As of 2009, 2,600 former leprosy patients were living in 13 national sanatoriums and 2 private hospitals in Japan. Their mean age is 80. There were no newly diagnosed Japanese leprosy patients in 2005, but one in 2006, and one in 2007.
Japan reopened its doors to foreign countries in 1868, and the power went to the Emperor and the democratic government. Checkpoints between provinces were abolished in 1871, and leprosy patients could also freely travel in the country. In the same year, leprosy patients began to line up on the road to Honmyoji, a noted temple in Kumamoto, Kyushu, Japan, for mercy.[5] The first national survey conducted in 1904 indicated that there were 30,359 patients, but because of the methodology, this figure may be vastly underestimated.
Japanese people were accustomed to seeing people with leprosy begging for money at temples and shrines or wherever people gathered, but this was a shocking event to Europeans. Upon seeing a miserable 30-year-old woman abandoned near a watermill, Father Testevuide became determined to establish a facility for such people. In 1889, he started the Kohyama Fukusei Hospital. His example was followed by Kate Youngman in Tokyo, and by Miss Hannah Riddell and Father Corre in Kumamoto.
In 1875, Dr. Masafumi Goto founded the Kihai Hospital in Tokyo which was specially designed to treat leprosy patients. Dr. Goto and his son, Dr. Masanao Goto, became widely known for their balneotherapy for leprosy patients. At the request of the King of the Hawaiian Kingdom, Dr. Masasao Goto visited Hawaii and introduced their method. Most of the Japanese doctors who established these facilities discontinued their activities after the start of public leprosy sanatoriums.
See main article: Hannah Riddell. Hannah Riddell established the Kaishun Hospital in 1895 in Kumamoto and her activities are mentioned elsewhere.Because of the Russo-Japanese War, she was in desperate financial straits because English people stopped sending money to her because of the risks that could occur during the sending process. An important meeting was held at the Banker's Club in Tokyo, both to save her and to discuss leprosy problems facing Japan. Various leaders, including those representing the government, statesmen, and journalists, attended the meeting.The timing was good. The Japanese government had begun to take an interest in leprosy problems since they found many patients in the drafts for military service. To become strong militarily was their biggest concern at the time. The meeting was chaired by Viscount Shibuzawa, who was a leading businessman. At the meeting Kensuke Mitsuda stressed that leprosy was infectious.Finally, the Japanese government, spurred by the events of the 1905 meeting, promulgated the first leprosy prevention law in 1907 and started five public sanatoriums in 1909.
See main article: No Leprosy Patients in Our Prefecture Movement. At the start of public sanatoriums, only the wandering patients were hospitalized. However, as time went, people wanted their prefectures to be "purified," and the belief began that there should be no leprosy patients in their prefectures. This movement started around 1930 and it naturally worsened leprosy stigma. In Kumamoto, 157 patients living near Honmyoji were "arrested" and transferred to other sanatoriums. A patient received unjust procedures and was sentenced to the death penalty.
In Japanese sanatoriums, in 1945, because of food shortage, many patients died of tuberculosis in mainland Japan with a rate of 20% at the worst leprosaria. In Okinawa, more than 25% of patients died in the sanatorium in the same year. In the Miyako Nanseien, Okinawa, the death rate was over 40% in 1945 and the cause of death was almost always malaria. It was reported that in a psychiatric hospital in Tokyo (Tokyo Metropolitan Matsuzawa Boi), the death rate in 1945 was 40% [6]
| 1945 | 14.8 | |
|---|---|---|
| 1946 | 8.8 | |
| 1947 | 6.6 | |
| 1948 | 4.7 | |
| 1949 | 4.1 | |
| 1950 | 2.8 | |
| 1951 | 2.2 | |
| 1952 | 1.6 | |
| 1953 | 1.3 | |
| 1954 | 1.5 | |
| 1955 | 1.6 |
Kensuke Mitsuda stated before the Upper House in 1951 that all patients be hospitalized. This was a segregation policy and all patients were against it. Some of them staged even hunger strikes, but the 1953 leprosy prevention law was passed; there were practically no changes from the strict 1931 leprosy prevention law.
Hiroshi Shima, Fujio Otani, Minoru Narita and Kunio Murakami were primary movers in the abolition of Japan's Leprosy Prevention Law. It was delayed because the opinions of patient autonomy associations differed.
The Zenkankyo (Patients' Union) staged a number of struggles against the Ministry of Welfare and they finally won the abolishment of the 1953 Leprosy Prevention Law in 1996. It was ruled that the law was unconstitutional between 1960 and 1996. During this period, the law should have not been present.[8] In 1998, many patients sued the Government for compensation and they won it in 2001.
The patients who do not have supporting men and women shall be treated in public leprosaria. Those who have supporters shall be cared for by them.
Patients with leprosy shall be hospitalized in leprosaria. (However, it is not compulsory at the start.) Patients should not be engaged in works which may transmit leprosy. The families of patients shall be given some financial aids. The privacy of patients should be respected by physicians and related workers.
All these laws were repealed in 1996.
| Kihai Byoin (Hospital) | Tokyo | Masafumi Goto | 1875–1907? | |
| Yoikuin | Tokyo | Kensuke Mitsuda (Kaishun Ward) | 1901–1904 | |
| Ihaien | Tokyo | Kate M. Youngman | 1894–1942 | |
| Kaishun Byoin (Hospital) | Kumamoto | Hannah Riddell | 1895–1941 | |
| Jinkeien | Yamanashi-ken | Ryumyo Tsunawaki | 1906–1992 | |
| St. Barnabas Home | Gunma-ken | Cornwall Legh | 1916–1941 | |
| Suzuranen | Gunma-ken | Kesako Hattori | 1926–1931 | |
| Manchuria Sanatorium Doukouin | Tetsurei-ken, Manchuria | Shunzo Sugimura | 1939–1945 |
There are about 2600 ex-patients in 13 national Hansen's disease sanatoriums and 2 private hospitals as of May 1, 2009. There are no active leprosy patients, and all are recovered or have after-effects of leprosy. Their mean age is 80. Because of sterilization and abortion, they do not have children. Many of them have diseases of advanced ages or handicaps and aids are necessary. Some earnestly hope for social rehabilitation, but there are very few who are active in society.
Those in the sanatoriums enjoy life in or out of the sanatoriums; medical and living care are helped by doctors and health workers. Their families visit them in sanatoriums and vice versa. They may be treated in other medical facilities, if necessary.
Every leprosy sanatorium in Japan has churches and Buddhist temples (there are no temples attached to sanatoria in Okinawa Prefecture), and it is true that patients had faith, though some patients stated that deciding on religion was in preparation for their death in the leprosaria. In days gone by, they could not share the family graves, an instance of leprosy stigma. In Kikuchi Keifuen Leprosarium, statistics showed Buddhism A 757, B 85, C 89, D (Sokagakkai) 51, Shintoism A 11, Shintoism B 9, Catholic 51, Christianity 95, as of 1979.
Since 1915, sterilization had been performed in public sanatoriums in Japan. Married life was permitted. Abortions were performed. Because of this, patients did not have children.
The Leprosy Prevention laws of 1907, 1931 and 1953, the last one only repealed in 1996, permitted the segregation of patients in sanitariums where forced abortions and sterilization were common, (even if the laws did not refer to it), and authorized punishment of patients "disturbing peace".
Some patients wrote novels, and many patients composed Tanka and Haiku, a short poem.
Education in prewar days was unsatisfactory. Educated patients taught patients who needed education. In postwar days, branch schools of primary schools and secondary schools were made within the leprosariums. A high school was made for some time starting in 1955; 369 patients were enrolled and 307 patients graduated from the school.
Education of children born of patients was insufficient. In Kumamoto, the enrollment of them into a primary school met social stigma or leprosy stigma in 1954 which was called the Tatsudaryo Incident or Kurokamikou Incident.
Leprosy in Japan is characterized by considerable leprosy stigma, by the Buddhistic concept of leprosy that leprosy is punishment and in modern times by three leprosy prevention laws requesting segregation.
See main article: Empress Teimei. Empress Teimei (貞明皇后, Teimei Kōgō, 25 June 1884 – 17 May 1951), also known as Empress Dowager Teimei (貞明皇太后, Teimei-kōtaigō), was empress consort of Emperor Taishō of Japan. She was the mother of Emperor Shōwa. Her posthumous name, Teimei, means "enlightened constancy". She was interested in leprosy problems and donated money to Hannah Riddell in financial distress since 1915, and other foreigners. She donated money with which a leprosy prevention foundation was established in 1931 and left money upon her death which became the basis of the Tofu Organization for Leprosy, in 1951.
See main article: Kensuke Mitsuda. Kensuke Mitsuda (1876–1964) was the most influential leader both in the administration of leprosy policy and the academic circle. He stated that all leprosy patients be hospitalized before the Upper House in 1951, and led to the 1953 leprosy prevention law. As a scholar, he found a lepromin reaction called Mitsuda reaction or Mitsuda test. This is very important in the classification of leprosy.
See main article: Hannah Riddell. Hannah Riddell (1855–1932) was an English woman who devoted her life to the salvation of Hansen's disease patients in Japan. She not only established "Kaishun Hospital", the first leprosy hospital in Kumamoto, but also inspired the conscience of the Japanese people on this problem.
See main article: Mary Cornwall-Legh. Mary Cornwall-Legh (May 20, 1857 – December 18, 1941) was a highly educated English woman who devoted herself, after age 50, to missionary work in Japan and especially to the welfare, education and medical care of leprosy patients in Kusatsu, Gunma Prefecture, Japan.
See main article: Keisai Aoki. Keisai Aoki (April 8, 1893 – March 6, 1969) was a Japanese missionary who virtually paved the way to the establishment of Hansen's disease sanatorium Kunigami-Airakuen, Okinawa, with extraordinary difficulties. At age 16, he developed leprosy and later, under the leadership of Hannah Riddell, he helped people with leprosy in Okinawa.
See main article: Matsuki Miyazaki. Matsuki Miyazaki (1900–1970) was the director of the Kyushu Sanatorium (1934–1958). He studied the war and leprosy and by his efforts, soldiers who developed leprosy could receive the same treatment as those who developed tuberculosis. He was a segregationalist. After retiring from the Kikuchi Keifuen Sanatorium (Kyushu Sanatorium), he established a leprosy facility in India. He died in an airplane accident in India.
See main article: Isamu Masuda. Isamu Masuda (1872–1945) was a Japanese doctor, known for writing "Leprosy and Social Problems" in 1907, the year of the promulgation of the first leprosy law, and openly criticized the crucial segregation policy. He advocated the nation's involvement in the discovery of treatments of leprosy, since he believed that it was curable.
See main article: Masako Ogawa. Masako Ogawa (1902–1943) was a female Japanese doctor who worked at the Nagashima Aiseien Sanatorium. She wrote a book, "Spring in a small island" in 1938, about her experiences in persuading leprosy patients in remote areas of Japan into hospitalization. It created a sensation in Japan, and was made into a film. On the other hand, she was criticized for accelerating the "No leprosy patients in prefecture" movement and giving the impression that leprosy is to be feared.
See main article: Masasue Suho. Masasue Suho (October 8, 1885 – June 20, 1942) was a Japanese physician, the director of the Sorok Island Sanatorium in Korea. He completed the world's biggest leprosy facility Sorok Island Sanatorium hospitalizing 6000 patients. He was assassinated by a patient while rushing to a morning ceremony. Forced segregation of leprosy patients, the worsening of treatment of patients and antipathy against colonial rule were behind the assassination.
See main article: Ryumyo Tsunawaki. Ryumyo Tsunawaki (January 24, 1876 – December 5, 1970, was a Buddhist priest who established a leprosy hospital Minobu Jinkyo-en, in Minobu-cho, Yamanashi-ken, Japan in 1906.
See main article: Noboru Ogasawara. Noboru Ogasawara (1888–1970) was a Japanese physician specializing in leprosy. He was an assistant professor at the Department of Kyoto Imperial University. He insisted that leprosy was not incurable and diathesis was an important factor in the development of leprosy. He was against strict segregation of leprosy patients and met strong opposition at a Congress of leprosy.
See main article: Masanao Goto. Masanao Goto (1857–1908), was a Japanese leprologist. He was the son of first Shobun Goto and called as the second Shobun Goto. He devoted his life to leprosy patients in Japan and on the island of Molokai in the Kingdom of Hawaii. Father Damien had trust in Goto's therapy, and he left the message, "I have not the slightest confidence in our American and European doctors to stay my leprosy, I wish to be treated by Dr. Masanao Goto."
See main article: Mosuke Murata. Mosuke Murata was a Japanese dermatologist who was the designator of erythema nodosum leprosum (ENL) in 1912.
See main article: Mieko Kamiya. Mieko Kamiya (1914–1979) was a psychiatrist who treated leprosy patients at Nagashima Aiseien Sanatorium. She was known for the translation of books on philosophy. She was said to be "one of doctors of the Department of psychiatry of Tokyo University soon after the war", who "greatly helped the Ministry of Education and the General Headquarters as English-speaking secretary", and to be "an adviser to Empress Michiko". She wrote many books as a highly educated, multi-lingual person; one of her books titled on the meaning of life (Ikigai in Japanese) based on her experiences with leprosy patients attracted many readers.
See main article: Kazuo Saikawa. Kazuo Saikawa (1918–2007) was a Japanese physician, who contributed to the treatment of leprosy and to the administration of leprosy policy in Japan. He was against Kensuke Mitsuda and worked in Taiwan and Okinawa.
See main article: Heibei Okamura. Heibei Okamura (1852–1934) produced Japan's finest "Okamura's" chaulmoogra oil, between about 1892 and 1944 at Sakai, Osaka, Japan. The chaulmoogra oil had been the only one remedy in wide use before Guy Henry Faget proved the efficacy of promin in 1943. Promin started the era of sulfur chemicals and revolutionalized the treatment of leprosy. Okamura was also known for caring for more than 1,000 leprosy patients between 1888 and 1901 in his house.
See main article: Suketoshi Chujo. Suketoshi Chujo (中條資俊 1872–1947) was a Japanese physician, a Hansen's disease researcher, the first director of Matsugaoka Hoyoen Sanatorium (1909–1947). He repeatedly reported turpentine spirit preparation he named TR as effective for leprosy.
See main article: Isamu Tajiri. Isamu Tajiri (1902–1966) was a Japanese physician specializing in leprosy. He worked at Nagashima Aiseien Sanatorium, Kikuchi Keifuen Sanatorium and Tama Zenshoen Sanatorium. In 1955, he proposed "acute infiltration" of leprosy.
See main article: Shigetaka Takashima. Shigetaka Takashima (1907–1985) was a Japanese physician and studied leprosy. He worked in Kuryu Rakusen-en Sanatorium, Tohoku Shinseien Sanatorium, Suruga Sanatorium and Nagashima Aiseien Sanatorium.
See main article: Fumio Hayashi (doctor). Fumio Hayashi (1900–1947) was a Japanese physician and leprologist. He worked in Tama Zenshoen Sanatorium, Nagashima Aiseien Sanatorium, Hoshizuka Keiaien Sanatorium and Ooshima Seishoen Sanatorium. He helped with Kensuke Mitsuda, and completed the first lepromin test or Mitsuda skin test.
See main article: Kageyoshi Tada. Kageyoshi Tada (?-1950) was a Japanese physician who worked in Miyako Nanseien Sanatorium, Okinawa Prefecture Japan between 1938 ad 1945. He put in-patients who were forcibly hospitalized under strict control. Barbwired fences were built around the sanatorium and a special prison was also built, not to allow in-patients to go out of the sanatorium. In 1945, 110 in-patients died of malaria, malnutrition and as direct effects of air attacks, while his group escaped to the army shelter.
See main article: Kohsaburo Iesaka. Kohsaburo Iesaka 家坂幸三郎(1878–1952) was a Japanese Christian physician who headed the Miyako Nanseien Sanatorium (1933–1938) and Okinawa Airakuen Sanatorium (1947–1951). The church he created as "Yomigaerino Kai" still remains in the Miyako Nanseien Sanatorium, as well a s a church of Nippon Sei Ko Kai and a catholic church.
See main article: Mamoru Uchida. Mamoru Uchida (内田守 1900–1982) was an ophthalmologist who worked for leprosy patients at Kyushu Sanatorium (Kikuchi Keifuen Sanatorium), Nagashima Aiseien Sanatorium, and Matsuoka Hoyoen Sanatorium. He taught leprosy patients "Tanka", in these sanatoriums. Later, he studied social welfare as professor at Kumamoto Junior College. He extensively studied the history of leprosy, and presented many documents to the Kumamoto Prefectural Library. 338 items were shown at an exhibition of Hansen's disease and literature in 2003.
See main article: Shunsuke Miyake. Shunsuke Miyake (三宅俊輔1854–1926) was born in Shimane Prefecture and was qualified as a doctor. He practiced in Tsuwano, Yamaguchi, Nagasaki, and Taniyama. He was baptized in Yamaguchi Prefecture and did missionary work. He was asked to work at Kaishun Hospital by Hannah Riddell in 1897 and lived in the hospital until his death for 30 years. He worked as a buffer between Hannah Riddell and patients, although he looked as if he was a servant of the hospital. He was loved by patients.
See main article: Takekichi Sugai. Takekichi Sugai (菅井竹吉, 1871–1944) was the first chief doctor at Sotojima Hoyoen Sanatorium (1909–1923) who wrote many papers on leprosy. Sotojima Hoyoen was a public leprosy sanatorium present in Osaka Prefecture between 1909 and 1934.
See main article: Koh Yasuda. Koh Yasuda (保田耕, 1907–1943) was a Japanese ophthalmologist who became the first director of Amami Wakoen Sanatorium, a leprosy sanatorium in Amami Ōshima, Kagoshima Prefecture, Japan. He was drafted into military service and died in China in 1943.
See main article: Taiji Nojima. Taiji Nojima (のじま たいじ, 1896–1970) was a Japanese dermatologist at Ooshima Seishoen Sanatorium, for 41 years, (director for 36 years). He attended many international leprosy congresses and visited many overseas leprosy sanatoriums.
See main article: Hakaru Miyagawa. Hakaru Miyagawa (宮川量 1905–1949) worked at Zensho Hospital, Tama Zenshoen Sanatorium, Nagashima Aiseien Leprosarium, Nagashima Aiseien Sanatorium, Okinawa Airakuen Leprosarium, Okinawa Airakuen Sanatorium and Hoshizuka Keiaien Leprosarium, Hoshizuka Keiaien Sanatorium and studied the history of leprosy.
Westerners who were involved in the care of leprosy patients based partly on Modernization of Medicine and Foreigners (Souda)[10] and others