136 • Takao Suzuki 



Figure 7. Two cases of tuberculosis in the Kofun period: left, spine of adult male 

 from Shiroyama-Kofun site (courtesy of Dr. T. Ogata); n^/i/, spine of mature 

 female from Unoki-Kofun site. 



following a rapid increase of population density. Neverthe- 

 less, it is still strange that not a single case of bone tuber- 

 culosis has been found from the Jomon skeletal remains. As 

 Morse ( 1961 ) pointed out, if prehistoric tuberculosis did ex- 

 ist there should be many cases of typical spinal tuberculosis 

 found among the large amount of excavated skeletal mate- 

 rial. The second hypothesis is more probable, dealing with 

 the migration of the causative organism Mycobacterium tu- 

 berculosis. A great number of immigrants from the Asian 

 continent migrated to this island country via the Korean Pen- 

 insula during the Kofun period (protohistoric, ca. third to 

 seventh century a.d.). Not only did they introduce various 

 cultural characteristics including the Chinese writing system, 

 agricultural methods, and crafts, but they brought some new 

 infectious diseases, probably including smallpox and tuber- 

 culosis, which disseminated throughout the country accom- 

 panying a rapid increase of population. The oldest written 

 record of respiratory tuberculosis appeared in a Buddhist 

 medical book published in the 12th century in Japan. Many 

 medical documents, particularly in the Edo period, described 

 a high prevalence of lethal, respiratory tuberculosis among 

 the p)eople. 



Unlike tuberculosis, the origin, dissemination and preva- 

 lence of venereal syphilis have already been elucidated by the 

 old medical documents. According to medical historians 



(e.g., Fujikawa 1904:172-177, 1912:42; Dohi 1921:70-75), 

 the first outbreak of a virulent venereal infection appeared in 

 this country in the decade following 1510, the late 

 Muromachi period, and suddenly prevailed in epidemic pro- 

 portions. The oldest documents describing the appearance of 

 syphilis in Japan are two documents written in a.d. 1512 and 

 1513. They showed that the first large outbreak of syphilis 

 was in the western part of Japan and then spread to the north- 

 eastern part within a year or so. The people at that time called 

 this curious epidemic disease Tau-mo (Chinese eruption) or 

 Ryukyu-mo (Ryukan eruption), which represent the original 

 epidemic area before they were involved. This virulent epi- 

 demic of syphilis struck the unsuspecting Japanese without 

 distinction as to age and sex. During the Edo period, the 

 people were very familiar with syphilis and called it by vari- 

 ous names. Many documents deal with the clinical man- 

 ifestations and therapies for syphilis during the mid and latter 

 Edo period. 



Koganei ( 1 894) described a case of an Ainu archeological 

 skeleton showing typical changes of osseous cranial syphilis 

 (Figure 8), and Suzuki ( 1 963: 1 3- 1 5) reported the oldest case 

 of osseous cranial syphilis from the Muromachi period (Fig- 

 ure 9), stating that 3 out of 23 skulls ( 13.0%) had the typical 

 features of os.seous syphilis. Another old case showing syph- 

 ilitic change in the skeleton from a ruin of a medieval castle in 



Zagreb Pateopathology Symp. 1988 



. 



