ABSTRACT
Medical modernisation in Japan had its foundational moment in 1871-72. The dawn of modernity came upon Nagayo Sensai (1838-1902), who visited the USA and eleven countries in Europe for two years from 1871 as one of the team of government officials led by Lord Iwakura Tomomi.1 The team had a mission to learn about Western civilisation and state policies in order to modernise Japan, which had just gone through the Meiji Restoration. The Tokugawa Shogunate, after ruling the country for 250 years, was brought down and the Emperor was restored as a powerful monarch who would lead Japan into a modernised power. The revolutionary activists, many of whom were lower samurai or members of the ruler-warrior class, quickly transformed themselves into politicians and bureaucrats of the central government.2 Nagayo was typical of the revolutionary-turned-bureaucrat: he was born into a medical family who served the small O
- mura Domain in the
South-Western part of Japan and from this relatively obscure background, he eventually became the Director of the Sanitary Bureau of the Home Ministry and laid the foundation of modern Japanese medical policies. While this future ‘father of public health in Japan’ was immersing himself
in Western medical policies, Nagayo had a moment of epiphany. He wrote that he had often heard English and German words such as ‘sanitary’, ‘health’ and ‘Gesundheitplaege’ but had not examined their meanings carefully. He started to suspect, however, that these words were far from simple and that he had missed their deeper implications. Eventually, he recognised that in Western countries the state was responsible for the protection of the health of the people; there was a state administrative office which planned and executed various medical policies based on science; Japan needed such an office in order to become a modernised state.3 Nagayo ‘discovered’ the basic principle which helped him to conceptualise the relationship between the state, the individual and the society. Nagayo implied that in Europe he encountered and discovered the principle of Western medical policy and public health; he introduced the concept to Japan as the Director of the Sanitary Bureau, and he modernised the medical polity of Meiji Japan.
