近代日本の農山村における病院医療供給と地域社会

－名望家から産業組合へ－

抄録

This article examines the conditions that determined the supply and maintenance of hospital care from the late 19th to early 20th century, and that in some cases led to its discontinuance. The region under examination is Kanoashi County in Shimane Prefecture, and the focus is on the characteristics and structures of the communities in question.

At first, in the 1890s, hospital care in the Kanoashi County area was supplied by Hatagasako Hospital, which operated under the auspices of Hori Tojuro, a local notable. Hori was a landowner and owner of a mining business in the prefecture. A leading member of the community, he established and sustained the hospital as a device for community integration and labor management. His family's hospital business expanded in the 1910s, but fell into stagnation in the 1920s with the decline of his mining business, and was reduced to the scale of a clinic in the 1930s. It was the changes in Hori's position that brought about these shifts in the hospital's status.

Hori's hospital was replaced in the 1930s by a new hospital established in Nichihara village. The new hospital took the form of a medical care cooperative, organized like an industrial or agricultural cooperative. Oba Masayo and Kanzai Naosaburo, who had developed into community leaders through their work in the cooperative and village offices, headed the effort to establish the new hospital.

In the 1940s, the hospital cooperative established a new hospital in Tsuwano, the county center, as part of an organizational upgrade. Several local notables contributed to this hospital as well, but it had by this time become impossible to finance hospital construction except by combining funds with those of the cooperative. Meanwhile, the original private hospital financed by Hori was absorbed into the cooperative hospital as a clinic.

This study demonstrates that ‘the medical practitioner model’ premise on which conventional modern Japanese medical history studies are based does not explain the supply of hospital care in this region, and that the subject must be newly examined in terms of a “community model”.