Ishinpō: Japan's Oldest Medical Encyclopedia at Ninnaji Temple

Tucked within the treasure hall of Ninnaji Temple — a UNESCO World Heritage Site in Kyoto — lies one of Japan's most remarkable National Treasures: the Ishinpō (医心方, "Prescriptions from the Heart of Medicine"). Compiled in 984 CE by the court acupuncturist Tamba Yasuyori, this extraordinary work stands as the oldest surviving medical text in Japanese history. The Ninnaji version, consisting of five surviving booklets (Volumes 1, 5, 7, 9, and fragments of Volume 10), offers an unparalleled window into the medical knowledge, healing practices, and daily concerns of people living over a thousand years ago.

What Is the Ishinpō?

The Ishinpō is a comprehensive medical encyclopedia spanning 30 volumes that covers virtually every aspect of health and medicine known in East Asia during the 10th century. Its compiler, Tamba Yasuyori (912–995), served as a master acupuncturist (hari hakase) at the imperial court during the Heian period. Drawing upon hundreds of Chinese medical texts from the Sui and Tang dynasties, Tamba systematically organized knowledge on medical ethics, disease diagnosis, treatments, pharmacology, hygiene, nutrition, and wellness practices.

In 984 — the second year of the Eikan era — Tamba presented the completed Ishinpō to Emperor En'yū. The work was written entirely in classical Chinese (kanbun), following the scholarly conventions of the time, with Japanese reading aids such as kana glosses and okototen punctuation marks added to help readers navigate the text.

The Ishinpō's 30 volumes encompass a remarkably wide range of topics:

• Medical ethics and general medical theory
• Acupuncture and moxibustion techniques
• Treatments for specific diseases and conditions
• Pharmacology and herbal remedies
• Beauty treatments and skincare recipes
• Pregnancy and childbirth guidance
• Dietary therapy and nutrition
• Divination and health prognostication
• Longevity practices and Taoist wellness traditions

The Ninnaji Version: A Treasure Among Treasures

Two copies of the Ishinpō are designated as National Treasures in Japan. The better-known "Nakarai-ke-bon" (Half-井 Family Copy), a near-complete set of 30 volumes now held at the Tokyo National Museum, was designated a National Treasure in 1984. The Ninnaji Temple version — designated even earlier, in 1952 — holds a distinct scholarly importance.

While the Nakarai copy was kept by the imperial court and later given to the Nakarai family of court physicians, the Ninnaji version traces its lineage to a separate copy retained by the Tamba family itself. It was later transcribed and came to be preserved at Ninnaji Temple. What makes this version particularly valuable is that it contains fewer annotations and later additions than the Nakarai copy, leading scholars to believe it may be closer to Tamba Yasuyori's original text.

Of the original 30 volumes, only five booklets survive at Ninnaji today: Volumes 1, 5, 7, 9, and fragments of Volume 10. Historical records indicate that as many as 20 booklets were still extant at the temple in the late Edo period, but the others have since been lost. Despite this, the surviving volumes remain of extraordinary value for understanding the original form of this monumental work.

Why Was It Designated a National Treasure?

The Ishinpō at Ninnaji was designated a National Treasure on November 22, 1952, for several compelling reasons that span multiple scholarly disciplines.

First, as a medical document, the Ishinpō cites more than 200 Chinese medical texts, many of which have been lost in China itself over the centuries. This means the Ishinpō serves as the sole surviving record of numerous ancient medical traditions — making it indispensable not only for Japanese medical history but for the entire history of East Asian medicine.

Second, the Japanese reading marks (kunten) added to the classical Chinese text in red and black ink provide invaluable evidence of how Japanese scholars read and pronounced Chinese characters during the Heian and Kamakura periods. These linguistic annotations make the Ishinpō a crucial primary source for the study of historical Japanese linguistics and calligraphy.

Third, the Ninnaji copy's relative lack of later annotations suggests it preserves a form closer to the compiler's original intent, offering researchers a purer textual baseline for comparison with other versions.

Ninnaji Temple also holds two other National Treasure medical texts — the Kōtei Naikyō Taiso (Yellow Emperor's Inner Classic) and the Shinshū Honzō (Newly Revised Materia Medica) — making it a uniquely important repository of ancient East Asian medical knowledge.

Highlights and Points of Interest

Seeing the Ishinpō in person is a deeply moving experience. The elegant brushwork on aged washi paper, with its faded vermillion reading marks and precise columns of classical Chinese characters, speaks quietly of the generations of scholars and physicians who studied and relied upon this text.

For visitors with an interest in the history of medicine, the Ishinpō provides a fascinating glimpse into how Heian-period Japan understood health and illness. The text's coverage extends far beyond what modern readers might expect of a medical manual, encompassing beauty treatments, dietary recommendations, longevity practices drawn from Taoist traditions, and even medical divination — reflecting the holistic worldview of the era.

The Reihokan (Treasure Hall) at Ninnaji, where the Ishinpō is periodically exhibited, is itself a registered tangible cultural property designed by architect Kataoka Yasushi and completed in 1927. The hall's dignified atmosphere provides a fitting setting for encountering these ancient manuscripts.

In the autumn of 2025, Ninnaji held a special exhibition titled "The World of the National Treasure Ishinpō: Prayer and Learning at Ninnaji," which showcased the medical manuscripts alongside related treasures including the Kōtei Naikyō Taiso, Honzō Kōmoku, and Meido no Zu (acupuncture charts). Such dedicated exhibitions are rare opportunities — described by the Japan Society of Acupuncture and Moxibustion as a "once-in-a-decade" event.

Ninnaji Temple: The Setting

Ninnaji Temple is one of Kyoto's most distinguished temples, founded in 888 CE by Emperor Uda and served by imperial-lineage head priests (monzeki) for nearly a thousand years until the end of the Edo period. Registered as a UNESCO World Heritage Site in 1994 as part of the "Historic Monuments of Ancient Kyoto," the temple grounds feature an impressive array of cultural properties.

Visitors to Ninnaji can enjoy the National Treasure Kondō (Golden Hall), originally part of Kyoto's Imperial Palace and relocated to the temple in the early Edo period. The elegant Five-Story Pagoda, the famous Omuro cherry trees that bloom later than most Kyoto cherry blossoms, and the beautifully maintained palace gardens all contribute to making a visit to Ninnaji a rich cultural experience that extends well beyond the Reihokan exhibitions.

The temple is also home to other National Treasures, including the exquisite miniature Yakushi Nyorai statue and the Song-dynasty painting of Kujaku Myōō (Peacock Wisdom King). Together with the medical manuscripts, these treasures paint a vivid picture of the intellectual and spiritual life that flourished within these temple walls.

Surrounding Area and Nearby Attractions

Ninnaji is situated in the Omuro district of northwestern Kyoto, surrounded by cultural treasures. Nearby attractions include Ryoanji Temple, famous for its enigmatic rock garden, and the golden splendor of Kinkakuji (the Golden Pavilion), both within easy reach by bus or a pleasant walk. The Kitano Tenmangu Shrine, dedicated to the god of scholarship, lies a short distance to the east.

For those wishing to explore further, the Myoshinji Temple complex — one of Japan's largest Zen monastery compounds — is just a few minutes' walk south. The area's relatively quiet atmosphere compared to central Kyoto makes it ideal for a contemplative day of temple-hopping and cultural exploration.