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Genders and Sexualities in Histor y
YUKI TERAZAWA
Genders and Sexualities in History
Series Editors
John Arnold
King’s College
University of Cambridge
Cambridge, UK
Sean Brady
Birkbeck College
University of London
London, UK
Joanna Bourke
Birkbeck College
University of London
London, UK
Palgrave Macmillan’s series, Genders and Sexualities in History, accom-
modates and fosters new approaches to historical research in the fields of
genders and sexualities. The series promotes world-class scholarship,
which concentrates upon the interconnected themes of genders, sexuali-
ties, religions/religiosity, civil society, politics and war.
Historical studies of gender and sexuality have, until recently, been more
or less disconnected fields. In recent years, historical analyses of genders
and sexualities have synthesised, creating new departures in historiogra-
phy. The additional connectedness of genders and sexualities with ques-
tions of religion, religiosity, development of civil societies, politics and the
contexts of war and conflict is reflective of the movements in scholarship
away from narrow history of science and scientific thought, and history of
legal processes approaches, that have dominated these paradigms until
recently. The series brings together scholarship from Contemporary,
Modern, Early Modern, Medieval, Classical and Non-Western History.
The series provides a diachronic forum for scholarship that incorporates
new approaches to genders and sexualities in history.
Knowledge, Power,
and Women’s
Reproductive Health
in Japan, 1690–1945
Yuki Terazawa
Hofstra University
Hempstead, NY, USA
Cover illustration: “The Birth of the First Child (Uizan)”, Suzuki Harunobu, 1725–1770
(Detail). A scene of a childbirth at a presumably wealthy merchant’s household in Edo
(Tokyo). The mother sits on a birth chair to the left. The woman who is wiping the child is
most likely a hired midwife. Photograph © 1769. Museum of Fine Arts, Boston.
One approach to the study of human bodies and sexuality involves uncov-
ering the diverse interpretations of physicality in other cultures and during
different periods of history. Yuki Terazawa’s Knowledge, Power, and
Women’s Reproductive Health in Japan, 1690–1945 explores how sexual
difference was understood in Japan from the early modern era to the mid-
twentieth century. She traces the gradual introduction into Japanese cul-
ture of the “modern” sexed body, unpicking the political, cultural,
institutional, and medical forces that led to the acceptance of the anatomi-
cal body as revealed in dissections. She is interested in unlicensed healers
as well as organized medicine. Crucially, she argues that shifting interpre-
tations of the body had major repercussions for gender relations. In com-
mon with all the volumes in the “Gender and Sexualities in History”
series, Knowledge, Power, and Women’s Reproductive Health in Japan is a
multifaceted and meticulously researched scholarly study. It is an exciting
contribution to our understanding of gender and sexuality in the past.
John H. Arnold
Joanna Bourke
Sean Brady
v
Acknowledgments
vii
viii Acknowledgments
I am also greatly indebted to two copy editors, Dan Harwig and Robert
Sauté, and the staff at Hofstra’s Educational and Research Technology
Services, Joseph Zona, in particular.
Special thanks to Professor Shizu Sakai in the Department of Medical
History at Juntendō University for her research advice, and to the staff
both in the department and at Juntendō Library for their generous help.
Although I did not incorporate it into this book, my interview with
Sumi Nagasawa, who practiced the profession as a well-known, highly
respected midwife, gave me invaluable insights. I would also like to thank
independent scholar Sachiko Harashima who informed me about the work
of Shihoko Muramatsu, who pioneered the midwife profession in the
Meiji period.
Professor Noriyo Hayakawa provided continuous and warm support all
these years, and professors Yuki Sakurai and Shō ko Ishizaki gave me essen-
tial assistance for the Tokugawa and modern sections, respectively.
I would also like to thank my colleagues in the departments of History,
Asian Studies, and Women’s Studies at Hofstra University for their sup-
port and encouragement. In particular, I would like to note the late John
Walsh whose warm and thoughtful advice was of invaluable support, espe-
cially at an early stage of my career there. Hofstra University’s School of
Arts and Science provided funds that enabled me to carry out research in
Japan and to write the later chapters of this book.
Prior to my graduate study at UCLA, I pursued a Master’s degree at
New York University (NYU). I would like to thank professors Molly Nolan
and the late Marilyn Young for directing me to the study of history. I also
greatly benefited from studying Marxism with Professor Bertell Ollman.
The greatest support I received while I was at NYU was from Professor
Timothy Mitchell, who was my advisor in the Department of Politics. It is
no exaggeration to say that without his kindness and intellectual guidance
at this initial stage of my journey as a young scholar, I would not have
developed my academic career as I did.
Finally, I would like to thank my family in Japan. My sister Tomoko
Nishioka shared anxieties about my uncertain future for many years, and
both of us also felt great pain when I could not fly to Japan to attend her
wedding because of a visa issue. My nephew and niece, Yoshinori and Saki
Nishioka, have provided great joy in my life. My greatest gratitude goes to
my mother, Itsuko Terazawa, and my late father, Hatsuyoshi Terazawa, for
their unwavering support and encouragement without which I could
neither have completed this book nor successfully pursued a professional
career.
Contents
1 Introduction 1
7 Epilogue 285
ix
x Contents
Select Bibliography 291
Index 305
Notes to the Reader
Tokugawa: 1603–1868
Meiji: 1868–1912
Taishō : 1912–1926
Shō wa: 1926–1989
Heisei: 1989–
xi
xii Notes to the Reader
served them. The fiefs and local governments that the lords maintained
are referred to as their “domains (Jp han).” In this book, “the Tokugawa
state” connotes the combination of the shogunate and domain govern-
ments, while the Tokugawa government is the shogunate.
xiii
xiv LIST OF FIGURES
xvii
CHAPTER 1
Introduction
For those of us who have grown up in the latter half of the twentieth cen-
tury, it is difficult to imagine an alternative picture of the body presented
in college anatomy textbooks. From our earliest education in science,
health, and hygiene, we encounter images of a dissected body with cardio-
vascular, respiratory, and digestive systems laid out as carefully delineated
component parts. Within this modern medical schema, it is the reproduc-
tive system, isolated as a set of functional parts, that marks the body’s sex.
The reproductive organs show the body to be “male” or “female,” each
charged with a specific reproductive function. These images, combined
with the authority of science as the ultimate arbiter of reality, have made
these sexual categories seem “natural.”
If we look to history, however, we find that this two-sex model is merely
one of a variety of ways of envisioning the sexed body. Thomas Laqueur
shows that from antiquity through the early modern period, European
medicine made no fundamental distinction between male and female bod-
ies. There was only one model: the male. The female body was conceived
as a weakened or inferior version of this master template, with the vagina
categorized as an inverted penis.1 Within this frame of reference, it was
difficult for women to articulate a feminine experience of the body.
Barbara Duden provides another model of the female body, using a
doctor’s notes from eighteenth-century Germany, which reveal how
women perceived their own bodies. The doctor who was educated in
healers, and medical patients? And, finally, how did this shift in under-
standing male and female bodies affect gender relations?
Even though this book addresses women’s reproductive bodies from
the early modern era to 1945, my starting point for the project is women’s
bodies today, where reproductive and maternal health have significance far
beyond individual women’s concerns and are vitally important to the
interest of the state and medical professionals. As long as we live in this
contemporary world, we cannot escape the dominance of modern bio-
medical knowledge and government health policies. That is, our bodies
have become captive of or colonized by bio-medical knowledge and prac-
tices, and government public health measures. While modern bio-medicine
is of European origin, its use spread to other parts of the world, and even-
tually people residing in Japan became subject to the modern power exer-
cised in the field of health and medicine. I clarify how this happened by
focusing on the area of midwifery and maternal health.
My approach invokes historical processes of the seventeenth to the mid-
twentieth century in which the state and organized medicine exerted an
ever-increasing influence over women’s bodies and reproductive lives in
Japan. Drawing on insights from Foucault’s writings, I reject theoretical
frameworks of the state as a distinct, coherent, oppressive agent, on one
hand, and “women” as an undifferentiated, oppressed group, on the
other. Instead, I want to focus on midwifery and maternal health policies,
discourses, and practices, and to analyze the ways that the engagement of
certain groups of women in such practices led to the generation and spread
of bio-medical power over those women.
The extensive research into the history of obstetrics and midwifery I
have carried out points to two important historical shifts that reshaped the
field of health and medicine in Japanese history, radically changing the
ideas and practices of obstetrics, midwifery, and maternal health. First, the
medical field in mid-eighteenth-century Japan saw the rise of new
approaches to analyzing the body, finding causes of diseases, and develop-
ing medical remedies, concomitant with what Foucault would call an
“epistemic shift” or an overarching change in the criteria for determining
what constituted legitimate medical knowledge. These new approaches
prepared Japanese physicians to accept Western medical methods and the
medical body that developed within this tradition in the mid- to late nine-
teenth century. In this eighteenth-century field of obstetrics and mid-
wifery, physicians belonging to the new obstetrics school, called the
Kagawa School, invented new methods that took advantage of newly
4 Y. TERAZAWA
encompassing the economic, social, and political spheres along with the
pressures of Western imperialism led to the breakdown of the Tokugawa
shogunate and the establishment of a modern nation state in Japan. To
survive the age of imperialism the Meiji ruling elites embarked on a
modernization policy that involved a fully fledged Westernization of
medicine, among many other fields.
Further research into this topic suggested problems with this initial
working hypothesis, however. Although modern medical institutions and
practices arose in conjunction with the establishment of the Meiji state, a
crucial shift in the system of scholarly and medical knowledge had occurred
during the mid-eighteenth century. What prompted this sweeping change
in the academic topography were the movements of progressive scholars
and physicians who questioned the then more established scholarly and
medical systems—namely, the neo-Confucian, Zhu Xi School tradition [Jp
Shushi-gaku] whose medical counterpart was called the Goseihō system.
Challenging these systems of thought and medicine, progressive and dis-
sident scholars and physicians prioritized empirical and practical knowl-
edge, corroborated by their own experience of seeing and touching the
objects of their investigations. It was the eighteenth-century move toward
empiricism within Chinese studies and Chinese medical traditions in
Tokugawa Japan, not specific medical models imported from Europe, that
led to the development of innovations in medicine and a new understand-
ing of the human body.
To understand this overarching shift in the scholarly and scientific
method that took place in eighteenth-century Japan, I draw on Foucault’s
theory of the “discursive shift.” Basic to understanding this concept is our
recognition of the importance of general principles governing a particular
cultural and historical moment, which collected together form an “epis-
teme.” This overarching epistemic framework structures the formation of
knowledge within various scholarly fields and determines what kinds of
knowledge are legitimate. In his important work earlier in his life, The
Archaeology of Knowledge, Foucault discusses a decisive epistemic shift
during the European Enlightenment that led to the emergence of an aca-
demic landscape governed by a new set of conceptual norms.6 A similar
shift occurred in eighteenth-century Japan in Chinese studies as well as in
the fields of science and medicine. The resulting new intellectual frame-
work challenged the neo-Confucian conception of nature, society, the
state, and morality that had been widely accepted as the mainstream
knowledge of late-seventeenth-century scholars and physicians.
6 Y. TERAZAWA