The history of Nagasaki, the Japanese birthplace of Western medicine and its education

Over the past several centuries, Western medical knowledge and practices have circulated globally through colonial, missionary, and educational networks. Contemporary trends toward standardization continue to shape medical education worldwide, often reinforcing asymmetric power relations between the Global North and South. Although dominant models have frequently marginalized local knowledge and traditions, medical education has also involved processes of adaptation and integration within local contexts. This study adopts a historical case study approach to examine the development of Western medical education in Nagasaki, Japan, during the nineteenth and twentieth centuries, focusing on the Dutch physician who established the Nagasaki Medical School in 1857. Drawing on critical analysis of his writings as primary sources, alongside relevant historical materials, the study explores how Western medical education was introduced, interpreted, and transformed within specific cultural and political conditions. We employed perspectives of colonialism, the Japanese concept of Wakon Yōsai (Japanese spirit with Western technology), and Cultural Fusion theory to analyze both the pedagogical intentions of the foreign instructor and the strategic engagement of Western medicine by Japanese students. The findings demonstrate that Western medical education in Nagasaki was not simply imposed but actively negotiated by local actors, resulting in hybrid educational practices. This interaction between foreign instruction and local agency continued to shape medical education beyond the founder’s tenure. By foregrounding these historical encounters, this study highlights the role of local actors in negotiating medical knowledge and expertise and underscores the importance of recognizing diverse historical and epistemological foundations in international collaborations in medical education.