Kaze wo hikanai de kudasai ne. (Don’t catch a cold!): Why do doctors treat a cold with antibiotics?

In Tokyo, the temperature is falling and the leaves are slowly dying. Everyone on the train is wearing a mask to protect themselves from getting a cold. “A cold” is translated as “風邪” (kaze) in Japanese. This word also means “wind”. It’s actually quite similar to our idea of the coldness around us making us sick, so our cultural ideologies about illness are comparable. But once you catch one, what should you do? That’s where we disagree.

 

 

One cultural misunderstanding that’s common between Japanese people and foreigners is how to deal with a cold. When Westerners have a cold, we usually don’t see a doctor because we believe there’s nothing the doctor can do; we just need to rest and get better. Whenever I have a cold, my Japanese co-workers urge me to go to see the doctor. They insist that any medicine I get from a pharmacy isn’t strong enough and that I need something stronger.
The few times I have seen a doctor, he prescribed antibiotics for a cold—a common practice in Japan. Westerners learn that antibiotics don’t work for colds. Are doctors trying to make patients happy by prescribing medicine? Are they just trying to make money off of you? Are they uneducated? Let’s take a closer look.

The Common Cold and Antibiotics (How they work)

First, let’s review some high school biology. There are two kinds of infections, viral and bacterial. The common cold is a virus, which enters your cells and lives inside of them. Bacteria, on the other hand, can live outside of your cells.

 

Antibiotics work by attacking the infection. Bacteria are separate entities in your body, so this medicine works well against them. However, when you have a virus and take antibiotics, the medicine essentially attacks your cells and can make your sickness worse.

Colds in Japan (What is a cold?)

So, now that we’ve refreshed our memories, let’s think about why doctors are giving medicine that doesn’t work.
I did some digging around on the internet to find information about colds in Japan. I found a blog called “This Japan Life” that says “a cold” is categorized as anything that isn’t the flu.

Following this, I examined the linguistics of the word “kaze”. On Maggie Sensei’s site, it says a head cold is “鼻風邪” (hana kaze) and “胃腸風邪” (ichou kaze) is the stomach flu. Seeing that “kaze” (a cold) is in both words, I took a look in the dictionary to see how many terms contain “kaze”. I found multiple different sicknesses, such as the mumps “おたふく風邪” (atafuku kaze) and several kinds of flu that include “kaze” in their name. This made me wonder exactly how Japanese people define “kaze”.

One explanation I found was this:

“風邪症候群は、鼻やのどなど呼吸器系を中心に起こる、比較的軽い急性の炎症の総称です。 風邪の原因となるウィルスや細菌は….”

This roughly translates as, “The common cold is inflammation in the nose, throat, or respiratory system. Viruses and bacteria that cause colds are…”

The person who wrote this clearly states that a virus or bacteria can cause a cold, which is contrary to what westerners learn about colds.

I did a bit more searching to see how wide-spread the belief that bacteria cause colds is. I turned to the Japanese Wikipedia page on “kaze” for answers.

Bacteria are mentioned on the page several times in instances, such as:

“数百種類の型が存在するためワクチンを作ることは事実上不可能であり、どのウイルスまたは細菌が原因なのか診断するのも困難である。”

This says, “It’s impossible to make a vaccine for the common cold because there are hundreds of types, and it’s difficult to determine which virus or bacteria caused it.”

When switching to the English version of the site, all of this information about bacteria causing colds disappears. The understanding of what “a cold” is changed when the language was switched.

Conclusion

Are the doctors idiots? Do Japanese people not understand basic high school biology?

No. It’s simply a case of cultural misunderstanding resulting from inadequate translation.

In English, we have “the common cold”, which is caused by a virus and cannot be treated with antibiotics. We categorize bacterial infections, such as upper respiratory infections that can be treated using antibiotics, as something other than “a cold”.

“Kaze”, however, encompass both viral and bacterial infections in the upper respiratory system. This explains why Japanese people believe you need antibiotics to treat a “kaze”. When Japanese doctors prescribe antibiotics, it’s likely because they believe we have a bacterial infection rather than a viral one, but it’s unclear to us because our understanding of a cold is different than theirs.

There are often words that simply don’t translate between Japanese and English. While looking up “kaze” in a dictionary will list “the common cold” as a translation, it’s too simplified. Rather than translating “kaze” as “a cold”, “upper respiratory illness” is probably more accurate based on the Japan’s usage of the word.

Comments