Jiǎoqì gàilùn 腳氣概論
A General Survey of Beriberi by 岡田昌春 (Okada Masaharu, zì Jūkoku 柔克) and 清川玄道 (Kiyokawa Gendō, zì Nenso 念祖)
About the work
The clinical manual of the Hakusaidō 博濟堂, the imperially-chartered Tokyo beriberi (脚気 / 腳氣) hospital that opened in the 8th month of Meiji 11 (August 1878). Compiled jointly by Okada Masaharu and Kiyokawa Gendō (both signatories of the preface, Meiji jūninen go-gatsu = May 1879) under the direction of the hospital’s in-chō 院長 淺田惟常 (Asada Sōhaku 浅田宗伯, hào Ritsuen 慄園). Three other staff kanpō physicians are named as institutional co-compilers in the preface — 高島久也 (Takashima Hisaya, zì Sukekei 祜啟), 下條貞固 (Shimojō Sadakata, zì Michiharu 通春), 淺田惟斆 (Asada Shisei 子誠), and 松山挺 (Matsuyama Sukekata 資剛) — but the preface ascription is to Okada and Kiyokawa only. Asada Ritsuen wrote the institutional postscript (Hakusaidō ki 博濟堂記). The full title on the cover-leaf is Hakusaidō Kakke gairon 博濟堂腳氣概論; the Kanwen iju (kanpō) kanseki hxwd cuts the first three characters.
The text is in literary Sino-Japanese (kanbun). It comprises a long doxographic 統論 (general theory) in roughly thirty short articles, harvesting classical and continental opinion on beriberi (its synonymy with huǎnfēng 緩風, zhòngtuǐ 重膇, zǐyǔ 呰窳, jué 蹶, etc.), its etiology (內因 / 外因, 風毒, 腎虛, 飲氣下流), its differentiation (乾 / 濕, 衝心, 似傷寒), and its prognostic semiology (pulse, colour, complications). The therapeutic part is organized by clinical type: 腳氣痹攣, 腳膝腫痛, 腫滿, 大小便不通, 小腹不仁, 上氣, 嘔逆, 衝心 (the cardiac-attack stage, here described as 險證), and 痿弱. An appendix on 婦人腳氣 quotes the Yangzhou physician 顧世澄 Gù Shìchéng (Yángyī dàquán 瘍醫大全) for the otherwise-rare Qīng diagnostic vocabulary of “gōng jiǎoqì” 公腳氣 / “mǔ jiǎoqì” 母腳氣. Each clinical type is supplied with three to twenty fāngjì, drawn from Jīnguì, Qiānjīn, Wàitái mìyào, Shènghuì, Shèngjì zǒnglù, the Sòng Héjì júfāng (cf. KR3e0033), Sānyīn (cf. KR3e0041), Jǐngyuè quánshū (cf. KR3e0086), plus the Japanese classics 醫心方 Ishinpō (丹波康賴 Tamba no Yasuyori, 984) and 萬安方 Man’an-hō (梶原性全 Kajiwara Shōzen, ca. 1315). Roughly one in four prescriptions is marked 本朝經驗 “indigenously tested,” recording Edo and Meiji formulations including the Sankō tan 三鎮散, Sajitan tan 砂膽散, Tonsui tō 禹水湯, and the Kakke sho 雞鳴散 — the last famously the contemporary kanpō mainstay for jiǎoqì (still standard in kanpō practice today).
Abstract
The text records that beriberi had become a public-health crisis in early-Meiji Japan (“近年腳氣之證最多 … 致橫夭者亦為鮮”), prompting the founding of the Hakusaidō by special imperial 准奏 in 1878. The preface cites a year-one figure of “almost several hundred” patients treated, with a mortality of “only two per hundred.” Within the work, Asada Ritsuen’s postscript records that Takashima had travelled Europe and observed kakke to be absent from European clinical experience (“歐西之人 … 腳氣則絕罔見也, 故歐西醫家亦無有發明焉”), framing the kakke problem as a specifically East-Asian disease for which Sino-Japanese kanpō held the only systematic literature. (Beriberi was in fact a thiamine-deficiency disease driven by the rapid spread of polished white rice as a dietary staple in late-Tokugawa and early-Meiji Japan, particularly in urban garrisons; this etiology was not understood until the work of Eijkman, Suzuki Umetarō, and Funk between 1897 and 1912. The Hakusaidō treatises are therefore among the most articulate documents of the kanpō response immediately before the nutritional explanation.)
The Japanese-specific historical sections are particularly valuable: Okada traces the disease in Japan to 藤原緒嗣 Fujiwara no Otsugu’s resignation memorial of Daidō 3 (808), recorded in the Nihon kōki; cites Tamba no Yasuyori’s separate 腳氣 chapter in the Ishinpō (984); and observes a long Sengoku-period eclipse followed by an early-modern resurgence. He follows 香川景與 Kagawa Shukugen in dating the current Japanese kakke surge to the Hōreki era (1751–1764).
The catalog meta lists only “岡田昌春等”; the preface confirms Kiyokawa Gendō as co-author rather than mere editor, and he is therefore added to the persons list.
Translations and research
- Alexander R. Bay, Beriberi in Modern Japan: The Making of a National Disease. Rochester, NY: University of Rochester Press, 2012 — the definitive English-language history of the kakke problem in late-Tokugawa and Meiji Japan; treats the Hakusaidō episode and Asada Sōhaku’s response directly.
- Hoi-eun Kim, Doctors of Empire: Medical and Cultural Encounters Between Imperial Germany and Meiji Japan. Toronto: University of Toronto Press, 2014, ch. 2.
- Tatsukawa Shōji 立川昭二, Edo byōsōshi 江戸病草紙. Tokyo: Chikuma shobō, 1979, on kakke in Edo Japan.
- Yamashita Seizō 山下政三, Kakke no rekishi: Bitamin hakken izen 脚気の歴史: ビタミン発見以前. Tokyo: Tokyo Daigaku Shuppan-kai, 1983.
- No standalone English translation located.
Other points of interest
The Hakusaidō was, jointly with the Kakke Byōin 脚氣病院 founded by Tōkyō Daigaku Igakubu the same year, the test-bed for the great late-Meiji kanpō vs. yō-i (Western-medical) public confrontation over beriberi etiology and treatment. The present manual articulates the kanpō position. Within five years the Imperial Japanese Navy (under Takaki Kanehiro 高木兼寛) would empirically demonstrate that beriberi could be prevented by dietary modification, and within a generation Suzuki Umetarō would isolate thiamine. The Asada-school kakke prescriptions documented here therefore stand as one of the last serious essays in a now-superseded paradigm — but several (notably Jīmíng sǎn 雞鳴散 and Bāwèi dìHuáng wán 八味地黃丸) remain in current Japanese and Chinese kakke / lower-limb-edema practice.