67-5

61/110

and medical care during the Edo period widely differed among each han; nevertheless, there were some common characteristics as shown below.Edo period educational facilities included the Shouheikou, run by the Tokugawa shogunate, schools run by the han, and private elementary schools and private schools. Private schools taught students who had completed elementary education; the curriculum widely varied in terms of subjects and levels. Confucianism, Japanese literature and culture, Dutch studies, or specialist fields such as military science and medicine were taught, with some private schools covering more material and at a higher level than public schools. Each region had private schools; however, some private schools at the Edo, Osaka, and Kyoto, the governmental, economic, and cultural centers, attracted many of their students from across the entire country.The Edo shogunate markedly restricted the international travel and trade of the Japanese people. Among the European countries, only the Netherlands was a trading partner. Dutch East India Company ships were only allowed to stop at the port of Dejima in Nagasaki, and only a few Japanese people were allowed to come in contact with these ships. Despite these strict limitations, the field of Dutch studies and the study of Euro-pean writings and scholarship in the Dutch language were born. Initially, Dutch language inter-preters in Nagasaki was the responsibility of research and education of the Dutch studies; however, after the latter half of the 18th century, those who had learned Dutch engaged in Dutch studies in Edo and other regions. Dutch studies were primarily taught in private, rather than public schools, with Western society, medicine, and science taught in addition to Dutch reading and writing.Japanese medicine during the Edo period was based on medicine originating in China. Japanese physicians made some refinements; however, China was the origin for treatments such as plant-based medicines, acupuncture, moxibustion, bloodletting, and the theories underlying these treatments.Ordinary people who fell ill sought treatment from physicians; however, “experience-based reme-dies were widespread in rural communities, and medical treatments were often based on magic. Nevertheless, books written on health regimens were widely available, and people were highly health-conscious.The shogunate had almost no governmental poli-cies or official measures regarding medical treat-ments at the state level. An exception during the first half of the 18th century was that facilities were established for the relief medical aid for the poor; nevertheless, medical treatment was typically delivered at the han or village level.In terms of physician’s training, there was no unified national certification system, and medical training differed among the han. Throughout the entire Edo period, of the 272 han schools, 44 had courses that taught medicine; further, 83 had some sort of established medical training organization, and occasionally the han was responsible for medical training. While this type of public training for physicians existed, many physicians first learned the basics of medicine as apprentices to a local physician before learning higher-level techniques at combined private schools/clinics run by physi-cians in the cities. In some cases, they would travel to Edo, Osaka, Kyoto, or Nagasaki for training. Skilled and practiced physicians would simultane-ously provide treatment at their medical facilities while also working as a han’i (han physician) hired by the han.The number of physicians studying Western medicine increased after the latter half of the 18th century. Japanese physicians were keenly inter-ested in the Western study of anatomy, one of the oldest scientific inquiry fields in Western medicine. The “Kaitai shinsho,” anatomical text translated from Dutch into Japanese, was evaluated as the representative of accomplishment of Dutch studies, even in fields outside of medicine. Until the first half of the 18th century, there were a small number of physicians in Nagasaki practicing Western medi-cine who had learned surgery from the physicians on the Dutch ships; however, by the latter half of the 18th century, physicians could be found throughout the country using techniques written in Dutch medical texts.Philipp Franz Balthasar von Siebold, who came to Nagasaki during the first half of the 19th century, was given special permission to teach Japanese physicians who were not interpreters. Siebold examined patients and gave lectures at a private school, Narutakijuku, which he had opened.465