Reference; https://mbp-japan.com/tokyo/seino-1987/column/5079627/
Modified and translated by CFJA
The first health care system in Japan is called ishitsuryo 医疾令 stated in taiho ritsuryo 大宝律令, established in 701 CE during the Asuka period (592 – 710 CE). Since this no longer exists, the context of this book can be known through yoro ritsuryo 養老律令, which is the modification of taiho ritsuryo 大宝律令 by Fujiwara no Fuhito in 718 CE (2nd year of yoro period). During the Nara period, isei 医制 (medical law) was Japan’s first medical law. Ishitsuryo 医疾令 is an imitation of the medical law used in China, during the Tang Dynasty, and there are a total of 27 articles. This has been followed for around 100 years, until the Kamakura period (1192 – 1333). Looking at the context, it says that they have been managing and educating people who take part in medical practice in the pharmaceutical department in the Ministry of the Imperial household. According to shiki-inryo 職員令, there were 23 job positions and the chief pharmacist was the head. The main structure is as follows:
10 Doctors 医師
1 Doctor of medicine 医博士
40 Medical students 医学生
5 Acupuncturists 針師
1 Doctor of acupuncture 針博士
20 Acupuncture students 針生
2 Anma therapists 按摩師
1 Doctor of anma按摩博士
10 Anma students 按摩生
2 Jugon therapists 呪禁師
1 Doctor of jugon呪禁博士
6 Jugon students 呪禁生
2 Herb gardener 薬園師
6 Herb gardener student 薬園生
The role of the doctor is to diagnose and treat various diseases. They had provided treatments such as tairyo 体療 (internal medicine), soshu 創腫 (surgery), shosho少小 (pediatrics), me 目 (ophthalmologist), ha 歯 (dentistry), kakuho 角法 (phlebotomy/bloodletting), etc. Kakuho 角法 is a treatment that removes blood stasis. Nowadays, it is referred to as oketsu chiryo 瘀血治療 which includes bloodletting (one of the acupuncture therapy), oketsu-kyuatsu therapy 瘀血吸圧治療, cupping therapy 抜缶治療, leech therapy 蛭治療, etc. The role of the acupuncturist is to treat soshu 創腫, referred to sosho 瘡腫 (ulcer) in the Tang Dynasty, which is considered surgery. Article 6 in ishitsuryo 医疾令 states, “One should learn combined methods of acupuncture and moxibustion.” Hence, acupuncturists studied both acupuncture and moxibustion and performed surgical treatment. Also, Yu Fujikawa mentions that the role of henseki anma shi 砭石按摩師 (wedging stone anma therapist) is to treat a dislocation, fracture and ligament injury. Anma therapist practiced bloodletting and bandaging, which is considered an orthopedical treatment in modern medicine. In addition, since they practiced anma therapy and daoyin 導引 (Jp. doin), it can be assumed that current therapies such as anma therapy and exercise therapy were practiced at that time. The role of the jugon therapist is to cast a spell and purge the evil spirit; at that time, there used to be a job position for it. Since ancient times, the world of sorcery exists throughout the world and even now, it is a pious approach. The role of the herb gardener is to cultivate and harvest herbs.
40 medical students were separated into two groups of 20, where 12 studied internal medicine, 3 studied surgery, 3 studied pediatrics, 2 studied otorhinolaryngology and dentistry. Although it takes seven years for medical students to graduate, it takes five years for a student who studied surgery and pediatrics and four years for students who studied otorhinolaryngology and dentistry to be acknowledged as a doctor. Thus, 24 students who studied internal medicine took seven years to graduate. Along with medical students, 20 acupuncture students studied for seven years. In contrast, anma students and jugon students studied for three years. For each department of doctor, acupuncturist and anma therapist, a single topmost student was given a doctorate, and later became a professor to educate future medical students, acupuncture students, and anma students. Doctor of medicine, doctor of acupuncture and doctor of anma therapy holds the top positions in their country’s medical practice. Note that Tanba Yasunori, who wrote Japan’s national treasure Ishinpo『医心方』, was the doctor of acupuncture. The differences were shown through ranking and salary. The ranking of the acupuncturist was set one rank lower than the doctor.
Until the end of the Edo period, this form of the medical officer’s system continued institutionally. Anyone was able to become a doctor by learning medical techniques. Therefore, doctors who practiced acumoxa techniques began to be called hari-i 鍼医 (acupuncture doctor) and kyu-i 灸医 (moxibustion doctor).
Next>