Religion and Medicine in Japan
Katja Triplett
Dominant forms of religion and medicine first started to appear inJapan during the Asuka period (538–710) when Buddhism was officially introduced from the Korean peninsular kingdom of Baekje.
This process continued in the Nara period (710–794) when power
was centralised in the Yamato Plain and ended in the long Heian period (794–1185) when imperial power was consolidated in the capital,
Kyoto. In Japan, medicine as a body of knowledge is referred to as“learning in regard to medicine”, igaku 醫學.
Chinese medicine and its incorporation into the medical system of early Japan were closely connected with the incorporation of
Buddhism and Chinese-style ceremonies and decorum into Japaneseculture. The institutional framework was created by incorporating
legal codes, establishing offices, introducing certification guidelines
and other bureaucratic measures. The codification of medical, pharmaceutical and calendrical practices led to the establishment of new
training institutions and the standardisation, at least in theory, ofknowledge. The Yōrō Code (Yōrō-ryō 養老令) serves as a rich textual
source for imagining Nara-period medical and religious institutions
and features dominantly in pioneering studies of the history of medicine in Japan. The use of foreign regulations, materia medica and formulae was by no means unopposed in the decades following the Nara
period. However, adverse positions did not have an enduring influence, and Buddhism and Chinese-style medicine in Japan eventuallybecame incorporation regimes in their own right.
In pre-modern China, medical activities were intimately associated with the Daoist tradition while in Japan, there was a conscious
decision to exclude formally institutionalised Daoism when incorporating continental forms of religion. The Yamato rulers did this to prevent power struggles as witnessed in China at the time. Because of thelack of Daoist institutions in Japan, deities from the Daoist pantheon

Official introductionof Buddhism to Japan
Centralisation ofhegemonic power

Introduction andincorporation ofChinese medicine into
Japanese culture

Buddhism andChinese-style medicine
dominant forms
Relation between
religion and medicine
in China differs from
Japan

1

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JAPAN BEFORE 1800

Coexistence of court or
governmental doctors
and Buddhist
monastic physicians

Itinerant ritual experts
provide healing services

Doctrine of Buddhism as
therapeutics, healing as
salvation
Lineages of monastic
physicians emerge

2

arrived, in Como’s words, as “stowaways” in Japan and added only
indirectly to religious plurality1 and curative techniques.
In addition to influences from Indian and Chinese medicine,
medicine in the Nara period was also influenced by ideas from Confucianism (jukyō 儒教), including the notion that a virtuous ruler
brings well-being to those under his rule. It may also have been influenced by Nestorian Christianity (kirishitankyō 基督教) as there arerecords of a missionary at the Japanese imperial dispensary.2 Court
doctors (醫者 isha, ‘medical practitioners’, kan’i 官醫, ‘governmental
physician’), trained in Chinese-style medicine, but benefitting also
from medical texts with a Buddhist background, were responsible forcaring for members of the ruling and educated elite, while Buddhist
monastics (sōi 僧醫, ‘monk doctors’, kanbyō-sō 看病僧, ‘care-giving monks’) and pious lay people also treated commoners. Healing
services were also provided by a heterogeneous group of miracle
workers that gradually entered the Buddhist world over the centuries. These included hijiri 聖, ‘holy men’, who were itinerant ascetics,
and shugenja 修験者, ‘practitioners of Shugendō 修験道’, a form of
mountain asceticism.
One potent motivation for incorporating Buddhism – initiallyfelt to be ‘foreign’ by the ruling elite and not adaptable to Japan – wasits image as being powerful in healing all ills and ultimately eradicating suffering from old age, sickness and death. In this view, all of
Buddhism is therapeutics. Buddhist monastics were actively engaged
in medical healing, especially in the Heian period. Monastic doctors
trained in temples connected to particular Buddhist medical lineages. These temples often specialised in the veneration of the Medicine
Buddha (Yakushi nyorai 薬師如来, ‘Master of Medicines Buddha’)but also venerated other Buddhist deities. In early Japan, and in later
centuries, charismatic monks worked as care-givers (kanbyō) using
spells (Sk. dhāraṇī, Jp. darani 陀羅尼, or ju 呪) and incantations contained in Buddhist texts. As part of the incorporation of Buddhism
into Japanese culture, nuns and Buddhist laywomen from the ruling
1 Michael Como, “Daoist Deities in Ancient Japan: Household Deities, Jade Women and Popular Religious Practice,” In Daoism in Japan: Chinese Traditions
and their Influence on Japanese Religious Culture, ed. Jeff rey L. Richey (London,
New York: Routledge, 2015), 26.
2 Toshiyoshi Hattori 服部敏良, Nara jidai igaku no kenkyu 奈良時代醫學の研究(Tokyo: Tokyo-do, 1945), 71−74.

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purpose at temples that were part of the Hoke-ji temple network. This
network was established in early Japan for the protection of the stateand for the benefit of all. Empress Kōmyō 光明 (701–760) is known
for founding dispensaries that distributed medicines (iyaku 醫薬).
She did this as an act of piety. In general, lay Buddhists were encouraged to support the monastic community not only with clothing,food and shelter but also by providing for their physical health withmedical drugs.
As an expression of his belief in the power of the bodhisattva
Mañjuśrī, the charismatic monk Eison (or Eizon 叡尊, 1201–1290) established bathhouses and other medical facilities at temples in his network to provide care especially for the underprivileged, the so-called‘non-humans’ (hinin 非人), and outcasts such as lepers. Apart from ritual healing activities such as the recitation of spells and mantras, Eison
and the members of his reformed order conferred Buddhist lay precepts (ritsu 律) on the outcasts to save them (kyūsai 救済).3
Eison was a Buddhist reformer of the vinaya rules; he was not
one of the medieval monastic doctors who treated those afflicted with
illness. Monastic doctors caring for members of the lay community
contravened early Buddhist ordination rules (Sk. vinaya). The vinaya
rules strictly banned members of the monastic community from engaging in healing householders. These rules were supposed to prevent physical contact with the worldly that may have led to monastics breaking their vows of sexual abstention or displaying unfitting
behaviour as (worldly) healers. In Japan, the ideal of the bodhisattva
acting in this world for the benefit of all took precedence over strict
adherence to the prohibition on treating the wounds or diseases of thelay householders.
The ‘Rules for Monks and Nuns’ (Sōni-ryō 僧尼令) section of theeighth-century Yōrō Code includes a clause on divination (boku, uranai卜) and exorcism with amulets as “magical techniques” (fujutsu, mujutsu 巫術). It prohibits Buddhist monks and nuns from curing sickness
through Daoist divination or with Daoist amulets (shōdō 小道, ‘smallway’).4 Such practices are said to result in laicisation unless the monastic
3 David Quinter, From Outcasts to Emperors: Shingon Ritsu and the Mañjusri Cult inMedieval Japan (Leiden, Boston: Brill, 2015), 105.
4 Paul Demiéville, “Byo,” in Hobogirin: dictionnaire encyclopédique du bouddhismed'après les sources chinoises et japonaises (Tokyo: Maison franco-japonaise, 1937),

Lay Buddhists of theelite engage in charity

Reformed Buddhist
order engages in
welfareRegulations ofhealing services

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uses exorcist healing spells (jiju 持呪) that form part of Buddhist teachings (buppō 仏法). It is not clear, however, whether Buddhist monks andnuns were only allowed to heal members of the monastic community inline with the vinaya, or whether they were also permitted to treat the laycommunity.
A ninth-century legal commentator describes the term shōdō 小
道 – an exorcism by means of amulets in the form of paper strips – as a“technique of the Way, Daoism” (dōjutsu fu 道術符). This was indeed
typical for Chinese Daoism. He also says that when Buddhist monks
and nuns engage in such Daoist healing and divination methods, they
practise the “left way“ (sadō 左道), the wrong way or heresy, and, as aconsequence, will be returned to lay status. The fact that Daoist practices are referred to as worldly – or secular – in early legal sources reflects the existence of a separate system of Buddhist law (buppō).
As recent research on the Heian period has revealed, however, combined Buddho-Daoist exorcisms were very popular.5 While astate office of exorcism no longer existed, exorcisms were practised
widely. Just as Buddhist monastics were not permitted to use Daoistic exorcism spells in the Nara period, some forms of Buddhist Tantric ritual and thought were deemed heterodox and “evil” (jagi 邪義)by inner-Buddhist authorities in the late medieval period. As for heterodoxies in medicine, we find a significant passage in a well-known
twelfth-century source, The Scroll of Diseases and Deformities (Yamaino sōshi 病草紙), in which a surgeon is depicted as a quack.
In the early seventeenth century, new views of nature, cosmos
and man – which developed independently but not without influences from European thinking – gradually replaced older worldviews.
This replacement of worldviews can be seen as increasing rationalisation and secularisation. However, mystical concepts also aboundedin this period. In early Tokugawa Japan, a group of unconventional
thinkers engaged creatively with Neo-Confucian models of thought
and practice. Some of them searched for salvation in Japan’s mythicalpast and formed the tradition of Confucian Shintō, which followed

JAPAN BEFORE 1800

Disregard of prohibitions of certain healing
services, widespreadpractice of exorcisms

Changes in worldview,
rationalisation andsecularisation

4260; Herman Ooms, “Framing Daoist Fragments, 670–750,” in Daoism in Japan:
Chinese Traditions and their Influence on Japanese Religious Culture, ed. Jeffrey L.
Richey (London, New York: Routledge, 2015), 52.
5 Benedetta Lomi, “Dharanis, Talismans, and Straw-Dolls Ritual Choreographiesand Healing: Strategies of the Rokujikyo hō in Medieval Japan,” Japanese Journalof Religious Studies 41 (2014): 255–304.

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Confucian models but simultaneously attempted to avoid any obvious
references to China. Many of these scholars, a large number of themdoctors, were highly critical of Buddhism although the majority weretrained or raised in a Buddhist environment.
The military government’s suppression and strict control of theonce exceedingly influential educational institutions associated with
Buddhist temples had a decisive influence on the training of medical
doctors and scholars in the ‘sciences’.6 Ultimately, the monopoly on(higher) education held by Buddhist institutions in Japan was ceded
to Neo-Confucian establishments in a process that was not without
violent conflict and strife.
Due to politics of ‘seclusion’ in a phase of consolidation on thedomestic front and a strategy to fend off colonialism in the Edo period (1600−1868), the military government officially also ended diplomatic contact with China. Until the Sino-Japanese war of 1894–95
that ended with China’s defeat, the Japanese, however, still looked up
to China as a respected, and to some extent highly idealised, model.
Because the import of medical books from China remained restricted during the period of ‘seclusion’ in the Edo period, the influenceof the medical tradition practiced in China on Japanese medical
practice was also limited. This state of relative isolation led to thedevelopment of a distinct medical tradition in Japan with the development of different schools of medical thought with numerous
branches. While the Japanese regarded the Chinese classic texts andcommentaries on them by Chinese doctors still as authoritative, distinctly different medical theories were developed in Japan. In addition, medical and pharmaceutical knowledge from Europe was also
increasingly adapted and processed, leading to a great diversity inthe healing arts in Japan in this time of ‘seclusion’.
The profession of the medical doctor underwent a radical change
in the early Edo period because of the radical modification of the social
structure. The social position of doctors now strictly depended upon
the social class they were born into. The classes comprised numerous
ranks and sub-ranks that were either hereditary or awarded accord6 Frederico Marcon, The Knowledge of Nature and the Nature of Knowledge in Early
Modern Japan (Chicago, London: University of Chicago Press, 2015); Shigeru Nakayama, Academic and Scientific Traditions in China, Japan, and the West (Tokyo:
University of Tokyo Press, 1984); Shigeru Nakayama 中山茂, Paradaimu to kagaku
kakumei no rekishi パラダイムと科学革命の歴史 (Tokyo: Kodansha, 2013).

Role of Buddhist
temples in training
physicians, Buddhism
loses influence on
medical training

Social positions ofdoctors changed

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JAPAN BEFORE 1800

Medical pluralism, increasing secularisationof medical training andpractice

Legal distinction
between medicine andBuddhism

New religions engage
in healing services

6

ing to merit and good service to the authoritative powers. Medical
teachings were passed on within the family profession. While court
doctors, and doctors for the elite in general, had a status that can be
described as secular, the majority of doctors still belonged to a Buddhist order, i.e. they held a position in the Buddhist clerical hierarchy– a position that doctors became more and more resentful of and thatwas eventually given up over the course of time.
From the Meiji period (1868–1912) onward, Buddhist priests
only provided pastoral care and raised funds for hospitals. Medicalcare was provided by medical experts. In 1874, a legal distinction
between medicine and Buddhism was established. After this, monastics either left their orders in order to continue practising medicine
or gave up medicine altogether. Medicine in modern Japan was subjected to a new state licensing system that excluded the practice oftraditional forms in favour of Western medicine.
Pre-Buddhist medicine never enjoyed any kind of significant
renaissance after the incorporation of Buddhist and Chinese-style
medicine into Japanese culture. An exception is the eighteenth-century attempt to divorce Japanese from Chinese ideas in the wake ofnativist endeavours. To speak of a revitalisation of Japanese pre-Buddhist, pre-Chinese-style medicine would however be an exaggeration. The incorporation of Buddhism and Chinese-style medicine
into Japanese culture was so complete that there is no evidence of
Shintō medicine in Japan today.
Another field of study of religion and medicine (healing) in Japan encompasses emerging or new religions, including those fromthe late Edo period such as Tenrikyō, and groups in contemporary
Japan who claim that medical psychotherapy is akin to Buddhist
teachings on the mind and publish or consume Buddhist self-help
books.

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Quoted and Further Reading
Como, Michael. “Daoist Deities in Ancient Japan: Household Deities, Jade Womenand Popular Religious Practice.” In Daoism in Japan: Chinese Traditions and Their
Influence on Japanese Religious Culture. Edited by Jeffrey L. Richey, 24–36. London,
New York: Routledge, 2015.
Demiéville, Paul. “Byō.” In Hōbōgirin: dictionnaire encyclopédique du bouddhismed'après les sources chinoises et japonaises, 224−65. Tokyo: Maison franco-japonaise,
1937. Reprinted in Médecine et société au Japon. Edited by Gérard Siary and Hervé
Benhamou. Paris: L’Harmattan, 1994.
Demiéville, Paul. Buddhism and Healing. Lanham: University Press of America, 1985.
[=Hōbōgirin Entry on “Byō”, transl. by Mark Tatz].
Hattori, Toshiyoshi. 服部敏良. Nara jidai igaku no kenkyū 奈良時代醫學の研究.
Tokyo: Tōkyō-dō, 1945.
Kleine, Christoph. “Religion als begriffliches Konzept und soziales System im vormodernen Japan: Polythetische Klassen, semantische und funktionale Äquivalente
und strukturelle Analogien.” In Religion in Asien? Studien zur Anwendbarkeit desReligionsbegriffs. Edited by Peter Schalk et al., 225–92. Uppsala: Uppsala Universitet, 2013.
Lomi, Benedetta. “Dharanis, Talismans, and Straw-Dolls Ritual Choreographies andHealing: Strategies of the Rokujikyōhō in Medieval Japan.” Japanese Journal of Religious Studies 41 (2014): 255–304.
Marcon, Frederico. The Knowledge of Nature and the Nature of Knowledge in Early
Modern Japan. Chicago, London: University of Chicago Press, 2015.
Miyata, Nana. Die Übernahme der chinesischen Kultur in Japans Altertum: Kultureller
Wandel im innen- und außenpolitischen Kontext. Berlin: LIT, 2012.
Nakayama, Shigeru. Academic and Scientific Traditions in China, Japan, and the West.
Tokyo: University of Tokyo Press, 1984.
Nakayama Shigeru. 中山茂. Paradaimu to kagaku kakumei no rekishi パラダイムと科学革命の歴史. Tokyo: Kōdansha, 2013.
Ooms, Herman. “Framing Daoist Fragments, 670–750.” In Daoism in Japan: Chinese
Traditions and Their Influence on Japanese Religious Culture. Edited by Jeffrey L.
Richey, 37–59. London, New York: Routledge, 2015.
Piggott, Joan R. The Emergence of Japanese Kingship. Stanford: Stanford University
Press, 1997.
Quinter, David. From Outcasts to Emperors: Shingon Ritsu and the Mañjuśrī Cult inMedieval Japan. Leiden, Boston: Brill, 2015.
Richey, Jeffrey L., ed. Daoism in Japan: Chinese Traditions and Their Influence on Japanese Religious Culture. London, New York: Routledge, 2015.
Rosner, Erhard. Medizingeschichte Japans. Leiden: Brill, 1989.
Salguero, C. P. “Reexamining the Categories and Canons of Chinese Buddhist Healing.” Journal of Chinese Buddhist Studies 28 (2015): 35−66.
Shinmura Taku. 新村拓: Nihon bukkyō no iryōshi 日本仏教の医療史. Tokyo: Hōsei
daigaku shuppankyoku 法政大学出版局, 2013.
Triplett, Katja. “Magical Medicine? − Japanese Buddhist Medical Knowledge and Ritual Instruction for Healing the Physical Body.” In “Religion and Healing in Japan.”
Edited by Christoph Kleine and Katja Triplett. Special issue, Japanese Religions,37/1−2 (2012): 63–92.

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Th i s text is part of the C ompanion to the Study of Secularity. Th e in tent of th e

JAPAN BEFORE 1800

Companion is to g ive scholars interested in the concept of Multiple Secularities,
who are not themselves specialists in particular (historical) regions, an insight into
diff erent regions in which formations of secularity can be observed, as well as into the
key concepts and notions with respect to the study of secularity.
Published by the Humanities Centre for Advanced Studies “Multiple Secularities −Beyond the West, Beyond Modernities”. For as long as the HCAS continues to exist, theCompanion will be published and further expanded on the HCAS’ website. Towards
the end of Multiple Secularities project, all entries will be systematised and edited inorder to transform the Companion into a completed Open Access publication.

Please cite as:
Triplett, Katja. “Religion and Medicine in Japan.” In Companion to the Study ofSecularity. Edited by HCAS “Multiple Secularities – Beyond the West, Beyond
Modernities.” Leipzig University, 2019. www.multiple-secularities.de/media/
css_triplett_religionandmedicine.pdf

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