Reforming Public Health in Occupied Japan, 1945–52: Alien Prescriptions? by Christopher Aldous and Akihito Suzuki (review)

Reforming Public Health in Occupied Japan, 1945–52: Alien Prescriptions? is a long-awaited volume borne out of the collaboration between Christopher Aldous and Akihito Suzuki. The authors adopt a straightforward, commonsense approach to the topic, which is public health reform under the occupation of Japan (1945–52). It is based on rich information and statistical data gleaned from printed sources and various archives, the most important of which was the archives of the General Headquarters, Supreme Commander for the Allied Powers (GHQ), available at the National Diet Library in Tokyo. As the book’s subtitle hints, Aldous and Suzuki engage with the question long at stake for scholars of Japanese history: whether or not the year 1945 signifies a moment of historical disjuncture. Thus, Aldous and Suzuki ask, was the health reform in occupied Japan a revolutionary, novel, and foreign prescription imposed by American occupiers on “backward” Japanese public health practices, or could one see in the reform any element alluding to the historical continuity? To tackle this question, Aldous and Suzuki embark on thorough and careful examinations of cases and come up with two main arguments. First, synergies between the Americans and the Japanese—though varying in degree and kind, depending on cases—often shaped the reform. While Crawford F. Sams, chief of the Public Health and Welfare Section of the GHQ (PH&W), might have initiated public health reforms with a grander mission to democratize and pacify Japan, “many Japanese officials, doctors and public health nurses embraced the prescriptions of the PH&W as a return to effective strategies of disease control” (183). Second, as opposed to the claim of Sams that he and his colleagues in PH&W single-handedly improved Japanese public health practices, the “Japanese scientific community was sufficiently advanced” and “opportunities presented by the Occupation enabled the more progressive approaches associated with the early interwar period” (183). In a nutshell, the public health reform in occupied Japan was neither alien nor prescriptive.

The book is organized roughly in chronological order. Within the main text, the first two chapters cover 1868–1945, the period prior to the occupation of Japan, while the other five are dedicated to the period 1945–52. In addition to chronology, the book is also structured around “disease as the key analytical construct” (7). Thus, chapter 1, in which Aldous and Suzuki look at the Meiji period (1868–1912), considers instances of smallpox, cholera, typhoid, dysentery, plague, and typhus. Aldous and Suzuki explain that the containment of these acute infectious diseases was the primary focus for the building of modern medical and hygiene infrastructure and for the ascendancy of the new idea and ideology of eisei (衛生 hygiene) as public hygiene during the period. Simultaneously, by probing cases based on disease category, the authors highlight differences in medical responses to each epidemic and claim that the difference was rooted in the past experience. In chapter 2, Aldous and Suzuki turn to the period 1900–1945 and focus on tuberculosis and venereal diseases. According to the authors, looking at public health through the lens of these chronic infectious diseases has two advantages. First, it makes us see the limitation of the medical approach established in the previous era that aimed chiefly at controlling acute infectious diseases. Second, it highlights the social dimension of public health. During the period, both tuberculosis and venereal diseases were pervasive and therefore emerged not only as public health problems but also as “major social issues” (41). Tuberculosis and venereal diseases became a subject of civic campaigns for the reform of domestic hygiene and health practices. In the 1930s, with the exigencies of war, the state began to control people’s health under the banner of public health, which manifested in the establishment of the Ministry of Health and Welfare in 1938. These first two chapters, which cover the period outside that specified in the book title, seem at a glance...