Nagayo Sensai

Image: Collection of the Keio Institute for Fukuzawa Studies

Fukuzawa Yukichi and Nagayo Sensai met at Ogata Koan's Tekijuku. Fukuzawa entered Tekijuku in March 1855 at the age of 20, while Nagayo had entered the previous year at the age of 16. They would spend their youth together at Tekijuku until Fukuzawa left for Edo in 1858.

This is also recorded in "The Autobiography of Fukuzawa Yukichi." It describes a time when Fukuzawa went flower viewing in Momoyama with his companions from Tekijuku.

"Suddenly looking to the west, I saw a great fire in the south of Osaka. (...) This was serious. Just that day, Nagayo Sensai had gone to see a play in Dotonbori. We flower-viewing companions had no personal interest in the fire in Osaka, so it didn't matter to us whether it burned or not, but Nagayo was there. We worried that Nagayo might burn to death. Thinking we had to rescue him no matter what, we ran the two or three ri from Momoyama to Osaka. When we reached Dotonbori, it had already burned down. (...) Though we worried about what happened to Nagayo, there was no way to search for him. Soon the sun set and it became night."

Regarding their relationship, Ishikawa Mikiaki, author of "The Life of Fukuzawa Yukichi," wrote, "Nagayo Sensai was his oldest close friend since the Ogata Juku days, and their intimacy was such that they could be called brothers or relatives." Fukuzawa himself used the term "close friend," and the two were indeed recognized by themselves and others as best friends.

After studying at Tekijuku, Nagayo moved to Nagasaki in 1861 to study Western medical sciences under Pompe van Meerdervoort. After returning to his hometown by order of his domain to serve as a physician for the Omura Domain, he returned to Nagasaki to audit lectures and clinical practice by Mansvelt. After serving as the head of the Nagasaki Medical School, he was called to Tokyo in 1871 and became involved in Japanese medical administration.

Nagayo recalled the time he accompanied the Iwakura Mission to inspect America and Europe from that same year in his autobiography, "Shoko Shishi," as follows.

"At first, I understood words like 'sanitary,' 'health,' and 'Gesundheitspflege' only by their literal definitions and did not take them deeply to heart. However, as my investigation progressed, I realized they did not simply mean the protection of health. (...) I discovered here a special administrative organization responsible for the general health protection of the citizens. This system actually draws its source from medical sciences and encompasses various fields such as physics, chemistry, engineering, meteorology, and statistics to operate them politically to eliminate hazards to human life and fulfill the welfare of the state. It covers everything from the prevention of epidemics and infectious diseases to the relief of the poor, the cleanliness of the land, the provision and disposal of water and sewage, the construction methods of city houses, and the regulation of drugs, dyes, and food and drink. It encompasses everything related to the interests of human life, large and small, forming a single administrative department (...) and becoming an important organ of national administration."

He stated that "since the matter of health protection did not even have a name in the East and was a completely innovative undertaking," he "secretly resolved to take this on as his life's work."

Upon returning to Japan in 1873, Nagayo was appointed as the Officer of the newly established Medical Affairs Bureau in the Ministry of Education. In 1875, the functions were moved to the Ministry of Home Affairs, and he became the Officer of the Sanitary Bureau, striving to lay the foundation for Japan's medical and public health administration. Incidentally, Nagayo was the first to use the word "Eisei" (hygiene/sanitation). He said, "When drafting the medical system, I thought of using words like 'Kenko' (health) or 'Hoken' (healthcare) as direct translations of the original terms, but they were too blunt and uninteresting. While searching for a more appropriate term, I thought of and used a word from the 'Zhuangzi,' though the meaning was different."

Nagayo also worked hard to enlighten the public about the concept of hygiene. An example of this was the establishment of the Great Japan Private Sanitary Association. Cholera outbreaks repeated from 1877, but as the government strengthened its authoritarian response, including isolation, the public not only hid cases but also began to show a rejection of everything related to hygiene. Therefore, the association was established in 1883 with the aim of spreading the ideas and methods of hygiene among the people so that the government and the public could harmonize and cooperate.

In 1891, Nagayo retired as the Officer of the Sanitary Bureau due to frequent illness. Since Fukuzawa and Nagayo "visited each other so closely that they could be called brothers or relatives" (recollection of the third son, Nagayo Matao), Fukuzawa well understood the hardships Nagayo faced as the Officer of the Sanitary Bureau. Regarding this, Fukuzawa wrote in September 1898 in "Celebrating the 60th Birthday of Mr. Nagayo Sensai" as follows.

Some people say Nagayo is "a person who soared in the political world and achieved perfect fame and profit," but if he simply sought fame and profit, he could have amassed great wealth by opening his own practice. Nagayo's efforts in the official world were driven by the fact that "he could not suppress his initial resolution to reform medical practices for the sake of Japan, and believing in the necessity of using the power of the government to execute that reform, he dared to decide his course of action." Fukuzawa further noted that improving medical affairs among the "vulgar crowd" of the official world was "no different from climbing a mountain while riding a pig, and I often secretly surmised that everything must have been contrary to his wishes."

Fukuzawa and Nagayo cooperated in various situations for the sake of Japanese medical sciences. When Fukuzawa passed away on February 3, 1901, Nagayo lamented as follows.

"For over forty years, I have always received the grace of his guidance and encouragement, and our friendship grew deeper with the years. I do not mourn for the world alone; I cannot help but grieve the loss of an old friend who is hard to find. Moreover, I cannot suppress my feelings of deep regret, as I owe much to this master of our medical world."

He then specifically mentioned the support for Kitasato Shibasaburo.

Kitasato first studied medical sciences at Kumamoto Medical School, where he was guided by Mansvelt. He then moved to study at Tokyo Medical School, where Nagayo was the principal, and found employment at the Ministry of Home Affairs Sanitary Bureau. It was as if he were following in Nagayo's footsteps, and Nagayo supported Kitasato with great care.

Dispatched by the Sanitary Bureau, Kitasato went to Berlin, Germany, in 1886 to study under Robert Koch and immersed himself in research. Kitasato, who achieved world-renowned results such as the anaerobic cultivation of tetanus bacilli and the development of serum therapy, returned to Japan in May 1892. Since Nagayo was the one who worked hard to extend Kitasato's study period abroad, Nagayo rejoiced in Kitasato's achievements as if they were his own.

However, the Japanese academic world was cold. Although he had turned down invitations from European and American universities and research institutes to return home, he was unable to start his research in Japan. Nagayo, deeply pained, consulted Fukuzawa.

Fukuzawa immediately established the Institute for Study of Infectious Diseases on leased land near Shiba Onarimon, which he had prepared for his children, with the cooperation of Morimura Ichizaemon. Soon after, the institute became the research center for the aforementioned Great Japan Private Sanitary Association, where Nagayo served as Vice President, and a system was established to expand it as a project of the association with government subsidies.

Furthermore, Fukuzawa and Nagayo discussed tuberculosis, for which there was no cure at the time. Following Nagayo's suggestion, Fukuzawa established the Tsukushigaoka Yojoen the following year, with Kitasato as the director and Nagayo as an advisor. It was a specialized hospital for tuberculosis built on land owned by Fukuzawa in Shirokane Sanko-cho, where Fukuzawa himself directed the purchase of adjacent land, the design and construction of the wards, and the establishment of the management system.

Many patients gathered at Yojoen, drawn by Kitasato's reputation. Administrative Director Tabata Shigeaki recalled the scene, saying, "The gate was suddenly crowded like a marketplace, and the sixty-plus hospital rooms were always full, leading to expansion after expansion and a constant state of full occupancy."

In 1914, after both Fukuzawa and Nagayo had passed away, when the Institute for Study of Infectious Diseases was transferred from the Ministry of Home Affairs to the Ministry of Education and made an affiliated institution of Tokyo Imperial University, Kitasato and his staff resolutely resigned en masse and immediately established the Kitasato Institute on the site of Yojoen through their own efforts. This was made possible by Yojoen and its profits. Indeed, the two men saved Kitasato even after their deaths.

I would like to introduce another instance of cooperation between the two that is not well known: the republication of "Rangaku Kotohajime" (The Beginnings of Dutch Studies).

"Rangaku Kotohajime," which told of the hardships of translating and publishing "Kaitai Shinsho" (New Text on Anatomy), had become a phantom book by the end of the Edo period. However, during the Keio era, Kanda Takahira happened to find a manuscript at a roadside stall in Kanda, and Fukuzawa read it thoroughly with his fellow Western scholars. Fukuzawa, believing that publication was the best way to preserve it, published it in 1869 after consulting with Sugita Genpaku's great-grandson, Renkei.

When Nagayo moved from Nagasaki to Tokyo in 1871, he immediately visited Fukuzawa, and the book they read together through the night was "Rangaku Kotohajime." Nagayo spoke of that time in 1898 in "Keio Gijuku Gakuho," the predecessor of Mita-hyoron (official monthly journal published by Keio University Press).

"Later, in the early years of Meiji, when I went to Tokyo and visited Mr. Fukuzawa, our conversation turned to the sages of the past, and he showed me a copy of 'Rangaku Kotohajime.' I stayed overnight and read it through; with every chapter, I was moved by their perseverance and reflected on their hardships at the time. I could not suppress my feelings of shame and gratitude, and before I knew it, the dawn had broken."

Nagayo carried the emotions he felt when reading it with Fukuzawa throughout his life, and upon holding the 1st Japan Medical Congress in 1890, he decided to reprint "Rangaku Kotohajime" in commemoration.

In a letter to Nagayo regarding this reprint, Fukuzawa wrote, "Indeed, this book has captivated people for many years, and even today as I write this, I cannot help but be moved. I am writing this while wiping away tears. I hope the reprint will be numerous and distributed throughout the country."

Fukuzawa cooperated by writing the "Preface to the Reprint of Rangaku Kotohajime" (included in "The Collected Works of Fukuzawa Yukichi, Vol. 5"). Below is an excerpt.

"When it comes to the passage describing how they faced the book 'Tafel Anatomia' like setting out on a vast ocean in a ship without a rudder, feeling utterly bewildered and amazed, every time we read this, we perceive the hardships of our predecessors, are surprised by their courage, and are moved by their sincerity and heart; there is no one who does not weep with extreme emotion."

Since Nagayo was "sickly by nature" ("Shoko Shishi"), Fukuzawa's concern was great. When Nagayo retired as the Officer of the Sanitary Bureau, Fukuzawa expressed his feelings. In a letter to Okamoto Sadayoshi, Fukuzawa wrote, "We have been close like blood brothers for over thirty years, sharing any private matter with each other. I have always worried about Nagayo's frail health (...) if by any chance he were to die today, it would be truly unbearable for me."

In reality, after more than 45 years of close friendship, Nagayo passed away in 1902, the year after Fukuzawa's death.