近代合理化の袋小路
The Dead End of Modern
Rationalization
☆Needless
to say, Japan’s colonial rule was historically a latecomer, and because
the peripheral regions where the empire was being built were
effectively at war from the 1930s onward, modern medicine could not be
fully utilized as a mechanism for developing the empire’s social
infrastructure. It can be said that these characteristics also underlie
the circumstances of Japanese colonial anthropology (Nakase 2000).
Furthermore, the faith that experts placed in medicine as a
panacea—particularly from the 1930s onward—gave rise to phenomena that
today seem downright strange and distorted.
| 言
うまでもなく日本の植民地統治は歴史的には後発の部類に属し、また帝国を構築していた周辺部分では1930年代以降、事実上交戦状態にあったために、
帝国の社会基盤整備の装置として近代医療を十分に発動機能させることができなかった。これらの特徴は日本の植民地人類学の事情にも通底すると言える（中生
2000）。また万能科学としての医療に対する専門家たちの信仰は、とくに1930年代以降、今日ではいかにも奇妙で歪（いびつ）ともいえる現象を引き
起こした。 |
Needless
to say, Japan’s colonial rule was historically a latecomer, and because
the peripheral regions where the empire was being built were
effectively at war from the 1930s onward, modern medicine could not be
fully utilized as a mechanism for developing the empire’s social
infrastructure. It can be said that these characteristics also underlie
the circumstances of Japanese colonial anthropology (Nakase 2000).
Furthermore, the faith that experts placed in medicine as a
panacea—particularly from the 1930s onward—gave rise to phenomena that
today seem downright strange and distorted. |
| 例
えば京都帝国大学出身の石井四郎［1892-
1959］は陸軍に軍医として入り、1933年東京の陸軍軍医学校の防疫研究室を経て、1936年（昭和16年）に関東軍防疫部長に昇進し、細菌兵器の開
発に中国人やモンゴル人をつかった人体実験を組織的におこなった（cf.
常石 1999）。京都帝国大学で石井の研究指導をおこなっていた清野謙次［1885-1955］は専門の病理学以外にも、人骨の解剖学研究や統計的手法
による日本人の起源論に一石を投じた人として知られているが、1940年代に大学を辞職してから、太平洋協会に属し、膨大な民族医療の文献を渉猟して、
『インドネシアの民族医学』という、今日の医療人類学の先駆けとも言える研究をしている（清野 2001[1943]）。もちろん清野は土着医療（「固有
医学」「民族医学」）に対する西洋医療（「真正医学」）の勝利を信じて疑わないのだが、後者の普及のためには現地人社会の理解が欠かせないと主張する。ま
た毒矢の塗り薬などに代表される生薬の知識を、今日で言うところの生物資源としてきちんと記録し、それらの成分を化学分析を通して明らかにすることが「真
正医学」への貢献となることを的確に指摘している。清野を太平洋協会に招いたのは、講座派マルクス主義経済学者であり戦後はアジアの自由と民主主義の擁護
者として神格化される平野義太郎［1897-1980］である。清野謙次は平野の妻が姉妹という義兄弟の関係にあった。平野は太平洋調査会部長の当時、
『大東亜民族誌』において、優生学にもとづく人種主義的蘊蓄を遺憾なく披瀝し、帝国内における日本人と外国人の混血がいかに種族の保存にとって危険である
のかを主張していた（平野 2001[1944]:234）。 |
For
example, Shiro Ishii [1892–1959], a graduate of Kyoto Imperial
University, joined the Army as a military doctor. After serving at the
Epidemic Prevention Research Laboratory of the Army Medical School in
Tokyo in 1933, he was promoted to Director of the Epidemic Prevention
Department of the Kwantung Army in 1936 (Shōwa 16), where he
systematically organized human experiments using Chinese and Mongolian
subjects for the development of biological weapons (cf. Tsuneishi 1999)
. Kenji Seino [1885–1955], who had supervised Ishii’s research at Kyoto
Imperial University, is known not only for his specialty in pathology
but also for his anatomical studies of human skeletons and for
challenging conventional theories on the origins of the Japanese people
through statistical methods; after resigning from the university in the
1940s, he joined the Pacific Association and, having combed through a
vast body of literature on traditional medicine, conducted research
titled *Traditional Medicine in Indonesia*, which can be considered a
precursor to today’s medical anthropology (Seino 2001 [1943]). Of
course, Seino had no doubt whatsoever in the triumph of Western
medicine (“true medicine”) over indigenous medicine (“native medicine”
or “ethnic medicine”), but he argued that an understanding of local
societies was indispensable for the spread of the latter. He also
accurately pointed out that properly documenting knowledge of herbal
medicines—such as ointments for poisoned arrows—as what we would today
call biological resources, and elucidating their components through
chemical analysis, would constitute a contribution to “true medicine.”
The person who invited Kiyono to the Pacific Association was Yoshitaro
Hirano [1897–1980], a Marxist economist of the Kōza-ha school who,
after the war, was deified as a defender of freedom and democracy in
Asia. Kenji Kiyono was Hirano’s brother-in-law, as Hirano’s wife was
Kiyono’s sister. While serving as director of the Pacific Research
Council, Hirano unreservedly expounded his eugenics-based racialist
views in *The Ethnography of the Greater East Asia Co-Prosperity
Sphere*, arguing that interracial mixing between Japanese and
foreigners within the empire posed a danger to the preservation of the
race (Hirano 2001 [1944]: 234). |
| 他
方で、日本の国内（および朝鮮半島の一部）で
は、それまでになかったさまざまな医療の社会化の運動が試みられた。これらは、戦前のファシズム体制に対する一種の草の根レベルでのカウンター運動とこれ
まで評価されてきたものである。例えば1920年代から30年代にかけておこなわれるようになった無産者診療運動。これは都市部における社会主義労働活動
の一環として、医療が労働者の福利向上に寄与するものと考えられたが、40年代に当局によって閉鎖された。医療利用組合運動もほとんど同時期に生まれ農山
村における医療の大衆化に貢献したと評価されている。これらの運動を通して、結核や乳幼児死亡の実態の把握が進み、病気の社会的起源や健康の達成には臨床
医学ではなく栄養条件の改善が重要であるという今日の常識となった見解がこの頃すでに共有されていた。しかし、後に述べるように、国家が主導する公的な医
療制度もまた貧困層や農山村における健康の水準の低下を危惧していた。同じ時期に、まったく異なった角度からではあるが、医療のまなざしがこれらの日本社
会の周縁化された社会集団に向けられていたことを忘れてはならない。 |
On
the other hand, within Japan (and parts of the Korean Peninsula),
various movements to socialize healthcare—which had not existed
before—were attempted. These have traditionally been viewed as a kind
of grassroots counter-movement against the prewar fascist regime. For
example, the proletarian medical care movement, which began in the
1920s and 1930s. As part of socialist labor activities in urban areas,
this movement viewed medical care as a means of improving workers’
welfare, but it was shut down by the authorities in the 1940s. The
medical care cooperative movement also emerged around the same time and
is credited with contributing to the popularization of medical care in
rural and mountainous areas. Through these movements, understanding of
the realities of tuberculosis and infant mortality advanced, and the
view—now considered common sense—that the social origins of disease and
the achievement of health depend on improved nutritional conditions
rather than clinical medicine was already widely shared at that time.
However, as will be discussed later, the state-led public healthcare
system was also concerned about declining health standards among the
poor and in rural and mountainous areas. We must not forget that during
the same period, albeit from a completely different perspective, the
focus of medical care was directed toward these marginalized social
groups in Japanese society. |
| こ
れらの社会改良の理念に裏付けられた、医療の社
会化のプロジェクトは戦後の民主主義の復活とＧＨＱ指導の公衆衛生政策の状況の中で、戦前の医療者のヒューマニズムの伝統が絶やされなかったと好意的に評
価されてきた。しかし、現在では患者の人権論や医療の権力論というリビジョニスト的再検討の中で、彼らが抱いていた医療者のパターナリズムや近代科学とし
ての医療の特権意識などが批判に晒されつつある。 |
The
project to socialize healthcare, underpinned by these ideals of social
reform, has been favorably evaluated as having ensured that the prewar
tradition of humanism among medical professionals was not lost, against
the backdrop of the postwar revival of democracy and public health
policies guided by the General Headquarters (GHQ). However, in the
current climate of revisionist reexamination—centered on discussions of
patients’ human rights and the power dynamics of healthcare—the
paternalism of medical professionals and the sense of privilege
associated with medicine as a modern science are increasingly coming
under criticism. |
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