1870-80년대 일본의 콜레라 유행과 근대적 방역체계의 형성

Abstract

In Japan, there were at least three pandemics until 1860s after the cholera outbreak of Nagasaki and Shimonoseki in 1822. However, at this time, the Japanese government did not actively respond to the cholera. After the Meiji Restoration, the Meiji government established a hygienic bureau, and hygienic bureau began to produce official death statistics, which was a very lethal disease with a cholera mortality rate of 70%. At that time, Japan did not actively cope with cholera and other infectious diseases. The Japanese government wanted to respond to cholera through cultivating medical scientists capable of studying infectious diseases and improving legal systems. In particular, the Japanese government paid attention to building a healthcare system using police force. Nagayo Sensai, who led the maintenance of the Medical System in 1874 as the head of the first hygienic bureau, has divided the role of the central government and the role of the local government. During this period, Japan's anti-disinfection administration aimed at idealistic management of the role of physicians in central areas, and strengthening local autonomy. In particular, he expected the strengthening of hygiene administration by local autonomy. Nagayo has given an important role to the role of autonomous hygiene and physicians in the anti-disinfection administration, but when the cholera epidemic in 1879 became widespread, the responsibility for the actual anti-disinfection was unclear and it was difficult to expect many roles for the local government and the private sector in the anti-disinfection administration. Goto Shimpei, through local field experience, submitted opinions emphasizing autonomous hygiene and doctor’s role, and proposed Health Police with professional medical insight. As a result, Goto succeeded to Nagayo’s hygienic bureau. However, the cholera epidemic in 1880s made Nagayo and Goto aware of hygiene as an idealistic view. Although the role of physicians and police was institutionalized around the 1880 "Prevention Rule of Communicable Diseases", the superiority of the police was not legalized. Despite opposition from the police hygiene bureaucrats, the Meiji government transferred most of the hygiene to the police administration, and the sanitary police became more important in the administration of the police. Strengthening the status of the sanitary police in the process of cholera disinfection became an important feature in the construction of the Meiji eradication system, which was a surprising result of cholera epidemics.