Korean Journal of Medical History最新文献

The history of medicine has been continuously devaluated in medical education but its importance should not be ignored as for other medical humanities. The educational value of the history of medicine could be summarized as follows ; it allows the students 1) to understand the humane aspect of medicine by telling them how medicine has dealt with human health-disease phenomena in each era of the human history. 2) to improve the professionalism by recognizing that medicine is a profession with a long tradition that dates back to the Hippocratic era 3) to improve current medical practice by understanding the limitations and uncertainties of medicine. 4) to understanding the historical changes of the disease phenomena 5) to develop the basic competence of learned intellectual. 6) to integrate the tradition of their own institutions with themselves.

This article explores the shaping of gender hierarchy between the nurse and the doctor in modern Japan, through the lens of the Tokyo Imperial University Hospital. I understand gender hierarchy of these two medical professions not just in terms of ranks in hospital bureaucracies, salaries, or educational credentials, but also the ways their work was defined, their skill levels were evaluated, as well as the probability of their united actions as members of a single profession to advocate their shared interests. Tokyo Imperial University is Japan's oldest university, which is the birthplace of modern medical education. The hospital of this university was a symbolic locus for the making of gender hierarchy of the doctor and the nurse, which often transpired in other institutions and articulated in state regulations such as the Nurse Regulations prepared by Home Ministry officials in 1915. In this hospital, doctors who were male, while designing nursing education and labor practices, defined nursing primarily as women's supplementary labor for doctors. While doctors had an exclusive professional territory, such as diagnosis, surgery, and medication, what nurses' exclusive professional territory was undefined and how their skill levels could be evaluated remained unclear. In other words, probationary nurses often worked together with trained nurses, which allowed managers of the hospital to exploit their cheap labor, as well as attenuating the professional authority of the trained nurses. But, this process did not go unchallenged. Leaders of nurses at this hospital, such as Suzuki Masa and Ōzeki Chika did not think that nurses should be subordinated to the doctor. As managers of the Tokyo Imperial University Hospital hired unmarried women to have them endure intense labor with low wages, Ōzeki publicly protested a doctor at Tokyo Imperial University to improve nurses' working environment, and these two soon resigned. After the resignation, Suzuki organized a visiting nurse service company called The Charity Visiting Nurse Corps (jizen kangofukai), and dispatched a group of its member nurses to the clients. Unlike when they worked in the Tokyo Imperial University Hospital, they became an independent service provider, deciding their work schedules, and the fees for their service for themselves. Compared to their wages in the Tokyo Imperial University Hospital, the service fees were two to three times higher in this new company. As nurses came to claim a high pay, visiting nurse service companies of this kind blossomed in Tokyo and other big cities, However, they eventually failed to gain a clear legal definition of what nurses could exclusively do as professionals and how their skills were assessed, and private nurses lost their high demand during the Great Depression. By looking at this process, this article reconfirms the conventional wisdom that the gender hierarchy of doctors and nurses were not biologically given but socially constructed thr

DDT exemplifies success and failure of modern science and technology. Once it was heralded as technological wonder that will deliver human from misery of insect-borne infectious disease. However DDT took dramatic downturn after failure in global malaria eradication program initiated by World Health Organization, with advent of DDT-resistant strain of mosquitoes. Although insecticide resistance has been know since late 19th century, the definitions and mythologies for finding resistance has not been settled until 1950s. This paper argues that discovery of DDT-resistant strain of body lice in prisoners of war camp in Korea during the Korean War provided essential knowledge and opportunity for advancing insecticide resistance studies. Since 1945 to the end of Korean War, US Army sprayed thousands of tonnes of DDT on Korean body and soil. DDT was only went into wide field application since 1943, was still a very new technology. The ways to deliver and utilize DDT was still under the investigation. And Korea, especially during the War, was ideal place to construct such knowledge and place it in the application. The main focus was to control public health threats, such as louse-borne typhus fever. Korean soldiers and prisoners of war exposed to regular dose of DDT, which soon gave rise to DDT-resistant strain of body lice. It was the first major outbreak of insecticide-resistance appeared in insect that has major public health importance. Until early 1950s, mechanisms of resistance, or even definition of insecticide resistance was unclear. Researchers in US Army and Department of Agriculture rushed to find the ways to quantify insecticide resistance. Network of laboratories, connecting Korea-Japan-US, had to devise new laboratory methods to rear, and test body lice. These body lice later migrate to laboratories in US, providing valuable asset for future insecticide resistance research in US. At the same time, laboratory methods of testing resistance in body louse became a standard across the globe, setting new research agenda through World Health Organization. This shows flow of knowledge, along with migration of body louse, during the Korean War. At the same time, this case show who new knowledge is constructed through the expense of involvement of minority populations, such as natives, soldiers, and prisoners of war.

Rabies prevention has become a vital part of public health administration owing to the high incidence of rabies in Japan in modern times. The rabies prevention system in Japan, which was gradually established based on the rabies knowledge and prevention policies from Europe and the United States, was centered on livestock dog control, wild dog culling, and vaccination. This epidemic prevention system was based on two premises. First, though rabies is a zoonotic infectious disease, the focus of epidemic prevention administration was to protect humans, not dogs. Second, this system attempted to eliminate the rabies hazard at its source by reducing the number of all dogs-livestock dogs included. Under this epidemic prevention mechanism, the survival space of dogs as an object of public health administration was significantly eroded. In contrast, during wartime, the Japanese Empire encouraged people to donate their dogs to the military so their fur could be used to make military coats, and in the name of existing rabies prevention programs, extended the target of culling from wild dogs only to all non-military dogs. This administrative model of epidemic prevention, which attempted to hide the violence and arbitrariness of dog killing by creating artificial distinctions among dogs, is a metaphor for the power training mechanism in modern society.

The efforts of the state and the literati, such as the implementation of beneficent politics and the rectification of folk customs, led to the alteration of the medical environment throughout the Song period. Epidemics with a severe impact that occurred frequently were what started the transition. Urbanization, increased transit accessibility, and population growth have all contributed to the emergence of epidemics. In addition, a disease that was indigenous to southern China, where regional development and population expansion were focused, started to spread widely. When an epidemic spread, the local population occasionally received medical care, but most of the time they relied on spiritual care from the neighborhood shaman or spirit medium. Spiritual treatment is utilized to treat malignant infectious diseases, even though professional doctors primarily focus on treating patients with traditional medicine. By editing and releasing publications on medicine at the national level, the Song dynasty government and intellectuals encouraged the development and transmission of efficient treatment procedures to advance medical practices. Meanwhile, folk remedies or medical prescriptions discovered by renowned scholars like Su Shi and Shen Kuo were included in the medical book and made available to the general public. Although there was a difference of opinion between the Song government and intellectuals, they commonly rejected shamanistic treatment and pursued the spread of medicine treatment through the transmission of codified medical knowledge. In the end, the spread of the epidemic and the subsequent transmission and development of Song dynasty medicine had a significant impact on the emergence of codified medicine treatment, but this was not solely to advance medical knowledge; it also served to further their political and ideological objectives. As a result, the following Jin and Yuan dynasties' physicians instantly criticized the Song dynasty's medical advancements. It is indisputable, however, that the medical development of the Song dynasty had a considerable influence on later Chinese medical practice in that it established the ideological superiority of formal and orthodox therapy over traditional and heterodox spiritual care.

The purpose of this paper is to analyze discussions on the matter of priority in treatment and prevention that took place in the medical community, the government and social hygiene associations to tuberculosis referred to as one of the national calamity in France at the turn of the 20th century. In other words, it is to show that treatment and prevention have complementary properties in France's anti-tuberculosis movement, considering the discussions on which institutions should preferably be expanded - between the Sanatorium that values medical treatment and the anti-tuberculosis dispensary that values social prevention. Tuberculosis, which is known to have existed from the ancient times, spread to the era of industrialization and urbanization, resulting in a large loss of lives in the second half of the 19th century following cholera in the first half of the century. Starting in Germany in the middle of this century, Sanatorium established a treatment for tuberculosis patients with air therapy, proper exercise or rest, and diet. In France, a public Sanatorium was built for the lower class, not like a luxury resort style Sanatorium for the wealthy class, from the 1890s. The spread was slow, however, due to financial problems. In the 1900s, anti-tuberculosis dispensary as a health center were increasingly built in working class quarters. The debate over whether to support the sanatorium or the dispensary was ignited at first, but since the mid-to-late 1900s, the two institutions' roles, namely, medical treatment and social prevention, have been recognized as complementary. The Anti-tuberculosis dispensary Act of 1916 and the Sanatorium Act of 1919 systematically supported the complementary relationship between treatment and prevention in fighting against tuberculosis.

In 1946, the U.S. Army established the 406th Medical General Laboratory as the central medical research institute for their new Asia-Pacific-occupied area. The primary mission of the 406th medical laboratory was to supplement the epidemiologic, sanitary, and diagnostic services available in other medical facilities and hospitals, and to investigate outbreaks of disease and conditions which affect or may affect the health of the people in the occupied area. At the time of its establishment, the 406th laboratory had considerable difficulties securing researchers, but it solved the related problems by actively cooperating with Japanese medical researchers and research institutes. According to the statistics in 1947, the 406th laboratory consisted of 46% of its total research personnel, Japanese researchers. The 406th medical laboratory's professional research departments included the department of Pathology, Serology, Bacteriology, Medical Zoology, Chemistry, Virus and Ricketts, Entomology (established in 1949), and Epidemiology (established in 1951). All research departments played a central role in the Asia-Pacific region in their professional fields. For example, the department of Pathology functioned as the "histopathology center of all hospitals in Japan, Korea, and the Mariana-Bonin Command" under the provision of "Army Regulation 40-410," and the department of Chemistry was called an "analytical chemistry laboratory for the Far East Command" because it performed various chemical experiments for many medical facilities in the area with insufficient research facilities.

If public health can be defined as "all activities to ensure universal medical use of the people and protect and promote health," it can be said that public health emerged in the process of developing the concept of hygiene in East Asia. While traditional hygiene emphasized individual curing and longevity, modern hygiene was the state in charge of individual body and discipline. East Asian countries had to practice modern tasks in the field of hygiene and medical care in line with the construction of modern countries, and it was considered legitimate for modern countries to intervene in individual bodies. As the demand for modern national construction became stronger, interest in public health rather than personal hygiene increased. In East Asia, a new interpretation of the concept of hygiene began in Japan. Sensai Nagayo(1838-1902) newly defined the concept of 'sanitation' to justify the physical intervention of the modern state in Meiji period. The concept of 'public health' began to be used in earnest in 1890, when Ogai Mori(1862-1922) translated Western-style health protection measures for the public as public health. Since then, public health has evolved into a universal social discourse in Japan. Japan's public health expanded to colonial Joseon, Taiwan, and China. Japan's victory in the Sino-Japanese War led East Asian countries to believe that hygiene was the root of the Japanese nation's power. In the early 20th century, the government of the Republic of China began to imitate the case of Japan while promoting modern education reform and institutional reform. Japanese-style 'public health' was transplanted into various hygiene laws and sanitary equipment. In Korea, modern hygiene was introduced and spread from the end of the 19th century to the first half of the 20th century, and the concept of 'public health' in Japan was mainly spreading. Public health in Japan was vaguely defined as an activity to protect and promote the health of the people, but in practice, it was focused on improving quarantine and environmental infrastructure. In response, the concept of American-style public health, which values prevention and treatment at the same time, has already begun to emerge under the Japanese colonial rule. In East Asia in the 1920s and 1930s, Japanese-style public health and American-style public health discourse competed, and measures to solve medical inequality were discussed in earnest. Interestingly, in common in East Asian countries, Actual Medical Expenses Campaigns to improve medical access at low cost and social medicine to universally provide prevention and treatment to the people have drawn attention. This was also a phenomenon caused by intensifying medical inequality as rapid urbanization and industrialization progressed in East Asian countries in the first half of the 20th century. Although it was impossible to resolve social contradictions or move toward fundamental reform of the national medical system due to the nat

This paper aims to historically re-evaluate the issues surrounding resident participation in health care and its legacy by examining the community participation in health care. In the 1970s and 1980s, community participation was one of crucial trends and a controversial topic in the international health as well as the international aid. Throughout the 1970s, local participation was regarded as one of essential elements for the access to basic healthcare and primary health care in developing countries. Community health projects which aimed to apply primary health care were implemented in rural areas and some urban areas in the 1970s and 1980s. Village Health Workers(VHWs) were a symbolic example of community participation in these projects. They consisted of local women and led health activities with simple skills in their villages. They served as a bridge between the project team and the residents. Health professionals expected them to be health leaders for "self-help" in health of their communities. In the mid-1980s, however, as the number of health facilities and professional health care workers increased, the activities of VHSs were decreased. The mixed understanding of the responsibilities and roles of VHSs among the health professionals affected the skeptical view on the achievement and effects of community participation in health care. In the mid-1980s, as the government officially organized the VHWs, the dilemma surrounding community participation intensified. When the community health projects were ended, most of the VHW organizations were also disbanded. After the projects, the spirit of community participation was only inherited by some healthcare movement organizations, such as medical cooperatives.