[Special Feature: Infectious Diseases in History] Lessons on Thinking About "Illness" Through Japanese History

2020/11/05

In April, along with the closure of the Hiyoshi Campus, it was finally decided that our school would also temporarily close. Day after day, the media reported the ever-increasing number of people testing positive for COVID-19. Even without stepping a single foot outside my house, I could easily sense the disease of "anxiety" spreading throughout society. In the midst of this, as a humble teacher of history, what I thought about was: "When epidemics broke out in the past, how did people of that time face them?" Coincidentally, the past and present are in the same situation regarding the fact that "there is no effective medicine." Whether it be the Jomon people, who had no choice but to obtain food themselves through hunting, gathering, fishing, and cultivation, or modern people, who can have anything delivered anywhere with a single phone call, we are ultimately equally helpless in the face of a disease for which there is no specific cure. That is precisely why we may need to learn the "way to face illness" from the past right now... and that is the theme of my classes for the first semester of this academic year. While it is not such a grand thing that I should be introducing it here, since I have been given this wonderful opportunity, I would like to list some examples below, focusing on stories where students "found it difficult to drift off into sleep-learning during class."

When conducting excavations at ancient sites such as the Heijo Palace site, wooden spatula-like objects called chugi are sometimes unearthed. In short, they are ancient toilet paper, but when observed under a microscope, they clearly convey how ancient people struggled with infectious diseases caused by parasites and their eggs. Of course, they likely could not have identified the pathogen, but it seems they actually knew that "bugs inside the body do something."

This is because there is a description of the Koshin belief in the "Nitto Guho Junrei Koki" (The Record of a Pilgrimage to China in Search of the Law), the travelogue of Ennin, a disciple of Saicho, the founder of the Tendai sect. The Koshin belief holds that "on the day of Koshin, the Sanshi bugs living inside the body slip out while the person is sleeping and go to Enma Dai-o (King Yama) to snitch on the person's sins. Enma Dai-o then reduces the person's lifespan according to those sins." Therefore, it was apparently necessary to stay awake all night on that day to prevent the Sanshi bugs from moving. In Japan, this became a time for drinking parties among the Heian nobility, and as time passed, it spread among the samurai as well. It sounds like a dream to be able to drink until morning in a semi-official capacity, but in any case, the people of the past must have known that "bugs inside the body do something."

On the other hand, the cause of illness was sometimes seen as a "curse" rather than "bugs." Among the epidemics that appear in Japanese history, the case with the oldest and most detailed records is likely the smallpox epidemic of the Nara period. Among the victims, said to be 20% to 30% of the population at the time, were all four of the Fujiwara brothers, who were the rulers of the time. At that time, a certain rumor was whispered convincingly in Heijo-kyo. It said, "This is the curse of Prince Nagaya." He committed suicide during the Prince Nagaya Incident in 729, but it is said that a conspiracy by the four brothers existed behind it. It is a plausible story that Prince Nagaya, who met a tragic death, turned into a literal "god of pestilence," spread smallpox, and took the lives of all four of his mortal enemies. Additionally, Emperor Kanmu's younger brother, Prince Sawara, was sentenced to exile—the heaviest punishment for the Imperial Family—as the mastermind behind the "Fujiwara no Tanetsugu Assassination Incident" concerning the construction of Nagaoka-kyo. His ten-day hunger strike in prison to plead his innocence and his resulting death from indignation are more than enough reasons for him to turn into a vengeful spirit. As a result, epidemics broke out in Heian-kyo, and the Emperor's own mother, Takano no Niigasa, and Emperor Kanmu's consorts fell ill. Examples linking "curses and illness" in this way are too numerous to mention.

However, people were not merely at the mercy of the "god of pestilence." Emperor Kanmu immediately enshrined the spirits of those who had died tragic deaths and become vengeful spirits, including Prince Sawara. By re-worshiping them not as "Onryo" (vengeful spirits) but as "Goryo" (sacred spirits)—that is, as holy deities—he attempted to convert that "negative power" into a "positive power" to protect against epidemics. This was the beginning of the "Goryo-e" ritual held at Shinsen-en in Kyoto. Furthermore, Gozu Tenno, the deity of Yasaka Shrine famous for the Kyoto Gion Festival, is a guardian deity of Jetavana Monastery while also being a god who presides over illness. Similarly, Susanoo-no-Mikoto, a hero of Japanese mythology who is identified with Gozu Tenno and is also a deity of Yasaka Shrine, has an aspect as a god of pestilence, as represented in the legend of Somin Shorai. The alternative name for this Gion Festival is also "Goryo-e."

In other words, for the people, illness and the god of pestilence were not simply beings to be feared and avoided. Rather, by daring to perceive illness positively, they effectively utilized that great power as nourishment for living. This extremely resilient way of life may be exactly what we should take as a precedent right now.

As Japan pushed forward on the path to becoming a modern state after the Meiji Restoration, the area around the Kofu Basin faced a serious problem. Many peasants were afflicted by a strange disease where "starting with an abnormal swelling of the abdomen, the limbs would thin out, and it would gradually become difficult even to move, leading to death." Because there were so many cases in that region, this disease was called "Endemic Disease" (Chiho-byo). While modern Western medicine was already spreading within the country, the cause of the endemic disease remained unknown... In fact, it seems this strange disease had been rampant in the Kofu Basin since the Sengoku period. This is because the cause of death for Masamori Obata, one of the Twenty-Four Generals of Takeda Shingen, is recorded as illness in the "Koyo Gunkan," and the symptoms were exactly those of the endemic disease. For at least 300 years, the people of the Kofu Basin were forced to live in fear of an invisible demon of disease.

Following petitions from local people seeking improvement in this situation, the scalpel of modern medicine was finally applied to the mysterious endemic disease. However, investigating the pathogen was extremely difficult. This was because, to understand the abnormalities inside the body, it was literally necessary to "apply a scalpel to the body of a deceased human." In an era where modern science and superstition were intermingled, even a pathological autopsy was still tended to be avoided as an act of desecrating the dead. However, later, triggered by a courageous elderly person providing their body for donation, the true identity of this demon of disease was finally revealed. Its name was "Schistosoma japonicum"; it finally became clear that the cause of the endemic disease was an infectious disease caused by a parasite.

At the hatching stage, Schistosoma japonicum cannot parasitize its definitive host, humans, and like the coronavirus, it enters the human body via an intermediate host. The intermediate host for Schistosoma japonicum is a type of small snail called Miyairi-gai (Oncomelania nosophora). In other words, without the Miyairi-gai, Schistosoma japonicum cannot parasitize the human body, and the endemic disease will not occur. Therefore, the people of the Kofu Basin pushed forward with the concreting of ridges and other habitats of the Miyairi-gai and the promotion of fruit cultivation to replace rice paddies, and in 1995, a declaration of the end of the endemic disease was finally made. For humans, it is a "happily ever after," but in other words, this means the extinction of a species of creature called the Miyairi-gai. The eradication of infectious diseases—that is, "saving many people suffering from illness"—is a common long-cherished wish for humanity. However, we must not forget that under the name of that wish or great cause, there are lives that are forced into extinction from the earth.

The subheading is a passage from "Datsu-A Ron" (Goodbye to Asia). If interpreted including the sentences that follow, it becomes: "Since the spread of civilization is as inevitable as an outbreak of measles, one should adopt it rapidly without fear." Now, I would like to consider these words once more with measles as the axis. That is, "The outbreak of measles cannot be prevented. However, just as when accepting civilization, there is no need to fear this more than necessary or fall into grief." It is, so to speak, "An outbreak of measles is like civilization."

Of course, the outbreaks of measles and infectious diseases including COVID-19 should not be considered exactly the same. However, as already mentioned, people who lived in eras afflicted by even more calamities of disease did not just fear and prostrate themselves before illness. In other words, whether it be the Goryo-e or the aforementioned "Datsu-A Ron," couldn't these be considered cheers from the past saying, "Turn the crisis of illness into an opportunity"?

Come to think of it, Microsoft Teams was introduced at our school during this closure, and through this, I was able to gain an opportunity to rethink new class formats and methods. Embarrassingly, this was something I could never have imagined in the days when I was overwhelmed by daily duties and chaperoning club activities. As for the students, from what I hear, there are opinions such as "I realized how grateful I should be to do club activities with my peers" and "I actually realized that taking classes in person is interesting." At the very least, having been able to learn "the importance of being able to enjoy daily life as daily life" is not a bad experience for them. Thinking that way, this situation is indeed a "crisis that should be turned into an opportunity."

In the past, in the face of a great crisis where the roar of cannons from Ueno signaled that the fires of war were close at hand, the predecessors of Keio University continued their studies without being perturbed and seized the opportunity to carve out the future of Japan. As a teacher, I sincerely hope from the bottom of my heart that the students of our school will also become people who can turn this current crisis into an opportunity.