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[[File:Practical_Pursuits.jpg|thumbnail|left|275px|<i>[https://www.amazon.com/gp/product/0674019520/ref=as_li_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=0674019520&linkCode=as2&tag=dailyh0c-20&linkId=2dc43b0f6c68bf78b1adc96420c32a55 Practical Pursuits: Takano Chōei, Takahashi Keisuku, and Western Medicine in Nineteenth Century Japan]</i>]]During the Tokugawa period, Western medicine filtered into Japan. Ellen Nakamura argues in her book <i>[https://www.amazon.com/gp/product/0674019520/ref=as_li_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=0674019520&linkCode=as2&tag=dailyh0c-20&linkId=2dc43b0f6c68bf78b1adc96420c32a55 Practical Pursuits: Takano Chōei, Takahashi Keisuku, and Western Medicine in Nineteenth Century Japan]</i> (Harvard University Press, 2005) that western medicine was dispersed throughout Japan by Japanese physicians who believed that the practical benefits of Western medicine could improve the quality of their patients’ lives. While these physicians did not completely adopt Western medical practices, they incorporated some Western medical ideas into their own treatments. Through the writings of Takano Chōei (1804-1850), a rangaku scholar and ranpō physician, and Takahashi Keisaku (1799-1875), a rural internal medicine doctor from the province of Kōzuke, Nakamura argues that Western medicine was spread by extensive social networks to physicians throughout the country. Practicing physicians were interested in examining Western medical methods, and Nakamura shows that Western medicine spread to rural Japan even as the Bakufu increasingly limited the flow of Western ideas into Japan.
The book is presented as an account of the dispersion of Western medicine to rural Japanese physicians through social networks, but it ultimately is an analysis of a specific relationship between Chōei and group of Kōzuke physicians, including Keisaku. While at times this may prevent from Nakamura from successfully arguing her wider thesis, it is a valuable look at this specific relationship. Whether or not this relationship is a typical arrangement in the Japanese medical society is not entirely clear, but there is no doubt that these individuals’ interactions influenced each other in meaningful ways. Whether or not any broader social trends can be extrapolated from this network is difficult to say. Nakamura clearly hopes to demonstrate that the previous scholarship in this area focused too heavily on physicians in Nagasaki and in the Bakufu without examining the expanding role of Western medicine in Japanese society. Ultimately, the author succeeds in demonstrating that Western medicine was not limited to those select physicians.
