Nagayo Sensai

2023/07/10

Image: Collection of the Fukuzawa Memorial Center for Modern Japanese Studies

Fukuzawa Yukichi and Nagayo Sensai first met at Ogata Koan's Tekijuku. Fukuzawa entered Tekijuku in March 1855 at the age of 20, while Nagayo had entered the previous year at the age of 16. They would go on to spend their youth together at Tekijuku until Fukuzawa left for Edo in 1858.

This relationship is also recorded in "The Autobiography of Fukuzawa Yukichi." It describes a time when Fukuzawa went flower viewing in Momoyama with his fellow students from Tekijuku.

"Suddenly looking to the west, I saw a great fire south of Osaka. (...) This was serious. Just that day, Nagayo Sensai had gone to see a play at Dotonbori. We flower-viewing companions had no personal stake in the Osaka fire, so it didn't matter to us whether it burned or not, but Nagayo was there. We worried that Nagayo might burn to death. Thinking we had to rescue him no matter what, we ran the two or three ri from Momoyama to Osaka. When we reached Dotonbori, it had already burned down, (...) and though we worried about what happened to Nagayo, there was no way to search for him. Soon the sun set and it became night."

Ishikawa Mikiaki, the author of "The Life of Fukuzawa Yukichi," wrote of their relationship: "Nagayo Sensai was his oldest close friend since the Ogata Juku days, and their intimacy was such that it would not be an exaggeration to call them brothers or relatives." Fukuzawa himself used the term "close friend," and the two were indeed recognized by themselves and others as such.

After studying at Tekijuku, Nagayo moved to Nagasaki in 1861 to study Western medical sciences under Pompe van Meerdervoort. After returning to his hometown by clan order to serve as a physician for the Omura Domain, he returned to Nagasaki to audit lectures and clinical practice by Mansvelt. After serving as the head of the Nagasaki Medical School, he was called to Tokyo in 1871 and became involved in Japan's medical administration.

Nagayo recalled his time accompanying the Iwakura Mission to inspect America and Europe starting that same year in his autobiography, "Shoko Shishi," as follows:

"At first, I simply understood words like sanitary, health, and Gesundheitspflege literally and did not take them deeply to heart. However, as the investigation progressed, I realized it was not merely the simple meaning of protecting health, (...) and I discovered that there was a special administrative organization responsible for the health protection of the general public. This was a system that drew its source from medical sciences and encompassed various fields such as physics, chemistry, engineering, meteorology, and statistics to operate them politically to eliminate hazards to human life and fulfill the welfare of the state. It covered everything from the prevention of epidemics and infectious diseases to the relief of the poor, cleanliness of the land, management of water and sewage, and building codes for city houses, to the regulation of drugs, dyes, and food and drink—encompassing all matters great and small related to human life to form a single administrative department, (...) becoming an important organ of national administration."

He wrote that "since the matter of health protection did not even have a name in the East and was a completely innovative undertaking," he "secretly resolved to take this on as his life's work."

Upon returning to Japan in 1873, Nagayo was appointed as the Officer of the newly established Medical Affairs Bureau in the Ministry of Education. In 1875, the functions were moved to the Ministry of Home Affairs, where he became the Sanitary Officer and devoted himself to laying the foundations of Japan's medical and public health administration. Incidentally, Nagayo was the first to use the word "eisei" (hygiene/sanitation). He said, "When drafting the medical system, I thought of using words like 'kenko' (health) or 'hoken' (preservation of health) as direct translations of the original terms, but they felt too blunt and uninteresting. While searching for a more appropriate term, I recalled and used a word from the 'Zhuangzi,' though the meaning was different."

Nagayo also worked hard to enlighten the public about the concept of hygiene. An example of this was the establishment of the Great Japan Private Sanitary Association. Cholera outbreaks recurred from 1877, but as the government strengthened its forceful response, including isolation, the public not only hid cases but began to show a rejection of everything related to hygiene. Therefore, the association was established in 1883 with the aim of spreading the ideas and methods of hygiene among the people so that the government and the public could harmonize and cooperate.

In 1891, Nagayo retired as Sanitary Officer due to frequent illness. Because Fukuzawa and Nagayo "visited each other so closely that they could be called brothers or relatives" (recollection of the third son, Matao Nagayo), Fukuzawa well understood the hardships of being the Sanitary Officer. Regarding this, Fukuzawa wrote in September 1898 in "Celebrating the 60th Birthday of Mr. Nagayo Sensai" as follows:

Some people say Nagayo is "a man who soared in the political world and achieved fame and fortune," but if he simply sought fame and fortune, he could have amassed great wealth by opening his own practice. Nagayo's efforts in the official world were because "he could not suppress his initial resolution to reform medical practices for the sake of Japan, and believing in the necessity of using the power of the government to execute that reform, he dared to decide his course of action." Fukuzawa further noted that improving medical affairs among the "vulgar crowd" of the official world was "no different from climbing a mountain while riding a pig, and I often secretly surmised that everything must have been contrary to his wishes."

Fukuzawa and Nagayo cooperated in various situations for the sake of Japanese medicine. When Fukuzawa passed away on February 3, 1901, Nagayo lamented as follows:

"For over forty years, I have always borne the debt of his guidance and mutual encouragement, and our friendship grew deeper with the years. I do not weep for the world alone; I also grieve the loss of an old friend who is hard to find. Moreover, I cannot suppress my deep regret, as I owe much to this master of our medical world."

He then specifically went on to mention the support for Kitasato Shibasaburo.

Kitasato first studied medicine at Kumamoto Medical School, where he was guided by Mansvelt. He then moved to study at Tokyo Medical School, where Nagayo was the principal, and found employment at the Ministry of Home Affairs Sanitary Bureau. It was as if he were following in Nagayo's footsteps, and Nagayo supported Kitasato personally.

Dispatched by the Sanitary Bureau, Kitasato went to Berlin, Germany, in 1886 and immersed himself in research under Robert Koch. Kitasato, who achieved world-renowned results such as the anaerobic cultivation of tetanus bacilli and the development of immune serum therapy, returned to Japan in May 1892. Since Nagayo was the one who worked hard to extend Kitasato's period of study abroad, Nagayo rejoiced in Kitasato's achievements as if they were his own.

However, the Japanese academic world was cold. Although he had turned down invitations from European and American universities and research institutes to return home, he was unable to start his research in Japan. A pained Nagayo consulted Fukuzawa.

Fukuzawa immediately established the Institute for Study of Infectious Diseases on leased land near Shiba Onarimon, which he had prepared for his children, with the cooperation of Morimura Ichizaemon. Soon after, the institute became a laboratory for the aforementioned Great Japan Private Sanitary Association, where Nagayo served as vice president, and a system was established to expand it as a project of the association while receiving national subsidies.

Furthermore, Fukuzawa and Nagayo discussed tuberculosis, for which there was no cure at the time. Based on Nagayo's proposal, Fukuzawa established the Tsukushigaoka Yojoen the following year, with Kitasato as the director and Nagayo as an advisor. It was a specialized hospital for tuberculosis built on land owned by Fukuzawa in Shirokane Sanko-cho, where Fukuzawa himself directed the purchase of adjacent land, the design and construction of the wards, and the establishment of the management system.

Many patients gathered at Yojoen, drawn by Kitasato's reputation. Administrative Director Shigeaki Tabata recalled the scene: "The gate was suddenly crowded like a marketplace, and the sixty-odd hospital rooms were always full, leading to expansion after expansion, and it remained constantly full."

In 1914, after both Fukuzawa and Nagayo had passed away, when the Institute for Study of Infectious Diseases was transferred from the Ministry of Home Affairs to the Ministry of Education and made an affiliate of Tokyo Imperial University, Kitasato and his staff resolutely resigned en masse and immediately established the Kitasato Institute on the site of Yojoen through their own efforts. This was made possible by Yojoen and its profits. Truly, the two men saved Kitasato even after their deaths.

I would like to introduce another little-known collaboration between the two. That is the republication of "Rangaku Kotohajime" (The Beginnings of Dutch Studies).

"Rangaku Kotohajime," which told of the hardships of translating and publishing "Kaitai Shinsho" (New Text on Anatomy), had become a phantom book by the end of the Edo period. However, during the Keio era, Kanda Takahira happened to find a manuscript at a street stall in Hongo, and Fukuzawa read it thoroughly with his fellow Western scholars. Fukuzawa, believing that publishing was the best way to preserve it, consulted with Sugita Genpaku's great-grandson Renkyo and published it in 1869.

When Nagayo moved from Nagasaki to Tokyo in 1871, he immediately visited Fukuzawa, and the book they read together through the night was "Rangaku Kotohajime." Nagayo spoke of that time in 1898 in "Keio Gijuku Gakuho," the predecessor of Mita-hyoron (official monthly journal published by Keio University Press).

"Later, in the early years of Meiji, when I went to Tokyo and visited Mr. Fukuzawa, our conversation turned to the sages of the past, and he showed me a copy of 'Rangaku Kotohajime.' I stayed overnight and read it through; I was moved by the perseverance of their spirit in every chapter, and as I recalled their hardships at the time, I could not suppress my shame and gratitude, and before I knew it, I was overcome with emotion at dawn."

Nagayo carried the emotions of reading it with Fukuzawa throughout his life, and upon holding the 1st Japan Medical Congress in 1890, he decided to reprint "Rangaku Kotohajime" in commemoration.

In a letter to Nagayo regarding this reprint, Fukuzawa wrote: "Truly, this book has captivated people for many years, and even today as I write this, I cannot help but be moved. I write this while wiping away tears. I hope the reprint will be numerous and distributed throughout the country."

Fukuzawa cooperated by writing the "Preface to the Reprint of Rangaku Kotohajime" (included in "The Collected Works of Fukuzawa Yukichi, Vol. 5"). Below is an excerpt:

"Facing the book 'Tafel Anatomia' was like setting out on the great ocean in a ship without a rudder; we were simply lost and utterly amazed... regarding the following passage, every time we read this, we perceive the hardships of our predecessors, are surprised by their fortitude, and are moved by their sincerity and heart; there is no one who does not weep with extreme emotion."

Since Nagayo was "sickly by nature" ("Shoko Shishi"), Fukuzawa's concern was great. When Nagayo retired as Sanitary Officer, Fukuzawa once expressed his feelings. In a letter to Okamoto Sadayoshi, Fukuzawa wrote: "We have associated like brothers of the same flesh and blood for over thirty years, sharing any private matter with each other, and I have always worried about Nagayo's sickly body, (...) if by any chance he were to die today, it would be truly unbearable for me."

In reality, after more than 45 years of close friendship, Nagayo passed away in 1902, the year after Fukuzawa's death.