Dr. Simmons

2019/10/28

Image: Simmons (Keio Institute for Fukuzawa Studies collection)

On February 19, 1889, Duane B. Simmons, an American physician who had contributed to Japanese medicine since arriving at the port of Kanagawa in November 1859, passed away. On the night of the 27th, at a memorial service, Fukuzawa delivered a eulogy, stating, "Our friendship has been the deepest for over twenty years, to the point where we were closer than brothers of the same blood," and concluded as follows.

"Thus, the Doctor was not only a close friend to all of you present, but a beneficial friend to our nation of Japan; the ways in which he benefited our society, both directly and indirectly over those 30 years, are too numerous to mention. Now, we have lost a close friend in our private lives, and the nation of Japan has lost a national friend in its public life."

In May 1870, Fukuzawa contracted typhus. He remained unconscious for 18 days, and his condition at the time was such that he later remarked, "The sounds I heard in a dreamlike state during my illness—the temple bells, steam whistles, or the noise of construction—stayed in my ears for two or three years, and hearing them would make me feel strange."

According to Fukuzawa's memorial public speaking, he was in an "extremely dangerous condition, and although his doctor friends and associates exerted great effort and concern, they reached a point where they were hesitant and undecided about the treatment; thus, they decided to hire Dr. Simmons from Yokohama" to request an examination. Souetsu Kumagawa, who was one of the school physicians for the Juku, served as the primary doctor and invited prominent physicians for their opinions, but Tokujirō Obata, who stayed by the bedside throughout, was perplexed because their opinions differed. Therefore, when Jinzaburo Obata visited Dr. Hepburn in Yokohama to ask for an examination, it was Simmons who was recommended by Hepburn. Following Simmons' instructions for medication and nutrition, Fukuzawa finally began to recover.

Simmons originally came to Japan as a missionary, but soon opened a clinic in the foreign settlement of Yokohama to focus on his work as a physician. He then traveled to European countries to further study medical sciences and had only recently returned to Japan.

Details regarding Simmons' activities in Yokohama can be found in Yasuo Arai's "Dr. Simmons: In Search of the Origins of Yokohama Medicine" and other works.

Simmons had a broad perspective and wide interests, and was active not only in clinical practice but also in the proposal and implementation of public health measures. For example, in 1872, he submitted a proposal for "Boyo-ho" (Prevention of Illness), or infectious disease prevention measures, to the Governor of Kanagawa Prefecture. With the increase in travel to and from overseas, infectious diseases were also being brought in. Therefore, a quarantine system was necessary. Furthermore, the population of Yokohama was growing rapidly, and Japanese people were crowded into areas built on reclaimed swampland, necessitating improvements in sanitary conditions. Thus, along with that system, he requested the establishment of a "Boyo-kyoku" (Prevention Bureau) as the corresponding department. Furthermore, as Western medical sciences spread, counterfeit medicines began to appear, so he also proposed a system to inspect and regulate drugs. When cholera broke out repeatedly in the 1880s, he was active in stopping the epidemic in Yokohama.

Simmons also worked with the physicians around Fukuzawa. One activity in infectious disease prevention was the 1872 publication of "Baidoku Shoso" regarding syphilis. This was a transcription by Ryokun Kondo of lectures given by Simmons, reviewed by Toan Matsuyama; both Kondo and Matsuyama were physicians who had studied English studies at the Juku.

In terms of clinical care, Simmons provided outpatient treatment once a week at a temporary hospital established in the spring of 1871 to bring a hospital to Yokohama. Those who worked hard to open the hospital included Ariteki Hayashi, who had studied English studies at the Juku and founded the Maruya Company (later Maruzen), and Toan Matsuyama served as the "Chief Medical Officer." The temporary hospital was soon destroyed by a fire from the neighborhood, but its successor, the Juzen Hospital (the predecessor of today's Yokohama City University Hospital), was created through the efforts of Kanagawa Prefecture Vice-Governor Taku Oie and others, and Simmons played a central role there.

An article in the Yomiuri Shimbun illustrates Simmons' reputation at the time.

"The American doctor named Simmons in Yokohama has lived in Japan for a long time, understands the language of this country well, knows the local conditions, and pays attention to everything from the way Japanese people work to their skeletal structure; because he prescribes the amount of medicine and the method of recuperation to be suitable for Japanese people, I believe one is safe in the hands of such a person."

Furthermore, it is recorded that because patients from Tokyo, both Japanese and foreign, were seeking his care, he began seeing patients in Tokyo two days a week, making house calls for serious illnesses and providing treatment as charity for the poor. This practice in Tokyo was also conducted at the home of Souetsu Kumagawa, and later at the Kyoritsu Hospital established by Matsuyama and Kumagawa.

As medical education centered on German medicine began in Japan, the Keio University Medical School was established on the Mita Hilltop Square in 1873, led by Matsuyama, to provide British and American-style medical education. Practical clinical education was conducted at Sonseido Hospital (later Matsuyama Hospital), which Matsuyama established with Gentan Sugita at the foot of Mita Hill, and those responsible for it were Matsuyama, Sugita, Kumagawa, and Simmons.

Although the Medical School closed in 1880, the following year, Matsuyama and other physicians who had run the school formed the "Sei-i-kai" with Kanehiro Takaki and others who had returned from studying in Britain. This is the origin of the later Tokyo Jikei University School of Medicine. The memorial service mentioned at the beginning was held by the Sei-i-kai, meaning the physicians of the Sei-i-kai and Simmons had a close relationship.

At the end of 1881, Simmons returned to America via Asia and Europe. En route, he wrote to Fukuzawa from India, expressing his deep affection for Japan: "I sincerely regret that I could not take your hand and make this pleasant journey together. Japan is a second home to me. I hope you can imagine the turmoil in my heart as I leave the friends of this home behind and part ways for a distance."

However, their friendship did not cease after his return. This was because Fukuzawa's eldest son, Ichitaro, and second son, Sutejiro, went to study in America in 1883. Ichitaro in particular was physically weak and had an introverted personality, so Fukuzawa's parental concern was great. Simmons was someone he could speak frankly with about those concerns and trust completely.

Regarding the study abroad, Fukuzawa wrote to Simmons, "Naturally, going to America, I know you, my close friend, are in that country; even if I do not trouble you with special requests, it is my wish that you generally keep them in your heart," and asked for advice regarding their health and conduct. He also wrote, "The bodies of Japanese youths seem weak compared to Americans. Therefore, rather than losing health by seeking a quick completion of studies, I would rather they spend four or five years."

Furthermore, Simmons' name frequently appears in letters to Ichitaro and Sutejiro, sometimes telling them to "repeatedly rely on Mr. Simmons regarding matters of physical health," and cautioning them, "I hear Mr. Simmons is prone to lecturing; this cannot be helped. However, he is a truly kind person, so you should value that friendship and, as youths, it is best not to oppose him fruitlessly." This was likely a caution following a letter containing complaints about Simmons' advice.

Simmons arrived in Japan again with his mother in December 1886. Simmons' return was something Fukuzawa looked forward to with joy, though he also felt anxiety thinking of his two children remaining in America. Fukuzawa was remarkably kind to Simmons, a situation described in detail by Raita Fujiyama. Raita, who would later be active as a businessman, had just graduated from the Juku at this time; when he told Fukuzawa of his desire to go abroad, he was advised that it would be better after improving his English, and for that purpose, it would be good to live in Simmons' house and help with translation.

Raita later recalled Simmons' deep filial devotion to his mother.

"That point was very much to Yukichi Fukuzawa's liking; whenever he had spare time, he would invite Dr. Simmons and his mother to his residence and have his children perform various talents for them. The consideration Fukuzawa showed to the Simmons mother and son was so thorough that even close relatives or brothers could hardly have matched it."

Fukuzawa built a house on Mita Hilltop Square for the Simmons mother and son to live in. Looking at letters to Raita, who was accompanying Fukuzawa on a summer retreat in Nikko while the house was under construction, one can see Fukuzawa's face as he joyfully layered small details and innovations, combining Western and Japanese styles to make it comfortable to live in.

Simmons retired from medical practice and intended to study the history of Oriental civilization, centered on Japan, and proceeded to collect materials. Also, concerned about the superficial Westernization of the time, he energetically wrote editorials criticizing the tendency to destroy even Japan's excellent customs and habits, which Fukuzawa published in the Jiji Shinpo.

Fukuzawa praised the content and "fairness of vision" of Simmons' editorials, noting that while he loved Japan, he "did not merely praise Japan recklessly; if there were weaknesses in our society that should be refuted, he would strike them down without hesitation." Simmons' criticism of the low status of women, such as the vice of keeping concubines in Japan's upper class, was described by Fukuzawa as "administering a sharp warning to Japanese society."

However, Simmons' health began to fail in the summer of 1888, and he grew weak. Despite Fukuzawa's morning and evening visits and treatment by his close friend, the German physician Dr. Baelz, he passed away on February 19, 1889. He was 57 years old.

Fukuzawa grieved the death of his close friend, worried for the nearly 80-year-old mother left behind, and lamented that Simmons' writings remained unfinished as a "regret for a thousand years." Fukuzawa attended the funeral at the Union Church in the Yokohama settlement, and after the service, he headed to the Foreign General Cemetery while guarding the side of the coffin along with Baelz, Matsuyama, Kumagawa, and other physicians.

The mother who was left behind returned to the United States in May of the same year, accompanied by Knapp, who had been sent to Japan by the American Unitarian Association and was returning home. Furthermore, the materials collected by Simmons were later compiled and published by Wigmore, the chief professor of the Law Department of the college. It was Knapp who exerted effort in recruiting the chief professor for the opening of the college in 1890, but in fact, Simmons' presence was also behind the close relationship between Knapp and Fukuzawa.