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Abstract

第125巻第5号

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Why was Shuzo Kure Upset and What was His Goal?
Hideo KANEKAWA1,2
1 National Hospital Organization Saitama Hospital
2 Showa University Psychiatry
Psychiatria et Neurologia Japonica 125: 430-442, 2023
https://doi.org/10.57369/pnj.23-060

 Shuzo Kure (1865-1932), the third Professor of Tokyo Imperial University Medical College, investigated home custody in 1918, mainly in eastern Japan, and compiled the "Actual Situation of Home Custody for Mental Patients." Based on these investigations, the history of home custody and psychiatry was analyzed. While Kure was studying in Europe to bring western psychiatry to Japan, the Mental Patients Custody Act was enacted in Japan. He was outraged because the Act was legally maintained, but there were no provisions for medical care of patients.
 Kure recommended the abolition of custody rooms and the building of a public psychiatric hospital in each prefecture. One means to reform the law was the publication and distribution of magazine serials from the Ministry of Home Affairs, which became the cornerstone for enactment of the Mental Hospital Law in 1919. Kure felt that it would be impossible to establish large numbers of public psychiatric hospitals at the time.
 The book states that the mentally ill can improve with proper medical care, so they should be hospitalized and receive treatment. There were not enough public psychiatric hospitals for this purpose, and the number of hospitals was different from Europe and the USA. He also analyzed the passage of the law and details surrounding it. The police strictly interpreted and enforced the law, as can be seen in Kojyuro Imamich's book, "Psychiatric Custody Procedures." Although the impression was that police forcibly isolated people with mental illnesses, in reality, their families requested home custody due to their inability to provide care. Contemporary records from Oita Prefecture indicate that home custody was difficult due to the complexity of the procedure, and a subsequent survey indicated that treatment of mentally impaired patients improved due to guidance from the police. There are similar records from the Edo period (1603-1867), where a doctor's medical certificate attached to the allegations of family relatives and the government office allowed home custody. The framework of the law was similar to statutes of the magistrate's office from the Edo period and modern laws. This law was not created suddenly, and there is a continuous connection to the present.
 "Recent Mental Illness Treatment Facilities in our Country" by Kure referred to the history of psychiatry, covering university psychiatric wards, public and private psychiatric hospitals, and private non-hospital detention facilities for the mentally ill from the Meiji era (1868-1912) to the Showa era (1926-1989). Kure wished to establish a psychiatric outpatient department at Tokyo Imperial University Medical College. However, a professor of internal medicine at the medical college resisted these attempts due to his resentment toward a previous professor of psychiatry, as they both had affairs with the daughter of German aristocrats while studying in Germany. Kure formed the Charity and Relief Society for the Mentally Ill, collected donations, built a psychiatric ward, and donated it to the university.
 Goro Kashida (died in 1882) recorded all of the incidents that occurred every year, which allowed Kure to write a number of books on the subject.
 Author's abstract

Keywords:Shuzo Kure, Goro Kashida, mental patients, home custody, psychiatric hospitals>
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