The Examination of Licensed Women at the Hospital for Venereal Complaints.
In September 1867, a hospital for the treatment of venereal diseases of prostitutes was established in Yokohama for the first time in the history of Japan, and subsequently similar institutions were established at K�be and Nagasaki. This measure was adopted by the Bakufu Government owing to the representations made by an Englishman—Dr. Newton, R. N.—who, in spite of much opposition from prejudice and ignorance, succeeded in converting the authorities to his views after a long struggle. At first the physical examination of prostitutes was limited to the three ports of Yokohama, K�be, and Nagasaki, but in September 1871 the measure was applied to the women at Senju. The vital importance and value of such inspection not being understood by the public at large, the courtesans regarded the system with strong aversion, and they accordingly began to remove away from Senju to other quarters which were as yet free from the objectionable measure. This anti-inspection movement so seriously interfered with their business that the brothel-keepers were eventually forced to apply to the authorities to suspend the system, with the result that it was abolished in April 1872. In June 1873, however, the T�ky� Municipal authorities again established physical examination offices, one being opened in each of the following six places:—Yoshiwara, Nedzu, Senju, Shinjiku, Shinagawa, and Itabashi. Examinations were made several times a month, and women who were found suffering from venereal diseases were sent to the hospital at Atagoshita for treatment. This was the first instance of a Lock hospital in T�ky�, but since then similar institutions have sprung into existence in different parts of the country.
In October 1888, physical examination places were established in the Yoshiwara and five other yūkwaku by the authorities, but in July 1889 these were abolished, and the brothel-keepers were ordered to fit up a hospital at their own expense: since that time the Lock hospital in every prostitute quarter has been maintained by the parties locally interested.
In the “Regulations of the Lock hospital of the Shin-Yoshiwara,� which obtained official sanction in June 1889, we find the following:—
“This hospital shall be known as the “Kubai-in� (Hospital for stamping out syphilis) and shall be established on the ground allotted for the purpose of providing against fire.
This hospital shall be devoted mainly to the treatment of prostitutes who are suffering from venereal diseases, and shall be conducted on the system pursued in the former Police Lock hospital.
There shall be a separate ward in the hospital in which prostitutes who are suffering from diseases other than syphilis may be treated.
The hospital shall have one chief physician and five assistant physicians, one chief pharmaceutist and two assistant pharmaceutists, four officials to attend to miscellaneous duties, two clerks, and ten female nurses.
The director and sub-director of the brothels shall supervise the monetary affairs of the hospital, and the appointment and dismissal of the chief surgeon and the members of the staff of the hospital shall be subject to the approval of the Metropolitan Police Board.
As to the mode of maintenance, and financial arrangements, etc., of the hospital, these matters are provided for in a separate set of regulations.�
[The rules relative to various details such as govern admissions, wards, etc., are omitted.]
The above extract will furnish some idea of the working of a Lock hospital, and as to the question of maintenance the following particulars may be interesting.
| Buildings, furniture, and surgical instruments | 15,000 |
| (This was defrayed from the reserve fund of the brothels). | |
| Working expenses per month | 969 |
| This is met as follows:— | |
| By levying a contribution of 1 sen per diem on each prostitute and reckoning the number of women as 2150. | 645 |
| By charges made to patients of 9 sen each with an average of 120 patients per diem. | 324 |
Generally speaking, the hospital is maintained in this manner, but when there is a deficit in its revenue this is made good by an appropriation from the reserve fund of the brothels (kashi-zashiki no tsumi-tatekin.)
As the number of prostitutes in the Yoshiwara is about three thousand women their physical examination cannot be effected in a single day; the quarter therefore is divided into districts to facilitate the process of inspection.
The regular examination days, and the inspection districts, are as follows:—
| Monday: | Ky�-machi It-ch�-me; |
| Tuesday: | Ky�-machi Ni-ch�-me, and Sumi-ch�; |
| Wednesday: | Ageya-ch�, and Yed�-ch� It-ch�-me; |
| Thursday: | Yedo-ch� Ni-ch�-me. |
Of course special examinations are made when necessity arises.
According to the latest investigations, the result of examinations showed the average rate of infected persons to be over 6 per cent. The annexed figures for 1897 may prove interesting, but it must be borne in mind that they can only be considered as comparatively reliable. The results of examinations of course depend very much upon the strictness of the doctors in attendance, consequently every prostitute quarter varies in its stated percentage of infected cases. In 1898 the percentage of disease rose to as high as 5.58 average as against 4.73 average in 1897. This difference has been caused by the more thorough inspection instituted by the present surgeon in charge—Mr. Doi.[35]