Japanese Medical Texts in Chinese on Kakké in the Tokugawa and Early Meiji Periods

This chapter discusses the process of framing kakké 腳氣 (lit. “leg-wind”) as a modern disease in Kanpō medical texts written in Chinese from the late Tokugawa to the early Meiji period. Before kakké was fully translated into the biomedical term “beriberi” and defined as a disease caused by nutrient deficiency linked to a diet of white rice, it had been understood and treated since classical times as a condition caused by a Wind toxin. Etiological and therapeutic discussions concerning kakké had long been based on those about jiaoqi in classical Chinese medical texts since the early medieval period, which focused on the pathogens of Damp and Wind entering by the lower limbs. Jiaoqi was curiously ignored by late imperial medical texts, and modern Chinese often had to rely on Meiji Kanpō texts to interpret this old disease. Modern Kanpō texts distinguished kakké from its old forms and understood it as an urban disease arising in warmer months and affecting essentially prosperous, young, able-bodied men who indulged in excessive food consumption and a hedonistic lifestyle. Doctors applied regimes of purging and replenishing for therapeutics, methods that were taken from traditional Chinese medical classics on jiaoqi. It was described as a distinctly modern Japanese disease in a prosperous period. This framing was radically different from the biomedical understanding of beriberi, which became dominant in Asia only in the 1930s and saw it as a disease of malnutrition caused by diets that relied too heavily on white rice