Medical welfare in Japan in 1883

Contagious disease and poverty

By William Wetherall

Posted 21 May 2021
Updated 15 October 2023

1948 Family Register Law Essential articles
Major revisions since 1948 1985 nationality selection • 1994 computerization
Related registration laws Alien registration laws since 1946 • 1951 Resident Registration Law • 1967 Basic Resident Registration Law

Cholera and the dawning of public hygiene in Meiji Japan

By the start of the Meiji period in Japan, understandings of infectious diseases, their treatment and prevention, were rapidly developing. Japan had its own long history of experience with epidemcics that had reached its shores, and people who were eager to join the globalizing search for insights into causes, aided by biology and its application in public policy and medicine were rapidly developing in Europe. Japan, too, had a long history of dealing with undergoing that civil disputes in Japan, partly fueled by forced to foreign powers and shifts in domestic

hich disease was caused by germs, carcinogens, vitamin deficiencies, and gen

In 1873, the Dajōkan -- the Great Council of State that governed Japan -- established a "Medical Affairs Bureau" (Imukyoku 医務局) in the "Education Ministry" (Monbushō 文部省), and the following year it promulgated vaccination regulations. In 1875, the Medical Bureau was moved to the newly created "Interior Affairs Ministry" (Naimushō 内務省) and renamed "Hygiene Bureau" (Eiseikyoku 衛生局).

In 1922, half a century later, the Interior Ministry established a "Society Department" (Shakaika 社会課) in its "Regional Bureau" (Chihōkyoku 地方局), and in 1922 the Society Department became the "Society Bureau" (Shakaikyoku 社会局). The department and bureau were mainly concerned with social welfare.

The in 1938, government government of Imperial Japan separated the Hygiene Bureau and Society Bureau from the Interior Minister to create a new ministry called "Kōseishō" (厚生省) or "Ministry of Health".

The new ministry had 5 bureaus -- a "Physical Strength Bureau" (Tairyoku-kyoku 体力局), a "Hygiene Bureau" (Eisei-kyoku 衛生局), a "Prevention Bureau" (Yobō-kyoku 予防局), a "Society Bureau" (Shakai-kyoku 社会局), and a "Labor Bureau" (Rōdō-kyoku 労働局) -- plus external agencies such as the "[Social] Insurance Agency" (Hoken-in 保険院). Its mission was to improve the quality of life of the people of Japan through promoting higher standards of public and personal sanitation, better nutrition, and more exercise to minimize the incidence of vitamin deficiencies and communual diseases like tuberculosis and syphilis. It also endeavored to assist people in need through social work, increase a sense of security through social insurance, and improve housing and labor conditions.

Coming as they did in the 1920s and 1930s, such endeavors were undertaken to boost the health, productivity, and prosperity of the subjects and nationals of Japan as an (ethnic) "nation" or "race" (minzoku 民族) -- hence terms like "minzoku eisei" (民族衛生) or "racial hygiene". As applied in Japan, the science of eugenics was mainly concerned with research related to problems familiar to health science studies and medical anthropology today.

Policies concerning leprosy victims, and individuals having certain genetically inherited defects, are rightly viewed in hindsight as inhumane and draconian. But eugenics in pre-postwar Japan was mainly concerned with objectives and activities considered essential in the health and education programs of all local and national governments and even corporations today.

The term "eisei" (衛生) means "guard life" Increasing awareness of the relationship between poor sanitation and contagious diseases led to the development of "sanitation" (eisei 衛生) policy and education that sought to improve "kōshū" (公衆衛生) -- either "public hygiene" or "public sanitation" -- in Japan.

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All costs of treatment for poor people
inflicted by a contagious disease
to be paid out of local taxes

Yosha Bunko scan

Densenbyo

Contagious disease treatment costs in 1883

The document to the right is an original printing of a directive from the incumbent head -- in today's terms the "prime minister" -- of Japan's government, the Great Council of State, to the Police Agency and all prefectures except Okinawa, Hakodate, Sapporo, and Nemuro.

It is written in the consise, crisp, and clear phrasing that characterized the best legal and other bureaucratic writing at the time.

The following transcription, structural translation, and notes are mine. The original text, like writing in most contemporary documents, was unpunctuated, and voicing was not marked, since junctures and voicing were clear from syntax.

第八號
警視廳 (Note 1) / 府縣 / 沖繩函館札幌 / 根室縣ヲ除ク (Note 2)
明治十四年四月第三十號達左ノ通改正候條此旨相達候事 (Note 3)
明治十六年二月十四日 (Note 4)
太政大臣 (Note 5) 三條實美 (Note 6)

傳染病 (Note 7) ニ罹リタル者身元赤貧ニシテ資力ナキトキハ本籍寄留旅行(Note 8)
ヲ問ワス其費用ハ總テ發病地ノ地方税中衛生 (Note 9) 費ヲ以テ支辨ヘ
シ   但流行 (Note 10) ノ勢盛ナルトキハ時機ニ據リ官費支給スルコトアルヘシ

No. 8
Police Agency (Note 1) / Prefectures / Except Okinawa, Hakodate, Sapporo, and Nemuro prefectures (Note 2)
It is hereby notified that April 1881 (Meiji 14-4) [Great Council of State] Notice No. 30 is revised as to the left. (Note 3)
14 February 1883 (Meiji 16-2-14) (Note 4)
Great Council of State Minister (Note 5) Sanjō Sanetomi (Note 6)

When a person inflicted with a contageous disease (Note 7) is destitute and lacks ability to pay, regardless of whether at one's permanent domicile (honseki), or at a temporary residence (kiryū), or traveling (ryokō), (Note 8) all costs are to be paid with health (hygiene) (Note 9) funds within the local taxes of the place where the disease breaks out.
  However (Provided that), when its spread (Note 10) is vigorous, depending on the time (conditions) there will be payments of government funds (kwanpi 官費).

  1. Notes

  2. The contemporary Police Agency (Keishichō 警視庁) originated as the Police Department (Keihoryō 警保寮) in the Interior Ministry in 1874. This became the Police Bureau (Keihokyoku 警保局) in 1876, the Police Agency (Keishichō 警視庁) in 1877, and again the Police Bureau (Keihokyoku 警保局) in 1881. After the Pacific War (1941-1945), from the start of the Allied Occupation of Japan in 1945, the police bureau's powers were limited by the Supreme Commander for the Allied Powers (SCAP), but the bureau continued to operate the Interior Minister was abolished on 31 December 1947. From 1 January 1948, remnants of the bureau, including its local police forces, were revamped into the present prefectural police departments, which since 1954 have been overseen by the bureau's reincarnation as National Police Agency (Keisatsuchō 警察庁 NPA). "Keishichō" (警視庁) today refers to the "Metropolitan Police Department" (MPD) of Tokyo prefecture.
  3. Sapporo, Hakodate, and Nemuro prefectures were established in Hokkaidō concomitant with the abolishment of the Development Commission (Kaitakushi 開拓使) in Hakodate on 8 February 1882. The commission had been established on 15 August 1869 (Meiji 2-7-8) to oversee the migration to and development of Ezochi (蝦夷地) -- a territory, north of Honshū, that included Karafuto and the southern Chishima islands. A month later, on 20 September 1869 (Meiji 2-8-15), Ezochi was renamed Hokkaidō (北海道), or "northern sea circuit", analogous to "Tōkaidō" (東海道) or "eastern sea circuit" and similarly named areas of Japan. This use of "dō" (michi 道) is like that of "-do" in the names of provinces in Korea and Chōsen.
    1. In 1875, Japan traded its claim to Karafuto to Russia for Russia's claim to the northern Kurils or Chishimas. Japan incorporated the northern Chishima's into Nemuro, which had jurisdiction over the southern Chishimas. Sapporo, Hakodate, and Nemuro prefectures were consolidated into Hokkaidō prefecture on 26 January 1886.
    2. Okinawa, like Hokkaidō, had not been an integral part of Japan at the start of the Meiji period in 1868. The islands were claimed and annexed as a domain (Okinawa-han 琉球藩) in 1872 and became a prefecture 4 April 1879. Okinawa's development, like development in Hokkaidō, was orchestrated from Tokyo, and after their prefecuturization, both territories continued to be overseen by agencies in Tokyo -- hence their exclusion from this Dajōkan notice.
    3. As a peripheral prefecture, Hokkaidō remains somewhat tethered to what today is called the Hokkaido <Regional> Development Bureau (Hokkaidō Kaihatsu Kyoku 北海道開発局) under the Ministry of Land, Infrastructure, Transport and Tourism. And Okinawa continues to depend on economic contributions from from -- while being annoyed by -- the presence of U.S. military bases on the islands on account of agreements between the United States and the Tokyo government, and on development funds controlled by the Okinawa General [Affairs] Bureau (Okinawa Sōgō Jimu Kyoku 沖縄総合事務局) of the Cabinet Office (Naikakufu 内閣府). The forerunner of the bureau was set up when Okinawa was reverted to Japan's control and jurisdiction in 1972, over a quarter of a century after being invaded and captured by the United States in 1945.
  4. The sōrōbun (候文) phrase ＸＹＺ候條此旨相達候事 signifies the direction of a "tasshi" (達) or "futatsu" (布達) -- a "circular" or "notification" -- to government agencies or officials regarding ＸＹＺ. It reads "ＸＹＺ sōrō jō kono mune o ai-tasshi sōrō koto" and means "the provision XYZ, this matter (to this effect) [I/we hereby] notify" -- "I/we hereby notify [you] to the effect that XYZ" -- "It is hereby notified that XYZ". A "fure" (布令) or "fukoku" (布告) -- "proclamation" or "decree" -- would have been directed to all the people in the country or to a specified jurisdiction therein.
  5. Circular 8, issued on 14 February 1883 (Meiji 16-2-14 明治十六年二月十四日), amends Circular 30 of April 1881. The two circulars may have been published in Tōkyō nichinichi shinbun" (東京日日新聞) [Tokyo daily news], a newspaper published by Nippōsha. It's president at the time, and one of its founders in 1872, was the journalist and publisher Fukuchi Gen'ichirō (福地源一郎 1841-1906). In the upper right corner of its 29 March 1872 (Meiji 5-2-21) inaugural issue, consisting of one woodblock-printed page, was a vermillion stamp reading "Kankyo" (官許), which meant that the paper was officially approved. Between 1877 and 1883, by then a multi-page broadsheetpaper, the paper served as the government's vehicle for promulgating national laws and publishing various official notifications.
    1. The Great Council of State published proclamations and notifications in the Dajōkan nisshi (太政官日誌), the "Great Council of State daily record" from 16 March 1868 (Keiō 4-2-23), it's 1st issue, to Janaury 1877, it's last issue (1177). Tōnichi took over this role until 2 July 1883, when the goverment began publishing Kanpō (官報), which continues to be Japan's "Official Gazette".
    2. Today, all laws are promulgated through publication in Kanpō, which also publishes all manner of notifications of legal actions, including Ministry of Justice notices of permission to naturalize and ministerial determinations of loss of nationality.
  6. "dajō daijin" (太政大臣) -- Great Council of State Minister" corresponds to todays "naikaku sōri daijin" (内閣総理大臣) -- "Cabinet Prime Minister" or "Prime Minister of the Cabinet". The Great Council of State was replaced by the Cabinet from 22 December 1885, pursuant to GCS directive No. 69, and a directive on that date from GCS minister Sanjō Sanetomi (see next note). The first Minister of the Cabinet was Itō Hirobumi (伊藤博文 1841-1909).
  7. Sanjō Sanetomi (三条実美 1837-1891) participated in the overthrow of the Tokugawa government and held high positions in Meiji Japan's first government, the Great Council of State, from its inception in 1868. He held its highest position as Dajō Daijin (太政大臣) -- Council of State Minister, commonly called "Chancellor of the Realm" -- from 13 September 1871 to 22 December 1885 when Dajōkan was replaced by a Cabinet. Under the cabinet government, he served as the Naidaijin (内大臣), commonly called "Lord Keeper of the Privy Seal of Japan", in charge of the imperial seal used by the emperor to sanction and promulgate orders and laws. As such, he served as the acting Prime Minister of Japan during a 2-month hiatus in late 1889, between the proclamation of the Meiji Constitution on 11 February 1889 and its coming into force on 29 November 1890. He became member of the House of Peers shortly before his death the following year.
  8. 傳染病
  9. "honseki, kiryō, ryokō" (本籍寄留旅行) to the three possible legal residency statuses. Family registers included membres of a household residing under the same roof at the address of the register, which affiliated the register with the municipality having jurisdiction over the address. As registers identified by their addresses, "koseki" are called "honseki", and the honseki address is called "honsekichi" (本籍地) or "honseki place (locality)". People who were who were"temporarily residing" at another address not residing at another address for more more than 90 days had to register their "kiryō" ortheir honseki address had to register their is called . The register, as a addresses on their family registers
  10. "eisei" (衛生) -- meaning "guard life" -- reflects the senses of terms like "hygiene", "sanitation", "health", and even "physiology" or "medicine" in English. At the time, health was closely linked with diseases that were spread by poor public sanitation or personal hygiene.
    1. The term "eisei" became familiar in expressions like "eiseihei" (衛生兵) for "medical corpsman" and "minzoku eisei" (民族衛生) for "racial hygiene". The latter embraces subjects that would fall under "eugenics" in the sense of improving the "race" or "(ethno)nation" (minzoku 民族) through good public health and hygiene, diet, and social behavior that minimizes risks to health and welfare. See Eugenics for details.
    2. In 1975, I became associated with the National Institute of Mental Health in Japan, which was then called "Kokuritsu Seishin Eisei Kenkyūjo" (国立精神衛生研究所). It was under the Ministry of Health and Welfare (Kōseishō 厚生省 MHW). "Kōsei" (厚生) means something like "improve the quality of life" hence "health and welfare". In 1980, NIMH's "health" was changed from "eisei" to "hoken" (保健) -- meaning "maintain strength" or "maintain health" -- a "healthier" term for "health" than "eisei", which all but suggested that "mental health" might a sort of "mental hygiene" problem. The compound "hoken eisei" (保健衛生) can be translated "health and hygiene". The most common word for "health" is "kenkō" (健康) -- meaning "strength and tranquility" -- as in "National Health Insurance" (Kokumin Kenkō Hoken 国民健康保険).
    3. NIMH was established in 1952 in facilities beside National Konodai Hospital in Ichikawa in Chiba Prefecture. In October 1986, while remaining at Kōnodai, NIMH was combined with the Musashi National Sanatorium (Kokuritsu Musashi Ryōyōjo 国立武蔵療養所), and its Center for Psychiatry, into a new organization called National Center of Neurology and Psychiatry (NCNP) (Kokuritsu Seishin / Shinkei Iryō Kenkyō Sentaa 国立精神・神経医療研究センター) or "National psychiatry / neurology medical treatment research center". In 2008, NIMH physically moved from Ichikawa to new facilities at NCNP in Kodaira in Tokyo.
    4. The current (2021) director of NIMH, which maintains its identity within NCNP, is Kim Yoshiharu (金吉晴 b1960), who joined the institute in 1990 as a young clinical psychiatrist who specialized in schizophrenia and related illnesses. I was there between 1975-1995, first as a research student (kenkyōsei 研究生), then as a visiting research fellow (kyakuin kenyūin 客員研究員). He was slated to be my sponsor when my then sponsor retired in 1995, but I decided to discontinue my association with the institute and Kim headed for London for research.
    5. The sanitorium, which originated in 1940 as a facility for disabled and mentally disturbed military veterans, was revamped into a large research and training hospital facility called National Center Hospital (NCNP Byōin NCNP 病院), which specializes in psychiatric, neurological, and related medicine.
    6. In 2001, the Ministry of Health and Welfare and the Ministry of Labor (Rōdōshō 労働省) were merged to become Kōsei Rōdō Shō (厚生労働省), which is dubbed "Ministry of Health, Labour, and Welfare" (MHLW) in English rather than Americanese.
  11. "ryūkō" (流行) means to "flow and go" hence "spread" or "become popular or fashionable" -- by extension a "fad" or "craze" or "vogue" -- or an "epidemic" or "contagion" or "pandemic". Some "popular music" (ryūkōka 流行歌) may be "sick" to some but "sick" to others.

Sources

I have used several Japanese sources in addition to the 1883 notice. The following English sources were also very insightful.

Johnson 2019

William Johnston, Wesleyan University
Cholera and the Environment in Nineteenth-Century Japan
Cross-Currents: East Asian History and Culture Review
Volume 30, pages 9-34

Cross Currents is an e-journal published on the "Cross Currents" server at the University of California at Berkeley. Johnson's article can be read online or downloaded as a pdf file.

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