Timothy M. Yang, A Medicated Empire: The Pharmaceutical Industry and Modern Japan

Timothy M. Yang’s A Medicated Empire: The Pharmaceutical Industry and Modern Japan tells the story of the rise and fall of Hoshi Pharmaceuticals and its founder, Hoshi Hajime (1873–1951) from the late nineteenth to the mid-twentieth century. As one of the most successful Japanese drug companies before World War II, Hoshi Pharmaceuticals had an extensive portfolio that spanned popular over-the-counter medicines for digestion to monopoly-produced opiates and antimalarial medicines that greased the wheels of Japan’s expanding empire. The book, however, is really about practically every major historical development of modern Japan up to 1945, a microhistory of a single firm that expounds on a range of macro-themes that include the role of biomedicine in nation and empire-building; innovations in marketing, management, and retail strategies; big business and crony capitalism; and blurred lines between the licit and illicit in the narcotics trade. In providing a detailed track record of the company and its various scandals, Yang argues that Hoshi’s career was paradoxically defined by his company’s portrait as a humanitarian project while tinkering with the legal and ethical boundaries of what was deemed acceptable business practice.

The account begins by describing Hoshi’s background in the context of the modernization of Japan’s pharmaceutical industry in the late nineteenth century. As an overseas student at Columbia University, Hoshi was exposed to the full brunt of America’s Progressive Era, with ideas such as Taylorism and corporatism informing his later approach to management and the state. He notably spent his early career befriending the A to Z of Meiji Japan’s “great men,” including Ito Hirobumi, the country’s first prime minister, and Noguchi Hideyo, a prominent researcher on syphilis. After the turn of the century, he established Hoshi Pharmaceuticals and achieved success through a widely consumed over-the-counter digestive drug, Hoshi Ichoyaku. Primarily through advertising such products, the company solidified its slogan of “Kindness First” and promoted the ideals of self-medication to Japanese consumers. The company’s early accomplishments are also attributed to its vast network of franchised drugstores, professionally trained door-to-door peddlers, and the use of employee stock options to ensure loyalty and performance.

The second half of the book takes on a slightly darker tone by focusing on the company’s complicity in the Japanese empire’s use of drugs as tools for colonial expansion and control. Upon the annexation of Taiwan, Hoshi used his elite connections to colonial administrators like Goto Shinpei to become the sole supplier to Taiwan’s state opium monopoly, as well as the exclusive buyer of opiates like morphine for the Japanese market. Although recreational opium smoking was prohibited for Japanese citizens, it was heavily encouraged for colonial subjects in Taiwan to the extent that at its peak, opium sales accounted for almost half of the colony’s annual income. It is surprising that such a profitable endeavor also precipitated Hoshi’s downfall when he was convicted of violating international narcotics laws in 1925. The company experienced a brief comeback in the 1930s from rising demand for its medical resources during World War II. In addition to producing morphine and cocaine for the army, Hoshi set up plantations in Taiwan and Peru to supply the empire with quinine, an antimalarial medicine that was vital to its expansion across China and Southeast Asia.

The death knell for the company came when its illicit production of morphine was discovered by US occupation authorities in 1945. Particularly in the book’s latter half, Yang presents a critical business history that highlights the dilemmas between the company’s claims of virtue and its drive to accrue greater profits from colonial ventures. A Medicated Empire is ultimately a story of soaring entrepreneurial success that culminated in a collapse so disastrous that, despite being the most successful drug company in the 1920s, the Hoshi brand is barely remembered today. However, this failure allowed Yang to access the internal documents of an extinct firm without having to deal with the political pressures that are often subjected to historians of still-existing corporations.

Although the book uncovers a whole canopy of stories from company and personal archives, the narrative, as the author admits, does not fully account for the voices of Hoshi’s consumers. Yang could have made further historiographical headway by more deeply interrogating cocaine use, an intoxicant underexplored by other drug histories of Japan by Miriam Kingsberg Kadia and Jeffrey Alexander. As Yang writes, the company’s portfolio was so extensive that a lot of the cocaine confiscated by US customs officials on the West Coast was produced by Hoshi (p. 232). Even so, A Medicated Empire proves to be an ambitious, impactful volume for medical and pharmaceutical historians beyond those just focusing on Japan or Asia and persuasively highlights the often underexplored commercial dimensions of biomedicine in the context of nation and empire-building. In weaving together approaches in business history with a focus on the history of medicine, Yang provides a template on how to produce a company history that reveals broader social developments that are of interest to more general historical audiences.