造東大寺司 合請藥 문서와 光仁天皇의 疾病 = Emperor Kōin suffered from Stroke and The Todaiji 7 kinds of Medicine Request Document

다국어 초록 (Multilingual Abstract)

The Todaiji Medicine Request Document, dated August 16, 781, records the urgent procurement of medicine to treat Emperor Kōin. He suffered from Stroke(中風). According to the chronicle, in August 770, his face began to show signs of illness, and General Fujiwara Hyakukawa expressed great concern and administered both medication and prayer. This is consistent with the symptoms of Stroke, a condition characterized by facial paralysis. In April 781, Emperor Kōin abdicated in favor of his son Emperor Hwanmu, citing Stroke, saying, “I have had Stroke since the beginning, and my body has been unwell year after year (元來풍병 身體不安復年)” and “I cannot even sleep , comfortably (枕席不安),” confessing that he had endured long-term treatment but had reached a critical point.
This document records seven kinds of medicinal herbs: cinnamon(桂心), Mirabilite(芒硝), Areca nut(檳榔子), ginseng(人蔘), Zixue(紫雪), Terminalia chebula(呵黎勒)and Piper longum(蓽撥). These are not produced in Japan and belong to a group of drugs used in the treatment of middle wind in Tang medicine. cinnamon warms the blood circulation and improves paralysis and cold symptoms, rhizome and citronellol remove phlegm-heat and stagnant body, and reduce the pressure rising to the brain. citronellol is an acute medicine that responds to high fever, convulsions, and loss of consciousness. ginseng, rhizome, and citronellol strengthen the weakened qi and blood and organ functions to suppress recurrence and chronicity. This is a systematic prescription that precisely responds to the pathology of stroke, which is a complex interaction of phlegm, heat, qi, blood, and deficiency.
The person who prescribed this was Naiyakushi Yoshida Hitamaro. He was a court physician who inherited the lineage of Baekje and Tang medicine, and he managed Emperor Kōin's chronic rheumatism from 771 to 781. His immediate superior, the powerful Fujiwara Uona, ignored all precedents and directly requested medicine from Todaiji Temple when the emperor's condition worsened, sending his nephew Fujiwara Ieyori to receive it. Ultimately, this document records the final medical treatment given to Emperor Kōin, who had been supporting Fujiwara Uona politically, and also represents the last vestige of Fujiwara Uona’s power. When Emperor Kōin died in December 781, the following June, Uona, Ieyori, and the head of Todaiji Temple were either dismissed or demoted. The document should be re-evaluated as a historical document that vividly testifies to the tense medical and political moment just before the downfall of Uona.