The Last Giant of Japanese Kampo Medicine—Asada Sohaku

In 1894, when Asada Sohaku—hailed as the last giant of Japanese Kampo medicine—died, the medical and Confucian scholars of Japan all deeply mourned this grandmaster of Kampo (Chinese) medicine.

On the day of his funeral procession, shops along the route spontaneously closed their doors; commoners set up altars, burned incense, and shed tears as they sent off this great healer. The number of eminent figures from all walks of Japanese life who attended his funeral reached ten thousand.

Asada Sohaku, whose art name was Ritsuen, mastered both Confucian learning and medicine. Japanese medical and Confucian circles described this unmatched genius of Kampo with the phrase: "Before Ritsuen there was no Ritsuen; after Ritsuen there is no Ritsuen."

Asada Sohaku was truly a giant without equal before or after him in Japanese Kampo medicine. Not only was his medical reputation illustrious and his output of works enormous, but he was also devoted to public duty, saving the nation and its people—truly "the greatest of knights, the greatest of Confucians, the greatest of physicians."

Asada Sohaku's history teacher, Rai Sanyo, once encouraged him with the words, "If a great man cannot be a person the world cannot do without, then he should write a book the world cannot do without." Asada himself often said, "The Analects cultivates oneself; the Shanghan Lun saves others; beyond these, there are no books worth reading under heaven."

Though born into a medical family, the young Asada Sohaku preferred reading tales of romance and history and admired ancient knights-errant, so he was often scolded by his grandparents.

Because of this early influence, Sohaku carried a chivalrous air throughout his life. Even after middle age, when he became famous throughout Japan for curing the stubborn ailments of Emperor Taisho (then Crown Prince Yoshihito) and the French minister—becoming the highest-paid doctor in Japan—he still insisted on aiding the poor and treating impoverished patients for free. Nearly half of the patients he treated in his lifetime received free care.

Asada Sohaku never stopped writing. From his teens until age 55, it is said he wrote every single day without a single break, and he published over eighty medical works in his life. At his peak, he treated as many as 300 patients a day—and that number was capped because his associates worried his health would not hold. It is hard to imagine how he maintained such boundless energy and endurance.

Asada Sohaku lived to 81. Before he died, he knew his time had come and gave his final admonitions to his disciples. He instructed his son that after his death, the four characters "Silent and unmoving" must be written on his body. Having studied Yangming Confucianism, Asada Sohaku achieved the unity of knowledge and action that Wang Yangming taught.

According to legend, from age 18 this legendary physician traveled to Kyoto to study ancient formulas under Nakanishi Saishu, a disciple of Yoshimasu Todo—the leading figure of Japan's Ancient Formula school (the jingfang, or classical-formula school, which reveres Zhang Zhongjing's Shanghan Lun and Jingui Yaolüe). He also moved in the circles of the Kawagoe and Fukui families to broaden his medical knowledge, studied Confucianism under Inushi Keisho, history under Rai Sanyo, and Yangming thought under Oshio Chusai in Osaka.

When Asada Sohaku was in dire straits, he was reduced to standing in the street holding a Buddha statue and striking a begging bowl, waiting for passersby to give him alms to stay alive. He himself once contracted a plague and was bedridden for a long time, nearly dying.

In 1838, when Asada Sohaku was 23 and traveling away from home, his father fell critically ill. Sohaku traveled day and night for home but could not arrive in time to see his father one last time.

His father left him the dying instruction: "Establish yourself through medicine, practice the ancient Way, and repay the world's grace." Hearing this, Sohaku resolved to strive. After the funeral, he entrusted his relatives to the care of kin and returned to Edo to continue his studies.

Until age 40, because his medical fame had not yet risen, Sohaku still lived in hardship. But at 41 he met his patron—the shogun's physician Moto Yasumaru. With Moto's support, Sohaku came into contact with the three great masters of Edo medicine of the time: Tao Genkitsu, Kojima Gakuko, and Kitamura Kojo. With these mentors and friends, his skill improved rapidly, and his clinical results and reputation grew ever more notable.

In 1861, the shogun Tokugawa Iemochi ordered Asada Sohaku to treat the French minister's stubborn illness. Sohaku cured it handily. The French minister wrote to Emperor Napoleon telling him that Japan possessed Kampo physicians of such skill; Napoleon not only rewarded Sohaku generously but also promoted his reputation in France, and Sohaku's name thus reached Europe.

In 1879, shortly after the birth of Prince Haru (later Emperor Taisho) of Japan, the infant fell critically ill with breathing difficulty. Japanese physicians of both Chinese and Western traditions were helpless. Asada Sohaku was called in: he inserted a curved tube into the prince's esophagus and poured in Zouma Tang, a TCM formula for copious phlegm. The prince vomited up phlegm and turned the corner.

Prince Haru's constitution was very weak; for more than two years afterward he remained frail, and it was through Sohaku's care that he grew up healthy. From then on, Sohaku's medical reputation was at its zenith.

During the Meiji Restoration, Western learning flowed east and Western medicine was introduced into Japan, dealing a huge blow to Kampo, which derived from Chinese medicine. Voices across Japan demanded the abolition of Kampo. Asada Sohaku, with his impressive clinical results and illustrious reputation, turned the tide and saved Kampo from the brink of extinction. That is why he is universally recognized as the last giant of Japanese Kampo medicine.

Throughout his life, Asada Sohaku remained a clinician rather than a theorist, seeking truth from facts. His works held to the classical-formula tradition and largely avoided the abstract speculations of yin-yang and five-phase cosmology.

The Shanghan Lun, which Sohaku revered, contains the line, "Always recognize this; do not err." Originally Zhang Zhongjing's warning to clinicians to value treating the pattern—"for such a pattern, use such a formula"—Sohaku took it to heart so deeply that he styled himself "Shici" (Recognize This), and titled his magnum opus The Pocketbook of Formulas: No-Error Rhymes (Wu Wu Fang Han Kou Jue).

The source of Asada Sohaku's outstanding results lay in his profound study of formula-pattern and drug-pattern correspondences. Though he revered the Ancient Formula school, he differed from traditional classicists: the 579 proven formulas in his famous work were selected from ancient formulas, later formulas, and Japanese experiential formulas for their marked clinical efficacy, not limited to the Shanghan Lun and Jingui Yaolüe.

Asada Sohaku left not only mountains of medical works but also fourteen literary books and a large body of poetry and essays, some surviving and some lost. His many talents are admirable.

The person is gone, but his spirit remains. Sohaku's diligence and love of learning, and his compassionate heart as a healer, are exactly what we who study medicine should inherit and carry forward.