)” – eKokuhou.

The fact that the two women start to laugh reveals their discriminating attitude, although it must be said that throughout the Scroll of Illnesses more ailments and deformities are depicted  – as ridiculed by other people. Another point worth mentioning is that mental disorders[19] are actually incorporated in this work, which proves that they were also regarded as illnesses, albeit somewhat peculiar. Furthermore, the word fubyō, “cold” is used, referring to the theory explained above. The idea that afflictions of the brain were caused by external forces would last till the Edo period, when mental disorders were contrarily viewed as internal problems[20].

Additionally, throughout the scroll, not one supernatural explanation is given. There is an obvious breach with the traditional linkage of “insanity” to religion or spirituality. Instead, the drawings show scenes of daily life, of common people suffering from diseases and anomalies, and of other people’s reaction on the afflictions depicted. In other words, the absence of a hare connection and the strong presence of ke elements suggest “impurity” or kegare. This enhances stigma, as can be seen in the reaction of the two ladies on the seizure of the go player. That’s it for today! In a next blog post, we will look at how “madness” was portrayed in the performing arts of medieval Japan and how this is again linked to the concepts of hare and ke.

Footnotes and references

[9] Omata, History of Psychiatry, p. 35, 56-57. [10] The first description of kitsunetsuki in Tales of Times Now Past (Konjaku Monogatari今昔物語), dates back to the late Heian period. [11] Hyōdō, Akiko 兵頭晶子. Mental Disease and Japanese Modernity: From the Possessed Mind/Body to the Diseased Mind/Body精神病の日本近代―憑く心身から病む心身へ (Seishinbyō no nihon kindai – tsuku shinshin kara yamu shinshin he), Trans-boundary Modern Times 越境する近代 (Ekkyō suru kindai) nr. 6. Tokyo: Seikyūsha, 2008, p. 71. Hyōdō refers to Nishiyama, Masaru西山克. “The Middle Ages of Mediators – Emperial Authority during the Muromachi Period and Fox Handlers”媒介者たちの中世―室町時代の王権と狐使い (Baikaitachi no chūsei – muromachi jidai no ōken to kitsunedukai) in Cities and Professionals都市と職能民 (Toshi to shokunōmin), edited by the Study Group on Medieval cities中世都市研究会 (Chūsei toshi kenkyūkai), Vol. 8. Tokyo: Shinjinbutsu ōraisha, 2001. [12] Bathgate, Michael. The Fox’s Craft in Japanese Religion and Folklore: Shapeshifters, Transformations, and Duplicities. Religion in History, Society & Culture 7. New York, NY: Routledge, 2004, p. 98. [13] Jien, Delmer Myers Brown, and Ichirō Ishida. The Future and the Past: A Translation and Study of the Gukanshō, an Interpretative History of Japan Written in 1219. Berkeley: University of California Press, 1979, p. 169-70. [14] Own translation. [15] Hosokawa, Ryōichi細川涼一. The Japanese Middle Ages of Deviance – Madness, Perversity and the Demon World 逸脱の日本中世―狂気・倒錯・魔の世界 (Itsudatsu no nihon chūsei – kyōki・tōsaku・ma no sekai) Tokyo: JICC Press, 1993, p. 18. [16] Two types of mental disorders are distinguished: a corruption of yin leads to ten illness (tenbyō 癲病), an attack on yang causes kyō illness (狂病). Nishimaru, Shikata 西丸四方. Reading Classics on Psychiatry 精神医学の古典を読む (Seishin igaku no koten wo yomu). Tokyo: Misuzu Shobo Co., 1989, p. 59. [17] This work was written in Chinese characters and thus understandable in China as well in Japan, where it was published and read in its original form. [18] The inserted orginal passage reads: ちかごろ、男ありけり。風病によりて、ひとみつねにゆるぎけり。厳寒にはだかにてゐたる人の、ふるひわななくやうになむありける. [19] Other examples are “The Insomnious Woman” (Fumin no onna 不眠の女) and “The Woman with Eyes for the Birds” (torime no onna鳥眼の女), depicting a schizophrenic or neurotic woman who lets crows peck her eyes. [20] Tatsukawa, Shōji 立川昭二. “Fūbyō, chūbyō and apoplexy – “The Man with a Cold” in Scroll of Ilnesses” 風病・中風・脳卒中―「風病の男」『病草紙』(Fūbyō・chūbyō・nōsotsuchū – “fūbyō no otoko” Yamai no sōshi) Emergency Life-saving救急救命 (kyūkyū kyūmei), Life and Cultural History 18, May 2007, p. 18-19.


wp-image-1575460682jpg.jpgAt this moment, my university (KU Leuven in Belgium) and other institutions are commemorating Thomas More’s Utopia. This work, written in Latin and edited by Erasmus, was published by Dirk Martens in Leuven, the city where I study, exactly 500 years ago. (Okay, I started working on this post in 2016, so it’s 501 years ago now.) Utopia is a frame story about a fictitious island. The title, a neologism invented by More’s good friend Erasmus but derived from the Greek language, means “no place”, not to be confused with eutopia, “good place”. Nevertheless, More gives the impression that Utopia really existed, providing the reader not only with a detailed description of the island, but also inserting several letters to his own friends such as Peter Giles, town clerk of Antwerp, who plays a role in the story too. Additionally, the book was furnished with a map of the island, the Utopian alphabet (designed by Peter Giles) and two poems in the Utopian language with translation.

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The work itself consists out of two books: the first book covers discussions and criticism on the “real” society while the second book goes into details about the unknown island of Utopia. A character called More (a surrogate for the author) is introduced by his friend Peter Giles to Raphael Hythloday, the Portuguese explorer that discovered Utopia. They discuss the current political situation in Europe, ethical issues in serving at court, social abuse that leads to theft and other topics. In the second book, Hythloday recounts his journey to Utopia. During his stay of 5 years, he familiarized himself with the remarkable Utopian customs. A description of these customs would take more than one post, so check out this summary if you are interested.

Utopia paved the way for a whole new genre of literature. The ideas the humanist and statesman More (1478-1535) put forward in his book, are still relevant and inspiring today (for example the 6-hour working day Sweden has been experimenting with), and some ideas have even come true. However, not all of the Utopian customs would be considered OK nowadays. Slavery, for example, was still a thing. Moreover, it is wrong to think that Utopia represents the perfect society because this was not More’s intention at all – the difference between “eutopia” and “utopia” is really important here. On the contrary, the author distances himself from some of the Utopian ideals and principles. Therefore, Utopia should be read as a criticism of the society More lived in. Not an easy task, by the way: the danger of critiquing society directly is illustrated by the fact that More was later beheaded because he did not go along with Henry VIII’s plan for the establishment of a Church of England.

Climbing the Utopia-themed stairs to the Japanese collection at the University Library

You are probably wondering what this has to do with Japan. Well, I was curious whether, traditionally speaking, Japanese literature also covers a genre of utopian writings. This has been a question often addressed by scholars, and the usual answer is: no, not in the Western sense of the word (not so strange because the genre was named after More’s Utopia), but yes, Japanese literature includes utopian-ish texts, especially works written during the Meiji period (1868-1912). Apparently, utopian works in the West are characterized by a constant shift in position between reality and the imaginary world. The difficulties the reader is faced with in trying to distinguish between what is fictional and what is real, is precisely the level of ambiguity utopian literature aims for.

It is argued that in Japanese works, this ambiguity is not very present. However, the differences between Western utopias and Japanese literature on a similar topic do not indicate that Japanese works are ‘underdeveloped’ or lacking what their western counterpart have: this would be measuring with a Western yardstick. Imagine if a pasta dish was critically evaluated based on its similarity to ramen, Japanese noodle soup (both are tasty in their own way, right?). Moreover, in the manga, anime and Japanese drama of today, a utopian setting is often used. This has certainly been influenced by the popularity of western science fiction from the postwar period on, but apparently utopian-ish genres date back to the Edo period or even earlier. The length of this post will convince you that comparing both literary traditions is more complex than is often assumed.


Example of a “kibyoshi” from 1809 – http://www.arc.ritsumei.ac.jp/

Burton (2007) points out that in mid-Edo times, a genre of fantastic travel narratives existed that was also used to critique contemporary society: kibyōshi 黄表紙 “yellow cover books”, the first comic books for adults. Because Japan was isolated from the rest of the world due to a policy of seclusion (sakoku 鎖国) at that time, the Japanese became fascinated by these booklets with their yellow covers that illustrated in words and (lots of) pictures the (imaginative) travels to far, exotic countries and their curious inhabitants. Burton further argues that the Japanese travel narratives were highly influenced by much older Chinese sources, often rooted in Taoist and Buddhist iconography. Such fantastic tales were regularly set in a different time period, to completely mask the fact that they were actually criticism on contemporary society. By doing so, authors could address political or other “forbidden” themes in a satirical way that would be censored otherwise. Although kibyōshi did not stand the test of time and popular authors soon disappeared into oblivion, the idea of a hypothetical world inspired Japanese writers in the centuries afterwards. 


Japanese translation of More’s Utopia

More highbrow alternatives for  kibyōshi  are Ihara Saikaku’s  “Island of Women” (女護島 nyogonoshima) in which the author criticizes gender inequality, and Yoshitsune’s trip to fantastic islands with half-human, half-animals creatures  in the classic  The Tale of the Heike (平家物語 Heike monogatari). Once Japan’s borders opened up for foreign literature in the second half of the 19th century, the Japanese public became fascinated by Western utopias. For example, Jonathan Swift’s Gulliver’s Travels was translated and published in 1880, More’s Utopia the year after that. Moichi (1999) argues that the Japanese imported Western novels as a type of Western technology that had a political purpose. As a result, Japanese utopian-style texts inspired by this Western literature mainly promoted a modern ideology, which they hoped would result in political change in Japan’s near future. Coincidently, the Japanese public gained an enormous interest in writings on the future – eutopian or dystopian (the latter was slightly favored because it could shock the readers more).

I could devote an entire post to the well-established tradition of futurological literature in Japan, but at least an introduction is in order since both genres are often interlinked (stories about other, unfamiliar worlds regularly take place in the future). Drawing on the contents of an interesting class I took last year, I was able to trace the origins of futuristic narratives back to early Japanese history. The genre of miraiki (未来記 “record of the future”) is a literary tradition in Japanese history that has its roots in Chinese dynastic writings. At the start of every new dynasty in China (often established by means of a massacre), the new royal family had to justify why they deserved the “heavenly mandate”  (tenmei 天命) by discrediting the previous dynasty. Hence, they referred to a text that had “predicted” the rightful establishment of a new dynasty (the massacre part of the old dynasty was also slightly downplayed).


“Prince Shotoku’s secret writings “Miraiki” disclosed”

It is not difficult to guess that this text was written by the new dynasty and not by someone in the past. As a result, we can regard traditional “futuristic texts” more as writings about the past than about the future. Since Japan does not have a dynastic system, their take on futuristic texts was different: most miraiki were attributed to Prince Shōtoku (Shōtoku Taishi 聖徳太子, 574-622) who is said to be capable of predicting the future. Those texts emerged throughout the Heian period and the Japanese Middle Ages. Similar to the Chinese original, miraiki were used in political discourse for refiguring the past. So here as well, miraiki are part of a literary tradition that claims to be futurological in spirit but is actually historical. The reliance on Prince Shōtoku’s authority to introduce certain standpoints clearly indicates the political character of miraiki. 

Miraiki underwent a drastic transformation from the Edo period  (1603-1868) on: they were trivialized and appeared in the form of satiric kibyōshi for the general public (this should ring a bell for attentive readers!). In other words, the genre of kibyōshi is believed to emerge from the tradition of miraiki. Yet, these “new” miraiki differed considerably. Kibyōshi stories are not necessarily set in the future, but those that are, are seen as equally impossible as utopian-ish stories, which results in absurd and comical narratives. This changed, again, with the arrival of Western futuristic works at the beginning of the Meiji period (1868-1912). The future became more approachable, and speculation about it less absurd. According to Kurita (2000: 6), “Japanese during the formative years of Meiji, like the founders of the United States (…) had an unusually keen interest in proactively creating their own future.” Reminiscent of miraiki literature, it is remarkable that, once again, Japan wanted nothing more than to glorify and at the same time rewrite its past: the Meiji Restoration is characterized by a desire to go back to imperial rule and make an end to the power of the shogunate that had been overshadowing the emperor’s leadership from 1185 on. Hence, the future of Japan was envisioned with the past in mind.

anno-2065Kurita further argues that the reception of the Dutch novel Anno 2065; Een Blik in de Toekomst (“A Glimpse into the Future”, 1865) by Dr. Dioscorides aka Pieter Harting in Japan acted as the stimulus to another change in literary perception of the future. Anno 2065 appealed to the Japanese because of its “dream device”. The narrator falls asleep and wakes up in the future. According to Kurita, this inspired many Japanese authors to use  the same dream device in their miraiki. However, it should be noted that the “dream”, or rather, “the magical dream pillow” is a traditional element in Chinese, Korean and Japanese storytelling, and we should be careful to interpret the presence of it in Meiji period miraiki as a mere imitation of Western works that use a similar device. From the 1880s on, the refashioned miraiki integrated a Western notion of utopianism and futurology by not only focusing on the past, but also taking present understandings into consideration. Between 1885 and 1890, more than 100 miraiki were published.

One work in particular, Nijūsannen miraiki 二十三年未来記 (The Year 23: A Record of the Future, 1886) by Suehiro Tecchō 末広鉄腸 (writer’s name Suehiro Shigeyasu 末廣重恭), helped the miraiki genre gain a nation-wide but short-lived popularity (previously published texts, sometimes with the same title, were also influential but Suehiro’s novel was the first one able to break through successfully). The year 23 refers to Meiji 23, or 1890. Not really that far away in the future to count as futurological literature, you would think. Nevertheless, life in 1890 was imagined very differently due to a drastic change: the introduction of a Diet system. In 1881, an edict called into existence a constitution and a National Diet. Since the public was not familiar with these concepts, journalists such as Suehiro wanted to educate people about this new political system and promote it through means of the popular genre of miraiki.

The story in The Year 23 depicts a parliamentary debate in 1890. Again, miraiki mainly played a political role. Yet, they were innovative in combining a Japanese traditional genre with a futurological perspective as introduced through Western literature. They are set in the (near) future, but do also reflect contemporary society mixed with expectations and desires about how Japan should look like (hopefully to be fulfilled in the future). In that sense, these kind of miraiki have a flavor of eutopian utopias, albeit a different one than More’s work evoked in the West. After the second World War, Japanese readers became interested in American science fiction (often in a dystopian setting)  which also resulted in SF novels flooding the market. Today, utopianism is a recurring theme in modern Japanese literature. Haruki Murakami’s Hard-Boiled Wonderland and the End of the World, for example (check one of my first posts on this book here!), or manga such as Akira and  Nausicaä of the Valley of the Wind. Enough reading material to feel like you are living in a different world…


Old Stories of Madness

20160623_193717.jpgNext up in our “Mental Health in Japan” series is a limited selection of stories on “madness” as recorded in Japan’s classic literature of the Heian period (794-1185), with a special focus on terminology. I have already written several posts on Heian literature, partly because it was by reading these books that I became fascinated with Japanese culture. I am a huge fan of Sei Shonagon (I recommend her Pillow Book to everyone who wants to explore court life in Japan around the year 1000) and, of course, I should mention Murasaki Shikibu, creator of Japan’s biggest playboy ever. Both female writers are featured in this post. If you’re interested in the topic of “madness”, you should also check out part one, two and three of my “Mental Health” series.

Story no. 1: The Great Mirror and Mad Emperors

The Great Mirror (Ōkagami大鏡), a historical account written during the latter half of the Heian period, briefly mentions the “madness” of emperor Reizei (950-1011). Ōe Masafusa (1041-1111) describes in his diary (Gōki江記) the eccentric demeanor of the emperor at a young age: One day, he kicked a football for a whole day without minding his bleeding feet; when a fire broke out in the palace, he was singing songs with a loud voice while fleeing; in response to his father’s letter, he once sent a drawing of a phallus and so on[1]. Reizei’s fits of insanity are explained in The Great Mirror as “an affliction attributed to the angry spirits of his half-brother and disappointed rival, Murakami’s oldest son, and of the mother and grandfather of the unsuccessful Prince, all of whom had died when Reizei was about three years old[2]”. His condition is the result of a curse (tatari祟) caused by the revengeful spirits (onryō怨霊) of the relatives he had allegedly robbed from their imperial title, upon which they had died out of despair[3]. Once acceded to the throne, Reizei was forced to abdicate due to his mental instability only two years later. The curse also had repercussions for the mental health of his offspring, among whom Reizei’s son emperor Kazan is discussed in The Great Mirror as well. Another example is Reizei’s daughter Sonshi. It was rumored that she left the palace and became a nun because of a hereditary mental illness. [4].

Reizei_kyoto tomb.jpg

Emperor Reizei’s tomb in Kyoto.

Reizei’s mental disorder is referred to as 御物の怪 (o-mono no ke of which o is a honorific prefix) several times throughout The Great Mirror, a term of which the meaning is linked to religion and spirituality. Another term that is used at a certain point in the narrative, is kurui (狂ひ), which has a more negative connotation. Kurui appears in a dialogue between Minamoto no Toshikata, Minister of Popular Affairs, and the priest Fujiwara no Michinaga. Minamoto is sharing some amusing anecdotes about the eccentric behavior of emperor Kazan with Fujiwara, and attributes his mental disorder directly to his “deficient character from birth”. He adds that “Kazan’s craziness (kurui) is even more difficult to handle than his father’s, emperor Reizei”, after which they both burst out in laughter[5].


Emperor Kazan, Reizei’s son.

Unlike The Story of Splendor (Eiga Monogatari 栄花物語), in which a metaphorical approach is adopted, The Great Mirror criticizes the mental condition of emperor Reizei and his son Kazan directly[6]. Moreover, it is suggested that they bear the responsibility for their disorder themselves, despite the fact that the pathogenesis is otherwise stated as mono no ke throughout the work. Hence, The Great Mirror further comments that Emperor Kazan was said to be “looking great on the outside, but lacking on the inside[7]”, while emphasizing the latter[8]. From the context in which kurui appears, we can deduce that the two terms used to describe a mental disorder here have different connotations. Whereas mono no ke has a spiritual background and a rather positive nuance, kurui appears to be a means to enhance criticism or mockery towards the possessors of such a mental condition.

Another suggestion is that Reizei was only slightly eccentric, and that the abnormality of his behavior was grossly exaggerated by the Fujiwara clan. As a result of these rumors, Reizei as well as Kazan were forced to abdicate at a young age[9]. Even if the assumed mental disorder of both emperors would be part of  a political set-up, the criticism and mockery, or the fact that badmouthing about the opponent’s mental condition was an efficient way to eliminate them, still shows that the ancient society in Japan was, to a certain extent, prone to stigmatization against people afflicted with a mental disorder.

References: [1] Yawata, Kazuo八幡和郎. Biographies of Successive Generations of Emperors: “National History” You Want to Know as a Japanese歴代天皇列伝: 日本人なら知っておきたい「国家の歴史」(Rekidai tennō retsuden: nihonjin nara shitteokitai “kokka no rekishi”). Tokyo: PHP Research Institute, 2008, p. 895. [2] McCullough, Helen Craig, Tamenari Fujiwara, and Yoshinobu Fujiwara. Ōkagami, the Great Mirror: Fujiwara Michinaga (966-1027) and His Times : A Study and Translation, 1980, p. 346. [3] “Emperor Reizei” 冷泉天皇 (Reizei tennō) in Asahi Encyclopedia of Historical Figures in Japan 朝日日本歴史人物事典 (Asahi nihon rekishi jinbutsu jiten) Tokyo: Asahi Shimbun Printing, 1994. [4] Groner, Paul. Ryōgen and Mount Hiei: Japanese Tendai in the Tenth Century. Studies in East Asian Buddhism 15. Honolulu: University of Hawaiʻi Press, 2002, p. 266. [5] For original text and translation in modern Japanese see appendix 3. [6] Satō, Asano佐藤あさの. “Emperor Reizei in The Great Mirror”『大鏡』冷泉天皇 (“Ōkagami” Reizei tennō) summary graduation thesis, Hokkaido university of Education, Association for National language and literature, Sapporo National Language Research, 17 (2012): 103. [7] Original text: その帝をば内劣りの外めでたとぞ、世の人申し. [8] Tsuji, Kazuyoshi辻和良. “The Appearance of Kazan: Narrative in The Great Mirror”花山の姿 : 大鏡の<カタル>方法 (Kazan no sugata: Ōkagami no ‘kataru’ hōhō) Journal of Nagoya Women’s University, Humanities and Social Sciences, 36 (1990): 304–297, p. 303. [9] Hattori, Toshiyoshi服部敏良. Research Tidbits on the History Medicine in Japan日本医学史研究余話 (Nihon igakushi kenkyū yowa) Kagakushoin, 1981, p. 299.

Story no. 2: The Pillow Book and  Mono no Ke


Writer Sei Shonagon

Mono no ke is a returning concept in Heian literature, represented in The Diary of Lady Murasaki, The Tale of Genji and The Pillow Book, all works written by women. It originated in 8th century China and became a popular term among the Japanese aristocracy during the 9th century. Mono no ke is composed out of the characters物 (mono, meaning “thing”, a substitute out of superstition for writing or saying the word “demon”鬼) and ke 怪, related to気 (spirit) and literally means “the spirit of an evil ghost[10]. It refers to the curse cast either by the ghost of a deceased person or by the vengeful spirit of a living creature. Such a curse took concrete shape in physical or mental illness. Sei Shonagon records in her diary The Pillow Book (Makura no Sōshi枕草子, 1002) under “hateful things” the following item:

Someone has suddenly fallen ill and one summons the exorcist. Since he is not at home, one has to send messengers to look for him. After one has had a long, fretful wait, the exorcist finally arrives, and with a sigh of relief one asks him to start his incantations. But perhaps he has been exorcizing too many evil spirits [=mono no ke] recently; for hardly has he installed himself and begun praying when his voice becomes drowsy. Oh, how hateful![11]

Doctors in the Heian period were called genza 験者, practitioners of esoteric Buddhism or folklore Shintoism, who treated illnesses by exorcizing the evil spirits causing the disease. Shirane explains: “The aim of the exorcist was to transfer the evil spirit from the afflicted person to the medium, usually a young girl or a woman, and to force it to declare itself. The exorcist used various spells and incantations to make the Guardian Demon of Buddhism take possession of the medium. When he was successful, the medium would tremble, scream, have convulsions, faint or behave as if in hypnotic trance. The spirit would then declare itself through her mouth. The final step was to drive the spirit out of the medium[12]“.

Once again, diseases are set against a religious and spiritual background. As the doctor in Sei Shonagon’s story is exhausted from overworking, it appears that sudden attacks of mono no ke were very common at that time. One believed that the most effective way to treat illness was to recite incantations. A failed exorcist session is covered in The Pillow Book as a “depressing thing”.

With a look of complete self-confidence on his face an exorcist prepares to expel an evil spirit [=mono no ke] from his patient. Handing his mace, rosary, and other paraphernalia to the medium who is assisting him, he begins to recite his spells in the special shrill tone that he forces from his throat on such occasions. For all the exorcist’s efforts, the spirit gives no sign of leaving, and the Guardian Demon fails to take possession of the medium. The relations and friends of the patient, who are gathered in the room praying, find this rather unfortunate. After he recited his incantations for the length of an entire watch [= two hours], the exorcist is worn out. (…) “Well, well, it hasn’t worked!” [13]

References[10] Takeguchi, Ryūsuke竹口竜介. “About the Genesis and Social Conditions of Mono no Ke during the Heian Period” 平安時代における物怪発生と社会状況について (Heian jidai ni okeru mono no ke hassei to shakai jōkyō nit tsuite) Journal of Ryūkoku University Graduate School for Literature Research 龍谷大学大学院文学研究科紀要 (Ryūkoku daigakuin bungaku kenkyūka kiyō), 27 (Dec 2005): 328-334, p. 330. [11] Shirane, Haruo, ed. Traditional Japanese Literature: An Anthology, Beginnings to 1600. Abridged ed. Translations from the Asian Classics. New York: Columbia University Press, 2012, p. 151.[12] Original footnote in ibid., p. 149. [13] Ibid., p. 149.

Story no. 3: The Tale of Genji and jealous spirits

In order to nuance our definition of mono no ke, it is necessary to look into its use in The Tale of Genji (Genji Monogatari 源氏物語, early 11th century). The fact that this term appears 51 times indicates its role as a key feature throughout the work. Writer Murasaki Shikibu attributes 18 personae with a spiritual possession, among which the story of Genji’s wife, Aoi, and the spirit of his mistress, the Rokujō lady, is perhaps the most representative.

At Sanjō, Genji’s wife seemed to be in the grip of a malign spirit [mono no ke]. It was no time for nocturnal wanderings. (…) Several malign spirits were transferred to the medium and identified themselves, but there was one which quite refused to move. Though it did not cause great pain, it refused to leave her for so much as an instant. There was something very sinister about a spirit that eluded the powers of the most skilled exorcists. The Sanjō people went over the list of Genji’s ladies one by one. Among them all, it came to be whispered, only the Rokujō lady and the lady at Nijō seemed to have been singled out for special attentions, and no doubt they were jealous. The exorcists were asked about the possibility, but they gave no very informative answers.[14]

aoi rokujo.png

Aoi and Genji, surrounded by anxious court ladies.

Aoi passes away due to an illness caused by the jealous spirit of the Rokujō lady, who is unaware of her own soul’s wanderings. Apart from Aoi’s suffering, Shikibu also emphasizes the mixed feelings of the Rokujō lady, unable to suppress her jealousy and overcome with self-loathing. In this sense, both ladies are victimized by the “madness” mono no ke generates. Other characters described as haunted by an evil spirit, nearly all of them female, are driven mad by love-related conflicts.


“Aoi no Ue” in Illustrated Book of Monsters (怪物絵本, kaibutsu ehon 1881)

It is clear that the Tale of Genji does not strive to render a realistic image of mental disorders. Shikibu employs mono no ke as a metaphorical tool to liberate women from social restrictions and empower them to express their suppressed feelings. As Bargen argues, “spirit possession and exorcism are understood, on the one hand, as a dramatic, subversive response to social injustice and the psychological repression of women and, on the other, as the attempt of controlling groups to pacify female frustration and rage[15]”. The Tale of Genji already enjoyed great popularity in the Heian period. It should, therefore, not surprise that its influence attributed to the establishment of mono no ke as a dramatic concept in the literature and arts of later periods.

References[14] Murasaki Shikibu and Edward G. Seidensticker, translator. The Tale of Genji. eBooks@Adelaide, chapter 9 “Heartvine”. [15] Bargen, Doris G. “Spirit Possession in The Context of Dramatic Expressions of Gender Conflict: The Aoi Episode of The Genji Monogatari.” Harvard Journal of Asiatic Studies 48, no. 1 (June 1988): 95–130, p. 96.

Next post in this series: Mad Monks & Medieval Medicine

The Perception of Mental Disorders in Ancient Japan

20160623_193344.jpgAs mentioned before, several parts of my Master’s dissertation (“The Stigmatization of People with a Mental Disorder in Premodern Japan: Research from a Cultural Historical Perspective”) will be posted on Nippaku. Click here to check out the first introductory part! Another history post related to this topic that might be of interest to you is this one about the similarities and differences between the Belgian city of Gheel and the Japanese hamlet of Iwakura. Today, we will go as far back in time as the eighth century to discover how people with a mental disorder were regarded and treated during the Nara and early Heian period.

“Madness” as a Privilege of the Shaman

The oldest notion of “madness” can be traced back to shamanism, a spiritual practice that originated in the Paleolithic period[1]. The Japanese form of shamanism, mikoism, was shaped with the diffusion of shamanism in Central Asia, although there are as many differences as similarities[2]. In the hunter-gatherer society, it was believed that the animals they hunted down for food could reincarnate. A Siberian fortune teller, or shaman, descended into the world of the sacrificed animals to predict by means of their bones whether this was the case or not. The shaman also wore animal hair and skin to adopt animalistic features. In order to psychologically immerse himself in the underworld, the shaman drank extracts of poisonous mushrooms, uttered incantations, danced fanatically until he or she eventually fell down on the ground and entered a state of apparent death. The poisonous substances triggered a state of altered consciousness, interpreted as “madness” and today known as a mental disorder caused by narcotics or alcohol. The fact that the character for “mad” (狂) in Japanese has the radical for dog or animal (犬)[3] can be traced back to this shamanistic practice.


Picture from an article in National Geographic, depicting a Mongolian shaman. The text says “shaman, the one chosen by the spirits” – http://natgeo.nikkeibp.co.jp/nng/article/20121120/331216/

With the emergence of sedentary agricultural societies, shamans continued to play an important role by predicting successful harvests. The harvest was a matter of life or death, and shamans were often appointed as king or queen of newly-formed states. Although they combined a spiritual responsibility with a political role, shamans still carried a strong link with “madness”. During times of war, the king or queen, “raging with anger” would lead the troops. “Anger” expresses just like “madness” a strong affective change[4]. In the shamanistic society, the privilege of being “mad” inferred a supernatural statute, and was only granted to shamans, or kings and queens.

Footnotes[1] Omata, Waichirō 小俣和一郎. The History of Psychiatry 精神医学の歴史 (Seishin igaku no rekishi). Tokyo: Daisan Bunmeisha, 2005, p. 21ff. [2] Fairchild, William P. “Shamanism in Japan.” Folklore Studies 21 (1962): 1, p. 105. [3] Kamada, Tadashi鎌田正and Toratarō Komeyama米山寅太郎 “狂.” (kyō) in New Kanji Forest新漢語林, Taishūkan Shoten, 2011.

Early Accounts of Mental Disorders


The oldest extant manuscript (眞福寺本shinpukuji-hon) of the “Kojiki” – Wikimedia Commons

The oldest preserved Japanese law documents that gives an account of the treatment of mentally disordered citizens, is the Taihō Ritsuryō (701). According to this premodern law system, mental disorders were divided into three categories[5] based on the severity of the disorder. Citizens suffering from the two most severe disorders, were registered as fukakō (不課口) or fukuwa (不課), and discharged from corvée. The law also stipulated that people with a mental disorder of the most severe type should receive nursing care[6]. Moreover, the punishment for crimes committed by individuals with a mental disorder was slightly reduced[7]. Although it remains unclear whether these provisions were actually realized, we can see that during the eighth century, the law system did not prescribe the proactive banishment or persecution of individuals with a mental disorder but pursued a policy of social integration.

Records of Ancient Matters (Kojiki古事記, 712), the oldest literary work in Japan, comprises another description of the reaction to “madness”.

Then His-Swift-Impetuous-Male-Augustness said to the Heaven-Shining-Great-August deity: “Owing to the sincerity of my intentions I have, in begetting children, gotten delicate females. Judging from this I have undoubtedly gained the victory.” With these words, and impetuous with victory, he broke down the divisions of the rice-fields laid out by the Heaven-Shining-Great-August deity filled up the ditches, and moreover strewed excrements in the palace where she partook of the great food. So, though he did thus, the Heaven-Shining-Great-August deity upbraided him not, but said: “What looks like excrements must be something that His Augustness mine elder brother has vomited through drunkenness. Again, as to his breaking down the divisions of the rice-fields and filling up the ditches, it must be because be grudges the land they occupy that His Augustness mine elder brother acts thus.” But notwithstanding these apologetic words, he still continued his evil acts, and was more and more violent. As the Heaven-Shining-Great-August deity sat in her awful weaving hall seeing to the weaving of the august garments of the deities, he broke a hole in the top of the weaving-hall, and through it let fall a heavenly piebald horse which he had flayed with a backward flaying, at whose sight the women weaving the heavenly garments were so much alarmed they died of fear.[8]


Susanoo, here in a sober state, saving a princess from a dragon – Wikimedia Commons

His-Swift-Impetuous-Male Augustness, otherwise called Susanoo, drank too much out of excitement and started to act like a “madman”. His sister the Heaven-Shining-Great-August deity, or Amaterasu, forgave him the first time, attributing his vicious behavior to a mental change caused by alcohol. However, when Susanoo threw a skinned horse through the roof, Amaterasu was terrified and hid herself into a cave.

The “madness” here illustrated can be further explained by the hare and ke dichotomy theorized by Yanagita Kunio in A History of the Meiji and Taisho periods: Social Conditions 明治大正史 世相篇 (Meiji taishō shi  sesō hen, 1930). Hare, “the sacred”, refers to something formal, festive, ritual, public and extraordinary whereas ke, “the secular”, alludes to the profane, mundane, private and everyday life. Based on Yanagita’s thesis, the suggestion here is that people who lost the ability to discern between hare, the sacred and ke, the profane, behaved as was only permitted on hare days, and were, therefore, labeled as a “mad”.

Susanoo, for example, was so proud of his accomplishment that he started drinking alcohol and acting violently, this in contrast with his sister and the other women, who were dealing with their daily activities. His actions were seen as “defilement”, kegare, in a ke context, whereas it would have been perceived as a sign of spirituality in a hare context. Although Susanoo was heavily punished for his vicious acts in the end, it should be noted that Amaterasu first shows some mercy regarding his mental condition.

Footnotes[4] Perhaps best illustrated in the English language, where the word “mad” covers those two connotations. [5] Zenshichi残疾, haishichi癈疾 and tokushichi篤疾.[6] Hashimoto, Akira橋本明. The history of psychiatric care in Japan. Were there rights for “mental patients”? – Gleaners in the history of psychiatric care in Europe.日本の精神医療史. “精神病者”の権利はなかったのか?―ヨーロッパ精神医療史の落穂拾い― (Nihon no seishin iryōshi. “seishin byōsha” no kenri ha nakatta no ka? – yōroppa seishin iryōshi no ochibohiroi), 2002.  [7] Omata, History of Psychiatry, p. 48.[8] Chamberlain, R. H. The Kojiki. Seattle: PublishingOnline, 2001, p. 32-33.

“Mad” People and Religion

One way to discover elements of (non-)stigmatization in a certain period in time, is by looking at the terminology used for individuals with a mental disorder and the positive, neutral or negative connotations these words bear. In Chronicles of Japan (Nihon shoki 日本書紀, 720)[9], Shoku Nihongi続日本紀 (797)[10] and Saimeiki 斎明記[11], the word tabure 狂is used to describe “madness”. Tabure has a double meaning: on the one hand, it is connected with the word tawamure 戯れ, meaning nowadays “jest”, “flirtation” or “joke”, and indicates a deviant social behavior, such as in the story about Susanoo’s ravage. On the other hand, tabure is derived from the phrase tamashii ni fureru 魂に触れる, “to touch the soul”, and refers to spirit possessions, as was practiced in Shintoism[12]. Accordingly, “mad people” were called taburebito狂人. This term appears neutral, even positive in combination with a context based on hare. Notwithstanding, only one word existed to point out “mad people” at that time, so it could in se also express strong disapproval of others’ deviant social conduct.

An example of taburebito used to condemn those not in their right mind, can be found in Veritable Records of Three Reigns in Japan (Nihon sandai jitsuroku日本三代実録, 901). An imperial edict from the year 866 warns that “in the case lunatics would conspire to destroy the state, all deities will quickly resurrect”[13]. This criticism is directed towards the conspirators of the Ōtenmon incident of the same year[14]. Those who would harm the state and therefore also its fundament, the emperor, officially the descendent of the gods, must be crazy. Taburebito is used here to argue that rebellion against the political institution or emperor is pure “madness”[15].


People running to the burning Otenmon Gate, painted scroll from the 12th century – Wikimedia Commons

Around the Nara period, the Sino-Japanese reading of the character for “mad”, kyō 狂, came into use. Kyō is not as old as the Japanese reading tabure and bears in addition a slightly more negative connotation: it is used to direct social criticism towards people behaving differently from what convention prescribes, especially when the motive or reason for this demeanor is known[16]. In other words, Kyō roughly overlaps with the first meaning of tabure, but has an additional element of criticism.


Yamabushi – Wikimedia Commons

Another characteristic of “madness” in Ancient Japan lies in the connection between taburebito and the practice of mountain worship (sangaku shinkō山岳信仰). With the development of an agricultural society on the flatland, mountains were held to be the abode of kami and became objects of worship[17]. They were, therefore, forbidden ground for normal villagers. On hare days, kami descended from the mountains to the village, and the “madness” originating at sacred heights was temporarily transferred. People who entered the mountains were thus regarded as “madmen”. Especially on ke days, this kind of deviant behavior represented a breach or escape from everyday interpersonal relations[18].

At the same time, however, mountains were supernatural places where an encounter with the gods became possible, and attracted for that reason people wandering around in search of spiritual enlightenment[19]. Taburebito who used to do so on normal days were regarded as “close to the gods” and gained a special status. Their aberrant conduct was not judged on a personal level but in a religious context, in the sense that their connection with kami was predestined and necessary for a smooth communication with the supernatural world. In the footsteps of shamans and miko, taburebito played an important role in mediating between the two worlds. Considering that “madness” was strongly connected with hare, we can conclude here that an interpretation of non-stigmatization can be applied.

Footnotes: [9] E.g. tabure gokoro no mizo 狂心渠 “the ditch of madness”, an enormous water construction ordered by empress Saimei (chapter 26). [10] E.g. tabure madō 狂迷 “go astray in madness” (16th emperial edict). Frellesvig, Bjarke, Stephen Wright Horn, Kerri L. Russell, and Peter Sells. The Oxford Corpus of Old Japanese. [11] Actually a part of the Nihon Shoki. Saimeiki gives an account of the feigned “madness” (itsuwari tabure) of prince Arima.[12] Oda, Japanese Sources on Madness, p. 15, 17-18. [13] Original text: 若狂人乃國家乎亡止謀留事奈良波。皇神達早顯出給比 (若し狂人の国家を亡さむと謀る事ならば皇神達早く顕出し給ひ).  [14] Although it is unclear who actually conspired against who, the incident started with the main gate of the royal palace (Ōtenmon) burnt down. Several accusations were made, but in the end Fujiwara no Yoshifusa seized the power, executed his political enemies and was promoted as Regent. [15] Dismissing those who rebel against the emperor and imperial family as “madmen” is not only limited to this period, but is a recurring phenomenon throughout Japanese history, also referred to as a side effect of the “chrysanthemum taboo菊タブー(kiku tabū, chrysanthemum refers to the imperial house)”. For an overview of such incidents in modern Japanese history, see Inoue, Shōichi井上章一. Madness and Royal Authority 狂気と王権 (Kyōki to ōken), Tokyo, Kodansha, 2008. [16] Oda, Japanese Sources on Madness, p. 15. [17] Yano, Kazuyuki. “Sacred Mountains Where Being of ‘Kami’ Is Found.” 16th ICOMOS General Assembly and International Symposium: Finding the Spirit of Place – between the Tangible and the Intangible. Quebec, Canada, 2008, p. 1. [18] Oda, Japanese Sources on Madness, p. 27-28. [19] Yanagita, Kunio. Mountain Village Life. Tokyo: Heibonsha, 1961.

“Madness” in Buddhism

During the 6th century, Buddhism was introduced in Japan and later adopted as the official religion. The monk Keikai edited 116 Buddhist stories from the Nara period and earlier in the Nihonkoku (Genhō Zenaku) Ryōiki日本(国現報善悪)霊異記 (822)[20]. In this compilation there are several stories dealing with mental disorders, but remarkable is that this “madness” is often reported as punishment for a crime committed towards Buddhism. For example, it is described how one man harbors ill feeling towards Buddhism and tries to lock up a Buddhist monk begging for money. The monk escapes and recites incantations, upon which the man loses his mind and starts running around like crazy.


The Nihon Ryōiki – Wikimedia Commons

It is likely that the introduction of Buddhism from mainland China via Korea brought along a change in the perception of “madness” in Ancient Japan. In contrast with the positive connotations attributed to taburebito in Shintoism and folk religion, “madness” here is in nothing related to supernatural beings, but perceived as a punishment on a personal level, a prevalent understanding of “illness” as “evil” in several religions around the world. “Mad” people do not contribute to society or gain a special status in a Buddhist context. They are marked with a mental disorder as proof of their “defiant” behavior and categorized as impure together with criminals, debtors et cetera. In such cases, the Sanskrit word ummatta is used to express “insanity”. Nevertheless, there was legal and social consideration towards people with a mental disorder, for example, monks who developed a mental illness were not accountable for crimes against the Buddhist law[21]. On the other hand, religious experiences such as possessions, illusions or hallucinations are not unusual in Buddhism[22]. These experiences are temporary, caused externally and mystically significant, but unlike Shintoism and folk religion in Japan, Buddhism differentiates between experiences with a spiritual connection and other “madness”, or ummatta. This perception views ummatta as devoid of religiosity (hare) and is more likely to encourage the stigmatization of individuals with a mental disorder, rather than the generalizing notion of “madness” in Shintoism does.

Footnotes: [20] This work is translated by Watson, Burton as Record of Miraculous Events in Japan: The Nihon Ryōiki. Translations from the Asian Classics. New York: Columbia University Press, 2013.[21] Koike, Kiyoyuki. “Mental disorders from a Buddhist View, especially those within the Nikaya, the Vinaya Pitaka and the corresponding Chinese translations” in Indian and Tibetan Studies Research, 7 & 8, p. 178.[22] Oda, Japanese Sources on Madness, p. 55-56.

Next post in this series: Old Stories of Madness

UNESCO World Heritage in Japan

unesco_blue_logoAfter a few research-based posts, I felt like presenting a more visual topic this time. And what better eye candy is there besides some of Japan’s most beautiful and culturally inspired places? Hence my topic: The United Nations Educational, Scientific and Cultural Organization (UNESCO) World Heritage. In this post, I will show you which places in Japan have been granted a world heritage status since the Japanese acceptance of the convention in 1992. Because I visited some of these places myself, I hope to share a few of my own pictures here as well (all pictures are mine, unless mentioned otherwise). Currently, the list includes 16 cultural and 4 natural sites in Japan.

To be included on the World Heritage List, sites must be of outstanding universal value and meet at least one out of ten selection criteria. – site UNESCO

Such criteria include, for example, being a representation of human creativity, an interchange of human values, a cultural tradition or a development in design, art or technology. Or, the site in question must be an outstanding example of technology, landscape or architecture that plays a significant role in human history and culture. Natural world heritage, on the other hand, should represent outstanding natural phenomena, significant biological and geological processes or the major stages in the history of our earth.


Buddhist Monuments in the Horyū-ji Area (1993)


Wikimedia Commons

I can’t believe I couldn’t find a decent picture of the Horyū-ji temple 法隆寺 from when I visited Nara. The main hall, entrance gate and pagoda date back to the early seventh century and are among the world’s oldest wooden buildings.

Himeji-jō (1993)


Himeji-jō 姫路城 is an excellent example of early Japanese castle architecture. It looks very sophisticated with its white walls and elegant rooftops. This fourteenth-century castle was remodeled and expanded in 1581 by the famous “unifier” Toyotomi Hideyoshi.

Historic Monuments of Ancient Kyoto (Kyoto, Uji and Ōtsu Cities) (1994)


The Temple of the Golden Pavilion (kinkaku-ji 金閣寺) is one of the most popular attraction in Kyoto. This gaudy piece of architecture was originally the villa of a rich statesman but was purchased by shogun Yoshimitsu and converted into a Zen Buddhist temple. In a novel of the same name by Mishima Yukio, an acolyte burns down the temple. This story was based on true events.


Other famous historic monuments in Kyoto include the Kiyomizu-dera “clear water” temple 清水寺 founded in 778. You cannot see it on the picture above, but the temple is located on a hill and therefore supported by tall pillars on one side. Not a single nail was used in the construction of the temple.


This famous stone garden is part of the Zen Buddhist Ryōan-ji temple (“Temple of the Dragon at Peace” 龍安寺). The placement of the stones is intended so that one is unable to see everything from one place.


I thought Byōdō-in 平等院 in Uji was truly a magical place. Again, this building was originally a villa and later transformed into a Buddhist temple. The central Phoenix Hall is surrounded by a pond and appears to be floating due to its reflection in the water. This hall and the phoenix statue on top of it are depicted on the 10 yen coin and the 10,000 yen bill.

Historic Villages of Shirakawa-go and Gokayama (1995)


Wikimedia Commons

I have never been to Toyama or Gifu but I would love to visit these traditional villages. Characteristic are the big houses with slanted roofs, an architectural style known as “prayer-hands construction” (gasshō-zukuri 合掌造り).

Itsukushima Shinto Shrine (1996)


Itsukushima 厳島, often called Miyajima (“shrine island” 宮島), is located not far away from the bay of Hiroshima. The key shrine on the island, Itsukushima Shrine, is particularly famous because its gate and main building are built in the sea. Looking at the picture above, you can see how far the water reaches at high tide, which gives the illusion of a floating gate.

Hiroshima Peace Memorial (Genbaku Dome) (1996)


Also in Hiroshima you can find the Atomic Bomb Dome (genbaku dōmu 原爆ドーム) as part of the Hiroshima Peace Memorial Park. This ruin was originally the Prefectural Industrial Promotion Hall and is the only building near the hypocenter that survived the atomic bombing  of August 6, 1945.

Historic Monuments of Ancient Nara (1998) 


Oh deer, we’re in Nara! This cutie was so kind to pose for us in front of the Tōdai-ji’s ( “Great Eastern Temple” 東大寺) Great Southern Gate (Nandaimon 南大門), reconstructed at the end of the 12th century since the original structure from the 8th century had been destroyed by a typhoon. On the gate is written “Daikegonji”  (大華厳寺), an alternative name for the Tōdai-ji temple.


The main “Big Buddha” hall (Daibutsuden 大仏殿) of the Tōdai-ji is an impressive construction of wood and houses an enormous bronze statue of a sitting Buddha (picture below). The 16 m high statue was completed in 751 and literally contained almost all of the bronze available in Japan at that time.


Shrines and Temples of Nikkō (1999)


Wikimedia Commons

Another destination on my Japan bucket list is Nikkō (日光) in Tochigi prefecture. Futarasan-jinja 二荒山神社, Rinnō-ji 輪王寺 and Nikkō Tōshō-gū 日光東照宮 were designated as UNESCO world heritage at the end of last century. On the picture you see the main hall of Nikkō Tōshō-gū, a Shintō shrine dedicated to Japan’s first shogun Tokugawa Ieyasu.

Gusuku Sites and Related Properties of the Kingdom of Ryūkyū (2000)


Wikimedia Commons

The Ryūkyū kingdom (15th – 19h century) ruled over the islands south of the main island of Japan. The remains of many gusuku (“castle” in Ryukyuan) on Okinawa such as Shuri castle 首里城 in the picture above have been listed as world heritage. Fun fact: the gate of this castle is depicted on 2,000 yen bills. Read more about its history in my blog post Money Matters.

Sacred Sites and Pilgrimage Routes in the Kii Mountain Range (2004)


I photographed this belfry on mount Kōya ( Kōyasan 高野山), the center of Shingon Buddhism. It belongs to the Garan (“temple” 伽藍), the main temple complex founded by Kūkai. Other sacred sites and pilgrimages include places in Yoshino, Omine and Kumano.

Iwami Ginzan Silver Mine and its Cultural Landscape (2007)


Wikimedia Commons

Since I did not know about this place, I was curious about the story behind this silver mine in Ōda: apparently, during the 17th century, its output accounted for one-third of all the silver in the world! The mine was active for almost four centuries until its closure in 1923. The heritage site also includes three castles that protected the mine, ports for export, transportation routes and various other sites that bear an important connection to its history.

Hiraizumi – Temples, Gardens and Archaeological Sites Representing the Buddhist Pure Land (2011)


Wikimedia Commons

The city of Hiraizumi 平泉 plays an important role in Japanese history as the home of the ruling Fujiwara clan during the Heian period. It developed quickly into a city of sophistication and splendor for 100 years, rivaling Kyoto as the place to be. As soon as the Fujiwara were overthrown, Hiraizumi became forgotten, but many buildings remain well-preserved even today. It is said that Hakusan Shrine 白山神社 (picture) was the structure first built in Hiraizumi in 717.

Fujisan, sacred place and source of artistic inspiration (2013)


Wikimedia Commons

This iconic view is so well-known that I should not need to expand further. Sakura, Fuji-san 富士山and shinkansen: Japanese scenery in a nutshell. I am, however, very much surprised that it took so long before Fuji Mountain was recognized as world heritage.

Tomioka Silk Mill and Related Sites (2014)


Wikimedia Commons

This mill in Gunma prefecture is Japan’s oldest modern silk factory and still in its original state today. The government established the mill in 1872 as a model factory to industrialize modern machine silk reeling imported from France.

Sites of Japan’s Meiji Industrial Revolution: Iron and Steel, Shipbuilding and Coal Mining (2015)

glover garden nagasaki.jpg

A collection of more than 20 sites illustrate Japan’s rapid development as a modern and industrialized country in the Meiji period. An example is Thomas Glover’s house on a hill in Nagasaki, looking out over the city. Thomas Glover, a Scottish merchant, played a crucial role in the modernization of Japan by introducing Western technology.

The Architectural Work of Le Corbusier, an Outstanding Contribution to the Modern Movement (2016)


Wikimedia Commons

Besides many buildings in other places of the world, Le Corbusier designed the National Museum of Western Art in Tokyo. This museum is the only work of Le Corbusier situated in the Far East.


Shirakami-Sanchi (1993)


Wikimedia Commons

The Shirakami mountains (Shirakami sanchi 白神山地) is an immense unspoilt forest situated in Akita and Aomori prefectures. The forest is highly protected and visitors without permission cannot enter the heritage site.

Yakushima (1993)


Wikimedia Commons

Yakushima 屋久島 is an island located in the south of Kyūshū and is particularly famous for its ancient cedar forest. Some of the trees are more than thousand years old. Because of its subtropical climate and boundless rainfall, Yakushima also has plenty of waterfalls, such as Ōko no Taki you see in the picture above.


Shiretoko (2005)


Wikimedia Commons

Of course, the Northern island of Hokkaidō has some natural heritage material as well. In the Shiretoko National Park (Shiretoko kokuritsu kōen 知床国立公園) you can find wildlife such as bears, foxes and deer. During wintertime, drifting sea ice can be seen from there.

Ogasawara Islands (2011)


Wikimedia Commons

The last world heritage site on our list is a chain of remote vulcanic islands known as the Ogasawara Islands 小笠原諸島, also called Bonin Islands. People live only on the two main islands, “father island” (Chichijima 父島) and “mother island” (Hahajima 母島). Next to beautiful beaches such as the Kominato beach and Kopepe beach, the Ogasawara Islands offer a warm climate, unexploited forests and a unique vegetation.

Have you visited one of these places? Let me know!


Iwakura: the Japanese Gheel?

13553337_10209027881150118_1336223955_nFor two years now, I have been doing research on the history of mental health stigma in Japan. Consequently, I have also written some reports and papers about this topic and the history of psychiatry in general. During my year at Kobe University, I wrote a paper in Japanese about the link between the hamlet Iwakura in Kyoto and the Belgian city of Gheel. Since this is perfectly acceptable Nippaku material, I thought it could be interesting to post a translated version on this blog!


In Flemish, we have a proverb “going to/coming from Gheel” which means being crazy. In Japan there is a similar expression about Iwakura, a hamlet North of Kyoto. Both places appear to be related to mental health patients: Gheel as well as Iwakura have gained fame as “colonies of the mad”. At the end of the 19th century, Gheel attracted worldwide attention because of its unique family care system. Since it was believed that traditionally a similar system existed in Iwakura, it was called “the Japanese Gheel”. We cannot deny that there are many similarities between these two places, but is it really true that family care which emerged from a very specific (religious and economical) context in Gheel is also ingrained in the history of Iwakura? In this post, we will compare the relevant history of both places in chronological order and take on the question whether or not Iwakura can truly be called “the Japanese Gheel”.

gheel iwakura.png

Mental hospital of Gheel (left) and Iwakura (right) – Sources: cultuurgeschiedenis.be/paradijs-der-krankzinnigen/ and kenkyukaiblog.jugem.jp/

1. The history of Gheel

st dymphna

Picture of St. Dymphna in Gheel – Photo taken at the Museum Dr. Guislain, Ghent.

Gheel (Geel in Dutch) has been an important pilgrimage destination since early times. From the 12th century on, ill people from all corners of Europe came to Gheel because they had heard about the legend of Sint Dymphna (Dimpna in Dutch), the city’s patron saint. It was believed that seeing and touching her relics had curative powers. According to the legend, Dymphna was the daughter of an Irish king ruling in the seventh century. When the queen died, the king started looking desperately for a woman to remarry who looked exactly like his deceased spouse, but could find no one who resembled her more than his own daughter. The king, by then insane from grief, proposed to Dymphna. She refused him and fled together with father confessor Gerebernus and some trusted others to Gheel. They were eventually tracked down and the king beheaded his daughter himself and had Gerebernus killed as well. Both were declared martyrs. The people in Gheel buried their bodies, but later exhumed the bones to function as relics in the Dymphna Church they established in the vicinity of their grave.


Jan Carel Vierpeyl, “Exhumation of the bones of St Dimpna and St Gerebernus”, beginning 18th century, St. Dymphna church in Gheel – wikimedia commons

In the beginning, Gheel attracted all kinds of diseased people as a place of pilgrimage, but from the 15th century on St. Dymphna became known as the patron saint for the mentally disordered, and the number of visiting “mad people” increased rapidly. The standard procedure was a “novena”, a nine-day ritual that required the diseased to stay during that period in Gheel. For that purpose, sick rooms were set up inside the church. However, space was limited and in high season (i.e. around May, since May 15 was St. Dymphna’s feast day) the number of pilgrims largely surpassed the number of novena participants the church could deal with, and those who arrived sometimes had to wait for weeks before they could receive spiritual healing.

V0048050 Pilgrims receiving the Eucharist in the chapel of St. Dymphn

Pilgrims receiving the Eucharist in the chapel of St. Dymphna – wellcomeimages.org

The inhabitants of Gheel provided a solution in the form of lodging at their own homes. Moreover, not few pilgrims wished to stay for an extended period longer than the nine days in church to maximize the healing effects of St. Dymphna’s relics. From this custom the family care system was born: for an unlimited period, the people of Gheel “adopted” one or two mental patients and in return received a compensation. The patients who could also helped with farming work. In other words, families without any medical knowledge lived together with mental health patients under the same roof, unlike the situation in hospitals or specialized boarding houses.

From 1532 on, the Communal Council of Gheel took care of the accommodation, supervision and novena for mentally ill pilgrims. In the 17th century, however, the patients were placed directly in the host families via a sponsored organization called the “table of the poor” (“De Armentafel” in Dutch). As a result, several pilgrims with a mental disorder stayed in Gheel and lived together with their foster family for the rest of their live. Although Gheel become known as “the merciful city”, the explanation behind this charity was mainly an economic one: for the authorities, family care was simply a cheaper solution to keep “mad” people off the streets than having them treated at mental asylums in surrounding cities.

Geel - De kolonie rond 1900

The mental hospital of Gheel around 1900 – Gemeentearchief Geel

gheel dr guislain museum

Literature on Gheel – photo taken at Museum Dr. Guislain.

In 1850, Belgium’s National Mental Illness Law legally recognized family care as equal to other forms of psychiatric care. The village was renamed “the Colony of Gheel”. A mental hospital was established in 1862, but the family care system remained, even today. In 1893, there were 1,156 foster families and in 1938, there were 3,736 mental health patients staying at the colony. Nowadays, many families still host one or more patients in exchange for a compensation [interesting video here]. The sight of mentally ill patients on the streets of Gheel is far from unusual. Today, as well as during previous centuries, the “pilgrims” enjoyed a relatively free life style, and there were remarkably few incidents or crimes involving the “mad”, a fact often used as an argument against the assumed strong connection between mental health patients and violence or crime. From the 1860s on, the colony gained fame as the model by excellence for family care and renowned psychiatrists and scientists from all over the world gathered in Gheel. Among them, there were also Japanese visitors. This is the point in history when the comparison with Iwakura began.


2. The history of Iwakura

During the Middle Ages (1185-1603) in Japan, a handful of religious institutions offered services for mental health patients, such as Chinese herbal medicine treatment and moxibustion (burning plant material close to or on the skin) in Buddhist temples, and incantations and exorcism sessions in Shintoist shrines. Because psychiatric treatment avant la lettre was often associated with spiritual healing, those in need undertook pilgrimages to “places of healing” that provided special treatment. Nevertheless, this was still exceptional, and most temples and shrines started to develop facilities for the mentally ill only late in the Edo period or at the beginning of the Meiji period. Hence, from the 17th century on, the number of religious institutions specializing in mental health treatment rose significantly. Shortly before the Meiji revolution, the reading of sutra, incantations, water treatment, moxibustion and Chinese-style herbal medication were available in 28 shrines and temples nationwide. Additionally, 2 mental asylums were established in the first half of the 19th century.


Water therapy at Fujinuta Falls (date unknown) – Kitsuta Masateru, http://kenkyukaiblog.jugem.jp/?cid=10


Waterfalls at Daiunji-temple in Iwakura – Kobayashi (1972) http://kenkyukaiblog.jugem.jp/?cid=10

Among these institutions, the Daiunji-temple in Iwakura, north of Kyoto, is a well-known example of a popular destination for mentally disordered pilgrims. Its reputation as a place of healing was based on a legend from 1072. The third daughter of emperor Go-Sanjō who suffered from a mental disorder, recovered by drinking from a well and bathing under a waterfall at the place that was later called Iwakura. From around the year 1765, people started to flock there, which urged the provision of housing, first inside the temple domain and then at inns and local farmers’ houses. The expansion in population called Iwakura as a hamlet into existence. In 1875, a private mental hospital was established, and the people in Iwakura were forbidden to accommodate mental patients any longer because they could not provide adequate treatment. The hospital, however, was closed in 1882 due to financial difficulties. Consequently, many patients returned to the inns and local families’ houses. A second hospital was established in 1884.

During and after the Taishō period (1912-1926) Iwakura experienced a facilities construction boom and at the beginning of the Shōwa period (1926-1989), 10 sanatoria were established there to take care of the mentally ill. Many of the patients stayed for a longer period, some of them for the rest of their life. Those who could, helped with household chores, worked on the land or in the mountains. At the same time in Japan, the custom, and later on legislation of confining “insane” family members at home in zashikirō 座敷牢, cage-like wooden constructions, was widespread.

hidekiueno.net zashikiro

zashikiro – hidekiueno-net.jp

Compared to this way of dealing with mentally disordered people, it is assumed that those staying at Iwakura could enjoy a relatively free lifestyle. Nevertheless, previous research has pointed out that patients who were difficult to handle, were often locked up and physically restrained. In the past as well, the inhabitants of Iwakura who were entrusted the care of these patients and therefore responsible for them, did not want to take any risks. As a result, the “mad” were tied down to prevent them from escaping or causing any harm.


Patients exercising at Iwakura Mental Hospital –  http://shuchiinfukushi.blog46.fc2.com/blog-entry-524.html

At the end of the year 1935, more than 500 mental health patients were admitted to the Iwakura hospital, and 300 more stayed at the surrounding sanatoria. The Second World War caused severe food shortage, and the mortality rate at mental hospitals nationwide rose sharply. The mental hospital and many of the sanatoria in Iwakura were forced to close their doors. Two new hospitals were established after the war, but the inns and sanatoria played no longer an important role. In the Iwakura of today, mental patients are mainly cared for at the hospital, and inhabitants taking on the task of housing them are hardly seen anymore.

It is believed that the famous Japanese physician Kure Shūzō 呉秀三 (often called the founder of psychiatry in Japan) was the first to draw the attention of specialists on the particular situation in Iwakura. Consequently, the “mad” of Iwakura and its psychiatric history attracted worldwide attention at the beginning of the 20th century. Many western psychiatrists visited Japan and pointed out the resemblance between the existence of sanatoria in Iwakura and the family care system in Gheel. Moreover, the interest in Iwakura was rooted mainly in the comparison with Gheel. We can assume that without the perception of Iwakura as “the Japanese Gheel”, the traditional practice of caring for patients at inns and farmers’ houses would have disappeared much sooner. The attention Iwakura gained during the early years of the 20th century “prolonged”, in a sense, the duration of this tradition. But on what exactly was the comparison with Gheel based?

3. Comparing Gheel and Iwakura


Kure Shūzō – Wikimedia Commons

In 1906, The Latvian physician Wilhelm Stieda visited Iwakura, and wrote the words “In this village – a Japanese Gheel” (original in German: “In diesem Dorfe – einem japanischen Gheel -” in a specialized journal article. The notion of a resemblance between these two places was widely publicized, and Iwakura gained worldwide recognition. However, if we carefully examine the background against which this comparison was drawn, we learn that Kure Shūzō was the one who pointed out the similarities with Gheel to Stieda. Kure mentioned in his “Essentials of Psychiatry part II” (1895) that in Gheel as well as in Iwakura, there existed a similar system of family care. Before that, no other Japanese physician had mentioned such a thing during study trips to Germany, the place-to-be for psychiatrists at that time and also the country where efforts were made to introduce a family care system based on Gheel’s example.


Map of the Daiunji temple domain with names of inns and shrines around 1779 – in “Encyclopedia of Famous Places” volume 6, 1968. http://www.kagemarukun.fromc.jp/page003j.html

In contemporary Japan, the traditional treatment in Iwakura was being perceived as “outdated”. After he visited Gheel in 1901, Kure compared the city once again with Iwakura, and this time, he expressed his disapproval of the Japanese situation. This was because Kure actually desired the development of a family care system exactly like in Gheel (which was not the case in Iwakura), but the accommodation of mental health patients at inns and tea houses became prohibited by the Mental Patients’ Custody Act promulgated in 1900. Furthermore, the care for mental patients at the sanatoria that resembled hotels rather than family homes, differed greatly from Gheel’s family care system. In other words, based on the strong desire that “Iwakura should be the Japanese Gheel”, Kure and other Japanese psychiatrists strived towards an introduction of the Gheel system. This failed.


Wilhelm Stieda – Wikimedia Commons

So we can assume that when Stieda met Kure in 1906, he was not really under the impression that Iwakura had a similar family care system like in Gheel. Probably, he referred to the religious background, high population rate of mental health patients and history of lay treatment that both places shared. Nevertheless, Iwakura became mainly known to western psychiatrists for its alleged family care system. As I explained before, this was not the case then, since mental patients stayed at the hospital or sanatoria, and were no longer “adopted” into the farmer’s families. There are examples of family care in Iwakura before 1900, but calling it a “system” would be incorrect. However, the Japanese side did not deny and even supported this erroneous understanding. Hence, Iwakura’s history was recreated as “the Japanese Gheel”. Because Iwakura was already being compared to Gheel, the (re)introduction of a family care system should be possible, Japanese psychiatrists such as Kure thought.

familienpflege iwakura

Translation German: “family care in Iwakura” – http://www.lit.aichi-pu.ac.jp/~aha/doc/Southampton%20congress.pdf

According to specialist Akira Hashimoto, the words “Iwakura is the Japanese Gheel”, written in a time the world of psychiatry was fascinated by the family care system in Gheel, should be understood as an idea created on Japanese soil. I agree that the model of “family care” did not really apply to 20th-century Iwakura, but besides that, there are many resemblances here that should not be overlooked. Moreover, it is clear that in both places, people earned their living by caring for mental health patients. The influx of mentally ill pilgrims resulted in economic profits. The culture of lay psychiatric treatment is also remarkable. By nursing people with a mental disorder on a daily basis, the villagers developed a particular set of skills and became fully experienced, despite their lack of medical knowledge. Furthermore, mental patients enjoyed a relatively free lifestyle and the boundaries between “patient” and “villager” were rather blurry in both places.

I hope this post was able to convince you that Gheel and Iwakura deserve special attention because of their exceptional history of mental health care. More posts on this topic will follow (soon)! In the meantime, those who are interested in psychiatry can read a previous blog post on forensic mental health in Japan here: part 1, part 2.


  • 小俣和一郎『精神病院の起源』東京: 太田出版, 1998.
  • 小俣和一郎『精神医学の歴史』東京: 第三文明社, 2005.
  • Official site city of Gheel
  • Nakamura, Osamu. “Family Care of Mentally Ill Patients in Iwakura, Kyoto, Japan.” presented at the International Research Symposium: Therapy and Empowerment – Coercion and Punishment: Historical and Contemporary Perspectives on Labour and Occupational Therapy, lecture at St Anne’s College, Oxford, June 27th, 2013.
  • 中村治「精神医療の流れと洛北岩倉: 第二次世界大戦後」人間科学:『大阪府立大学紀要』 1 (2005): 111–30.
  • 中村治「洛北岩倉における精神病者の処遇」人間科学『大阪府立大学紀要』 2 (2006): 97–114.
  • Hashimoto, Akira. “The Invention of a ‘Japanese Gheel’: Psychiatric Family Care from a Historical and Transnational Perspective.” In Transnational Psychiatries Social and Cultural Histories of Psychiatry in Comparative Perspective, C. 1800-2000, edited by Ernst Waltraud and Thomas Mueller, 142–71. Newcastle upon Tyne: Cambridge Scholars, 2010.
  • 橋本明『京都・岩倉の国際関係論「岩倉は日本のゲールである」という虚構をめぐって』第83回精神科医療史研究会
  • 橋本明「二十世紀前半における京都・岩倉の“国際化”について(その二)」『日本医史学雑誌』48, 3 (2002): 374–75.
  • 橋本明『日本の精神医療史. “精神病者”の権利はなかったのか?―ヨーロッパ精神医療史の落穂拾い―』講演, 2002.
  • 兵頭晶子『精神病の日本近代―憑く心身から病む心身へ』越境する近代 東京: 青弓社, 2008.
  • Mueller, Thomas. “Re-Opening a Closed File of the History of Psychiatry: Open Care and Its Historiography in Belgium, France and Germany, c. 1880-1980.” In Transnational Psychiatries Social and Cultural Histories of Psychiatry in Comparative Perspective, C. 1800-2000, edited by Ernst Waltraud and Thomas Mueller, 172–99. Newcastle upon Tyne: Cambridge Scholars, 2010.
  • 八木剛平, 田辺英『日本精神病治療史』東京: 金原出版, 2002.
  • Wilhelm Stieda. “Über die Psychiatrie in Japan.” Centralblatt für Nervenheilkunde und Psychiatrie 29 (1906): 514-522.
  • full text of “Gheel: the city of the simple” (1869)
  • time line history of Gheel

150 Years of Japan-Belgium Relations

150_fb_sharingAs some of you perhaps already know, this year we celebrate 150 years of friendship between Japan and Belgium (so 150 years Nippaku 日白, actually). In this post, I will give a short overview of the events leading to the signing of the treaty and some (early) history that both countries share.

It all started in 1866 when a Treaty of Amity, Commerce and Navigation was signed. Belgium was the ninth Western state the Japanese shogunate entered such a treaty with. The Japanese were particularly attracted by Belgium’s technology, e.g. the railroad industry and glass techniques, and institutional organisation, such as law and the central bank system (the Bank of Japan was actually founded in 1882 based on the Belgian model). It is also suggested that the Meiji constitution was indirectly influenced by the Belgian one. The visit from the younger brother of the shogun, Tokugawa Akitake (1867), Japanese students (1871) and the Iwakura mission (1873) are proof of that interest. Belgium, on the other hand, believed that Japan was a promising new market.


1866 Treaty –  belgiumjapan150.jp/150-years


Count de Mountblanc with a Japanese retainer.

Ironically, it was a French journalist that suggested in 1847 that Belgium should send a military expedition to Japan in order to pursue foreign trade (“gunboat diplomacy”). Although the project was firmly rejected and the interest in Japan was almost non-existing at that time, the appearance of American Commodore Matthew Perry in 1853 who forced the Japanese to sign a treaty, impressed the Western countries greatly. Thus, Belgium used the opportunity to sign a similar treaty on 1 August 1866. Count Charles Descantons de Mountblanc established the first official contacts and negotiations were undertaken by Auguste t’Kint de Roodenbeke. Despite the title “Treaty of Amity, Commerce and Navigation” 修好通商条約, it was clearly an unequal/semi-colonial one: it included extraterritoriality (foreigners in Japan were exempted from local jurisdiction) and denial of the right for Japan to determine the import tariffs. The foreign ministers in the following years would devote a big deal of their time on revising these unequal treaties.

The amount of export from Belgium to Japan was around ten times the amount of import, but trade between the two countries in general was limited for a long time. The policy Belgium adopted to encourage marine trade brought a change: now the shipping company Nippon Yūsen made a stop at the port of Antwerp on its way to London. The line was inaugurated in 1896.

map iapan nippaku

Old map of Japan. “Indiae Orientalis Insularumque Adiacientium Typus”. f. 63 of Abraham Ortelius. in Theatrum orbis terrarum […] Antwerp, 1575. Collection KU Leuven.

Informal connections between Belgium and Japan, however, go back much further in time and originally rooted in religion. The first “Belgian” avant la lettre to ever set foot in Japan was Jesuit missionary Theodoor Mantels in 1588. The arrival of the second Belgian, missionary Ludovicus Frarijn, in 1620 was rather short-lived since he was burnt alive two years later. A third unlucky missionary, Lambert Trouvez, befell the same fate. This was due to the ban on Christianity promulgated in 1587.


Float with Belgian tapestry at Gion festival – blog.goo.ne.jp/kenken1948

Flemish art, mainly inspired by religious figures, reached Japan at an early stage. During the sixteenth century, copper engravings and such were sent to Japan and China as a visual means of spreading Christianity. For example, some Brussels tapestries dating from that period are still used today to decorate the floats at the Gion festival in Kyoto.

During the “splendid isolation” (sakoku 鎖国, ca. 1633-1853) period, the Low Countries (including The Netherlands and Belgium of today) was the sole Western country Japan maintained a relationship with. [Check out my post on Jacob de Zoet if you want to know more about this topic!] Via the VOC (East India Company) various books written in Dutch or Latin were imported and exerted considerable influence as new sources of knowledge on technology, medicines etc. In order to understand the members of the VOC residing on the island of Dejima, and read the books they brought along, the Japanese started to learn Dutch (the so-called rangaku 蘭学, “Dutch learning”).

13293122_10208766063484840_1783271670_nOne work that played a crucial role in the development of rangaku is the Cruydt-Boeck (“herbal book”, 1554) by Rembert Dodoens, a botanist and physician from Mechelen. Shogun Tokugawa Yoshimune (r. 1716-1853) was curious about its contents and ordered a translation. Problem: no one could read Dutch well enough. It took ten years to offer the shogun some sort of summary, and the complete translation in Japanese was ready only two hundred years after the original publication date. Nevertheless, its translation laid the groundwork for a flourishing study of Dutch in the first half of the nineteenth century. We know, for example, that Hiraga Gennai was an avid collector of Dutch works such as Dodoens’s.

201933Vice-versa, the enormous influence of Japan on Belgium during the late nineteenth century can not be overlooked. The treaty of 1866 set in motion the cultural exchange we now call “japonisme/Japonism”. The Belgian bourgeoisie and nouveaux riches became obsessed with Japanese fine arts and decorative arts, such as fans, kimono, paintings, woodcut prints, nature motifs, ceramics, textiles etc. The VOC had imported Japanese objects as curiosities before, but these objets d’art really became fashionable around the 1880s. International exhibitions played an important part in the diffusion of Japanese culture, as did  the magazine Le Japon Artistique by art dealer Siegfried Bing.

The impact of Japanese art is visible in neo-impressionism, decorative art, symbolism and Art Nouveau. Examples of Belgian artists influenced by Japonism are Théo Van Rysselberghe, Fernand Khnopff, James Ensor, Alfred Stevens (pictures below), Henri Van de Velde and Victor Horta. [A Dutch example is Vincent Van Gogh, post here.] They were attracted by elements such as simplicity, two-dimensionality and asymmetry. In short, a style completely different from traditional Western painting. Japanese elements are also present in fin de siècle literature for example the work of the Destrée brothers, Max Elskamp or Émile Verhaeren. Nevertheless, there is the critique that artists influenced by Japonism hardly made any distinction with chinoiserie and had a rather superficial idea of Japanese arts.

Inversely, there were also Japanese artists influenced by their visit to Belgium. The poet Kaneko Mitsuharu and European-style painter Kojima Torajirō, for example. The former read work of Flemish authors and interacted with the Belgian artistic society during his stay in Brussels. The latter’s work, as you can see below, is obviously influenced by pointillism or neo-impressionism (luminism in Belgium). Kojima studied in Ghent and was acquainted with Emile Claus. Furthermore, he brought many European works back home. Nowadays, these are displayed at the Ohara museum of art in Kurashiki, the oldest museum featuring Western art in Japan.


Japanese tower in Brussels. – picture by author

Other things that indicate a link between Japan and Belgium are 1) the Japanese tower in Brussels. King Leopold II had the plan to establish a district in North East Brussels full of majestic buildings from different cultures. Besides a Chinese pavilion, he required the building of a Japanese tower. Although the bottom part was a piece from the 1900 world exhibition in Paris, the rest of it was designed by Belgian and French architects. Hence, the tower is far from an accurate representation of a pagoda. The number of roofs, the structure and the interior design are way off the mark. It is more a reflection of how the West saw Japan than a real effort to understand Japanese culture. What is more, King Leopold lost all interest in the tower once it was completed. 2) there is a second Manneken Pis, the iconic statue of a urinating boy, in  Tokushima. The statue was a gift from the Belgian embassy. But that is not the only replica: apparently there is also a Manneken Pis in Itami, Hamamatsu and Tokyo.

Concerning diplomacy, bilateral relations intensified during the 1960s after a difficult start in the postwar period. Japanese companies sought access to the European market for investments. Nowadays, Belgium’s most important export product to Japan is pharmaceuticals, while Japan mainly exports cars to Belgium and Europe in general. It is also known that there are close ties between the imperial Japanese family and the Belgian royal family. Both families frequently make official or private visits, for example in the vintage photograph below.

1992 royal imperial family

1992. © Collection of queen Fabiola – more pictures on royalementblog.blogspot.be/search/label/Japon [in French]

Although I would love to go into more detail about this fascinating topic, I fear this post might become too long. In case you would like to know more, check out the referenced materials!


Japanese Poetry and Nature


Sakura-themed coffee I enjoyed earlier this spring in Japan.

Japanese culture is often said to have a special connection with nature. Japanese aesthetics are therefore characterized by this “traditional love of nature”[1]. It is true that Japanese people, young and old, participate in several festivals and annual observances celebrating the beauty of nature, such as viewing cherry blossoms in spring or admiring the bright foliage in fall. Daily life also reflects those seasonal associations: cooking, house decorations, clothing and even greetings are systematically adjusted to weather, fauna and flora.  But do the Japanese really have an inherent affinity with nature, more than other people worldwide? For one of my classes at Kobe University, I read parts of Haruo Shirane’s book titled “Japan and the Culture of the Four Seasons: Nature, Literature, and the Arts” (2012). Shirane provides an interesting theory on how this myth was developed throughout Japanese history. In this post, we will look into the connection between nature and poetry.

shiraneThose who know waka 和歌, Japanese poetry, will certainly agree that nature plays a central role in many poems. Haiku 俳句, for example, a still popular poetry genre of poetry nowadays, requires a seasonal word. The connection between nature and poetry is very clear from the fact that “the imagery of Japanese poetry for more than a thousand years was drawn almost exclusively from the natural phenomena of the four seasons[2]”. Hence, nature became a literary device through which human emotions were expressed. To illustrate this, I have tried to closely translate (with the same syllable structure) a tanka 短歌, or short poem, from the Collection of Ten Thousand Leaves (Man’yōshū万葉集), the oldest Japanese poetry anthology. This poem is actually part of a long poem (chōka 長歌) praising Yoshino in spring, a place close to Asuka, the capital at that time.

三吉野乃                            み吉野の                  In fair Yoshino,
象山際乃                            象山の際の              between the Kisa-mountains,
木末尓波                            木末には                  where in the tree tops
幾許毛散和口                    ここだも騒く              you can hear their loud noises,
鳥之聲可聞                        鳥の声かも               the voices of singing birds.
(no. 924 by Yamabe Akihito)

A more poetic translation by Earl Roy Miner[3]:

From among the branches
of the trees upon Mount Kisa’s slopes,
the flocks of birds
fill the lovely vale of Yoshino
with their free and joyous songs.

And a translation by Haruo Shirane[4]:

In beautiful Yoshino’s
Kisa Mountains,
in the tops of the trees
how many, how noisy,
the voices of birds.

Shirane explains that Yoshino symbolized the current political order, but that later on, it would gain fame for its beautiful cherry blossoms and snow scenery. Thus, Yoshino became a place with a poetic essence (utamakura歌枕): only the name of “Yoshino” sufficed to evoke a seasonal association, i.e. spring.


One side of “Folding Screen Depicting Yoshino and Tatsuta”. Although only blossoms and a river are painted on this screen, the scenery can immediately be associated with the poetic place of Yoshino. – 17th century, Museum of Hakone

New for me was Shirane’s argument that the nature embedded in Japanese visual and material culture was not taken directly from primary nature, but was in fact a reference to poetry[5]. In that sense, seasonal associations were originally developed by Japanese poetry and were only then passed onto other genres. As a result, classical paintings with a seasonal theme were not a direct reflection of nature, but rather inspired by the waka tradition that flourished among the urban nobility. Proof is the frequent combination of textual and visual elements, in which an image representing elements from nature or seasonal topics was further embellished by the well-chosen characters from a famous waka poem. From the few characters, a technique called scattered writing (chirashigaki 散書), one could guess what poem was depicted. Examples are clothing designs, paintings and screens, like the one below.


Painted screen depicting flowers and birds of the four seasons, with scattered writing of waka by Shōkadō Shōjō. – 17th century, http://bunka.nii.ac.jp/

During the Heian period (794-1185), poetry was limited to the nobility, and it is therefore somewhat ironic that the people who barely set foot out of their palaces, wrote thousands of poems about the nature they had isolated themselves from. Moreover, inside they were surrounded by seasonal elements and references to nature’s beauty.

Since Heian aristocratic women rarely went out, screen and partition paintings, decorated with small sheets of waka, became, along with the garden, a surrogate for nature. The women often composed poems not on the actual small cuckoo that they heard in the garden, but on the hototogisu painted on a screen painting or partition. – Shirane (2012), 64.

Shirane calls this “secondary nature” (nijiteki shizen 二次的自然), a culturally constructed nature that resembles in no way the real, raw nature. Hence, it should not come as a surprise that classical poetic motifs were strictly codified. A canon of nature images came into existence: all seasonal elements with their own established associations, set combinations and temporal and physical location. For example, April was represented by the lesser cuckoo (hototogisu ホトトギス) and Deutzia flower (unohana卯の花) in the canonized Poems on Flowers and Birds of the Twelve Months (1214) by Fujiwara no Teika (1162-1241). Plants, flowers and animals that did not make the waka shortlist were left unsung for centuries. For example, the only four-legged animal was the deer, associated with loneliness, since birds and insects were more fancied among high-class society.


“Fragment of Rough Sketch of Deer and a Poem” by  Hon’ami Kouetsu – 17th century, Gotoh Museum

Another example is the fact that the most popular seasons to write about were spring and autumn, while in reality summer and winter are the dominant and lengthy seasons. This is perhaps linked to the idea that the Japanese finds identification with nature based on the transience that applies to both man and nature[6]. In that sense, cherry blossoms and bright foliage are representative elements of “fleeting nature” in a “fleeting world”. When poetry diffused to the lower classes during the Edo period, the genre of haikai 俳諧, humorous poetry, gained popularity. Other, even vulgar topics such as cat love (neko-koi 猫恋), were introduced, along with a different perception of the seasons. As a result, new seasonal words were created, greatly varying from the traditional waka-based canon. The focus on nature, however, remained strong, and is still visible in the Japanese culture of today.

In case you would like to know more, I highly recommend the work of Dr. Shirane. Also interesting are two of his presentations on YouTube:


[1] Saito, Yuriko. “The Japanese Appreciation of Nature” in The British Journal of Aesthetics 25, no. 3 (1985): 239–51, p. 239.
[2] Asquith, Pamela J., Arne Kalland, Japan Anthropology Workshop, and Nordic Institute of Asian Studies, eds. Japanese Images of Nature: Cultural Perspectives [Seventh Meeting of the Japan Anthropology Workshop Held in April 1993 in Banff, Alberta]. Repr. Man and Nature in Asia 1. Richmond, Surrey: Curzon, 2004, p. 23.
[3] Miner, Earl Roy. An Introduction to Japanese Court Poetry. 1. publ. 1968. Stanford, Calif: Stanford Univ. Press, 1975, p. 68.
[4] Shirane, Haruo, ed. Traditional Japanese Literature: An Anthology, Beginnings to 1600. Translations from the Asian Classics. New York ;Chichester: Columbia University Press, 2008, p. 92-93.
[5] Shirane, Haruo (2012). Japan and the Culture of the Four Seasons: Nature, Literature, and the Arts. New York: Columbia University Press, p. 57.
[6] Saito, The Japanese Appreciation of Nature, p. 248.

Anthropomorphism in Japanese Culture

japan anthropomorphism nippakuAnthropomorphism, or “the attribution of human characteristics or behaviour to a god, animal, or object” (Oxford Dictionary), is a cultural phenomenon that can be observed throughout history all around the world. The Old Egyptians depicted their gods as animals, Aesop set the trend of moralizing animal fables and several Native North American tribes’ share the tradition of totemism. Japan as well, has a rich history of anthropomorphism, gijinka (擬人化)  or gijinhō (擬人法) in Japanese.


Cute flyer from my university

It is remarkable, however, to what extent anthropomorphic objects and animals are integrated into Japanese society. Due to their enormous popularity, everyday life in Japan cannot be imagined without  these “mascots” and other forms of anthropomorphism. Take for example the cute mascots every company and institution creates to sell products or promote services. Because a mascot should represent the best qualities of the product its company has to offer, it has to be unique, eye-catching and above all, kawaii (cute 可愛い). For example, the mascot of Sato Pharmaceutical is an elephant, because in Japanese culture this animal symbolizes a long life. Another example is the mascot of my university here in Japan, Kobe University. The main campus is situated on Mount Rokko, where you can often spot wild boars (I met one once! And fled.) and the University is therefore represented by a wild boar piglet (uribō 瓜坊).

Minister Hatoyama as Saiban'inko.

Minister Kunio Hatoyama as Saiban’inko.

Without doubt, these kind of mascots would be considered childish and highly unprofessional in the West. In Japan, on the contrary, not having a mascot would be like a huge missed sales or advertising opportunity. Mascots are a way of familiarizing the public with a certain product, company or service. Because of their cuteness, human characteristics and approachability, people will feel an emotional connection with these mascots. Not only animals, but also lifeless objects and even concepts are strategically transformed into huggable human-like creatures and given cute names, referring to what they stand for. The local public transport in Japan is often represented by an anthropomorphic vehicle, for example. Even prefectures have their own mascot, resembling a specific historic or cultural aspect of the prefecture in question. Also, institutions who should be taken very serious, like the police or the government, rely on mascots to appeal to Japanese people of every age. For example, the introduction of the new jury system to the public in Japan, is smoothed by the appearance of Saiban’inko the parakeet (saiban’in 裁判員 means lay judge; inko インコis Japanese for parakeet). Japanese Minister of Justice once made an appearance on TV wearing a Saiban’inko costume to promote the new system of trial by jury.

This kind of customed mascot character is called a yuru-kyara ゆるキャラ. Because of their huge popularity in Japan, there is a countless number of yuru-kyara, all with their own way of walking, talking and dancing. There is even a specialized school where you can master the mascot art: the Choko group mascot school in Tokyo provides specific training for aspiring mascots. In short, it is not at all unlikely in Japan to run into mascots at matsuri (festivals 祭り), tourist attractions, on shopping streets and in extreme cases, at events like the one in the following video (World Character Summit):

From Animism to Anime

Anthropomorphism is a crucial concept in Shintoism 神道, Japan’s ethnic religion. Shintoists believe that everything – the universe itself included – has a soul or spirit. Based on this belief, called animism, the Japanese regard animals and nature as the messengers of the gods. The Kojiki 古事記 (“Records of Ancient Matters”, 712) contains a few stories in which animals speak, think and act like humans. Next to that, the transformation of foxes and raccoon dogs into human beings is a returning topic in Japanese folklore. Not only animals and elements in nature, but also artificial objects can obtain a soul. These animated objects are named tsukumogami 付喪神, after the work tsukumogami emaki 付喪 神絵巻 from the Muromachi period (1333-1573). This work contains drawings of old household items that gain a soul after 99 years and change into ghosts.


Tsukimogami in Hyakki Yakko Emaki 百鬼夜行絵巻

With the introduction of Buddhism in Japan, animals were also associated with reincarnation. Despite the fact that this kind of reincarnation was considered a punishment, animals were able to attain nirvana which was still in line with the animistic Shinto theories. The Buddhist work Nihon Ryōiki from the Heian Period (794-1185), for example, mentions various animals with anthropomorphic characteristics. During the Japanese Middle Ages (1185-1603), animal stories became more popular than ever, and with the development of Noh theater 能 and Kyōgen 狂言 (Noh comedy) in particular, animals who behaved like people were put on stage regularly. Sometimes even plants played a lead role. Just like animals, plants were attributed certain qualities or characteristics. The iris, for example, represents a young women while an old woman is impersonated by the willow.

The Scrolls of Frolicking Animals and Humans (鳥獣人物戯画 Chōjū-jinbutsu-giga) are four scrolls in monochrome drawing style depicting various scenes of daily life. The scrolls date back to the 12th of 13th century. This work is nowadays known as the first manga, but was already popular back then. The scrolls are an excellent example of anthropomorphism in Medieval Japan. There are animals preparing for a matsuri, horseback riding, holding a Buddhist funeral, making jokes, bathing in the river, playing a game and so on. The animals depicted include animals well-known to the Japanese public as well as exotic animals and even mythological creatures. Although the caricatures are a slightly ironic representation of typical human activities, they are not meant to moralize the reader.


Scrolls of Frolicking Animals and Humans (鳥獣人物戯画), first scroll. A stealing monkey is being chased by rabbits and frogs with sticks.

During the Edo Period (1603-1868) and after that, stories and pictures like ukiyōe 浮世絵(woodblock prints) featuring anthropomorphism became increasingly popular. Cats, mice and insects were the animals most often depicted as human beings. From the moment Japan opened up his borders in the nineteenth century, the introduction of foreign anthropomorphic figures soon followed. In the ’50s and ’60s American comics and Disney’s animation movies heavily influenced the Japanese manga scene. Animals and objects were given large eyes and a head that was proportionally too big for their small body, features contributing to their cuteness.



Today, this trend is called “moe anthropomorphism”. Moe 萌え refers to one’s strong affection towards a certain character (kyara キャラ). One of the more advanced forms of moe anthropomorphism is kemonomimi 獣耳(“beast ears”): the depiction of a cute, human-shaped character with animal ears and a tail. Apart from the many official moe characters, these kind of characters are usually created by amateurs and fans and circulate freely on the internet. The result is always cute and innocent, but the animated concept itself often is not. There exists, for example, a moe character to depict terrorist organisation ISIS.

Anthropomorphism explained 

Why is anthropomorphism so prevalent in Japanese culture? The reason remains unclear but scholars have already formulated some plausible explanations. 1) Anthropomorphism in Japan is heavily influenced by animistic Shintoism. The Japanese ancestors shaped objects and animals like human beings in order to understand the world around them. In the same way that monotheistic cultures attribute incomprehensible phenomena to their god, Shintoism describes these phenomena as having a soul. 2) Another explanation is based on the Japanese psychology. Japanese people tend to internalize their own feelings because they want to express sympathy towards the other, rather than stating their own opinion. Doing so, the relationship can continue in harmony, and the personal feelings of the other are not expressed but only assumed. In the same way, the emotions animals and even inanimate objects cannot express are being assumed and interpreted in a human way. 3) Thirdly, there is a social explanation.  When communication as a basic need is not being fulfilled, the tendency to interact with a human-shaped object becomes stronger. This could probably explain the enormous popularity of characters among socially withdrawn internet users like hikikomori 引き篭もり.  4) And last but not least, anthropomorphism would appear to have a positive effect on our efficiency. We consider predictable operations as human and expect the same from anthropomorphic objects. When these objects do so, it leads to peace of mind and improves our efficiency. This is for example the reason why Japanese people prefer android robots.

Fun Facts 


  • 平野重雄, 関口相三, 奥坂一也, and 喜瀬晋. “モノ創りにおける 擬人化と縮み志向の文化について.” In 日本設計工学会. 山形大学, 2014.
  • 高畑、勲.十二世紀のアニメーション―国宝絵巻物に見る映画的・アニメ的なるもの―.初版.東京:徳間書店、スタジオジブリ・カンパニー、1999.
  • 榊原、悟.江戸絵画万華鏡―戯画の系譜.初版.大江戸カルチャーブックス. 京都:青幻舎、2007.
  • Imuhata, Hachiri, and Tachibana Calamansie. “KEMONO: The History of Japanese Anthropomorphic Culture.” 2013. Prezi
  • Wikipedia.org