Toward the end of Willem ten Rhijne’s (1647–1700) De Acupunctura, the Dutch physician narrates what appears to be the first time he saw the acupuncture procedure performed. He is on a ship with an imperial Japanese soldier, on the hofreis, the 1,000-kilometer journey from Nagasaki to visit the emperor in Edo. The soldier is seasick, and perhaps also a bit too much of a bon vivant. There is only one solution, which is to be self-administered:

In my presence he performed the acupuncture in the following manner (from this case, reader, form your judgment about others). Lying on his back, he drove the needle into the left side of his abdomen above the pylorus at four different locations. (For this task, he cautiously held the point of the needle with the tips of his fingers.) While he tapped the needle with a hammer (since his skin was rather tough), he held his breath. When the needle had been driven in about the width of a finger, he rotated its twisting-handle. He pressed the location punctured by the needle with his fingers. No blood, however, appeared after the extraction of the needle; only a very slight puncture mark remained. Relieved of the pain and cured by this procedure, he regained his health.

For a seventeenth-century European doctor — whose Hippocratic training still rested on the importance of the humors — the bloodlessness of the procedure was probably as much of a surprise as the rest of it. The hammer he saw the soldier use was a Japanese innovation on the nearly 2,000-year-old Chinese tradition of acupuncture. Ten Rhijne immediately set out to find out how it worked; De Acupunctura, a much-annotated translation of a Chinese acupuncture manual, including five copperplate engravings (the first two of the Chinese acupuncture points, two of the Japanese, and then one of an acupuncture needle and hammer) was his attempt to bring this wisdom to Europe. It did not entirely work out.

Ten Rhijne had arrived in Japan on July 31, 1674, taking up residence in the Dutch factory at Dejima, an artificial island off Nagasaki that was the only part of Japanese territory open to Europeans during the Edo period. The Dutch East India Company (VOC) had taken the island over after the Portuguese were expelled in 1639, its merchants sequestered there by a spike-topped wooden wall. The island was connected to the mainland by a single stone bridge that only Japanese people were allowed to cross. That the Dutch were willing to live like this — indeed, that Ten Rhijne had enthusiastically volunteered for the opportunity — is testimony to the commercial and intellectual attractions of seventeenth-century Japan. Until the American Navy showed up to forcibly open Japan’s ports in 1854, Dejima was the only official conduit between Japan and the West.

If Dutch visitors were interested in Japanese medical knowledge, the fascination ran both ways. The Portuguese introduction of the matchlock arquebus in 1543 had also introduced to Japan a new category of injuries — gunshot wounds — that Japanese doctors were enthusiastic about learning how to mend. In 1650, a VOC surgeon named Caspar Schamberger (1623–1706) had visited the imperial capital and attracted the interest of the local medical establishment, leading to the creation of “Caspar-style surgery” (Kasuparu-ryū geka). A few years later, the neo-Confucian scholar and physician Mukai Genshō (1609–1677) published the results of his study with another VOC surgeon as the Secret Outlines of Red-Haired School Surgery (Kōmō-ryū-geka-hōmō). (The Dutch were called “Red Hair,” Kōmō, to distinguish them from the Portuguese.)

When Ten Rhijne came to Japan, he complained that had to spend the bulk of his time in Dejima, answering medical questions (“bothersome trifles”) sent to him by the governor of Nagasaki: his answers would be compiled and published for the benefit of interested Japanese doctors. For this task he was assigned a motley phalanx of translators who had varying degrees of medical and linguistic knowledge. While some answers proved straightforward in translation, others caused confusion. For instance, according to Howard J. Cook, Ten Rhijne and his interpreters seem to have gotten bogged down in a long-standing misunderstanding about what a “carbuncle” even was — a specific symptom, or a general indicator of disease?

De Acupunctura reversed the flow of knowledge, and of misunderstandings. Ten Rhijne seems to have found a copy of a Chinese acupuncture text in Dejima, perhaps collected by another, unappreciative, VOC doctor. Ten Rhijne’s goal was to translate it, but no one on the island could go directly from Chinese to Latin, so he organised a relay. Iwanaga Sōko (1634–1705), a student of Genshō, translated the Chinese into Japanese; Shōdayū Motogi then rendered that into Dutch. Finally, Ten Rhijne translated the Dutch into Latin. In the process, no little accuracy was lost.

As a consequence, the text would thus be more or less impossible to use as a manual. Though he is a remarkably generous interlocutor of this unknown medical tradition, urging his European reader not to dismiss it out of hand, Ten Rhijne misunderstood the lines on the figures as (inaccurate) representations of the veins. Most notably, qi got lost in translation. Ten Rhijne thought of it as a wind, an overabundance of which could cause swelling that required acupuncture to let out. Thus, he mistakenly explains by way of a startling analogy, the doctors “perforate those parts [that are in pain] in order to permit the confined wind to exit (in the same way, sausages, when they threaten to explode in a heated pan, are pierced to allow the expanding wind to go out)”. He then imperfectly mapped his Galenic concepts of the humors onto yin and yang, producing explanations of the “wet radicals” and “weak primigenial humors”.

Perhaps these errors account for why the publication of De Acupunctura in 1683, some seven years after Ten Rhijne returned to Batavia (modern-day Jakarta), did not immediately spark a European craze for acupuncture. In the realm of secret information about Japan, Ten Rhijne even found himself overshadowed by another VOC surgeon, Engelbert Kaempfer (1651–1716), whose Amoenitarum exoticarum (1712) proved more immediately popular. But Ten Rhijne’s diagrams and notes, however ineffective, speak to a moment in history when Western medicine was open to the idea of its own partialness. After all, Ten Rhijne notes, a surgeon must sometimes use the tools and techniques of a carpenter, a metalworker, or even a tailor. You already have a needle — why not try something new?