Journal of Anesthesia History

Volume 4, Issue 4, October 2018, Pages 209-213

Physiological and Pharmaceutical Knowledge

in “Ninja” Society: Suggestions for Modern
Anesthesiologists and Intensivists

Highlights
A survey of historical documents was useful for learning the
knowledge of ninjas.
Ninjas utilized ample knowledge of physiology and pharmacology.
Some of this knowledge remains compatible with modern medical
science.

Abstract
Anesthesiologists and intensivists are modern professionals who
provide conscious sedation and respiratory care and prescribe
medicines with potential toxicity. Similarly, ninjas, covert agent
soldiers who carried out special operations in medieval Japan, also
had ample knowledge of toxicology, psychology, human consciousness
and respiration. Although the extent of their knowledge remains
largely unknown, that which has been described in the literature
appears to be practical and scientifically explainable from the
standpoint of modern medical science.
Introduction
Accurate medical knowledge is important for human survival. This
fact is also true for those in mentally and physically stressful positions
such as military and intelligence personnel. Medieval special
operations agents in Japan known as ninjas also had ample medical
knowledge, which was fundamental for survival and success in high-
risk missions. In this review, we investigate the medical knowledge
held by ninjas by referring to historical documents and descriptions
from martial arts masters.

Section snippets

Who Were Ninjas?

Ninjas were highly trained secret agents and mercenaries in the
politically intense feudal period of Japan who are considered the
equivalent of special operations personnel or intelligence agents in
modern society. Ninjas followed strict rules regarding feudalism and
1

combat, and they undertook missions that included the need for
espionage, infiltration, sabotage, assassination, and guerrilla attacks.
Ninjas are said to have appeared during the power struggles in the 9th
and 10th centuries that…

Documentation of Ninja Tactics

The methods, activities, and knowledge of ninjas were not
systematically documented because they needed to keep their
techniques secret, especially from possible enemies. Knowledge was
therefore primarily transmitted through direct verbal communication
and in-group training. Ninjas aimed to hide their existence and
actions.5
However, the following 3 textbooks are known to have been prepared
near the end of the ninja era: Ninpiden (1655), Bansenshukai (1675),
and Shōninki (1681).[2], [6], [7]

Herbal Medicine and Nutrients

Ninjas had a profound interest in herbs. In Bansenshukai, ninjas were
described as independently planting herbs and manufacturing herbal
medicines. Two major ninja villages, Iga and Koga, were known as
villages that specialized in growing herbs. In addition to health care
and strategic purposes, pharmaceutical knowledge had another
function. Ninjas based in the Koga area were reported to have also
sold herbal medicines on the street. This activity was believed to be
effective for gathering…

Toxins
Toxins were indispensable for ninjas to complete their missions
successfully. Some toxins were used for assassinations, while others
were used for killing animals or mind control.
Bansenshukai described a cannabis-based hallucinogen referred to
as aho-gusuri (Fig. 1) that was reported to drive the enemy insane. It
was said that hemp leaves were dried and ground into a powder and
then mixed with tea. Three cups of this tea were said to cause the
drinker to hallucinate. Hemp leaves harvested in…

Cognition Management
Cognition management was important for ninjas. The first aspect of
cognition management was disrupting the enemy's cognitive ability,
and the second was the use of anxiolytics for themselves. During
battle, ninjas attempted to confuse the enemy. By disseminating false
information through undercover agents, ninjas often tried to provoke
internal conflict among their enemies prior to actual battle in the field.
Ratti noted that ninjas had highly developed knowledge and command
of practical…
Knowledge of Respiratory Physiology
Anesthesiologists and intensivists are modern professionals who
provide respiratory care during surgery, interventional procedures,
and intensive care. In medieval Japan, ninjas had a profound interest
in respiratory management for their own survival and the successful
completion of a mission. Examples of their knowledge regarding
respiration included estimating sleep depth, suppressing their own
breathing sounds, adapting special breathing techniques for long
distance running, and fostering…

Applying Physiology to Ninja Snorkels

Survival techniques regarding crossing moats surrounding castles by
going over or under the surface of the water were known as suiton-no-
jutsu. In several textbooks and the related literature, Ninjas were
5

described as using a special bamboo snorkel as an underwater

breathing device to stay under the surface for long durations and
thereby conceal themselves in the moat of an enemy's
castle. Shōninki notes that ninjas carried a bamboo tube or the sheath
of a short sword (a specially designed

Conclusion
Ninjas utilized ample knowledge of pharmacology, toxicology,
respiration management, and physiology for not only their own
survival, but also for the successful completion of their missions.
While some of this knowledge is considered nonscientific and
somewhat superstitious in modern society, some remains compatible
with modern medical science, including anesthesiology and intensive
care.

Acknowledgment
This work was funded by the Japanese Ministry of Education and
Science with JSPS grants to Shigeru Saito (No. 16H02678).
References (16)
 Stephen Turnbull
Ninja: AD 1460–1650
(2003)
 The historical ninjutsu research team
Hattori Hanzo's Ninpiden
(2011)
 R. Yuki
Ninja-Saikyodensetsu
(2015)
 Oscar Ratti et al.
Secrets of the Samurai: the martial arts of feudal Japan
(1973)
 A. Nakajima
Kanpon-Bansenshukai
(2015)
 A. Nakajima
“Shoninki” by Fujinoissuishi M
(1996)
 Y. Hatsumi
Ninpodaizen
(2013)
There are more references available in the full text version of this
article.

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 Competing interests: The authors declare that they have no
competing interests.
Funding: Contributions to funding this manuscript were obtained
from the Japan Society for the Promotion of Science, Grant-in-
Aid for Scientific Research, 16H02678.
© 2018 Anesthesia History Association. Published by Elsevier Inc. All rights reserved.