Sey Nishimura 氏の論考“Promoting Health in American-Occupied Japan: Resistance to Allied Public Health Measures, 1945–1952”（American Journal of Public Health, 2009）について、詳細な要約、論文がはらむ史料論的・構造的問題点の指摘、ならびに総合的論評は、次の通りである

Sey Nishimura論文総合論評・構造的解読

1.）論文の全体要約（Executive Summary）

本論文は、連合国軍最高司令官総司令部（GHQ/SCAP）公衆衛生福祉局（PHW：Public Health and Welfare Section、局長クロフォード・F・サムズ［Crawford F. Sams］大佐）主導の下で実施された占領期（1945–1952年）日本の公衆衛生改革に対し、日本側の抵抗や反発、および占領権力の退潮に伴う「施策の覆し（反動・修正）」の構造的メカニズムを検証した歴史研究である。

　従来の研究（特に地方レベルにおけるDDT散布や感染症対策等）では、米軍の医療福祉施策が現地住民に好意的に受容され、対米感情の改善に寄与した側面（イデオロギー的摩擦の低減）が強調されがちであった。しかし本論文は、ナショナル・レベルおよび制度的文脈において、PHWの施策が必ずしも相互協調の成功モデルばかりではなかったことを実証する。

　著者（Nishimura）は1951年4月のマッカーサー解任に抗議して同年5月にサムズ局長が突然辞任・退任し、PHWの絶対的権力が弛緩した瞬間をとらえて、日本側（政府・日本医師会・当事者団体など）が速やかに変更・撤回・骨抜きにした代表的な5つの施策を抽出・分析している。

　5つの主要施策と抵抗の構図

戦傷病者恩給の打ち切りと生活保護・障害者福祉枠組みへの一元化
- 背景・施策： 非軍事化徹底のため、旧陸海軍病院の国立病院化や軍事援護団体の解体を進め、1946年に軍事恩給を停止。傷痍軍人（推定70万人）を「特別待遇」せず、1946年制定の生活保護法、次いで1950年の身体障害者福祉法の対象として一律に扱った。
- 日本側の抵抗・帰結： 「国家のための犠牲」を否定され、社会的烙印（ステグマ）を伴う「困窮者」「身体障害者」として分類された傷痍軍人は激しく反発。白衣での街頭募金活動や国会ロビー活動を展開。1950年の朝鮮戦争勃発に伴う米国の対日政策転換（警察予備隊創設）と相まって、1952年4月の占領終結時に「戦傷病者戦没者遺族等援護法」が成立し、国家による手当・恩給給付が復活した。
混血孤児の隔離養護施設の拒否（完全統合方針の過度な強行）
- 背景・施策： 占領軍兵士と日本人女性の間に生まれた混血孤児（推定数千人以上）に対し、サムズ局長は「日本社会への完全統合（Integration）」を主張。澤田美喜のエリザベス・サンダースホームや聖母愛児園のような専門的・隔離的養護施設への公的援助を排除・圧力をかけた。
- 日本側の抵抗・帰結： 当時の日本社会における強い人種的偏見や「純血」意識を無視したサムズの楽観的社会観（「日本人は多民族の混血であり寛容」との強弁）は実態から離脱していた。混血児に対する差別がいじめを生む中、神奈川県は1950年に児童福祉法の「再解釈」を行い、これらの施設を独自に公的児童福祉施設として認可・救済した。
原爆被災・放射線障害医療報告書の公表検閲および抑圧
- 背景・施策： 1945年秋以降、日本学術研究会議（辻鈴木正雄ら）の医療専門家が取りまとめた原爆被害報告書（119編）に対し、占領軍は出版・公表を全面禁止（1946年末〜1948年）。
- 日本側の抵抗・帰結： 現場医師や分散避難した被爆者に対する広域の医療情報共有が阻害された。背景には、対ソ冷戦構造下における「原子爆弾機密情報の漏洩防止（情報統制）」および「原爆の殺傷力・放射能効果に関する国際世論の抑圧（心理戦）」という米国側の安全保障・国家利益が存在した。1951年8月（サムズ退任後）に『原子爆弾災害調査報告書』として結実・刊行されたが、臨床・公衆衛生上の即効性は失われていた。
医薬分業の強行と日本医師会による骨抜き
- 背景・施策： 医師が調剤・投薬を行い薬価差益を得る日本の慣行を排除するため、米国型の職能分離（医薬分業）を目指し、米薬剤師協会（APA）ミッションの勧告を盾に「医師法・歯科医師法・薬剤師法」の改正を図った。
- 日本側の抵抗・帰結： 主要な経済的基盤（投薬益）を失う日本医師会（武見太郎ら）は猛反発。「全国の自治体の87%が無薬剤師村である」という圧倒的なインフラ不足を実証的に突きつけた。サムズの退任直前（1951年5月〜6月）、医師会は法案に「患者の求め等がある場合は医師の調剤を認める」との例外規定（但し書き）を挿入させることに成功。法案は成立したものの実質的に無力化（骨抜き）された。
看護教育の高度化・大学教育化改革
- 背景・施策： 看護職を従属的労働力から「専門職（Profession）」へと昇格させるため、高等教育レベルへの教育水準引き上げと資格統一を推進。
- 日本側の抵抗・帰結： 戦後復興期における安価な看護労働力を求める病院経営者や、医師の絶対的権威を前提とする医療現場の慣行と著しく激突し、一時撤回・縮小・停滞を余儀なくされた。

2.） Nishimura論文が提示する問題点と史料批判的考察

本論文は、占領期公衆衛生史に「日本側の主体的な抵抗と文化的対立」という視角を導入した点で高い学術的価値を有する。しかし、歴史学および社会科学の分析枠組みとして検証した場合、以下の6つの構造的問題点・論理的課題が浮き彫りとなる。

① 「米国の国家的利益」と「イデオロギー的教条主義」の混同

　論文では、PHWの施策挫折の要因として「米国の国家利益の優先」を挙げるが、実際には「国家戦略的リアルポリディクス」と「アメリカ型理想主義（ニューディール派的ニューマンシップ）」が同列に扱われている。

原爆報告書の検閲（冷戦下の核機密保護）は明確な「国家利益・軍事戦略」に基づくものである。
一方で、混血孤児の「完全統合論」や「医薬分業」は、米国の直接的利益というよりは、アメリカ型制度モデルの正当性を盲信する教条主義的押し付け（制度的インペリアリズム）に起因する。両者の政策決定メカニズムの違いを弁別せずに一括して「US national interest」と括る点は、分析概念として粗雑と言わざるを得ない。

② 日本側ステークホルダー（日本医師会等）の「自利（利権）」と「公共性」の過度な同調

　医薬分業をめぐる抗争において、著者は武見太郎らの抵抗を「現場の実態（無薬剤師村の存在など）に根ざした正当な反論」として好意的に叙述する傾向がある。しかし、日本医師会の抵抗の最大動機が「医師階級の伝統的・経済的特権（薬価差益）の防衛」にあったことは否定できない歴史的事実である。医師会が掲げた「患者の利便性」や「インフラの未整備」という主張は、自らの利益誘導を覆い隠すための「修辞（ロジック）」でもあった。論文は、日本側抵抗勢力が有していた「保守的利権構造」への批判的視座を欠いており、日本側の主張を真面目に受け止めすぎている（アポロジティックな傾向）きらいがある。

③ サムズ個人のパーソナリティへの過度な因果関係の帰結

論文は、1951年5月のサムズ退任を政策転換（揺り戻し）の最大の「トリガー」として描く。しかし、これは歴史的変化を特定個人の威光や退任に帰する「英雄的（あるいは権威主義的）指導者史観」の罠に陥っている。 1951〜1952年という時期は、単にサムズが去った時期であるにとどまらず、「サンフランシスコ平和条約の調印・発効」「講和成立に伴う主権回復の確実化」「朝鮮戦争の激化による逆コース（Reverse Course）の本格化」という、占領構造全体の構造的転換期であった。制度の修正は個人（サムズ）の離脱のみならず、占領体制そのものの解体過程の不可避的産物として捉え直す必要がある。

④ 「混血孤児問題」における社会解釈の硬直性

　サムズの「混血児は日本社会に吸収されるべき」という見解を、単に「無知と冷淡」として切り捨てる議論にも再考の余地がある。確かに当時の日本社会の差別意識（純血主義）に照らせばサムズの言動は現実無視であった。しかし、人種隔離（Segregation）の歴史的トラウマを抱える米国出身者（特に連邦政府官僚）の倫理観から見れば、「特定の混血児を人種ごとに隔離した施設で育てる」こと自体が、かつてのアメリカ南部や南アフリカ的セグリゲーションの再現に見えたという文脈も考慮されるべきである。論文は、「米国のセグリゲーション忌避という倫理的文脈」と「日本の単一民族的純血主義」という二つの『正義』あるいは『偏見』の不噛み合いを多角的に解剖しきれていない。

⑤ 原爆検閲問題における「医療」と「軍事」の結節点の単純化

　原爆被害報告書の抑圧について、論文は「日本側医師が被爆者治療のために緊急出版しようとしたものをGHQが阻んだ」という二元論（「人道・医療」対「政治・軍事」）で描写する。しかし、ABCC（原爆傷害調査委員会）や初期調査団の活動は、日本人学者側も学術的功名心や「最新の科学研究へのアクセス」を求めて自発的に協力した（あるいはデータを差し出した）複雑な相関関係の上に成り立っていた。単なる「被害者（日本側研究者）対加害者・抑圧者（PHW/SCAP）」という単純な構図では、戦後日本の医学界（旧帝国大学主導の医学体制）が有していた権力構造や共犯関係を分析しきれない。

⑥ 「早すぎた改革（Premature Reforms）」概念の帰結の曖昧さ

論　文の結論部において、著者は「医薬分業や看護教育の高度化が20世紀末になって日本で結実した」ことを根拠に、「PHWの改革方針自体は健全（sound）であったが、時期尚早（premature）で日本の伝統と過度に断絶していた」と結論づける。しかし、この「早すぎた改革」という概念は論理的な裏返しをはらんでいる。もし半世紀後に定着したのであれば、それは「アメリカの導入したモデルが普遍的に正しかった」ことを追認することにならないか。それとも「日本の内発的発展によって到達した制度が、たまたまPHWの掲げた形と類似していた」だけなのか。歴史的進化論（近代化論）的罠に足を取られ、改革の「妥当性」と「導入プロセスの暴力性」の評価が両刃の剣となっている。

3. 総論・論評（Critical Appraisal）

　Nishimura論文の最大の功績は、戦後占領期における公衆衛生分野を、単なる「恩恵的な人道支援と近代化の達成」という神話から解放し、「軍事占領という非対称的権力関係における文化的・制度的摩擦の闘争領域」として再定義した点にある。

制度の移植（Transplant）における「拒絶反応」の構造化 行政学および比較法制度学の観点から見れば、本論考が描いたドラマは、外部権力によって強制された「制度の移植」が、移転先の社会的文脈（社会的インフラの欠如、職能団体の利権、当事者の自尊心や尊厳）といかに衝突し、いかに「骨抜き（Emasculation）」という日本的適応技法によって去勢されたかを示す極めて良質なケーススタディである。
制度修正のグラデーションと後続への影響
- 完全な再覆し（戦傷病者援護法）： 国家責任の再承認と伝統的価値（お国への貢献）の復権。
- 実質的無力化（医薬分業）： 例外規定の導入による制度の形骸化（ただし枠組みのみ残存）。
- 地域・実務主導の修正（混血孤児認可）： 現地行政（神奈川県）による実利主義的な現場救済。

このように、日本側は全面対決を避けつつも、「省令の書き換え」「但し書きの挿入」「ローカルルールの運用」といった実務的アプローチを通じて、GHQのイデオロギー的強制を緩和・解体していった。

結論として、Sey Nishimuraの論考は、「占領期医療改革の光と影」を立体的に浮き彫りにした秀逸な歴史叙述であり、同時に、政治的・軍事的大義名分のもとで推し進められる「上からの近代化」が、現地の文化的文脈や人々の尊厳（傷痍軍人のアイデンティティや混血児の生存権）と衝突する際に生じる現代的課題（制度改革と社会的慣習の摩擦）を問い続ける普遍的知見を含んでいると評価できる。

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＜原論文＞

Promoting Health During the American Occupation of Japan The Public Health Section, Kyoto Military Government Team, 1945-1949

Sey Nishimura

PMCID: PMC2253585 PMID: 18235076

Abstract

During the American occupation of Japan (1945–1952), young public health officers from the US Army Medical Corps were posted in local US Army military government teams. These young doctors (aged 25 to 27 years), who had not absorbed the strong anti-Japanese tradition of the US military during World War II, seem to have alleviated the initial resentment felt by the Japanese toward the new governors of their homeland. The case of the Kyoto Military Government Team illustrates the Kyoto citizenry’s positive view of some American-directed public health measures. The team’s services helped to counter widely held negative views on colonialism, occupation, and public health; lessened resentment toward the unilateral command structure of the occupation forces; and contributed to improved relations between the United States and Japan at the local level.

AS A RESULT OF WARTIME military operations that had depleted the public health budget, the Japanese faced health problems on an unprecedented scale at the end of World War II.1 They were mentally disoriented and physically exhausted. The country’s morale had declined significantly2 because of the economic blockade in effect since 1940, the loss of 2.3 million lives in combat, and the loss of 800 000 civilians killed in air raids and bombings, including the 196 000 who perished in the atomic bombing of Hiroshima and Nagasaki.3 More than 6 million Japanese waited for repatriation in the ports of Asia and the Soviet Union.4 Food was scarce because the means of production, transportation, and rationing were not functioning well, and malnutrition made the Japanese susceptible to disease and untimely death. Crowded living conditions and lack of opportunities to bathe exacerbated their vulnerability.

The General Headquarters, Supreme Commander for the Allied Powers, led by General Douglas MacArthur, retained the existing Japanese state structure by setting up sections that paralleled the functions of the ministries of the Japanese government. The Public Health and Welfare Section instructed the Ministry of Health and Welfare by means of directives, memoranda, and oral communications, and the Ministry passed these instructions down to the prefectural hygiene departments. Concurrently, the US Eighth Army units were divided into 6 regions, each of which took responsibility for 5 to 8 prefectures.5 A military government team consisting of 8 to 10 officers and civilian specialists and 20 to 30 enlisted men was set up in each prefecture. The commanding officer of each team maintained surveillance over the prefectural government as it carried out the directives of the Supreme Commander for the Allied Powers by giving “guidance.”

Surveillance duties relating to public health were the responsibility of the public health officer of the team, who was in the chain of command under Colonel (later Brigadier General) Crawford F. Sams, chief of the Public Health and Welfare Section. Sams was qualified for the task. A 1929 graduate of the Washington University School of Medicine in St Louis, Mo, he had served as a US Army medical officer in Panama, North Africa, the Middle East, and Europe. While posted in Washington, DC, in 1945, the 43-year-old colonel was chosen to accompany General MacArthur to occupied Japan.

With a logical, disciplined personality and a progressive view toward the international promotion of health,6 Sams made an unconventional decision in recruiting his local public health officers. Instead of mature physicians from deactivated military medical units, he chose young doctors who had recently finished their internships and been inducted into military service. He felt that they were “sufficiently mobile in their thinking that they could be trained on the job by frequent seminars and could be a real asset.”7 These young men had spent the war years engaged in study and lacked not only veterans’ combat experience but also their passionate, belligerent involvement in the war. They did not have overt acrimonious feelings toward the Japanese.

When these young doctors were posted as lieutenants from the US Army Medical Corps to the prefectural hygiene (later public health) departments, with theoretical authority over Japanese health officials much older than themselves, the Japanese marveled at the Americans’ up-to-date knowledge. Japan lagged behind the United States in medicine and public health by 10 years at that time because of the wartime ban on “unnationalistic” foreign technical journals.8

After recruiting these young officers, Sams started coping with the epidemics that were rampant in Japan after the war. Repatriated Japanese nationals from Asia and the Soviet Union had brought back a plethora of diseases. Public utilities and sewage systems had been damaged during the war, and the extermination of disease carriers (lice, rats, flies, and mosquitoes) was a slow process. By the end of 1946, more than 10 000 citizens were infected with smallpox, 3122 of whom died; about 20 000 had contracted murine typhus, which caused 3351 deaths; and another 560 had died of cholera. Additional deaths resulted from dysentery, typhoid fever, scarlet fever, tuberculosis, and malnutrition.9 The Public Health and Welfare Section drew up plans for preventive measures and handed them over to the Ministry of Health and Welfare to be forwarded to the prefectural hygiene departments. Simultaneously, the military government’s local public health officers received identical plans from the Public Health and Welfare Section, along with instructions to oversee the prefectures’ implementation of the plans. The outcomes were reported back through the same channels at regular intervals, which reestablished the war-torn public health infrastructure of the local prefectural governments. Additional projects intended to improve the health of the populace were developed at the local level as public health officers, in cooperation with their Japanese staffs, saw fit.

In most of occupied Japan, the Americans’ primary interests—protecting US troops and preventing social unrest—did not prevent them from maintaining a professional attitude and displaying empathy for the Japanese. This behavior is in contrast to other 20th-century examples of the interplay between colonialism or occupation and public health.10 Public health measures in destitute, occupied Germany, for example, received little assistance from the Allied Forces,11 and medical treatment of civilians during the Japanese occupation of China in World War II, particularly in the case of the 731 Medical Battalion,12 resulted in the inhumane exploitation of the Chinese.

All public health officers were required to submit monthly reports to the Public Health and Welfare Section. These reports can now be examined in the declassified microfiche records of the Public Health and Welfare Section and Civil Affairs Section of the Supreme Commander for the Allied Powers, compiled by the National Diet Library of Japan. Matched with Japanese documents, the monthly reports provide detailed accounts of the public health officers’ activities as stipulated by the Public Health and Welfare Section. These activities were particular to the problems of the respective localities. Louis B. Fierman, MD, of Fukuoka Military Government Team (Fukuoka Prefecture)13; Jay F. Harris, MD, of Kanagawa Military Government Team (Kanagawa Prefecture)14; and William C. Beck Jr, MD, of Niigata Military Government Team (Niigata Prefecture)15 all wrote such reports, and any of them could have served as the focus of this study had additional supporting documents, interviews, and photographs been available.

The case of John D. Glismann, MD, a public health officer of the Kyoto Military Government Team, provided a more-detailed account. In addition to the declassified records, I was able to obtain 61 letters written by Glismann to his parents, 13 other letters, and photographs taken by Glismann between 1947 and 1949. Glismann’s case illustrates how an American public health officer, together with his Japanese colleagues, addressed urgent and diverse public health problems in occupied Japan, some of them particular to Kyoto Prefecture: venereal disease, a shortage of food, hospitalization of tuberculosis patients, epidemics, inoculations, maternal and child health care, trachoma, disaster relief, and ambulatory treatment of Hansen’s disease (leprosy).

GLISSMANN’S ARRIVAL

John D. Glismann was a native of Oklahoma City, Okla. He graduated from Oklahoma University School of Medicine in 1946 and finished his internship at the University of Indiana Hospital in Indianapolis in July 1947. In September 1947, after 40 days’ training in the US Army Medical Corps, he reported to the Hygiene Department of the Kyoto Prefectural Government, which was responsible for 1 800 000 residents in an area of 1780.5 square miles. The department had 187 Japanese staff, including about 10 professional health specialists with degrees in medicine.16

The director, Tadayoshi Tsuchiya, MD, and his chiefs of staff welcomed Glismann on his first day. Whereas Glismann would later organize his own reports into categories (e.g., “administration of hospitals,” “veterinary affairs,” “dental affairs”), the reports he was given for the spring of 1947 presented a jumble of information: a mere 350 cattle per month had been slaughtered for food; penicillin had arrived for use in the treatment of venereal disease; there had been a lack of food, water, and utilities; DDT had been distributed; and Japanese employees of the Kyoto Military Government Team had been inoculated against murine typhus and cholera.17 Glismann’s assignment on this day was to host the venereal disease consultant of the Public Health and Welfare Section, Oscar M. Elkins, MD, who was on an inspection tour of the prefectures. In 1947, the number of venereal disease cases in occupied Japan doubled to about 400 000, a fact that relegated a number of occupation personnel to the status of “ineffectives.” Elkins reported that Glismann was a “conscientious physician” and that Glismann’s team “should continue to be one of the best examples of modern [venereal disease] work.”18

In his first month as public health officer, Glismann dealt with Japanese encephalitis B, murine typhus, typhoid fever, cholera, dysentery, and polio; learned that 80% of the population had ascaris infestation; gave lectures on public health; and inspected health institutions, tuberculosis sanatoriums, schools of nursing, dairy farms, and a penicillin production factory.19

Tsuchiya had 40 years’ experience in preventive medicine but was given low marks by the local newspaper Kyoto Shinbun as “unresourceful as a bureaucrat due to lack of political maneuvering, deception and bluffing.”20 Tsuchiya greeted Glismann’s proposals warmly, saying “Thank you, Glismannsan, very good idea,” but acted upon them only if he thought them feasible. Several social occasions—dinners of sake and sukiyaki—gave Glismann some inside knowledge of the department’s tight budget and lack of human resources. He was evenhanded in his first monthly report: “Inspections … revealed many discrepancies, but improvements are progressive,” he wrote, before observing that Kyoto physicians were “found to be somewhat careless in handling of narcotics.”21 His harmonious relationships with the Japanese prompted Glismann to write to his mother 2 weeks after his arrival in September, asking for Christmas presents for his secretary, Tomi Okamoto, and other “Japanese friends.”22

HEALTH CHALLENGES IN POSTWAR JAPAN

Tuberculosis

Tuberculosis had been the primary killer in Japan since before the war. In 1947, 146 241 deaths from tuberculosis were reported.23 Glismann found that at one tuberculin examination for citizens younger than 29 years, a staggering 70% (142 250 of 203 500) tested positive, of which 3.7% (5319 persons) required X-rays. Patients with advanced cases were isolated in sanatoriums, where daily food rations amounted to less than 1386 calories (5802 kJ).24 Glismann negotiated with the Kyoto Military Government Team to use rejected US Army food for patients. He arranged for twice-a-week delivery of dented cans of soup, stale bread, partially spoiled bags of potatoes, and discolored hunks of meat. After a year, the patients’ daily food intake had increased to 2492 calories (10432 kJ), an amount that included 81 g of fat.25

A year later, an agent of the Criminal Investigation Department offered Glismann a large shipment of black-market streptomycin, worth $200 000 in the United States, that the department had confiscated.26 Glismann suggested that the Japanese organize a committee of medical school professors, heads of research institutes, and Hygiene Department officials to select patients to receive the drug. Teruo Yano, MD, chief of the Tuberculosis Prevention Section, was impressed with Glismann’s suggestion of creating a collective decisionmaking process. He was also astonished to see how effective streptomycin was when it was administered to 15 patients whose illness had been considered terminal.27 It was a year before Japan, under the supervision of the Public Health and Welfare Section, began to produce streptomycin; Japanese production was meant to meet the demand of about 50 million grams.28

Trachoma

In early 1948, Father Leo J. Steinback of Kawaramachi Catholic Church, also known as St. Francis Xavier Catholic Cathedral, approached Glismann with a donation of US $1000 (¥360 000).29 Glismann suggested that the money be used for a campaign against trachoma, and Steinback, nicknamed “Cranky Father” for his strict penitence assignments,30 agreed. The infectious eye disease affected 130 000 (7.5%) of the prefectural population. It often led to blindness, and it stigmatized patients as socially deprived. Thirty thousand tablets of sulfadiazine would cost ¥1 million (US $2778), an expensive expenditure considering that the total prefectural Hygiene Department budget was ¥20 million (US $55556).31 Kyoto citizens—who had earlier disappointed Emilie E. Putnum of the Welfare Section by ignoring the American-style Community Chest Campaign she had proposed32—volunteered to provide posters, press messages, slide shows, and free lecture sessions for the project. When the first eye examination was held in the small town of Sonobe, with a population of 2000 residents, 170 people were diagnosed with trachoma.33 Glismann’s parents arranged an additional donation for the project from the citizens of Oklahoma City. Glismann wrote gratefully a year later,

Thus far we have examined well over 6000 prospective patients—in Maizuru city, 394 primary school children in the early stages of trachoma were treated, with a cure rate of 61% and an overall effective rate of 91%—your dollars have been instrumental in saving the sight of hundreds of Japanese children and adults.34

Prostitution and Sexually Transmitted Diseases

Prostitution in Kyoto had been supervised by the prefectural government, which licensed organized brothels in several delineated districts. Prostitutes were registered and required to report for weekly venereal disease examinations. If they were found to be infected they received treatment, but contact tracing was not required. The examination, conducted by prefecture-registered gynecologists, was hardly rigorous; more than 90% of those examined were released with a health certificate. The postwar culture of sexual abandon35 led to the swift spread of sexually transmitted infections to the occupation forces. Glismann resolved to abolish this government-licensed prostitution. He wrote to his father, a general practitioner in Oklahoma City,

I’m trying to put through a vagrancy law to break the cycle of venereal disease of which the street walkers are a definite part, but I know nothing about writing such a law, neither does the Commanding Officer, and neither do the Japanese.36

Meanwhile, Major General Joseph M. Swing, who in January 1948 became the new commander of the First Corps (in charge of the southern half of Japan), took a different approach by ordering the military police to arrest all “likely” women out on the street after 6:00 pm. A presidential advisory commission had recommended that all military commands take disciplinary actions to reduce the venereal disease rate among their personnel, which led some local military government teams (Metropolitan Tokyo and Ôita Prefecture, for example) to take this measure to suppress prostitution.

The arrested women were detained for gynecological examination at Heian Hospital, a large “jail-like” place with barbed wire and guards. After 3 nights of mass arrests, Glismann threatened to file a military suit against Swing. The general threw Glismann out of his office, but the practice of nightly arrests was stopped. Glismann sent a letter directly to the Kyoto Post Command Venereal Disease Council, stating that although the weekly examinations revealed a 5% to 8% infection rate, the actual infection rate was 75% to 95%, according to worldwide research by the US Public Health Service.37 He argued that since the prostitutes should be considered infected at all times, the issuance of health certificates gave their patrons a false sense of safety. It was also a waste of medical expenditure and personnel’s time. Glismann suggested that the prostitutes be treated at prefectural and municipal health centers along with the public.

The Public Health and Welfare Section took Glismann’s proposal through the Kyoto Post Command Venereal Disease Council and ordered all military government teams to stop the practice of prefectural health certification of prostitutes. Although this measure would eliminate a lucrative business for the local medical society and the taxes and perks (e.g., drinking parties offered by the brothel owners) enjoyed by the prefectural governments,38 Kyoto promptly complied “despite many protests and objections.”39 The venereal disease epidemic in Kyoto would persist until passage of the Anti-Prostitution Law in 1958,40 but the practice of prefectural health certification was stopped. As of June 1948, the Enlisted Men’s Club in Kyoto required any Japanese woman wishing to enter the club’s premises to have an up-to-date health certificate41 issued by a local health center. Yomiuri Newspaper tried to report the new measure in Kyoto as the “first in the country,” but the story was censored by the Civil Censorship Detachment of the Supreme Commander for the Allied Powers, which consulted with Sams, chief of the Public Health and Welfare Section. Sams ordered the newspaper to change the wording to “[this] step was ordered by the Ministry of Health and Welfare.” “So that it doesn’t look like Kyoto alone is doing it,” he commented.42

Hospital Labor Unrest

The Japan Communist Party, legalized in the fall of 1945 by the occupation forces, was actively trying to “discredit, undermine, and eventually overthrow the occupation,” according to Sams.43 The Communists asserted that their survey showed 65% of Japanese workers to be in ill health,44 and they made the “socialization of medicine” one of their major objectives. They organized hospital workers into labor unions; patients, following suit, organized themselves into unions to make demands. The earliest confrontation took place at the Japan Red Cross Hospital in Tokyo in 1946, where workers and patients demanded to take over the hospital management and the Tokyo Metropolitan Health Department.45 The Public Health and Welfare Section and the Labor Division of the Economic and Scientific Section of the Supreme Commander for the Allied Powers intervened by prohibiting strike action, limiting negotiations to working conditions and wages.46

Postwar hardship led many Japanese to join the Japan Communist Party, which swelled to about 120 000 registered members by 1948. Kyoto Prefectural Medical College Hospital was a frequent target of disruption, owing to its authoritarian management and low wages. Of the hospital workers, 78% were dissatisfied, as were 69% of the nurses.47 Their strike actions led to the confinement of the hospital’s director, the takeover of the switchboard and electrical controls, the flying of the red Communist flag on the hospital chimney, and loud demonstrations in the wards.48

Glismann was a sympathetic listener, realizing that the workers had legitimate reasons for complaint.49 The Kyoto Military Government Team suggested the formation of a secondary labor union, which absorbed most of the physicians, only 14% of whom had been willing to strike.50 The situation was also defused by the timely distribution of relief material donated by the American people, collected by an American nonprofit organization known as the Licensed Agency for the Relief of Asia. A total of 6766 pounds of food staples, 1260 pounds of dried meat, 1463 pounds of soap, and 2127 pairs of shoes, together with US Army rations, were given away.51

Hospital labor strife ceased in 1949 after passage of the Law for the Total Number of Civil Servants. The legislation was designed to enable public institutions to dismiss active Communists as “extraneous” staff and to eradicate the influence of the Japan Communist Party, which was believed to operate under Soviet directives.52 After this “Red purge,” the dismissed staff formed cooperative clinics and hospitals, some of which continue to exist today.53

A Natural Disaster

At 5:14 pm on June 28, 1948, an earthquake with a magnitude of 7.3 on the Richter scale struck in Fukui Prefecture by the Japan Sea, directly north of Kyoto. Glismann had just returned from work and was taking a nap. He awoke as his bed “gave a hard shake and the walls were going back and forth”; outside the window, he saw the “telephone pole doing a hula dance.” Some time later, he learned the extent of the damage, which had killed 3154 people, destroyed 33 681 houses, and burned down one third of the city of Fukui.54 The quake caused the wooden houses to collapse under their roofs. The sight of the intact roofs from the air led the crew of a US Army reconnaissance plane to believe that the city itself was intact, until the fires started spreading. General Swing, who had been hosting a cocktail party at home, reported to Kyoto Railway Station as head of the inspection team while continuing the party with his guests in his railway car. This team took no medical supplies or staff, a fact that Glismann discovered at 11:00 pm.55

Glismann organized a medical team and 4 trucks full of supplies, which traveled for 8 hours over mountain roads to reach the hardest-hit area. The team, consisting of both Americans and Japanese from the Kyoto area, spent 2 full days in the city of Fukui. The Hygiene Department of Kyoto Prefectural Government sent a generous donation of ¥300,000 (US$833) worth of medical supplies, 56 physicians, 136 nurses, and 25 staff.56 Glismann saw a house in which some family members were fighting the fire on one side while others were starting to reconstruct the other side. It was no surprise to him that most of the city was restored in 6 months, although the occupation forces had predicted it would take 5 years.

The 1948 Diphtheria Inoculation Accident

Epidemics of diseases such as smallpox, cholera, dysentery, murine typhus, scarlet fever, and diphtheria were often fatal in post-war Japan because of widespread malnutrition and the lack of medicine. To protect the occupation forces as well as the Japanese, the Public Health and Welfare Section promoted an inoculation program with full force, even to the point of deploying armed soldiers to round up noncompliant Japanese citizens.57 Glismann underlined the need for inoculation in an article for the newspaper Kyoto Shinbun. “Have you taken measures to prevent your children from dying with diphtheria?” he wrote, chiding Japanese parents who tended to blame their children for the misfortunes of childhood, including the contracting of contagious diseases. He pointed out that parents had the responsibility to “act on inoculation immediately, whether you are poor or wealthy.”58 In accordance with the Preventive Vaccinations Law of June 1948, Glismann and the Japanese began an extensive diphtheria inoculation program for preschool-aged children, including infants as young as 1 year, in November 1948. It was the first such program in the country.

On November 9, several cases of sudden diphtheria inflammation were reported. It was disclosed that the Osaka Red Cross Research Institute had produced the vaccine in four batches, detoxified two of them, and then mistakenly lumped all four batches into one lot number. When the lot was sent to the Ministry of Health and Welfare laboratory in Tokyo for an assay, it happened that the vaccine from the two good batches was selected for testing, leading to erroneous certification of the entire lot as safe. Glismann wrote to his parents, “The accident has been a blow—improperly detoxified and improperly sampled and assayed, we took it in the neck.”59 In his memoir, Sams explained how the Public Health and Welfare Section had played a supervisory role in producing active prophylactic vaccine using diphtheria toxoid:

Unfortunately, one manufacturer failed to detoxify two flasks of vaccine. Those children who were immunized with this batch of the vaccine became seriously ill; there were a few deaths.60

In fact, there were 68 deaths among the 99 children hospitalized; 507 others were seriously affected. The vice minister of health and welfare apologized on behalf of the Japanese government in a made-to-order news film, and the Kyoto Prefectural Government spent ¥20 million (US$55 556) to provide affected families with emergency monetary assistance for hospitalization and treatment costs, extra rations of food, and funeral gifts. The families of the 68 children who died were given ¥100 000 (US$278) each—a substantial amount at that time. In a press conference, Sams blamed the Japanese, who, he said, “have been known throughout the world in past years for producing cheap goods of poor quality,” a practice that “cannot be carried out insofar as biologicals are concerned.”61 It was the responsibility of the Public Health and Welfare Section to supervise the production process, and it had rushed the vaccine production to an unreasonable degree.62 That may be why the Ministry of Health and Welfare laid charges against the individuals who were working with the Osaka Red Cross Research Institute. By prosecuting them, both the Ministry and the Public Health and Welfare Section hoped to absolve themselves of administrative responsibility.63

The blow was serious, because until that time, the members of the Hygiene Department of the Kyoto Prefectural Government had prided themselves on being first and best in the country. Tsuchiya, director of the Hygiene Department, along with Shizuo Fujita, chief of the General Affairs Section, came to work in black suits for days. Glismann found out later that they had been attending the victims’ funerals. Glismann’s second Christmas party in Kyoto was a humble affair, held in his apartment with Coca Cola and sandwiches.

Hansen’s Disease (Leprosy)

By 1947, the number of Hansen’s disease patients in Japan had decreased from 30 000 to 10 000 as the result of 50 years’ enforcement of compulsory isolation of patients with the disease.64 In early 1949, Glismann sent his father a $150 money order for the purpose of paying Glismann’s income tax; he asked that his father use whatever was left over (which turned out to be $28) to buy the drug promin, which Glismann would “supply to the Kyoto University Hospital whose dermatology department is willing to open their beds to cases of leprosy.”65 Glismann was referring to the project of Mitsugu Nishiura, MD, associate professor in the Special Dermatological Research Unit of Kyoto University Hospital. Nishiura was the successor to Noboru Ogasawara, MD, who had started ambulatory treatment of patients with Hansen’s disease in 1936 despite the bitter disapproval of the Japan Dermatological Association.66 In 1949, while the majority had been placed in the national leposariums, there were 32 registered Hansen’s disease patients (i.e., patients reported to the prefectural government by physicians) in Kyoto.67 Glismann planned to assist Nishiura by providing promin to be used in combination with streptomycin to treat these patients and by publicizing the fact that Hansen’s disease was curable.

To learn more about the disease, Glismann visited Nagashima Aiseien, an island leprosarium in Okayama Prefecture. There he met Kensuke Mitsuda, MD, a 73-year-old authority on the disease, whom he found “extremely well-informed.” Although Mitsuda was a proponent of isolation, Glismann wrote that he “has been using Japanese manufactured Promin for over a year now and has some very good results to report.” After observing the patients (who appeared to have “adjusted quite well to their enforced imprisonment” in the beautiful Inland Sea surroundings), Glismann returned from his trip convinced that with assistance from the Kyoto Military Government Team, Nishiura’s project would bear fruit in 5 to 20 years.68

GLISMANN’S DEPARTURE

Glismann’s own tour of duty in the Army was set to end in April 1949. Of Glismann’s approaching departure, Waka Kawakita, Glismann’s secretary, wrote to Glismann’s mother (who had sent generous care packages to the female Japanese staff) that her son would be missed:

He always keeps his gentlemanly attitude and pays appropriate respect to each individuals [sic], although they may very often appear to him quite ignorant or ridiculous. I have known so many times just the opposite cases. …

She wrote that the Japanese staff, who generally “[wear] a mask of duty and disguised contempt and will not do anything more than the lowest necessity,” did their best for Glismann because they felt that he had recognized and appreciated them. She concluded, “I am feeling a fear—I pity for ourselves for losing him.”69 His former secretary, Tomi Okamoto (who had become Tomi Kimura when she married Glismann’s interpreter, Katsumi Kimura, MD), wrote to his mother that Glismann had been given parties and presents and had “left Kyoto [Railway Station] very gaily with many flowers in his arms,” seen off by more than 100 friends and acquaintances.70

The time coincided with rumors of a planned amalgamation of the prefectural hygiene and welfare departments. Fearing for their own career prospects, all but 2 section chiefs of the Hygiene Department threatened to resign.71 Although the merging of departments never took place and only 2 section chiefs actually resigned, the Hygiene Department was in an uproar in the spring of 1949. Projects such as improving the curriculum at Kyoto Prefectural Medical College, strengthening an ineffective internship program, reducing illnesses at orphanages, and enhancing hygiene education in the dairy and fish industries remained unfinished.

John B. Bryson, a 1945 graduate of Southwestern Medical School at the University of Texas, Dallas, became Glismann’s successor.72 He proved able and conscientious but was not as friendly as Glismann. On orders given by the Public Health and Welfare Section after the diphtheria inoculation accident, he conducted unannounced inspections of facilities, which had previously been notified and given time to prepare for inspection. He rated a vaccine manufacturer and the staff of 3 prefectural health centers as “poor” and found that 25% of the wells tested produced water that was unfit to drink. In addition, he reported 86% of the population still infested with ascaris; 57 000 citizens inoculated because of a recent case of smallpox; and 446 prostitutes arrested by the vice squad. Of the last incident, he wrote that “it is hoped some convictions will be secured to discourage prostitution.”73 According to his monthly reports, he gave “strong recommendations” in most matters, which brought swift improvements. Unfortunately, he dashed Glismann’s hopes for ambulatory treatment of patients with Hansen’s disease by sending 3 of them to a leprosarium; he said, “it is hoped that eventually all lepers will enter the leprosarium.”74

In July 1949, the Kyoto Military Government Team changed its name to the Kyoto Civil Affairs Government Team in preparation for the November 1949 withdrawal. Bryson’s final report, written with a touch of concern and sympathy on September 10, describes how the Japanese staff had shown a “noticeable let-down” because

the health officials do not feel that they can carry on without the guidance of Kyoto Civil Affairs Government [Team], and … their funds will be limited in the future by the Prefectural Assembly.75

Indeed, the conservative prefectural assembly was unsympathetic to any public health plan that would not produce an immediate economic profit. Moreover, a Communist governor was elected in 1950, to remain in power for 2 decades. He was unable to obtain enough funds from the Japanese government, ruled by the conservative Liberal Democratic Party, for his progressive policies. The public health team had disintegrated, as all but one (Teruo Yano) of Glismann’s “friends” had left. With regard to the ambulatory treatment of Hansen’s disease patients, the Leprosy Prevention Law of 1953 (which replaced the Law Regarding Prevention of Leprosy of 1907) promoted compulsory isolation for another 43 years until it was terminated in 1996.

LOOKING BACK

Teruo Yano, who retired from the Kyoto prefectural government in 1973, reminisced 13 years later:

During the occupation, I had no complaint against the Kyoto Military Government Team. In particular, I remember a Public Health Officer named Glismann; he usually spoke only to my supervisor so that the order came down in the governor’s name. We felt that Glismann was democratic, wanted us to be healthier, and besides, one cannot argue against scientific facts. Seeing that tuberculosis was cured by streptomycin, how could we hate it for being American?76

Glismann was not only a professional, he was a Good Samaritan. He found a Japanese boy who had dislocated a shoulder at a ski run, carried him back to Kyoto, and treated him.77 He obtained an oxygen tank from the 35th US Army Hospital for a Japanese youngster shot in the chest by a sergeant who was “trying to see if American 38 shells would fit into a Japanese 38 gun.”78 He trained the staff of Kyoto Central Health Center so that a visitor “felt indescribably good because all the workers treated the patients with such a kind and gentle manner.”79 Instead of going to the 35th US Army Hospital to have a sebaceous cyst on his ear removed, Glismann asked an experienced Japanese surgeon, Tadashi Matsushige, MD, to remove the cyst at the Kyoto Second Red Cross Hospital. He did this in spite of “a few misgivings.” He wrote,

I lay on the outdated operating table, draped with a head sheet that should have been discarded 10 years ago, unable to watch the surgery or to translate the conversation between the two doctors and a nurse.80

The 26-year-old Glismann did not stand aloof from the people of Kyoto as he performed his duty. The same can be said of some of his colleagues.81

In September 1945, the Public Health and Welfare Section had observed “a very evident post-surrender inertia and demoralization.” In the first monthly Summation of Non-Military Activities in Japan, a confidential report of the Supreme Commander for the Allied Powers, the Public Health and Welfare Section explained that “the loss of key men, lack of equipment and destruction of buildings and supplies” stifled the spirit of the Japanese in authority.82 It was the initiatives of the Public Health and Welfare Section that led to considerable improvement in public health in occupied Japan. Of the American attitude behind the health reforms, Sams reminisced, “Had we attempted to impose on the Japanese our way—I am quite sure we would have failed.” He believed that the programs of the Public Health and Welfare Section were fundamental to successful democratization, and that he had modified them to fit the Japanese cultural context.83

The mortality rate of the Japanese dropped from 14.86 per 1000 in 1947 to 8.9 per 1000 in 1953, and the birth rate per 1000 dropped from 35.01 in 1947 to 21.4 in 1953.84 The neonatal death rate dropped from 76.2 per 1000 in 1947 to 49.1 per 1000 in 1953.85 Average life expectancy increased from 50 years in 1945 to 61.9 years in 1953 for men, and from 54 to 65.7 years for women. Daily protein intake per person increased from 10.7 g in 1945 to 40.3 g in 1953.86 The mortality rate for diphtheria, which was 3.1 per 100 000 in 1947, dropped to 0.74 per 100 000 in 1952.87

It should be noted that these statistics are a simplified index, and the medical and social history of health reforms in occupied Japan is considerably more complex. Kyoto Prefecture was spared from Allied bombings during the war, in deference to the city’s internationally acclaimed cultural heritage. Both hostility toward the occupation personnel and the incidence of postwar illness and disease were somewhat muted in Kyoto compared with bombed-out Tokyo, for example, or Hiroshima, where the long-term effects of radiation sickness generated strong anti-American sentiment.

In retrospect, Sams was wise to bring in young doctors who had just finished their internships, instead of mature military physicians more likely to be prejudiced against the Japanese populace, to oversee and inspire public health reforms in occupied Japan. Although I cannot state categorically that Glismann was a typical public health officer (arguably he was one of the best), much good work was done by the Public Health and Welfare Section of the General Headquarters, Supreme Commander for the Allied Powers, in improving the dire public health conditions in postwar Japan. Despite the accident, it must be remembered that the provision of inoculations in 1948 saved 48 672 Kyoto infants from contracting diptheria that year88—including me.

John D. Glismann, MD (fourth from left), Tadayoshi Tsuchiya, MD (fifth from left), and the staff of the Hygiene Department, Kyoto Prefectural Government, 1948.
*Source. Courtesy of John D. Glismann.*

The Kujô Prefectural Health Center, 1949.
*Source. Courtesy of John D. Glismann.*

Kyoto Military Government Team members assisting relief efforts after the Fukui earthquake, June 1948.
*Source. Courtesy of John D. Glismann.*

A baby accidentally inoculated with toxic diphtheria vaccine, November 1948.
*Source. Courtesy of John D. Glismann.*

Acknowledgments

I wish to thank John D. Glismann, MD, who provided information and photographs. I am very grateful to Margaret Davidson, who edited the article, and to Trevor Levere and Anne-Emanuelle Birn of the University of Toronto for their suggestions.

This article is dedicated to the 68 children who died in the 1948 Kyoto diphtheria inoculation accident.

Peer Reviewed

ENDNOTES

1.Supreme Commander for the Allied Powers, General Headquarters, Summation of Non-Military Activities in Japan and Korea, 1945–1948, no. 1, section 1 (1945), 1–2 [confidential], National Diet Library, Tokyo, Japan.
2.The atmosphere is described, with photographs, in John W. Dower, Embracing Defeat: Japan in the Wake of World War II (New York: W. W. Norton & Co., 1999), 88–89, 104–105.
3.Costello John, The Pacific War (London: Pan Books, 1981), 583; Henshû Iinkai, Hiroshima Nagasaki no genbaku saigai [Atomic Bomb Disasters in Hiroshima and Nagasaki] (Tokyo: Iwanami Shoten, 1979), 273.
4.Supreme Commander for the Allied Powers, General Headquarters, Summation of Non-Military Activities in Japan and Korea, 1945–1948, no. 18, section 1 (1947), 255; Sey Nishimura, “Maizuru no Sôdan [Consultation at the Port of Maizuru],” Nihon Iji Shinpô [The Japan Medical Journal] (March 16, 2002), 61.
5.Takemae Eiji, The Allied Occupation of Japan—Inside GHQ, trans. Robert Ricketts and Sebastian Swann (New York: Continuum, 2002), 119.
6.During his Panama assignment, 1937–39, Sams conducted research on anopheline mosquitos that led to improved malaria control in the Panama Canal Zone (Crawford F. Sams, “Medic” [unpublished manuscript, 1955–1958], 58–74). Sams represented Japan and Korea at the organizational conference of the World Health Organization in New York in 1946 and continued to supply information from Japan to the World Health Organization (Crawford F. Sams, Medic, ed. Zabelle Zakarian [Armonk, N.Y.: M. E. Sharpe, 1998], 190). His work in Japan is summarized in Crawford F. Sams, “American Public Health Administration Meets the Problems of the Orient in Japan,” American Journal of Public Health 42 (1952), 557–65. [DOI] [PMC free article] [PubMed]
7.Sams, Medic (1998), 35.
8.“Henshû Kôki [Editor’s note],” Sôgô Igaku [General Medicine], February 15, 1946, 32.
9.“Hasshin chifusu to hôsô [Murine typhus and small pox],” Nihon Iji Shinpô [The Japan Medical Journal], May 11, 1946, 7; Henshû iinkai, Kôseishô Nijûnenshi [20-year history of the Ministry of Health and Welfare] (Tokyo: Kôseishô, 1960), 94–95; Kôseishô kôshû eiseikyoku, Ken’eki seido hyakunenshi [100-year history of the Quarantine System] (Tokyo: Gyôsei, 1980), 76–78.
10.MacLeod Roy, “Introduction,” in Disease, Medicine, and Empire, ed. Roy MacLeod and Milton Lewis (New York: Routledge, 1988), 10.
11.Richard A. Leiby, “Public Health in Occupied Germany, 1945–1949” (PhD diss., University of Delaware, 1984), 193.
12.See Bareblatt Daniel, A Plague upon Humanity: The Secret Genocide of Axis Japan’s Germ Warfare Operation (New York: Harper Collins, 2004).
13.A similar experience as a public health officer at Fukuoka Military Government Team is described in Louis B. Fierman, “Tai-I san Oishasan Fiermansan (Captain Doctor Fierman),” in Shrink: On Becoming a Psychotherapist, in (Nevada City, Calif.: Blue Dolphin Publishers, 2006), 35–49.
14.“Nihon ishikai toshoshitsu kôkai [Opening of the Japan Medical Association Library],” Nihon Ishikai Zasshi [The Journal of the Japan Medical Association] 9 (September 1, 1949), 660. [Google Scholar]
15.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Niigata Military Government Team, Annex B-1 to Monthly Military Government Activities Report (April 30, 1948), National Diet Library, Tokyo, Japan.
16.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, September 13, 1945, in the author’s possession.
17.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (March 25, 1947), 1, National Diet Library, Tokyo, Japan; Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (May 25, 1947), 1, National Diet Library, Tokyo, Japan; Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (June 25, 1947), 1, National Diet Library, Tokyo, Japan; Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (July 31, 1947), 1, National Diet Library, Tokyo, Japan.
18.Supreme Commander for the Allied Powers/Public Health and Welfare Section Record, Oscar M. Elkins Memorandum for Record (September 19, 1947), 2, National Diet Library, Tokyo, Japan.
19.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (September 30, 1947), National Diet Library, Tokyo, Japan.
20.“Hadaka ni suru [Undress the personality],” Kyoto Shinbun [Kyoto Newspaper], March 19, 1948, 1.
21.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (September 30, 1947), 6, National Diet Library, Tokyo, Japan.
22.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, September 27, 1947, in the author’s possession.
23.Mitsuo Segi and Ichirô Fukushima, “Shôwa 23 nen no eisei jôtai [State of Hygiene in 1948],” Nihon Iji Shinpô [The Japan Medical Journal]], July 2, 1949, 14.
24.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (October 31, 1947), 7, National Diet Library, Tokyo, Japan.
25.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (November 30, 1948), 1 [restricted], National Diet Library, Tokyo, Japan.
26.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (February 28, 1949), 2 [restricted], National Diet Library, Tokyo, Japan.
27.“Sutoreputomaishin riyô shi kekkaku chiryô [Tuberculosis treatment using streptomycin],” Kyoto Shinbun [Kyoto Newspaper] (February 15, 1949), 2.
28.Sams, Medic (1998), 113.
29.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, February 21, 1948, in the author’s possession; Toshio Asada, St. Francis Xavier Catholic Cathedral of Kyoto, personal communication with author, May 13, 2005.
30.Masaru Ino, personal communication with author, December 10, 2004.
31.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, June 3, 1948, in the author’s possession.
32.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Kyoto Military Government Team, Annex B-2 to Monthly Military Government Activities Report (October 10, 1948), 1, National Diet Library, Tokyo, Japan.
33.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (April 30, 1948), 1 [restricted], National Diet Library, Tokyo, Japan.
34.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, February 11, 1949, in the author’s possession.
35.The cultural atmosphere can be evoked, with photographs, in Dower, Embracing Defeat, 125, 128, 148–58.
36.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, November 21, 1947, in the author’s possession.
37.Ibid. The women passed the examination by going to the ambulatory venereal disease treatment the day before, or avoided it by deregistering themselves for the day or by claiming that they had husbands. “Pontochô jukensha 9 mei [In Pontochô district, 9 receive examination],”Kyoto Shinbun [Kyoto Newspaper] (June 22, 1946), 2; Tokuji Kato, personal communication with author (October 10 and November 8, 2005).
38.Supreme Commander for the Allied Powers/Public Health and Welfare Section Record, John D. Glismann Memorandum for the Kyoto Post Command Venereal Disease Council (June 18, 1948), National Diet Library, Tokyo, Japan.
39.Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (May 31, 1948) [restricted], National Diet Library, Tokyo, Japan; John D. Glismann to Dr. and Mrs. Marvin B. Glismann, June 20, 1948, in the author’s possession.
40.Tokuji Katô, “Seibyô no rekishi to saikin no dôkô [History of venereal disease and the recent tendencies],” Kankyô Kagaku Sôgô Kenkyûsho [Environmental Science General Research Institute] (Kyoto, Japan, October 30, 1976), 176, in the author’s possession.
41.Supreme Commander for the Allied Powers/Public Health and Welfare Section Record, I. Nieda Memorandum for Record (June 24, 1948), National Diet Library, Tokyo, Japan.
42.Supreme Commander for the Allied Powers/Civil Intelligence Section Record, Patrick Malloy, Log of stories referred to or checked with Supreme Commander for the Allied Powers sections (June 30, 1948), 1 [confidential], National Diet Library, Tokyo, Japan.
43.Sams, Medic (1998), 174.
44.Zen’ei [Van Guard] (November 1, 1946, (10/11), 65.
45.Sams, Medic (1998), 176–77.
46.Supreme Commander for the Allied Powers/Public Health and Welfare Section Record, Theodore Cohen and Crawford F. Sams Memorandum for Record (June 5, 1946), National Diet Library, Tokyo, Japan.
47.“Kyoto furitsu idai no yoron chôsa [Opinion survey at Kyoto Prefectural Medical College],” Sôgô Igaku [General Medicine], February 15, 1947, 33.
48.Tokuji Katô, personal communication with author (May 6, 2005).
49.In 1948, Glismann wrote to his parents, “May Day was yesterday. All officers were to be armed with sidearms, but I told my Commanding Officer that I would stick to a first aid kit—philosophy of ‘if you can’t use your head, use your fists (or a gun)’ is a damn poor one” (May 2, 1948), in the author’s possession.
50.“[Opinion survey],” 33; Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (July 31, 1948), 2 [restricted], National Diet Library, Tokyo, Japan.
51.“Sekkyakufu no teiki kenshin wa haishi [Regular examination of service girls terminated],”Kyoto Shinbun [Kyoto Newspaper] (June 19, 1948), 2; Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (May 31, 1948), 2 [restricted], National Diet Library, Tokyo, Japan.
52.Takemae Eiji, Sengo Rôdô Kaikaku [Post-war Labor Reforms] (Tokyo: University of Tokyo Press, 1982), 387.
53.Nakano Susumu, “Kyoto ni okeru nagare: sengo no minshuteki iryô gurûpu [Current in Kyoto: postwar democratic group of medical professionals],” Shakai to Iryô [Society and Medical Care] 1 (1964), 4; Sey Nishimura, “Minshu iryô no yukue [Whereabouts of socialized health care],” Mainichi Shinbun [Mainichi Daily], May 19, 2006, 23, Kyoto edition. [Google Scholar]
54.“Hokuriku chihô ni ôjishin [A great earthquake in Hokuriku area],” Kyoto Shinbun [Kyoto Newspaper]], June 29, 1948, 1; “Hokuriku shinsai no higai zetsudai [Stupendous casualties from Hokuriku earthquake],” Kyoto Shinbun, June 30, 1948, 1.
55.John D. Glismann, personal communication with author (February 19, 2000).
56.Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (June 30, 1948) [restricted], National Diet Library, Tokyo, Japan; John D. Glismann to Dr. and Mrs. Marvin B. Glismann, July 1, 1948, in the author’s possession; “Kyoto no kyûgotai Fukui e ichiban nori [Kyoto relief team first to arrive at Fukui],” Kyoto Shinbun [Kyoto Newspaper], July 1, 1948, 2.
57.Supreme Commander for the Allied Powers, General Headquarters, Summation of Non-Military Activities in Japan and Korea, 1945–1948, no. 9, section 1 (June 1946), 1225, National Diet Library, Tokyo, Japan.
58.“Jifuteria no yobô ni chûsha [Inoculation for preventing Diphtheria],” Kyoto Shinbun [Kyoto Newspaper] (November 11, 1947), 2.
59.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, December 24, 1948, in the author’s possession.
60.Sams, Medic (1998), 102.
61.“Immunization Program Halted After 64 Die from Bad Toxoid,” Stars and Stripes, January 1, 1949, 2.
62.John D. Glismann, personal communication with author (February 19, 2000).
63.Katsuhito Tainaka, Rokujûkyûnin me no giseisha [the 69th Victim] (Tokyo: Shinpûsha, 2005), 221, 246–49, 252–53.
64.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, March 1, 1949, in the author’s possession.
65.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, January 25, 1949, in the author’s possession.
66.Kôsuke Hatta and Satoshi Nogami, “Kyôdai tokken Hansen byô gairai hishi [Secret History of Ambulatory Treatment of Hansen’s Disease at Special Dermatological Research Unit, Kyoto University Hospital],” Mainichi Shinbun [Mainichi Daily], November 18, 2005, 17; Nobuo Harada, personal communication with author (May 5, 2005).
67.Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (March 10, 1949), 2 [restricted], National Diet Library, Tokyo, Japan.
68.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, January 25, 1949, in the author’s possession.
69.Kawakita Waka to Ada J. Glismann, January 18, 1949, in the author’s possession.
70.Kimura Tomi to Ada J. Glismann, April 1949, in the author’s possession.
71.Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (April 12, 1949), 1 [restricted], National Diet Library, Tokyo, Japan.
72.Philip E. Mohr, American Medical Directory, 19th edition (Chicago: American Medical Association, 1956), 1931.
73.Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (June 30, 1949), 1 [restricted], National Diet Library, Tokyo, Japan; Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (July 31, 1949), 2 [restricted], National Diet Library, Tokyo, Japan.
74.Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (June 30, 1949), 1 [restricted], National Diet Library, Tokyo, Japan.
75.Supreme Commander for the Allied Powers/Civil Affairs Section Records, Annex B-1 (September 10, 1949), 1 [restricted], National Diet Library, Tokyo, Japan.
76.Yano Teruo, personal communication with author, July 15, 1986.
77.James G. Devine to Commanding Officer, Kyoto Military Government Team, “Commendable Actions of Lieutenant Glismann on 10 January 1948,” January 21, 1948, in the author’s possession; “Shinsetsu na Gurisman chûi sukî yame chiryô [Kind-hearted Lieutenant Glismann stopped skiing and gave care],” Mainichi Shinbun [Mainichi Daily]], January 13, 2.
78.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, May 2, 1948, in the author’s possession.
79.“Kyoto chûô hokensho e [To Kyoto Central Health Center],” Kyoto Shinbun [Kyoto Newspaper]], July 29, 1948, 2.
80.John D. Glismann to Dr. and Mrs. Marvin B. Glismann, April 25, 1948, in the author’s possession; Sey Nishimura, “Nihonjin no mesu ni mimi wo azukeru [Entrusting an Ear to the Japanese Scalpel],” Mainichi Shinbun [Mainichi Daily], June 16, 2006, 23, Kyoto edition.
81.Louis B. Fierman describes similar experiences in Shrink, 35–49. He and Dr. Glismann were trained at Fort Sam Houston in the summer of 1947. Fierman recalls the colleagues Harold W. Harrower, MD (1st Lt, Kyushu Military Government Region), James E. Bondurant, MD (1st Lt, Nagasaki Military Government Team), or Robert C. Peterson, MD (Capt, Kumamoto Military Government Team), and states in his written communication of July 24, 2006: “Dr. Glismann’s tenure in Kyoto was typical of services provided by other Public Health Officers in other prefectures. Also, the programs implemented by all the prefectural Public Health Officers were part of a country-wide public health program as directed by Dr. Sams in Tokyo. Dr. Glismann’s successful collaboration with Japanese health providers was not isolated or atypical, but rather was reflective of the altruistic, dedicated, professional competence of the American doctors assigned to upgrade and modernize the health services of post-war Japan.” He and his three military colleagues are listed together in “Roster of Officers.” See Supreme Commander for the Allied Powers/Civil Affairs Section Records, Kyushu Military Government Region, April 12, 1948, 1–2, National Diet Library, Tokyo, Japan. Fierman is a graduate of Case Western Reserve University School of Medicine, trained in internal medicine and psychiatry, and was on the clinical faculty of the Yale School of Medicine.
82.Supreme Commander for the Allied Powers, Summation of Non-Military Activities, no. 1, section 1 (September/October 1945), 8 [confidential], National Diet Library, Tokyo, Japan.
83.Sams, Medic (1998), 188.
84.Kôseishô Yobôkyoku, “Shôwa 22-nen jinkô dôtai tôkei no sôkatsu gaiyô [Summary of 1947 vital statistics],” Eisei Tôkei [Health Statistics] (March 1948), 19; Kôsei no Shihyô Henshûbu [Editorial Office of the Reference Indices of Health and Welfare], “Shôwa 27-nen no jinkô dôtai [1952 vital statistics],” Kôsei no Shihyô [Reference Indices of Health and Welfare] (May 1953), 5–7.
85.Ibid.
86.“[1952 vital statistics],” 5–7; Crawford F. Sams, DDT Kakumei [DDT Revolution]. trans. Eiji Takemae (Tokyo: Iwanami Shoten, 1986), 436.
87.Kôseishô Yobôkyoku, “Shôwa 22-nen jinkô dôtai tôkei no sôkatsu gaiyô [Summary of 1947 vital statistics],” Eisei Tôkei [Health Statistics] (April/May 1948), 40; Kiyotsuna Watanabe, “Jifuteria no ryûkô [Diphtheria epidemic],” Kôsei no Shihyô [Reference Indices of Health and Welfare] (October 1954), 30–31.
88.Iinkai Hensan, Kyotofu Hokensho Gojûnenshi [Fifty-Year History of Health Centers in Kyoto Prefecture] (Kyoto: Kyotofu, 1985), 673; Supreme Commander for the Allied Powers/Civil Affairs Section Record, Annex B-1 (November 30, 1948), 2–3 [restricted], National Diet Library, Tokyo, Japan.

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論評「Promoting Health During the American Occupation of Japan The Public Health Section, Kyoto Military Government Team, 1945-1949

Sey Nishimura論文総合論評・構造的解読

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5つの主要施策と抵抗の構図