4 - Empire and the Making of a National Disease

Summary

“Beriberi research,” wrote an anonymous doctor in 1907, “must be the enterprise of the nation,” because “as imperial subjects,” and “as great citizens of the empire,” disease prevention was a duty for all Japanese. This sentiment represented the new importance assigned to controlling beriberi. As a nation of modern citizens under the Meiji Emperor and at the center of a wider empire, Japan had to mobilize all its strength to battle beriberi—a problem increasingly highlighted as a national disease (kokuminbyō).

Scholars agree that the Russo-Japanese War and especially Japan's victory over a Western power consolidated a new sense of the nation based on Japan as an imperial power. Having secured an empire that stretched from Karafuto to the north, Taiwan to the south, and Korea and the Liaodong Peninsula on continental Asia, Japan came to maturity as a modern nation. It was in this context that medical men began talking about beriberi as a national disease that required governmental attention. William Johnston, in The Modern Epidemic: A History of Tuberculosis in Japan, argues that it was only in the late 1930s after public health officials could show that tuberculosis threatened Japan's warmaking ability, using data on morbidity among army recruits and factory workers, that the state proactively addressed prevention throughout society. That is, disease prevention became a necessary support for empire.

In his social history of medicine, scholar Tatsukawa Shōji observes: “In the Meiji period, beriberi was so prevalent that it should be paired with tuberculosis as one of the two great kokuminbyō.” Tuberculosis was the reigning king of national diseases, with beriberi a close second. The medical journal Eiseizasshi (Hygiene) called tuberculosis the “biggest national disease” (saidai kokuminbyō). Tuberculosis is, as many scholars have noted, a quintessential disease of modernity. Urbanization, factory work, modern military service, and the development of a class of working poor all facilitated the spread of this disease. In the case of Japan, TB became a national issue not at the time when nation and empire were being built, but when an established imperial power turned to disease prevention as a tool to harness more national resources for its further aggressive expansion. Both tuberculosis and beriberi were national diseases, but the story of beriberi as a state concern is a bit different. Medical men had a new sense of Japan in the post–Russo-Japanese War era; they could both know and imagine it numerically.