Jiǎoqì gàilùn 腳氣概論
General Treatise on Beriberi (Hakusaidō Kakke gairon 博濟堂腳氣概論) by 岡田昌春 (撰)
About the work
The Jiǎoqì gàilùn 腳氣概論 (Japanese Kakke gairon), full title Bójitāng Jiǎoqì gàilùn 博濟堂腳氣概論 (Hakusaidō Kakke gairon), is the institutional clinical manual of the Hakusaidō 博濟堂 beriberi hospital in Tokyo, the imperially-chartered Meiji-government experimental hospital established in the 8th month of Meiji 11 = 1878 to test kanpō treatment of the early-Meiji urban beriberi (kakke 腳氣) epidemic. The work is independently catalogued in the hxwd series as KR3eh054 in the present knowledgebase. Its catalog-listed author 岡田昌春 et al. signs the preface jointly with Kiyokawa Gendō 清川玄道 清川玄道 in Meiji 12 / 5 = May 1879; the senior physician (院長) is the Edo-trained kanpō clinician Asada Sōhaku 淺田宗伯 (sobriquet Lìyuán 慄園 Ritsuen).
Abstract
The joint preface of 1879 supplies the foundational facts. The court, prompted by the high mortality of the early-Meiji urban beriberi epidemic, in Meiji 11 / 6 (= 1878.6) chartered a state beriberi hospital; in 8th month of the same year 岡田昌春, Takashima Hisaya 高島久也 (Sukekei 祜啟), Shimojō Tsūshun 下條貞固 (Tōshun 通春), Asada Korenori 淺田惟斆 (Shisei 子誠), Matsuyama Yasutaka 松山挺 (Sukekata 資剛) and other associates jointly opened the Hakusaidō on the site Honryōgaebō 本兩替坊 with Asada Sōhaku as 院長. The preface reports that in its first year the hospital treated some hundreds of patients with severe and life-threatening cases, with mortality of “only about two in a hundred.” The book is the codification of the hospital’s clinical experience.
The fanli 凡例 declares the work to be a practical hospital-protocol manual rather than a comprehensive treatise: for full beriberi taxonomy and detailed formularies the reader is referred to Qiānjīn fāng 千金方, Wàitái mìyào 外臺秘要, Tàipíng shènghuì fāng 聖惠 / Shèngjì zǒnglù 聖濟, and the Japanese Yīxīn fāng 醫心方 and Wàn’ān fāng 萬安方. The internal divisions reorganise beriberi into nine syndromes (分為九道), with attention to seasonal-climatic distinctions (dry vs. damp, urgent vs. slow), and contraindications. Acupuncture and moxibustion are admitted only at the very beginning of onset or in convalescence; external lavage and counter-irritant therapies are explicitly warned against because of observed harm in the hospital’s practice. A short appendix gives women-specific treatment.
The text is securely datable to 1879 by the dated preface and is itself the publication of that year’s experience; the 1879 expanded recension of the Xièyì xīnlùn by Yamada Gyōkō was published in the same season, both episodes of the Meiji-period defense of kanpō against the rising tide of state-sponsored Western biomedicine. The Hakusaidō was itself a deliberate exhibit in that defense: kanpō physicians lobbied for, and obtained, official sanction to demonstrate the empirical efficacy of classical-formula therapy on a measurable scale.
The text was transmitted to China and entered 湯本求真 Tāngběn Qiúzhēn’s Huáng Hàn yīxué cóngshū 皇漢醫學叢書 (Shanghai: Shìjiè Shūjú, 1936), the immediate vector for the hxwd-series text.
Translations and research
No substantial Western-language scholarship of the work specifically located.
- Trambaiolo, Daniel. 2013. “Native and Foreign in Tokugawa Medicine.” Journal of Japanese Studies 39 (2): 299–324 — for the late-Edo / Meiji kanpō context.
- Bay, Alexander R. 2012. Beriberi in Modern Japan: The Making of a National Disease. Rochester: University of Rochester Press — the standard English-language history of Meiji-era beriberi, with extensive treatment of the Hakusaidō and the kanpō / Western medicine rivalry around the disease.
- Tatsukawa Shōji 立川昭二. 1971. Kinsei byōsōshi 近世病草紙. Tokyo: Heibonsha.
Other points of interest
The Hakusaidō was, with the rival Western-medicine Kakke byōin under Naval-Surgeon Takagi Kanehiro 高木兼寛 (whose Royal-Navy-derived clinical experiment eventually established the dietary aetiology of beriberi as a B-vitamin deficiency), the institutional setting of the most consequential Meiji-period kanpō-vs.-biomedicine controlled comparison. Despite the Hakusaidō’s reasonable clinical results within the framework of classical formula prescription, the kakke problem was eventually resolved by Takagi’s and Suzuki’s nutritional science, and the kanpō claim to general clinical authority was correspondingly weakened.