福島医学雑誌 54 巻 4 号 2004

〔総  説〕

ハンセン病政策と医学I

―― 隔離政策の提唱と進展 ――

森  修一

福島県立医科大学医学部微生物学講座
東京大学大学院総合文化研究科
広域科学専攻相関基礎科学系博士課程

(受付 2005年1月11日)

Leprosy Policy and Medicine I
―― Proposal and its Progress of an Isolation Policy ――

SHUICHI MORI

Department of Microbiology, School of Medicine, Fukushima Medical University, Fukushima
Department of Basic Science, the Graduate School of Arts and Sciences,
The University of Tokyo

要旨: 日本のハンセン病政策は1907年(明治40年)の法律第11号「癩予防ニ関スル件」による浮浪する患者の収容政策に始まり,その後,大正,昭和の隔離世論の高まりの中,1931年(昭和6年)の全患者収容を目指した「癩予防法」の成立により確立されたといえる。今日のハンセン病政策研究からは,それは全患者収容,生涯隔離,社会防衛,患者の人権軽視という複数の言葉に形容され得る日本独自の絶対隔離政策であり,結果,多くの患者の悲劇が生じたのだと説明されている。しかし,日本のハンセン病政策は本当に独自のものであったのか,絶対隔離政策の成立の要因は何であったのか,という疑問に明確に答え得る研究は少なく,かつ,曖昧である。本稿はこれらの疑問に対し,ハンセン病政策と医学の関わりに焦点を当て,日本の隔離政策の独自性と世界の政策との共通性の検証,絶対隔離政策の進展の要因などを明らかにしようとするものである。その過程は,明治期の国家医学の定立と隔離政策の関係,土肥慶蔵,北里柴三郎,山根正次などの医学者による隔離政策の提唱および光田健輔による実践,内務省衛生局の政策決定とその背景,絶対隔離政策選択への諸要因などの歴史的,医学史的検証の総体である。

索引用語: ハンセン病,医学,隔離政策

Abstract: The leprosy policy of Japan began from when the government enacted "law No. 11 (The leprosy prevention act)" in 1907 (Meiji 40) and several leprosy sanatoriums were built to receive previously homeless patients. Then, with the rise of totalitarianism, the isolation policy of Japan gained national support under the slogan "Patient Relief", which would become a major factor behind the enactment of "Leprosy Prevention Law" in 1931 (Showa 6) by which the leprosy policy was changed to one of absolute isolation aimed at the internment of all leprosy patients.
 From recent research on the leprosy policy of Japan, the internment of all leprosy patients, isolation for life, social defense, and neglect of patients' human-rights had tragic results in many cases. However, there is little research which can reply clearly to the question of whether the leprosy policy of Japan was really original and what factors led to the formation of the absolute isolation policy.
 This paper focuses on the relation between leprosy policy and treatment, and from this, I make clear the similarities, or peculiarities, of the isolation policy between Japan and the rest of the world, while clarifying the factors associated with the progress of the absolute isolation policy.
 The processes involved were historical and medical historical in that the relation between the formation of a national health system and the progress of the isolation policy of Meiji Era, the proposal of the isolation policy by Dr. Keizou Doi, Dr. Shibasaburo Kitazato, and Dr. Masatsugu Yamane;the practical application of this policy by Dr. Kensuke Mitsuda, and the decision to enact this policy and its support by the Health and Medical Bureau and the Department of the Interior, as well as many other factors, all contributed to the final implementation of the absolute isolation policy.

Key words: Leprosy, Medicine, Isolation policy