26184

Unrefereed

In 1869, the new Meiji government decided to suppress traditional Sino–Japanese medicine and introduce modern Western medical education based on the German model. While Tokyo University hired European, preferably German, professors to train their elite students, less gifted aspirants to the medical profession and practicing physicians all over the country had to attend one of the regional medical schools (igakkō) to obtain their obligatory medical licenses. Most of these schools were established by prefectural and municipal assemblies that felt an obligation to provide sufficient services to the local community. In 1882, the Ministry of Education divided these institutions into two groups. Whereas those in the first group (kō) were allowed to issue licenses to students who passed their final examinations, the vast majority of schools belonging to the second group (otsu) were required to organize additional examinations. Understandably, many schools in the second category sought to upgrade to the first category, but the required extension of the curriculum to four years and the requirement that at least three teachers with a doctoral degree (igakushi) be employed, in addition to other specifications, placed a heavy financial burden on students and local budgets. Ōe Okuji (1864–1919), whose ancestors had served as physicians in the domain of Nakatsu for generations, became the first in his family to receive a medical education under this new system by entering the Public Medical School of Ōita Prefecture (Ōita-ken kōritsu igakkō). This school was founded in 1880, and was plagued by the difficulties experienced by all early Meiji-era institutions. Torigata Tsunekichi, a young graduate from Tokyo University, managed the establishment, taking care of dozens of students, most of whom were older than him. This school in the small city of Ōita opened its doors by offering a three-year program (soon expanded to four years) with courses in physics, chemistry, surgery, internal medicine, pharmaceutics, ophthalmology, gynecology, anatomy, and physiology, and a one-year internship in the adjoining hospital. Four reports compiled by Tomigata provide detailed information on the curriculum, teaching staff, buildings, regulations, equipment, and subjects and examinations, including statistics related to the small affiliated hospital. Although the school ran smoothly for a while, it soon ran out of funds. In 1889, after the government in Tokyo had stopped providing regional subsidies to public medical schools, the Ōita Medical School closed its doors, as did many other regional schools. The hospital was reopened later that year, and continued to operate as a prefectural hospital. The Ōe Medical Archive holds a few items from the years Ōe Okuji spent in Ōita: a diary that contains occasional notes made in 1885, lecture notes, and several books, which primarily contain printed lectures given by foreign professors at Tokyo University, including Benjamin Karl Leopold Müller, Theodor Eduard Hoffmann, and Erwin Baelz. Because medical literature was extremely expensive and difficult to obtain, students used to write down lectures word by word. Anatomical instruction was also based on texts. Because Japanese society abhorred the idea of postmortal dissection, there was hardly any opportunity for students to see inside the human body, let alone conduct dissections themselves. In Ōita, although a papier-mâché anatomical model (probably imported at great expense from Jerome L. Auzoux) was occasionally shown to students, it was usually kept locked away. Books held by the library could not be taken out, but had to be read there. In 1876, Imada Tsukanu (1850–1889), an anatomy professor at Tokyo University, published at his own expense a life-sized color chart of the human artery system using the “Icon synoptica arteriarum corporis humani” printed by Robert Friedrich Froriep (1804–1861) at the famous Landes-Industrie-Comptoir publishing firm in Weimar (Germany). Although Imada’s version, Dōmyaku Ichiranzu, was widely circulated among medical institutions throughout Japan, only a few copies have survived to the present day. The chart used in Ōita vanished long ago. However, Ōe Okuji, a young man deeply rooted in tradition, did what monks and scholars in Japan had been doing since the beginning of religious and secular scholarship: he made a meticulous copy of Imada’s copperplate engraving. Considering his busy schedule of classes, this project must have taken weeks, after which it must have been impossible for him not to know the human arterial system. After graduating in 1886, he mounted these sheets and kept the scroll in his clinic. A cursory look at this copy was enough to refresh his memory of the hardships suffered in those early years of his modern medical education.

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