Tokugawa Yoshimune and his healthcare projects

Abstract In Japanese scholarship, the notion of public health is closely associated with modernisation and the adoption of Western medicine in the nineteenth century, which influenced the centralisation of medical affairs and the establishment of hospitals. This article aims to challenge this assumption. A closer look at Japan's medical history shows that government institutions caring for the sick and destitute existed before the introduction of Western concepts of medicine. Furthermore, Japan had other ways of providing welfare, in addition to establishing hospitals. These included government-sponsored medical manuals designed to deliver healthcare via published texts, an aspect of welfare that has been neglected in the history of public health in Japan. This article fills this gap by illuminating and grasping lesser-known strands of healthcare delivery to enhance our understanding of the relationship between the state and medicine in early modern Japan. In particular, it examines welfare initiatives implemented by the tenth shogun, Tokugawa Yoshimune (r. 1716–1745), a prominent and well-researched figure in the history of Tokugawa Japan and a key player who laid the foundations of welfare in this era.