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Kanpo Consumption Among Japanese Students at Western Michigan University: Case Studies in Medical Pluralism

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Kanpo Consumption Among Japanese Students at Western Michigan University: Case Studies in Medical Pluralism Western Michigan University ScholarWorks at WMU Master's Theses Graduate College 4-1997 Kanpo Consumption among Japanese Students at Western Michigan University: Case Studies in Medical Pluralism Joseph Paul Siuda Follow this and additional works at: https://scholarworks.wmich.edu/masters_theses Part of the Anthropology Commons Recommended Citation Siuda, Joseph Paul, "Kanpo Consumption among Japanese Students at Western Michigan University: Case Studies in Medical Pluralism" (1997). Master's Theses. 4705. https://scholarworks.wmich.edu/masters_theses/4705 This Masters Thesis-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Master's Theses by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. KANPO CONSUMPTION AMONGJAPANESE STUDENTS AT WESTERN :MICIDGANUNIVERSITY: CASE STUDIESIN MEDICALPLURALISM by Joseph Paul Siuda A Thesis Submitted to the Faculty of The Graduate College in partial fulfillmentof the requirements for the Degree of Master of Arts Department of Anthropology WesternMichigan University Kalamazoo, Michigan April 1997 Copyright by Joseph Paul Siuda 1997 KANPOCONSUMPTION AMONG JAPANESE STUDENTS AT WESTERN MICIBGANUNIVERSITY: CASE STUDIES IN MEDICAL PLURALISM Joseph Paul Siuda, M.A. WesternMichigan University, 1997 Many societies have pluralistic medical systems in which biomedicine and alternativetherapies coexist. Some anthropologists view medical pluralism adaptively, where the strengths of various therapies complement each other. Others highlight the hegemonic power of biomedicine and its tendency to suppress or co-opt alternativetherapies. To understand medical pluralism, one must examine alternative therapies in particular cultural contexts. Kanpo, or Japanese herbalism, has sur:vivedpolitical and legal suppression resulting fromJapan's 19th century attempts at westernization and now poses a challenge to the biomedical model of health and illness. Since the 1970's more Japanese are turning to kanpo rather than biomedicine forchronic illness. This article reports on three case studies of the usage of kanpo herbs by Japanese students at WesternMichigan University. Interviews of Japanese students reveal a remarkable degree of consensus regarding attitudes toward Western medicine and kanpo. The article contributes to understanding Japanese perceptions of health and illness and how these impact treatment choices. TABLE OF CONTENTS INTRODUCTION . .. .. .. .. .. .. .. .. .. .. 1 STATEMENT OF THEPROBLEM .. .. .. .. .. .. .. .. 2 Relevance to Existing Literature .. .. .. .. .. .. 2 OVERVIEW OF KANPO MEDICINE . .. .. .. .. .. 6 KANPO DIAGNOSIS ANDTREATMENT . .. .. .. .. 8 Kanpo and Shinto .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9 Kan po and Diet .. .. .. .. .. .. .. .. .. .. 10 Where Kanpo Is Acquired ...................................... 12 Problems With Acquisition ..................................... 12 My Experience With Chinese-derived Martial and Healing Arts in Japan . .. .. .. .. .. .. .. 13 Japanese Students at Western Michigan University: A Profile ........... 15 METHODSAND POPULATION STUDIED .. .. .. .. .. .. .. 17 CASE STUDIES ................................................. 19 Noriko .................................................... 19 Kazue ..................................................... 22 Ai ........................................................ 26 Other Informants .. .. .. .. .. .. .. .. .. .. .. .. .. .. 29 RESULTS ...................................................... 31 CONCLUSION .................................................. 36 Medical Pluralism . .. .. .. .. .. .. .. .. .. 3 7 Assessment of the Utility of the Extended Case Study Method . .. 3 8 11 Table of Contents-Continued RECOMMENDATIONSFOR FURTHERRESEARCH ................... 39 APPENDICES A. Approval Letter From the Human Subjects Institutional Review Board ............·. .. .. .. .. .. 40 B. History ofKanpo: From Chinese Origins to Contemporary Practice .................................... 42 BIBLIOGRAPHY. .. .. .. .. .. .. .. .. 51 lll INTRODUCTION Chinese-derived herbal medicine (kanpo) has been practiced in Japan for centuries. Existing alongside biomedicine in contemporary Japan, kanpo is an effective treatment for many chronic ailments. The increasing awareness of the potential health hazards associated with synthetic drugs has led to kanpo usage becoming even more widespread among the Japanese since 1970. Little until now has been written about kanpo usage outside of Japanese borders. I selected forstudy six Japanese students at WesternMichigan University who use kanpo medicine. I obtained information about informants' diet, lifestyle, attitudes toward health and illness, and how these affectedchoice of treatment. Infor­ mants were preselected for kanpo usage; they are not intended to be a representative sample of the Japanese student population at WesternMichigan University. I also obtained specific descriptions of actual episodes of illness, the informants' choice of treatment, and the treatment outcomes. These latter case studies provide a vivid, micro-scale illustration of the dynamics of medical pluralism. This article provides the reader with a brief sketch of the contemporary practice of kanpo medicine, reports on three case studies of kanpo consumption among Japanese students, and compares the results of these studies with published accounts of kanpo consumption patternsin Japan. In addition, the article contributes to the theoretical understanding of medical pluralism 1 and demonstrates the utility of case studies in anthropological research. 1 Medical pluralism is a case in which different options for medical treatment coexist in a particular society. STATEMENTOF THE PROBLEM Most research on kanpo has focused on issues of efficacy in the narrowest sense: the analysis of kanpo herb mixtures for pharmaceutically active chemical compounds, and the isolation and concentration of these substances foruse in a biomedical setting. More recently, some medical anthropologists have studied kanpo holistically, as a viable indigenous medical system. Comparatively little has been published detailing the transformationof indigenous Japanese models of illness after a sustained period abroad. I hypothesized that the use ofkanpo by Japanese students at Western Michigan University reflects a fear ofbiomedical iatrogenesis (physician­ caused disease) resulting fromtheir experience ofbiomedicine in the context ofthe Japanese Health Care System. To test this hypothesis, I used the Extended Case Study method (Van Velson 1967) to elicit information about Japanese student use of kanpo herbs and to uncover the network of values related to perceptions ofhealth and illness (i.e., an Explanatory Model of Illness [Young 1982]). This article contributes to the scant anthropological literature regarding the use of indigenous Japanese medicine in a foreigncontext. Relevance to Existing Literature To undertake any ethnomedical study in a pluralistic society entails some understanding of the interrelationships between a medical system and the cultural values ofthose who administer and use its health-promoting practices (Worsely 1982:316). In the treatment of mental illness forexample, the Japanese therapist 2 3 (Morita therapy) reinforces the sense of duty a patient feelstoward social relations, enabling the patient to better accommodate him/herself to society. That illness is viewed as a kind of selfishness(Ohnuki-Tierney 1984:212) is understandable only in the context of a culture without an essentialized conception of Self where identity is a dynamic state composed of an ever-changing complex ofsocial roles (Kondo 1990). Ohnuki-Tierney (1984:212) attributes the success ofmedical pluralism in Japan to the way each therapeutic option (including biomedicine) has become thoroughly embedded in Japanese culture and society. While Ohnuki-Tierney (1984) and Lock (1987) agree that the Japanese have the option of biomedical, Chinese­ derived [herbal, acupuncture, moxibustion, massage], or magi co-religious treatment forillness, Lock's later work (1990) highlights the cultural hegemonic power of biomedicine and attempts on the part ofthe biomedical establishment to co-opt kanpo herbs into their own medical system. I agree with Lock (1990) that the divorcing ofthe content ofkanpo treatment [i.e., herbs] from the form [e.g., active participation ofpatient in his or her own diagnosis and treatment] threatens the integrity and efficacyofkanpo drugs and the continued practice of Chinese-derived medicine in Japan. Herbs are merely one facet of this medical system. The piecemeal study ofherbs neglects the potential synergistic effects among combinations ofherbs commonly prescribed. Moreover, kanpo diagnosis ( detailed in a later section) and extended patient-practitioner interaction are integral parts of the practice of kanpo. It is the efficacyof this holistic medical system rather than one isolated component of it which needs to be evaluated. An example ofthe artificial separation of the content of kanpo treatment from the traditional context in which the treatment takes place is biomedicine's attempt to isolate the medically efficacioussubstances in kanpo herbs (Ohnuki-Tierney 4 1984:222). Biomedicine has come under attack for its narrow definition of efficacy (Hare 1993; Lock 1990; Ohnuki-Tiemey 1984). Results of these studies have been inconclusive as the gradual nature of kanpo treatments
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