A Modern History of ‘Imperial Medicine’ Surrounding Hansen's Disease: Strategies to Manage Public Opinion in Modern Japanese Media / 의사학

The purpose of this study is to understand the reality of imperial medicine by exploring the strategic attitude of the Japanese authority targeting the public who were not patients of Hansen's disease. For this purpose, this study examines the mass media data related to Hansen's disease published in Korea and Japan during the Japanese colonial rule. Research on Hansen's disease can be divided into medical, sociohistorical, social welfare, and human rights approach. There are medical studies and statistics on the dissemination of medical information about Hansen's disease and management measures, the history of the management of the disease, guarantee of the rights of the patients and the welfare environment, and studies on the autobiographical, literary writings and oral statements on the life and psychological conflicts of the patients. Among existing research, the topics of the study on Hansen's disease under the Japanese colonial rule include the history of the Sorokdo Island Sanatorium, investigation on the forced labor of the patients in the island, human rights violations against the patients, oral memoirs of the patients and doctors who practiced at that time. All of these studies are important achievements regarding the research on the patients. An important study of Hansen's disease in modern Japan is the work of Hujino Utaka, which introduces the isolation of and discrimination against the patients of Hansen's disease. Hujino Utaka's study examines the annihilation of people with infectious diseases in Japan and its colonies by the imperial government, which was the consequence of the imperial medical policies, and reports on the isolation of Hansen's disease patients during the war. Although these researches are important achievements in the study of Hansen's disease in modernity, their focus has mainly been on the history of isolation and exploitation in the Sorokdo Island Sanatorium and discrimination against the patients within the sanatorium, which was controlled by the director of the sanatorium. Consequently, the research tends to perceive the problem within the frame of antagonism between the agent of imperialism and the victims of exploitation by the hands of imperialism. Hence, it has limitations in that it has not fully addressed the problem of the people who were not Hansen's disease patients and as such, existed somewhere in between the two extremes in the process of administering medicine under the imperial rule. The purpose of this study is to identify the direction of imperial medicine in the history of Hansen's disease in Japan and to comprehend the characteristics of policy on Hansen's disease developed by Mitsuda Kensuke, who was behind the policy of imperial medicine, and examine the process of imperial medicine reaching out to the people (of Japan and its colonies). To achieve the goal, this study explores how the agent of imperial medicine gain the favor the public, who are not Hansen's disease patients, by means of the mass media. Specifically, this paper examines data in the Japanese language related to Korean patients of Hansen's disease including the mass media data on Hansen's disease in the source book titled The Collection of Data on Hansen's Disease in Joseon under the Colonial Rule(8 volumes) compiled by Takio Eiji, which has not been studied until now. It also reviews the cultural and popular magazines published in Japan and Joseon at that time.

The Morbidity and Mortality of the Patients with Hansen's Disease in a Leprosarium / 나학회지

ansen's disease, death certificates of the inpatients of Sorokdo National Hospital between 2001 and 2008 and died during the same time period were used to analyze the causes of their death, and the morbidity patterns of those patients who are hospitalized in the same hospital as of 2008 were analyzed. The results are as follows: The average number of diseases per inpatient was 3.4 with the maximum being 10. The distribution of morbidity was 67.2% for circulatory diseases, 58.4% for musculoskeletal diseases, and 36.3% for infectious diseases and skin diseases respectively. The morbidity rank of all patients was 50.1% for primary hypertension, 34.4% for chronic viral hepatitis, 27.4% for arthritis, 27.2% for skin diseases, and 23.7% for cataracts. The age-standardized death rate of males per 100,000 was 557.6 for heart diseases, 500.2 for liver diseases, 460.5 for respiratory diseases, and 459.8 for cancers. The age-standardized death rate of females was 266.3 for sepsis, 232.6 for liver diseases, 212.0 for cancers, 208.8 for pneumonia and 206.9 for respiratory diseases. The standardized death rate for all patients was 456.6 for heart diseases, 414.7 for liver diseases, 393.8 for respiratory diseases, and 383.0 for malignant neoplasms. In conclusion, the patterns of morbidity and mortality of patients with Hansen's disease was different than those of the general population. Additional public health approaches will be needed to improve the health status and quality of life of these patients, and additional studies on related factors will also be in order.

Fracture in Sorokdo National Hospital / 나학회지

INTRODUCTION: There are insufficient researches about the causes and the actual condition of fracture in Hansen's disease. Hence, I would like to indicate the problem by analysing the actual condition of fractures in Sorocdo Hansen's disease and a link between electromotion scooter and fracture. MATERIAL AND METHODS: Object is 75 patients who were admitted at Sorocdo National Hospital due to fracture from 2003, January to 2006, December. The medical record was analysed by retrospectively. Patient's general feature and the feature related to accident were analysed. Moreover, use of electromotion scooter and the relation between them were researched. RESULTS: The proportion of males to females is 1.41:1. Average age is 73.6 and over 65 years old shows 78.7%(59 persons) which means fracture happens frequently at old age. Predominant percentage of fracture is occurred at summer(34.7%) and autumn(33.4%). In addiction, the number of fracture patients is increased surprisingly since electromotion wheelchair and scooter were introduced in 2005. Hip joint fracture(34.7%) and distal radius fracture (16.0%) are the main region. The major reasonsof fracture are falls(52.2%) and accidents related to electromotion scooter(17.9%). The mortality of patients who were treated surgically(4.9%) is meaningfully lower than that who received conservated treatment(23.5%). CONCLUSION: The aged population and the number of electromotion scooter are been increasing in Sorocdo. Therefore, We need to find the fundamental and specific measure to prevent fracture caused by falls and electromotion scooter accident. Furthermore, surgical treatment is required actively.

Acute abdomen in Hansen's disease / 나학회지

INTRODUCTION: The acute abdomen define as an acute abdominal condition which needs immediate decision for treatment. The retrospective study was conducted to evaluate the characteristic of the acute abdomen in Hansen's disease. MATERIALS AND METHODS: An analysis was made of the records of 53 patients in surgical department at the National Soocdo Hospital from January, 2003 through December, 2005 for 3 years. RESULTS: The sex ratio of male to female was 1:1.04, and the mean age was 75.1 years. The most prevalent age group was in between 71 to 75 years of age(24.5%). Common diseases of acute abdomen were gastrointestinal bleeding(28.3%), acute appendicitis(17.0%), biliary tract disease(15.1%), intestinal obstruction(15.1%) in order of frequency. The operation rate was 32.1%(17 case). As for operative procedure, appendectomy was done in 9 cases, cholecystectomy was done in 3 cases, subtotal gastrectomy was done in 2 cases , palliative gastrectomy and gastric primary closure with omental patch and adhesiolysis with small bowel primary closure was done in 1 case each. The overall mortality rate was 24.5%(13 case). CONCLUSION: Gastrointestinal bleeding and intestinal obstruction was more frequent than other old age group. The operation rate was low, and the mortality rate was high. This study suggests that more active and surgical treatment need in acute abdomen of Hansen's disease patients.

Trends & Evaluation of K-ADL in Sorokdo / 나학회지

Background : Korean Activities of Daily Living(K-ADL) scale and Korean Instrumental Activities of Daily Living(K-IADL) scale were developed to measure the function of the old. The evaluation through K-ADL and K-IADL is important for the optimal medical service to the disabled old people on the Sorokdo. This study was conducted to assess the functional disability of them and to find out the suitable medical service. Method : This research was collected from 731 Sorokdo residents in Oct, 2003. The data were compared by chi-square test, independent t-test and ANOVA test using SPSS(ver 10.0) with alpha-error=0.05. Result : Bathing-points and clothing-points on ADL scale are comparatively low: points of the women lower than those of the men; the group over 65 years than group under that age; the patients who have combined disease than the patients who have not; and the patients who have been hospitalized more than once than those who have not been. Besides, the points of the not-disabled are lower than those of disability, the lower one`s points on ADL scale. It is due to the fact that there are many not-disabled persons over 65 years old. Preparing-a-meal points and washing-points on IADL scale are comparatively low: points of the women lower than those of the men; the group over 65 years than group under that age; the patients who have combined disease than the patients who have not; the patients who have been hospitalized than those who have not been one a more; and the seriously- disabled and the slightly-disabled. The points on Barthel ADL scale are dwindling annually by 0.3 to 0.5, the decrease of the women being greater than that of the men. Conclusion : Special medical programs for the old patients and a rehabilitation health service will improve the reliability of medical service on Sorokdo hospital and increase quality of life.