The story of the first doctor to operate with general anesthesia (and the women who made it possible)

After studying medicine in Kyoto, Hanaoka Seishū (1760-1835) returned to his native Wakayama, near Osaka, with an obsession: to surpass the milestones of oriental doctors and carry out treatments that no one had managed to complete successfully. Unlike most of his contemporaries, he had not only trained in Eastern medicine, but also in Western (“Dutch,” as they were known) techniques. The combination of knowledge of medicinal plants, which he learned above all from the Chinese Hua Tuo (c. 140-208), a great medical reference on the Asian continent, with European practices allowed him to become the first known doctor to operate under general anesthesia.

Being interested in the past is not exclusive to our time, and already in the sixties of the 20th century the writer Sawako Ariyoshi (Wakayama, 1931–Tokyo, 1984) wanted to tell the story of this researcher. She was a pioneer herself: she became known in 1950, first as an author of plays and short stories, and then focused on novels. Social inequalities and generational conflicts in a Japan with one foot anchored in old traditions and another that seeks to modernize are the basis of his work. After completing his studies in Tokyo, he traveled widely and lived for a year in New York, where he began writing professionally with articles, narratives and scripts.

She died at the peak of her career, with a long career that had made her a key figure in Japanese literature. He always paid special attention to women, to their subordinate social role, an approach that also applies in his recreation of the life of the doctor Hanaoka, nicknamed Unpei in the novel, titled The two rivals (Seishu no tsuma1966) and published for the first time in Spanish by Errata naturae, with a translation by Akihiro Yano and Twiggy Hirota, a publisher that had already opted for it in 2022 with The Kimoto Ladies (Kinokawa1959), a splendid family saga about the social transformations in the transition from the 19th to the 20th centuries, with the focus on successive generations of women.

Mother-in-law and daughter-in-law, friends and enemies

Instead of narrating the doctor’s life in the usual chronological order that begins with childhood, he opts for a point of view centered on Kae, a young woman from a wealthy family who will become his wife. At that time, serving as a provincial doctor, like Unpei’s father and as expected of the boy, lacked prestige. Accepting the marriage implies a “reduction” for Kae, having a more distinguished origin, but she has reasons to say yes: on the one hand, she was always curious about the doctor’s visits, they brought her fresh air; On the other hand, since she was a child she noticed the beautiful Otsugi, her future mother-in-law, a lady with elegant manners that contrasts with the rusticity of her surroundings.

It is Otsugi who convinces the family, arguing that a doctor needs a wife with the tenacity and character of Kae, whom he has been observing. This profession, as the young woman confirms, involves the entire house, which functions as a consultation, a school for apprentices… and a laboratory, although she will discover this later. When she arrives, her husband is still in Kyoto. Kae lives with her in-laws, which includes Otsugi and two sisters-in-law, who will remain single, with whom she shares the tasks. Everything flows, despite having distanced himself from his loved ones; and Kae is willing to learn from her admired mother-in-law, who welcomes her like another daughter.

Everything changes with the return of the son. With him, even without knowing him, Kae has no problems; It is Otsugi who suddenly stops being the maternal mother-in-law and becomes the mother of the heir, an heir who is not satisfied with following in his father’s footsteps and is determined to make history. Otsugi fears that marital duties will distract him from his goal, and he interferes between the couple. Nor does he allow, upon the death of the patriarch, Kae to take over as lady of the clan. Thus begins a rivalry, a power relationship between mother-in-law and daughter-in-law that extends over the decades, with critical moments, fine description of characters and role exchanges.

The doctor’s back room

Ariyoshi delves into the doctor’s vicissitudes from the perspective of the women who knew him closely. An imaginary recreation, which achieves what is expected from a novel, which is not only verisimilitude, but also expressing, through fiction, a truth deeper than that emanating from simple facts, a truth that does not only speak of the 19th century in that context, but of timeless, universal drives and affects. Furthermore, the point of view – omniscient third person centered on Kae – provides the perspective of someone who settles in a foreign home and observes the doctor – his ambitions, his shame, his doubts – from the outside, giving him nuances that he would not have as a narrator. protagonist.

Unpei pursues one goal: to completely anesthetize the patient to intervene in ailments that at that time had no cure. He experiments with herbs, a field in which the revered Hua Tuo paved the way. The influence of the West, this greater openness of vision, will be key when integrating conclusions from both branches; Even working alone, the collaboration of different disciplines, different researchers, is crucial. And there will be another topic of interest: breast cancer, which added to its severity the stigma on the sick, who out of modesty hid it until it was untreatable. The author did not choose Hanaoka by chance as inspiration: with him she enhanced feminist consciousness.

Hero for science, trusted man for patients, patriarch of a family that becomes rich thanks to his work, good brother, inspiring teacher… Unpei is all that, but also what is not seen: making a scientific discovery is not It is not an easy or quick task, and it certainly entails costs. Not only does he put his personal life in the background to focus on work and study – something that the family assumed normally – but he dedicates himself to experimenting on animals in secret, and not under today’s conditions. More than one animalist would shake their heads at certain descriptions, but it is undeniable that scientific knowledge has been and is nourished by this.

The cats are the first test; Then human beings will come, their litmus test. And that’s where Ariyoshi raises the tension, confronting mother-in-law and daughter-in-law to become the most helpful to Unpei in an investigation that, as such, is by nature risky. The history manuals compile the discoveries of the inventors, but they say nothing about the sacrifices behind them, nor about the invaluable help of those who offered to collaborate with them. A lot of invisible feminine effort; the one here, fictional and taken to the limit, although its breath is real and exciting, it is felt in the gut. The two rivals It is considered Ariyoshi’s masterpiece, and rightly so.

Indoor portrait (female)

Beyond rediscovering the figure of Hanaoka, the novel stands out as an x-ray of Japanese society in the Edo period (1603-1868). Specifically, the domestic sphere and the space, ambiguous and less sealed than one might think, of women; a brilliant portrait of customs with an exceptional cast. The protagonists are cunning and brave, each in their own way: Otsugi, iron fist in a silk glove, intelligent and quick, dominant and proud, ultimately victim of her own demands; Kae, the newcomer who makes her way, quiet and observant, without the mischief of age, but strong and persevering at the same time. Its evolution, its conflicts, do not disappoint expectations.

As happens in many novels, even though women are the oppressed, in the core of the family they are the ones who pull the strings. It’s not that the son/husband lacks authority; is that he only cares about what is important, that is, his career. He is also stubborn and clever, polite, without being a despot to his people; Ariyoshi does not fall into the cliché of the tyrant or the faint-hearted. In reality, they all respond with elegance to the role expected of them as members of a reputed clan, hence the even greater merit of penetrating into what they do not say, into the silences, into the struggles and complicities without stridency.

And it’s not just about the main trio: the doctor’s single sisters are important secondary characters, well developed and with their own plots that are linked to the main one. They enrich the social x-ray of the female hierarchy beyond the woman called to be a wife-mother-patron, they add layers due to their delicate links with the two protagonists and, perhaps most relevantly, they have their charisma, they are not mere extras. As he already did in The Kimoto LadiesAriyoshi proves to be a superb narrator of domestic dynamics and feminine characters, to which she incorporates, in The two rivalsa fascinating historical exploration of the dawn of modern medicine.

Women’s voices in contemporary Japanese narrative

The first half of the 20th century in Japan gave rise to many exceptional novelists, including the 1968 Nobel Prize winner Yasunari Kawabata, who along with authors such as Junichiro Tanizaki, Natsume Soseki, Ōgai Mori, Osamu Dazai, Ryūnosuke Akutagawa, Kobo AbeYukio Mishima or the crime novel specialist Seicho Matsumoto, aroused the interest of the West. His other Nobel Prize, Kenzaburō Ōe, in 1994, already belongs to Ariyoshi’s generation. Less is known about women writers; but there were some and little by little they are being translated into Spanish: along with Ariyoshi, it is worth highlighting Fumiko Enchi, Fumiko Hayashi, Yuriko Miyamoto and Jakuchō Setouchi.


Before them, at the end of the 19th century, there was Ichiyo Higuchi (1872-1896), considered the first modern Japanese author. Although he died very young, he left several notable stories, such as those collected in cherry trees in the dark (Satori, 2017, trans. Hiroko Hamada and Virginia Meza) and a snow day (Satori, 2019, trans. Rumi Sato). Their themes revolve around family and women, with realism and without giving up the symbolism inherent to their culture. By the way, although more and more publishers are betting on the recovery of writers like them, Satori deserves a mention, which since its foundation in 2007 has established itself as the reference for Japanese literature in Spain, with translations of the original and editions that take care of both formal aspects and, when appropriate, the context of the work and linguistic particularities.

Currently, three names stand out: Hiromi Kawakami, Yoko Ogawa and Banana Yoshimoto, who have international recognition and numerous translations. Among those who have arrived later (at least to Spanish bookstores), it is worth taking into account Yūko Tsushima, Minae Mizumura, Yoko Tawada, Mitsuyo Kakuta, Yukiko Motoya, Sayaka Murata, Kaori Ekuni, Tomoka Shibasaki, Mieko Kawakami or Hiroko Oyamada, among others. There are also authors who have adopted another literary language, but retain their Japanese “soul”: Aki Shimazaki and Ryoko Sekiguchi, based in Canada and France respectively, do so in French; while Milena Michiko Flasar, born in Austria, in German.

Thus, Haruki Murakami is not alone, just as his male predecessors were not alone. Titles like The two rivals They bring us closer to a reality less portrayed in Japanese fiction, with a social portrait closer to realism and the psychological novel than the lyrical and sensual evocation to which Japanese narrative has accustomed us. Ariyoshi outlines a model of femininity that, due to its high demands, faces (self)destruction; an issue that women, despite the obstacles overcome, continue to deal with. And it does so through a moving story, of courage and sinuous affections, of attachments and renunciations, of love and ambition. Splendid.

#story #doctor #operate #general #anesthesia #women

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