MMAJ-Princeton1403113 (Mikedas)

Making Medical Anthropology in Japan:
A memoir of the ten years of Osaka in 1980s
Mitsuho Ikeda
The Center for the Study of Communication-Design, Osaka University
rosaldo[at]cscd.osaka-u.ac.jp

1. Historical metaphors and Actual Realities
2. HIHANTEKI-IRYŌ: A Critical Medicine
3. Visiting Foreign Medical Anthropologists
4. Japanese Medical Anthropologists in a teacup
5. Recombination of “DNA of Japanese” Medical Anthropology***
1. Historical metaphors and Actual Realities
The story that I would like to tell is not a historiographical fact but a kind of fable about
making an academic discipline, medical anthropology in Japan around the 1980s. Even
though the story depends on my historical realities, I would like to narrate in detail. My
story can be an allegory for making originally “a kind of academic discipline” in Japan
where the native habitants were/are good at faking as “imported scholarship”(YU-NYŪGAKUMON) [Suzuki 2007]. Why is the allegory important? I would like to explain how
young Japanese students imagined what is called “medical anthropology” when this was
not in presence in the 1980s university curriculum. For me it is not important if this is an“imported scholarship” or not, because any kind of scholarship should be contextualized toits specific locality1. It’s origin does not matter for me.
1 This reminds us the episode of the Sugita Genpaku’s book, “RANGAKU-KOTOHAJIME” (1815).

Genpaku and his collages had labourd to translate Duch edition of German anatomist, Johann Adam Kulmus’“Anatomische Tabellen”(1722), without translators and dictionaries in Edo period (ancient Tokyo). Theirown struggle work like a cryptanalysis were reflected in his memoir by Genpaku forty one years later after
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In 1980 I graduated as a Bachelor of Science at Kagoshima University. I studied field
ecology of wild Japanese monkeys in Miyazaki Prefecture, southern Japan. ‘Unfortunately’
I began studying in a master course at the Graduate School of Medical Sciences at Osaka
University, because I failed my entrance examination for a primatology and ecologicalanthropology master course at the Graduate School of Science in Kyoto University. Afterthe first half of my year at Osaka University, I applied to enter a biochemical laboratory to
prepare my master thesis. The biochemical lab is incorporated with one of world’s most
famous research institutes for biochemistry, physical chemistry, and molecular biology. I
participated in a small research unit studying rat brain metabolism relating to bio-circadianrhythm under the effects of various psychotropic medical substances (Ishikawa et al. 1984).
But eventually I could not handle a series of animal experiments with “sacrificing objects
painless,” as it made me, the ‘subject,’ painful (Ikeda in preparation). I had enjoyed mytime before with monkeys in a wild forest environment for more than one year. Anyway I
dropped out of the natural science lab after only within a few months.
I just start from the anecdote in which I met with Prof. Yonezō Nakagawa in early 1981.
Do you remember the name of Yonezō Nakagawa in the Prof. Margaret Lock’s book? Hisname is appeared in the dedication of her book, “Twice Dead: Organ transplants andreinvention of death,” published in 2002.
In early 1981, I visited the office of Prof. Yonezō Nakagawa (1926-1997), who taught
medical history, medical ethics (later bioethics), and history of ideas in environmental
medicine. I told him that I wanted to study something “like a cultural anthropology” in amaster course in the medical sciences. He said that actually there had been a new emerging
area, with the name “Medical Anthropology.” I was fascinated by its sound of“anthropology” because I dedicated myself to the task of my first fieldwork with wild
Japanese monkeys in undergraduate days, 1978-1980. Anyway in Nakagawa-sensei’s
office, I borrowed the textbook, “Medical Anthropology” written by George Foster andtheir finishing.
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Barbara Anderson published in 1978 by John Willy & Sons, from him. Prof. Margaret
Lock’s first medical ethnography, “East Asian Medicine in Urban Japan,” based on her
fieldwork in Kyoto from 1973 to 74, had just been published in 1980. Two years later her
book was translated into Japanese under Prof. Nakagawa’s name with his introductorynote.
At the same time he introduced me to his laboratory members. They were some graduate
students, and his followers, ‘Nakagawa-philes,’ or enthusiasts for the professor’s books andhis thought – however I doubt whether “his thought” can be understood easily. They held aspontaneous study group and seminar once a week where they read not only his books but
also books written by Iago Galdston (1895-1989), Pedro Laín Entralgo (1908-2001),
George Rosen (1910-1977), Thomas McKeown (1912-1988), George Libman Engel(1913-1999), Ivan Illich (1926-2002), Michael Foucault (1926-1984), and so on. Soon after
we organized a new sub-group which tended more toward the medical anthropology
discipline. As we denominated our group, the Medical Anthropologists in Osaka, its
acronym was M-A-O. So we were members of this group, the MAOists. The MAOists is ahomonym for the communists who embraced the political doctrine of militaristic andpeasant-populist Mao Zedong thought. One Chinese visiting scholar explained us that“mao” has four different meanings according to four different pinyin; cat (māo),contradiction (máo), rivet (mǎo), and flourish (mào). As such, we enjoyed it because it
represented our own diverted images of medical anthropology. Needless to say our
spiritual leader or “great guru” was Nakagawa-sensei. Under the liberal and anarchistic
atmosphere of his and our laboratory, we were reaching toward some kind of “criticallythought,” HIHANTEKI-SHIKŌ/SHISŌ. We wanted to criticize the present medicine
reforming towards a utopian medicine. According our vision the present medicine would
reflect on its negative instances, e.g. misuse, malpractice, and structural corruptions, allthings come from the structural problems of the capitalist society.
We denominated this perspective of our idealistic medicine, HIHANTEKI-IRYŌ (critical
medicine). We expected that medical anthropology gave a hint to construct and reconstruct

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idealistic medicine through critical methodology. We were not megalomaniac utopians on
a sudden inspiration. We shared in a part the history of the liberalist social-hygiene
academics (Gesellschaft für Hygiene) of the Osaka Imperial University from 1930, in the
difficult years before 1945 (Maruyama 1969) .
2. HIHANTEKI-IRYŌ: A Critical Medicine
I began to study medical history, including its history of ideas, sociology, economics,
ethics, and anthropology. On collecting these sub-disciplines Prof. Nakagawa invented aneologism, “medical humanities”, for which he contrasted with biomedicine. In his sense
there were two cultures in the studies of medicine, medical humanities and biomedicine.
He used biological medicine to refer to the “narrow” scientific medicine. These terms werelike C.P. Snow’s book, The Two Cultures (1959), he used to divide two categories, thesciences and the humanities. I think Nakagawa-sensei’s idea of the dichotomy between
medical humanities and biomedicine seems to be sui generis because the Japanese medical
authorities used the completely different dichotomies between basic and clinical medicine,and/or between clinical and social medicine. All these dichotomies, though, belonged
among just one side of scientific medicine; biomedicine or natural sciences(SEIBUTSU-IGAKU or SHIZEN-KAGAKU). We never had medical humanities as anintegrated discipline. The only exception was medical historiography, e.g. the works of Yū
Fijikawa (1865-1940), but I think that this academic work, budded from amateur science,
was not an integrated discipline to university curriculum.
(Now I will back to Nakagawa-sensei’s personal history relating with ethos that we haveshared).
Dr. Nakagawa and his disciples share a similar “ethos” (the distinctive spirit of a “culture”)
against “social control by medical establishment.” We thought that all the social
institutions could be erroneous in their treatment of patients. We remembered that
Nakagawa sensei used to say, “All types of medical treatments have attributes of4

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experiment, e.g. having a trial & error aspect, while the object of medicine is a humanbeing, therefore we can say that all medical treatments are human experiments.”
Dr. Nakagawa was born in Seoul of Korean peninsula, the colonial town of the Japanese
Empire in 1926. He was fostered as a pro-militarism boy, he said after 60 years later. But
he was shocked when that undefeated imperial army was finally defeated. After 1945,
during his medical student period in Kyoto Imperial University, until 1947, then in Kyoto
University he had drastically converted into something liberalist. After his graduation, heparticipated in a voluntary party, called “SEINEN-KAGAKUSHIKA-SHŪDAN” (YoungGroup of Historians of Science) in the 1960s. This was after the political movement against“NICHIBEI-ANPO” (the US-Japan military alliance)2 conflict of 1960. In the period of“young radicals in campuses” during the conflicts at the end of 1960s and the beginning of
1970s, our elder colleagues among the MAOists had radical experiences as university
undergraduate students. But I was one of parts of later generations fallen behind the time.
So to say it simply, I was in part of the post fēstum (after the feast) generation, because I
was born in 1956. As a four years old boy, I was too young to understand the politics in1960 of the first renovation of NICHIBEI AMPO. Even 10 years later, I was still too young,as a fourteen years old kid, to participate in the “struggle” of university students in 1970. In
this sense the fēstum means political disturbance. So I was in an in-between generation of
two big political fēsta.
Why did a dozen of students, sharing the same ethos against “social control by
establishment”, gather around prof. Nakagawa who was part of an older generation?
Because there were no other social spaces where young students could talk freely about of
this topic. This was true not only in Kansai (western Japan) but also throughout Japan.
There were two major academic currents for studying medical history at the beginning of
1970s: one was Thomas Kuhn’s, and the other was orthodox Marxism. His old friend, Dr.
The NICHIBEI-AMPO is a Japanese second level acronym of “NICHIBEI ANZEN HOSHO JYŌYAKU,”
that is also first level acronym expression of the original redundant title. The official name of this agreement
is translated as “the governmental Treaty of Mutual Cooperation and Security between the United States andJapan.”
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Shigeru Nakayama translated Thomas Kuhn’s book, “The Structure of Scientific
Revolutions” into Japanese in 1971, nine years after of original edition published in 1962.
We could not accept fundamentally the Marxist theories, especially one of the JapaneseCommunist Party’s localized version, because they were too dogmatic in their analysis of
medical practice, which always used the framework of labor processes. But at the sametime, we had a tolerance for the framework of Marxist theory, especially in the case ofWestern Marxism, which could be used to analyze how patients were alienated. The
Kuhnian model of “revolution3”, conversely, was attractive to us because we pursued akind of paradigm change by inventing the medical humanities as opposed to the
biology-dominant medicine, “biomedicine”.
Until 1980, Dr. Nakagawa was an associate professor that had no chance of being
promoted above this position. When he was finally promoted to the professorship, he was
54 years old – I am now three years older than him. He had the charisma to be our spiritual
guru and best theorist for medical humanities, like our western heroes that I mentioned
before. His personal character was that of a good egalitarian, unlike any other professor in
the faculty of medicine. He had great tolerance and never to directed in a magisterial stylewhen he would comment on our research presentations.
A senior student, who was a medical doctor, proposed to us his creative concept of“HIHANTEKI-IRYŌ,” the Critical Medicine4. We welcomed this conception of him. It
helps us develop our position that would take us away from social control by medical
establishments and towards the liberation of oppressed people. We were charmed easily by
this dogma of critical medicine. At that time, there were a dozen of key concepts forconstructing a medical “theology for liberation” in the western medicine e.g.,
anti-psychiatry, illness labeling theory, a series of negative aspects of modern medicine;
total institution, involuntary hospitalization, professional dominance, medicalization,
3 At least for me, the wording of “revolution” is more like to “brand-new renovation” than “politicaluprising.” I have been used to using this wording as “Matrix Revolutions” more than as “Sandinista
Revolution.”
4 The concept of “critical/critique” was borrowed from Marxist Critical Theory. Later we have confronted
with the same wording of the “Critical Medical Anthropology, CMA” and “Political Economy of Health” inMerrill Singer and Hans Bear’s textbook with same title in 1995.

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iatrogenesis,

victimblaming,

and

also,

Foucauldian

concepts

ofpanopticon,

anatomopolitique, and biopower, et cetera. But today I regret that we had very naïve
political thinking, and believed that all medical institution would be simply oppressive.
Anyway we were too idealistic to make a concrete plan to reform the “conservative”
medical system.
At that time we encountered prof. Margaret Lock’s paper in Japanese, entitled“RYŌSAI-KENBO NO TEIKŌ” (Resisting against becoming good wife and wise mother)published in “KIKAN-JINRUIGAKU” (Anthropology Quarterly), Vol.15, No.1, Pp.36-60,
1984. At least for me, it was amazing article because she wrote a sophisticated argumentthat took a critical approach to both the grand theory of Japanese womenʼs somatizationand the newly emerging neologism of pseudo-disease, e.g. “BOGEN-BYŌ” and“DAIDOKORO-SHŌKŌGUN.” “BOGEN-BYŌ” can be translated into “Child illness
induced by deficiency of mother’s social responsibility” on one side, and“DAIDOKORO-SHŌKŌGUN” can be translated into “House wife “kitchen” syndrome,”
both were very curious pseudo-disease terminologies even for Japanese. Her argument isvery clear that the concept of somatization could not only be necessary to know one ofuniversal types of psychopathology but also should be understood as a certain culturalrepresentation of personal distress. I had just apprehended that her style of writing could beneeded to create “our” medical anthropology, as HIHANTEKI-IRYŌ (critical medicine).
Unfortunately I had no time to do so because I should leave from Japan to Honduras,
Central America, for volunteer work in a rural public health program, from 1984 to 87. In
Honduras, during the first year I worked in a malaria prevention program, and for the final
two years in a rural health program in western Honduras. After arriving in Central America
under the political atmosphere of Cold War, I wanted seriously to preach the importance of
medical anthropology for Honduran health workers. Needles to say that was a losing battle.
Although I was serious, they felt that my ideas were bizarre because they thought that it
was useless to introduce my cultural sensitive approach to a rural public health program.
They were satisfied with their own work. They did not have a comparative perspective to7

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need a better good life for rural people. They did not even care if rural people achieved
good health; the public health work was only work for minimum wage (Ikeda 2001). So I
abandoned my preaching and my plan to introduce medical anthropology to them. And
then I started myself to do fieldwork on traditional folk medicine, commoditization of rural
health, and medicalization processes, for the purpose writing academic papers. After
returning to Japan, I began publishing a series of papers on medical anthropology based on
my rural fieldwork experience. But it took more than 14 years before published my firstbook of ethnography, “JISSEN NO IRYŌ JINRUIGAKU” (Medical Anthropology ofHealth Practice in Rural Honduras) in 2001.
3. Visiting Foreign Medical Anthropologists
In George Foster and Barbara Anderson’s text (1978), there were major four historicalroots of medical anthropology: Physical Anthropology, Ethnomedicine, the Culture andPersonality School, and International Public Health. Three of the four are theories oriented
in schools or the sciences, and the other is applied science. Psychiatrist George Engel’s
paper “The Need for a New Medical Model”(1977) insists that it is very important to rush
into making “bio-pycho-social” medicine instead of the problematic “biomedicine.” We
can observe a lot of his critiques of biomedicine, but he could not succeed in suggesting a
concrete image of “bio-pycho-social” medicine, in proposing an alternative medicine.
Anyway back to Nakagawa’s lab again. I had not been educated into becoming an
ethnographer. And I did not receive systematic education in cultural anthropology. We
were more familiar with medical sociology, for example sociological works by Irving Zola,
Ivan Illich and Eliot Freidson, than with medical anthropology. The only exception was
Arthur Kleinman’ first ethnography, “Patients and Healers in the Context of Culture: An
Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry”(1980).
Even though we knew of his celebrity as a young and smart psychiatrist cum anthropologist,
we were slightly frustrated by his phenomenological approach, which seemed “scholastic”,
far from the critical medicine approach. But we loved very much his ethnography in the8

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later parts of his book. On the one hand, we were impressed by his vivid description of
Taiwanese Tâng-kis’ shamanistic trance and their interaction with their clients’ family
members. On the other hand we complained a bit about his style of dispassionate
description, which we felt was like E-P’s (Edward E. Evans-Pritchard’s) ethnography(Geertz 1988:61-62).
By the way before leaving from Japan, I had more than two years fieldwork experience on
the healing processes of the Tantric Buddhists-Shintoists, SHUGEN-DŌ, in various
esoteric Temples around the IKOMA Mountains in eastern Osaka, 1982-84. We have
happy memories with Joan and Arthur Kleinman, when they visited Japan to participate ininternational conferences in the 1980s. Nakagawa Sensei asked us to invite themsightseeing in Osaka. We, young graduate students, had just read Arthur’s ethnography andconceived of the idea of taking them to an exotic temple in Osaka, similar to the Taiwanese
one. That place was the ISHIKIRI-JINJYA (Ishikiri-Shrine of Sintoism) in eastern Osaka
near the IKOMA Mountains.
We enjoyed a half-day excursion to the shrine and observed the “exotic” petition ofpatients and their families for curing disease, healing paraphernalia, and “traditional”
therapeutic workshop offices in these areas. After leaving the shrine, ISHIKIRI-san -- weare used to this anthropomorphic terminology even for shrines or gods -- I remembered that
it was around January 10th, because we visited the other famous shrine for commercial andfishery god, EBETTSU-san, at the IMAMIYA-EBISU shrine, in the south of Osaka City.
Joan and Arthur were a young mid forties couple when we met each other, Arthur, who
was famous as one of the founders of the “Culture, Medicine, and Psychiatry” journal in
1976, seemed a very quiet guy on the one hand. For us Joan – later we knew she was a
Sinologue who helped Arthur’s fieldwork in Taiwan -- was friendlier than Arthur, on theother.
4. Japanese Medical Anthropologists in a teacup

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We, MAOists, sometimes have been criticized that we are NOT medical anthropologists,
by “mainstream” cultural anthropologists in Japan. Mainstream means that they wereeducated at and graduated from an official anthropological course. In one academic
meeting that we organized in 1980s, I remember one big name medical anthropologist used
to say that, “You are social medicine oriented, not by cultural and social anthropology.”
We were not hurt but we never forgot it. The big-name might think that Japanese medical
anthropologists should be educated in an “orthodox” anthropology course. We did notworry about this slight accusation because we ourselves, even ethnocentrically, thoughtthat medical anthropology ought be a part of critical medicine. But we dislike this type oflabeling on us because the criticizer cannot take a cultural relativist position. They
neglected the fact that we also had learned from textbooks in not only medical but also
cultural anthropology. This is the common sense that even an undergraduate anthropology
student knows. This anecdote always reminds me of a typical Japanese intolerance ethos
towards

thestrangeroutsideofclosedcorporate

community;inJapanese,“TATE-SHAKAI” (vertical society) (Nakane 1970), “BURAKU” (local hamlet) (Kida
1967), or “TAKO-TSUBO” (small cell pot of octopus trap by using their own habit)(Maruyama 1961).
In the 1980s Japan, when becoming a medical anthropologist, their identity politics werevery important but now it seems to be trivial, I think. Once the identity was a concrete
reality for each subject, but now it is a source of power for creating a concrete subject.
When Michel Foucault mentioned what is identity he said, “I think identity is one of thefirst products of power, this kind of power that we have is in our society. ... It should be
remembered that the power is not a set of mechanisms of denial, refusal, and exclusion[means oppressive power – the author]. But the power actually produces [productive power– by author].”5 This teaches us, if one wants to self-nominate as Medical Anthropologist,
he or she just uses the creative force [productive power in Foucaudian sense] of making
who wants to be; Remember, Yōda, the master of Jedi said, “May the force be with you.”
5 Je crois que l'identité est un des produits premiers du pouvoir, de ce type de pouvoir que nous connaissons

dans notre société. ... Il faut rappeler que le pouvoir n'est pas un ensemble de mécanismes de négation, derefus, d'exclusion. Mais il produit effectivement.
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This is not only my personal lesson but also historical fact that I will mention below. Thus
one day we, the graduate students, were invited to a closed business meeting whose agenda
was not made clear to us. One assistant professor of Tokyo University who had met before
in our organized academic meeting said; “We should have an academic association of
medical anthropology in Japan. We need your help for supporting this gentleman, who willbe the president of our society that will be established.” The gentleman who met us thisfirst time was chief of the Department of Biological Drugs in the Ministry of Welfare,“KŌSEISHO” (1938-2001, present name is KŌSEI-RŌDŌSHŌ, Ministry of Health,Labour and Welfare, 2001- ). He would later become well known publicly in the
HIV-tainted blood scandal. At that time he had just become professor of Tokyo University.
We were naïvely surprised at this authoritarian way of thinking of both the
KASUMIGASEKI6 bureaucrat and the Japanese most famous university. Then we decided
to cut off our relationship with these kinds of people. We went back to Osaka and rushed toestablish our own society of medical anthropology. We respected the founders of theSociety of Medical Anthropology in North America. We entitled our newsletter,“Newsletter, Medical Anthropology.” We did not want to make our group a“GATTSUKAI” (authorized academic society) but to give name “KENKYU-KAI”(voluntary research group) with our anti-bureaucratic feeling. Our first newsletter, Vol.
Zero was issued on July 1st, 1988 with prof. Nakagawa’s preface essay entitled “Thebeginning of Medical Anthropology.” Prof. Margaret Lock’s headline review article
entitled “Changing Medical Anthropology: From Ethnomedicine to Critical-Interpretive
Approaches,” appeared in Vol. 2, No.5, November 1989.
5. Recombination of “DNA of Japanese” Medical Anthropology
The story that I have mentioned above is not a value-free (Wertfeiheit) nor real, butdeviated or decentered (Weber 1946).

You may read or listen to the fictional (fictiō) likea roman picaresque. It seems very difficult to explain the early period of making Japanese
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KASUMIGASEKI is the locality in Tokyo where are the governmental ministries are headquartered.
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Medical Anthropology. So I recommend that you suspect if I have fabricated this story.
And also you may use your own imagination to read any kind of fabulous story7 including
medical ethnography. This is a reason why I use historical anecdote.
Now I summarize two major limitations of our critical medicine project mentioned below.
(1) A priori critique against biomedicine
We borrowed the relativistic concepts from medical humanities as tools of critique against
biomedicine. Because we focused on only negative aspects of biomedicine, we could
automatically made the “begging the question error” (petito principii) in evaluating
neutrally biomedicine. We could not consider the alternative. Our image of“bio-psycho-social” medicine can be still poor (Engel 1977). We loved critiques ofcritiques but did not to look at the realities of biomedicine as it had transformed during
over thirty years. Biomedicine has the potential to become an oppressive institution on the
one hand, but in some aspects patients are possible to tame biomedicine to guarantee theirown survival probabilities even as they have their own limitations. Needless to say today
we should treat our analysis of biomedicine more dynamically(Lock 2013).

(2) Need for ethnographies of various types of ethnomedicine-s
We always insisted on the importance of holism when we taught in the classroom. But our
holism images diverge in detail. Our image of biomedicine is monolithic on the one hand,
while the image of ethnomedicine-s relatively is broad on the other hand. Both arestereotyped images. We needed more ethnographic conceptual enrichment in
ethnomedicine.
We have to inquire again what medical anthropology is. We sometimes define that medical
anthropology is anthropological study of health and illness. But in our society, biomedicine
and the medicalization process are very influential today (e.g. Lock 2013). We cannot
ignore or neglect the biomedical presence in our modern life. Our problem is which aspect
7 In this sense I love reading Kary Mullis’ fabulous “Dancing Naked in the Mind Field” (Pantheon, 1998)
more than Paul Rabinow’s plain “Making PCR: A story of biotechnology” (Univ. Chicago Press, 1996).

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MMAJ-Princeton1403113 (Mikedas)of biomedicine-s evokes universality on the one hand, and which aspects of biomedicine
diversifies locality on the other. We can use biomedical knowledge when we analyze
biomedicine itself. I wonder how our relativistic sense fosters when we analyze
biomedicine by using biomedical epistemic tools.
Another aspect I question is which kind of radicalism is medical anthropology. For
discussing profoundly I borrow his concept of Clifford Geertz’ article, “Blurred [blə'ːrd]
Genres: The Refiguration of Social Thought” in his book “Local Knowledge,” 1983.
Needless to say, medical anthropology seems to be taking a position of the interdisciplinary
genre between anthropology and medicine. According to the inspiration of Kenneth
Burke’s “A Grammar of Motives” (1945)8, the problem should be understood how both
agents, so to say, anthropologists and medical scientists, inter-act, what is the context ofthe scene, which agency is mediated between them, and what purpose they expect. This isa reason why I would like to say that medical anthropology is a blurred genre. At least
modern medical anthropologists share epistemologically the belief that this challenging
field can be a transgressive area between anthropology and medical sciences with theircreativities. Students of each side can also share ontologically the other partner’s
methodologies for analyzing their own topics. These situations can be understood using themetaphor of “dialogue” between anthropology and medical sciences. But the problem iswhat kind of dialogue can be possible in this case? Even though both inhabitants look likeneighbors, they use a different language and live in a different culture.
How many years do we have medical anthropology? “Our” field has actually accumulatedhuge studies for more than thirty years. Somebody says etymologically that we have morethan fifty years of tradition. In North America, and even in Japan and other East Asian
countries, medical anthropology is one of the most popular disciplines. So we cannot say
this area is a “sunset industry.” But I think that the true crisis is to be satisfied by our own
mind not to challenge to participate controversies with other disciplines.
“What is involved, when we say what people are doing and why thy are doing it?” Burke (1962[1945]:xvii)
says, we shall use five terms, Act, Scene, Agent, Act, Agency and Purpose, for generating principle of his
investigation.
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Our critical medicine studies group, the MAOists, respect North American colleges who
published in the Medical Anthropology Newsletter from 1970 to Nov. 1982. So we decided
to publish our newsletter, entitled “Newsletter, Medical Anthropology” in 1988 in Osaka.
Unfortunately we confronted problems ourselves with mannerism more than financial
problem. We experienced the newly emerging similar academic areas of medical
anthropology, e.g. medical sociology, bioethics, and so on. We had to stop publishing theNewsletter; the final volume was No.21 (Vol.4, No.6) in 1996. That was the final stage forthe academic voluntary group of medical anthropology, the MAOists.
Medical anthropology is popular among Japanese as well as between North Americans andEuropeans, but today there is not academic voluntary group in Japan. What are thedifferences between them? We cannot explain it by population. Last year I advised one
young medical anthropologist to organize a studying group within the Japanese Society of
Cultural Anthropology, JASCA9. I have a new dream that medical anthropologists in theworld are able to disseminate “anthropological knowledge and its use to solve humanproblems10.” What should medical scientists and anthropologists do now?
The popular image of medical anthropology in 1980s had still been a “blurred genre.” Theblurred genre is ambivalent, potentially provocative, and critical. I remind that we should
re-read prof. Lock’s article on “Resisting against becoming good wife and wise mother,”including a re-consideration of the Japanese social and political atmosphere11. I can assert
some agendas that this article made important for us;

9 In February we have good news that the JASCA has decided to support our studying group having plan todevelop standardized under- and post graduated curriculum of medical anthropology in Japan.
10 These are borrowed from the phrase of the Statement on Ethics, AAA, 2012.
11 Lock’s Japanese article (1984) published in “KIKAN-JINRUIGAKU” has two Japanese big-names
comment; One is Hayao Kawai (1928-2007), a Jungian psychoanalyst also ex-Commissioner for Cultural
Affairs, MEXT, 2002-2007, and our Master Nakagawa-sensei. I think both comments were not impressive
nor appropriate because Kawai-sensei attacked the disharmony between her methodology and representationof the data and Nakagawa-sensei complained that she should not take “minor” health problem of women but
treat “major” health issue, e.g. cancer and heart disease. Both sensei-s complained that her descriptive style is
too westernized to fascinate the Japanese intellectual. Today I have more sympathy her article than theircomments. My brain has been westernized already, hasn’t it ?

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MMAJ-Princeton1403113 (Mikedas)(1) The article can be interpreted as a message to Japanese unaccomplished “medical
anthropologists” on how to make an “anthropological critique” according to concrete
ethnological issues.
(2) Some stereotyped pseudo-disease labels for Japanese women can be understood not asa psychosomatic biomedical disorder but as a cultural representation that indicates the
positionality of Japanese women in the medicalization process.
(3) The article made the strong traditional gender ideology visible; this ideology could bemaintained not only by traditionalist conservatives but also by women themselves. And,(4) The article does not depend on a cultural determinist approach, but presents thepotential possibilities that can empower to women by representing them as subjects ofresistance.
Needless to say, the Japanese women’s good wife and wise mother ideology has been
criticized as statecraft by many feminists scholars. Through Prof. Lock representation ofJapanese women as partaking in a performative practice which has adapted to the
medicalization of women, she can propose that women have the potential to dislocate andself-fashioning (Greenblatt 1980) a new identity as autonomous subjects, apart from thestate ideology of “good wife and wise mother”, even if they are still maintaining thisstereotype.
When I re-read Lock-sensei’s old paper at this time, I am encouraged myself by her
productive power, the force, of maintaining the blurred genre. It is important to imagine
historically the critical aspect of this blurred genre, Medical Anthropology, because the
etymology of “revolution” means, “rolling back to ideal past.”
Remember, as the Jadi master’s phrase, “May the Medical Anthropology be with you!!”[Thank you for your attention]-----------------------------------------Tables and Images

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MMAJ-Princeton1403113 (Mikedas)

Table 1. My Classification of Sub-disciplines of Medical Anthropology (Ikeda 1997)
1. Physical anthropology
Paleopathology
Epidemiological geography and Historiography
Nutritional Ecology
Human Ecology
2. Ethnomedicine
Sorcery and Witchcraft Studies
Shamanism Studies
Ethnobotany and Ethnozoology
Folk Etiology Studies
Folk Pathology Studies
Anthropology of Body
3. Culture and Personality School (Studies)
Psychoanalysis
Psychological Anthropology
Transcultural Psychiatry
Comparative Psychiatry
Ethnopsychiatry
4. International Public HealthBehavioral Sciences in Public HealthAcculturation Studies under Introducing Modern Medicine
Development Anthropology
Table 2. Topics of Medical Anthropology (SMA online)
What is Medical Anthropology?
- Health ramifications of ecological “adaptation and maladaptation”- Popular health culture and domestic health care practices- Local interpretations of bodily processes

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MMAJ-Princeton1403113 (Mikedas)- Changing body projects and valued bodily attributes- Perceptions of risk, vulnerability and responsibility for illness and health care
- Risk and protective dimensions of human behavior, cultural norms and social
institutions- Preventative health and harm reduction practices- The experience of illness and the social relations of sickness- The range of factors driving health, nutrition and health care transitions- Ethnomedicine, pluralistic healing modalities, and healing processes- The social organization of clinical interactions- The cultural and historical conditions shaping medical practices and policies- Medical practices in the context of modernity, colonial, and post-colonial social
formations- The use and interpretation of pharmaceuticals and forms of biotechnology- The commercialization and commodification of health and medicine- Disease distribution and health disparity- Differential use and availability of government and private health care resources- The political economy of health care provision.
- The political ecology of infectious and vector borne diseases, chronic diseases andstates of malnutrition, and violence- The possibilities for a critically engaged yet clinically relevant application ofanthropology
Source: http://www.medanthro.net/feature/what-is-medical-anthropology/
Photograph 1.

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MMAJ-Princeton1403113 (Mikedas)(Cover article by Prof. Yonezō NAKAGAWA, July 1988)

Photograph 2-1.

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MMAJ-Princeton1403113 (Mikedas)(Cover article [partial] by Prof. Margaret LOCK, November 1989)
Photograph 2-2.

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MMAJ-Princeton1403113 (Mikedas)(Cover article [front page] by Prof. Margaret LOCK, November 1989)
Glossaries- BOGEN-BYŌ - Child illness induced by deficiency of mother’s social responsibility, apseudo-disease invented by a Japanese medical doctor.
- BURAKU - local hamlet in Japanese.
- DAIDOKORO-SHŌKŌGUN - House wife “kitchen” syndrome, a pseudo-disease
invented by a Japanese medical doctor.
- GATTSUKAI - authorized academic society or association.
- HIHANTEKI-IRYŌ - critical medicine.
- JISSEN NO IRYŌ JINRUIGAKU - "Medical anthropology of practice": The author'sbook on Medical Anthropology of Health Practice in Rural Honduras, an ethnography
published in 2001.
- KENKYU-KAI - voluntary research group.
- KIKAN-JINRUIGAKU - Anthropology Quarterly, a Japanese Journal of Anthropology
published Kyoto Association of Anthropology, Kyoto University, 1969-1989.
- KŌSEISHO - Ministry of Health,1938-2001, now Ministry of Health, Labour andWelfare, 2001- .
- KŌSEI-RŌDŌSHŌ - Ministry of Health, Labour and Welfare, 2001- .
- MAOists, M-A-O - acronym of the Medical Anthropologists group in Osaka.
- NICHIBEI-AMPO, NICHIBEI ANZEN HOSHO JYŌYAKU - the US-Japan military
alliance, “the governmental Treaty of Mutual Cooperation and Security between the UnitedStates and Japan.”- RANGAKU-KOTOHAJIME - "Beginning of Duch Scholarship,"(1815) The book nameof SUGITA Genpaku, 1733-1817, Medical doctor of the Edo period.
- RYŌSAI-KENBO NO TEIKŌ - Resisting against becoming good wife and wise
mother.A title of the Margaret Lock's paper.
- SEIBUTSU-IGAKU - biomedicine.
- SEINEN-KAGAKUSHIKA-SHŪDAN - Young Group of Historians of Science.

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MMAJ-Princeton1403113 (Mikedas)- SHIZEN-KAGAKU - natural sciences.
- SHUGEN-DŌ - a syncretic Japanese Mountain Religion influenced by the esoteric-tantric
Buddism, MITTKYŌ.
- TATE-SHAKAI - vertical society. A typical character of Japanese society, by Chie
NAKANE, 1970.
- YU-NYŪ GAKUMON - “imported scholarship”of western academics to Japan.
Bibliography- Burke, K., 1969. A Grammar of Motives. Berkeley: University of California Press.
- Engel, G.L., 1977. The Need for a New Medical Model: A Challenge for Biomedicine.
Science 196, No.4286, Pp.129-136.
- Foster, G. M. and B. G. Anderson., 1978. Medical Anthropology. New York: John Willy& Sons.
- Geertz, C., 1983. Local Knowledge. New York: Basic Books.
- Greenblatt S., 1980. Renaissance Self-fashioning: from More to Shakespeare. Chicago:
University of Chicago Press.
- Ishikawa, T., M.Tamura, S.Nakamura, M.Ikeda, K.Nagai, 1984. Topographic analysis of
the redox state of rat brain by NADH florescence photography of cross sections. J.Biochem,
Vol.95, Pp.213-221.
- Ikeda, M., 1997. What is the field for Medical Anthropologists ?: Past and Present.
BUNGAKUBU-RONSŌ published by Faculty of Letters, Kumamoto University 56:31-51.
- Ikeda, M., 2001. JISSEN NO IRYŌ JINRUIGAKU (Medical anthropology of practice).
Kyoto: SEKAI-SHISŌ-SHA.
- Ikeda, M., in preparation. Epicurean children: On interaction and “negotiation” between
experimental animals and laboratory scientists. 34pp.
- Kida, Mioru (Yamada Yoshihiko), 1967. NIPPON-BURAKU (Japan hamlet). Tokyo:
Iwanamishoten.
- Kuhn, T.S., 1996. The Structure of Scientific Revolution. 3rd ed. Chicago: University of
Chicago Press.

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MMAJ-Princeton1403113 (Mikedas)- Lock, M. 1980. East Asian medicine in urban Japan: Varieties of medical experience.
Berkeley: University of California Press.
- Lock, M. 1984. "RYŌSAI-KENBO NO TEIKŌ: GENDAI-NIPPON NI OKERUSHINTAI-KA TO IRYO-KA" (Resisting against becoming good wife and wise mother:Somatization

andMedicalizationinModernJapan).

KIKAN-JINRUIGAKU(Anthropology Quarterly), issued by the Kyoto University Anthropological Association,
Vol.15, No.1, Pp.36-60.
- Lock, M. 2013. The Alzheimer conundrum: Entanglements of dementia and aging.
Princeton: Princeton University Press.
- Maruyama, H., 1969. KISHIWADA-SHI NO NYŪJI-SHIBŌ WO MEGGUTE (Oninfant mortality survey in Kishiwada City, Osaka in 1930-40s). In “IRYŌ-SHAKAIKA
NO DŌHYOU”(Landmarks of Socialization to Medicine), Studium historiae medicae and
T.Kawakami eds., Pp.367-383, Tokyo: Keisō Shobō.
- Maruyama, M. NIHON NO SHISŌ (The Japanese own thoughts). Tokyo: Iwanami
Shoten.
- Nakane, C., 1970. Japanese Society. Berkeley: University of California Press.
- Suzuki, T. 2007. YU-NYŪ GAKUMON NO KŌZAI (Merits and Demerits of Our
Imported Scholarship). Tokyo: Chikuma Shobō.
- Weber, M., 1946. Method of Social Science. In “From Max Weber : essays in sociology.”translated, edited and with an introduction by H.H. Gerth and C. Wright Mills. Pp.55-61.
London: Routledge.
Internet Source- Inédit extrait d'une série d'entretiens que Roger-Pol Droit a eus avec Michel Foucault au
mois de juin 1975, quelques semaines après la publication de « Surveiller et punir ». Le
Point 01/07/04 - N°1659 p.82, http://1libertaire.free.fr/Foucault70.html

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