Ruri Ashida
Tokyo, Japan

The Jikei University Hospital stands in the middle of Tokyo near the governmental offices and Tokyo Tower. It was established in July 1882 as the first charity hospital in Japan; its original name, Yushi Kyoritsu Tokyo Byoin (Tokyo Charity Hospital), suggested that it was cooperatively supported by voluntary contributions. The founders were Kanehiro Takaki, Toan Matsuyama, Bunkai Totsuka, and other members of the medical society called Sei-I-Kwai, who sought to improve the medical situation in Japan and to provide humanistic care to patients. The Japanese Meiji government had adopted German medicine as an official model in which physicians were more interested in research than in caring for patients. This model was led by the physicians at the University of Tokyo. Kanehiro Takaki, strongly influenced by the British doctors William Willis and William Anderson practicing in Japan, went to London to study at St. Thomas’ Medical Hospital School for five years (1875-1880). When he returned, Takaki aspired to introduce patient-centered medicine in Japan to improve care for patients, and founded the charity hospital with the other young doctors. The hospital also had the mission to serve as an educational hospital for students of Sei-I-Kwai Koshujo (a medical training school opened in 1881) and of the naval medical college.

Tokyo Charity Hospital had its formal opening in 1884 with Prince Takehito Arisugawa becoming its president. The hospital was supported by donations collected by doctors and businessmen, but a ladies’ charity society also played an important part in sustaining the hospital. With Princess Tadako Arisugawa as president, the ladies’ charity society was organized by many wives of the leading figures in the Meiji government. The society held charity bazaars and raised a huge amount of money, which enabled them to build the first nursing school in Japan, Tokyo Charity Hospital Training School for Nurses, inside the hospital in 1885. The increasing number of patients, however, brought about financial difficulties. Takaki sought the support of the empress as he had seen the royal family help the poor in England. In 1886 the hospital was honored to have Her Majesty the Empress Shoken accept the role of president. Donations from the Empress and other supporters sustained the hospital. In 1887, along with the Empress’ wish, the hospital was renamed Tokyo Jikei Hospital (“jikei” means mercy, love, and giving), and Takaki became the hospital director.

It is worth mentioning Takaki’s other achievement during this period: finding the cause and treatment of kakke, the endemic form of beriberi, from which many sailors were suffering and dying. He applied his knowledge of epidemiology, preventive medicine, and nutrition, and focused on helping patients, all of which he learned during his stay in London. His lectures on nutritional imbalance and kakke, given in London in 1906, were later published in The Lancet.

The number of patients at the charitable hospital increased continuously. Princess Yasuko Arisugawa, on hearing about hospitals in the Western countries from Takaki, realized the need to expand the hospital facilities. She actively explained her plans to various people, and this led to the establishment of a powerful association called Tokyo Jikei-Kwai in 1907. With Princess Yasuko Arisugawa as president, it was organized by prominent figures of varied social status in that period: the royal family, the former Tokugawa shogunate, business leaders, bureaucrats, statesmen, wives of prestigious figures in the government, and navy/army officers. They were united in their purpose to provide medical care for those who had no money to receive treatment. The hospital was renamed Tokyo Jikei-Kwai Hospital. With Eichi Shibusawa, a prominent business leader taking the lead, donations increased and the hospital doubled its size. This powerful association has enabled the hospital to continue until today.

Although the hospital was forced to relocate or rebuild several times due to damage caused by the Great Kanto Earthquake and WWII, it had always been supported by the nobles and bureaucrats. However, after WWII when the peerage system was abolished, it faced the danger of closing down entirely. In 1947 the Tokyo Jikei-Kwai Hospital became affiliated with The Jikei University School of Medicine (originally Sei-I-Kwai Koshujo), entrusted its management to the university, and became a private entity. This meant the end of a charity hospital. In 1962 the hospital was renamed The Jikei University Hospital.

After more than 130 years, the hospital still stands today in the middle of Tokyo close to the site of the original charity hospital. The hospital is certified as an Advanced Treatment Hospital and has three branches within and outside Tokyo. The founding spirit of Takaki still prevails throughout the university and the hospital: “See the patient, and not the disease.”

Acknowledgments

I would like to thank Professor Emeritus Satoshi Kurihira and Professor Emeritus Kazuhiko Nakayama for their support in writing this article.

References

1. Kanehiro Takaki. “Three Lectures on the Preservation of Health amongst the Personnel of the Japanese Navy and Army.” The Lancet May 19, 1906 :1369-1374; May 26:1451-1455; June 2:1520-1523. Reprinted in Jikei Medical Journal 2002; 49(2):69-83. http://ir.jikei.ac.jp/bitstream/10328/1754/1/49-2-69.pdf.
2. Makoto Matsuda and Tsuneya Ohno. Kanehiro Takaki and Sei-I-Kwai Medical School (Special article). Jikei Medical Journal 2002; 49(2):85-90. http://ir.jikei.ac.jp/bitstream/10328/1752/1/49-2-85.pdf.
3. Fusayoshi Murata. Dr. William Willis and Dr. Kanehiro Takaki (Special article). Jikei Medical Journal 2002; 49(2):91-100. http://ir.jikei.ac.jp/handle/10328/1750.
4. P John Rees. Evidence-Based Medicine: Past, Present and Future (Special article). Jikei Medical Journal 2002; 49(2):63-7. http://ir.jikei.ac.jp/bitstream/10328/1753/1/49-2-63.pdf
5. Eisei Ishikawa and Masao Okazaki. Life of Kanehiro Takaki. http://ir.jikei.ac.jp/handle/10328/1597 (Jikei Repository).
6. Founding Spirit – Patient-Centered Medical Care. http://www.jikei.ac.jp/eng/found.html
7. Our Roots—To Serve the Suffering Poor. http://www.jikei.ac.jp/eng/our.html
8. Makoto Matsuda. Kanehiro Takaki and Medicine. The Jikei University School of Medicine. 2005. (in Japanese)
9. Kazuhiko Nakayama et al. (Eds). The Jikei University School of Medicine 130 years’ History. The Jikei University. 2011. (in Japanese)