Ohta T
Institute of Brain Function, Iseikai Hospital, Osaka, Japan.
Acta Neurochir Suppl. 2006;98:19-24. doi: 10.1007/978-3-211-33303-7_4.
In Japan, almost all culture and civilization were introduced from abroad; in the past from China and now from U.S. and European countries, owing to her geographical features circumscribed by oceans and separated from the continents. Neurosurgical science and practice have been received in the same way as other activities. However, there are some exceptions such as organ transplantation from the brain dead and brain-dock, which means a brain check-up system of asymptomatic brain diseases. Reasons why these are practised or not in Japan are considered from the viewpoint of Buddhism and Shintoism. If our special practises could appeal to people in other countries, our neurosurgical philosophy might become widespread and welcome worldwide.
Organ transplantations from brain dead have routinely been performed in many countries, while only 37 cases have been executed in Japan, after the Japanese government accepted its application in 1997. In contrast, brain-dock is widely practised without any national insurance systems, while this is rarely practised in other countries. It seems to me that Buddhism and Shintoism have influenced on these special situations, due to extreme fear and impurity of the dead body and a way of comprehending the oneness of body and mind, and also deep concern for the impact of their diseases to their families rather than for themselves.
We neurosurgeons should realize that our profession is directly related to ultimate human sufferings such as aging, disease, and death, as pointed out by Gautama Buddha. We are in fact in a position to study the real way for resolution of the human sufferings, mentally and physically. Based on our experiences, the foundation of a new academic discipline like "cultural medical science" should urgently be considered in all parts of the world and in light of individual cultural, economical, geographical, and population problems.
在日本，几乎所有的文化和文明都是从国外引进的；过去是从中国引进，现在则是从美国和欧洲国家引进，这是由于其岛国地理特征使其与各大洲隔绝。神经外科学的科学与实践也和其他活动一样是从国外引进的。然而，也有一些例外情况，比如来自脑死亡者的器官移植以及脑部健康检查（“brain-dock”），脑部健康检查是指针对无症状脑部疾病的一种脑部检查系统。从佛教和神道教的角度来思考这些做法在日本实施与否的原因。如果我们这些特殊的做法能够吸引其他国家的人，我们的神经外科理念或许就能在全球广泛传播并受到欢迎。
在许多国家，从脑死亡者身上进行器官移植已是常规操作，而在日本，自1997年政府批准相关申请后，仅进行了37例此类手术。相比之下，脑部健康检查在没有任何国家保险制度的情况下广泛开展，而在其他国家这种检查很少进行。在我看来，佛教和神道教对这些特殊情况产生了影响，这是由于对尸体极度的恐惧和嫌恶，以及对身心合一的一种理解方式，同时也是因为更关注疾病对患者家庭的影响而非患者自身。
正如释迦牟尼佛所指出的，我们神经外科医生应该认识到我们的职业与诸如衰老、疾病和死亡等人类终极苦难直接相关。事实上，我们有能力从身心两方面去探寻解决人类苦难的真正方法。基于我们的经验，迫切需要在世界各国并根据各自的文化、经济、地理和人口问题来考虑建立像“文化医学”这样一门新学科的基础。
