Paper short abstract:

Analysis of an influential work attributed to the Tendai monk Annen (841-889?) entitled Collection of Secret Rituals on Seeking Offspring, Conception, and Childbirth (Gushi nintai sanshō himitsu hōshū), which discusses operations of the female body, including fertility, pregnancy, and childbirth.

Paper long abstract:

For noblewomen in Heian and Kamakura Japan, the inner workings of the female body, including fertility, pregnancy, and childbirth, were most likely little discussed in public. These issues, however, were certainly important in private life and could have significant political repercussions for their families. Aristocratic daughters who married high-ranking courtiers or even became imperial consorts had to take special care of their health and well-being, particularly during pregnancy. But how could women know what exactly was happening inside their bodies? Was this process ever explained to them? And if so, how?

An undated collection attributed to the Tendai monk Annen (841-889?) may be one of the earliest Japanese Buddhist handbooks that brought together the knowledge of how women's bodies work. The Collection of Secret Rituals on Seeking the Offspring, Conception, and Childbirth (Jp. Gushi nintai sanshō himitsu hōshū) in five fascicles casts light on a variety of subjects dealing with women's reproductive health, materia medica, and esoteric rituals focusing on conception, pregnancy, and childbirth. This collection is remarkable in that it explains the bodily sensations and mental perceptions of both the expectant mother and the unborn child and underscores the necessity of upright moral conduct by both, thus implying that both the living and the unborn should correctly exercise their bodies and minds.

If Annen's authorship was indeed proven, this collection may have appeared more than a century before Japan's earliest medical compendium, Tanba Yasuyori's Ishinpō (Essentials of Medicine, ca. 984), which contains several fascicles on women's health, including explanations of embryological development. In addition, Gushi nintai sanshō himitsu hōshū can be treated as a precursor to the vast array of ritual strategies that became the cornerstones of esoteric rituals for safe pregnancy and childbirth practiced at court during the Heian and Kamakura periods, that is, long after Annen's time.