title: [Contradiction and intention of actual situation and statistical observation on home custody of mental patients].
abstract: Actual Situation and Statistical Observation on Home Custody of Mental Patients (1918) by Kure and Kashida has diverse content but contains many contradictions. This book is a record of investigations performed by 15 psychiatrists regarding home custody of mental patients in 15 prefectures between 1910 and 1916. The book is written in archaic Japanese and contains a mixture of old Kanji characters and Katakana, so few people have read the entire book in recent years. We thoroughly read the book over 2 years, and presented the results of our investigation and analysis. The contents were initially published in Tokyo Journal of Medical Sciences as a series of 4 articles, and published as a book in 1918. The Department of the Interior distributed 100 copies of the book to relevant personnel. Until its dissolution in 1947, the Department of the Interior included the Police Department and had a great deal of authority. The Health and Welfare Ministry became independent from the Department of the Interior in 1938. Therefore, mental institutions were under the supervision of the police force for many years. At the time, an important task for police officers was to search for infectious disease patients and to seclude and restrain them. Thus, home custody for mental patients was also supervised under the direction of the Police Department. This book is a record of an external investigation performed by psychiatrists on home custody supervised by the police. When investigating the conditions, one of the psychiatrists obtained a copy of "Documents for mental patients under confinement" at the local police station. The contents of these documents included records of hearings by the police, as well as applications for confinement submitted by family members, as well as detailed specifications and drawings of the confinement room. With a local photographer, they traveled deep into the mountains to investigate the conditions under which mental patients were living. The book illustrates how psychiatrists from Tokyo were shocked at the way families in rural areas took care of mental patients. While they were surprised with the conditions of the confinement rooms, they commented that nothing could be done because the households or the entire villages were poor. Some patients under confinement while under home custody had previously been hospitalized at a mental institution. Although they were told that there was no hope for recovery, the family could not continue to pay the fees required for hospitalization and took the patients home. The family members often sought help at shrines, temples, and by shamanism, but became resigned to apathy when the patient showed no signs of improvement after many years. The limitation of medicine is still a problem seen in today's society. Based on the records, we can tell which shrines and temples were popular among mental patients in the Kanto region. The book illustrates how patients sat under a waterfall at Takaosan Yakuo temple in Tokyo and Oiwasan Nissekiji-Temple in Toyama prefecture. The book also illustrates domestic utensils for meals and living as well as magazines at the time, making this book a source of information not only related to medicine but also of ethnological and sociological interest. Some investigators indicated the class of mental patient, making this book a valuable reference indicating that at the time society still had remnants of the class system from the Edo era. The book is also a quality reference regarding Chinese herbal remedies, Shugen-do, and as an overall ethnological reference for the times. Most locations of many confinement rooms were identified through this book.
authors.affiliation: Tokyo Musashino Hospital.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kanekawa
mesh_terms: D005190:Family; D005191:Family Characteristics; D049673:History, 20th Century; D006699:Home Care Services; D006778:Hospitals, Psychiatric / Q000266:history* / Q000706:statistics & numerical data*; D006801:Humans; D033182:Intention; D007564:Japan; D028642:Persons with Psychiatric Disorders / Q000266:history* / Q000523:psychology*