In 1877, Hiroshima Medical School and Hiroshima Prefectural Hospital (hereafter, in order to avoid confusion, those names are used when referring to the pre-war period, though different names are used depending on the source materials), both of which led to the development of medical care and medical study in Hiroshima. However, the medical school closed on March 31, 1888, and since then, medical care in Hiroshima was improved by medical facilities including Hiroshima Army Hospital, Kure Navy Hospital and Geibi Igakukai (Geibi Institute of Physicians) which consisted of medical professionals who were related to Hiroshima on April 17th, 1896 １）.
Analysis of inpatients at Hiroshima Reserve Hospital showed 9,741 recovered out of 54,020 inpatients (18%), 16,885 suffered from beriberi, which was not seen among Navy officers due to the introduction of rice and barley (31%), 12,361 had infectious diseases that could be reduced by developing prophylactic measures (23%), and only 4,261 were injured (8%). Additionally, cholera spread among citizens, leading to 3,910 patients and 2,957 dead within the prefecture (the second-worst nationwide, 1,556 patients and 1,302 dead in Hiroshima City). While this cholera outbreak was caused by the lack of the army’s preventative system, the epidemic was stamped out by the thorough disinfection conducted by the army and the establishment of a hospital (Ninoshima Rinji Rikugun Kenekijohibyouin Irifunemura Bunin:later Hirsohima City Funairi Byouin).
Upon the occurrence of the North China Incident, the army established Hiroshima Rikugun Yobi Byouin (“Hiroshima Army Reserve Hospital”) using Hiroshima Eiju Byouin Honin (“Hiroshima Garrison Hospital, Headquarters,” capacity 230) on June 27, 1900, and branches in the third district (capacity of 464) on June 27th, 1900, housing patients sent back from the battlefield from July 18th. After that, due to the acceptance of French wounded and an increase in the number of patients recovering from the battlefield, additional temporary hospitals and provisional hospitals were constructed. In these hospitals, 7,919 patients were accommodated and 5,029 (64%) healed, marking a huge improvement compared to the Sino-Japanese War. This was due to the fact that were no cholera patients of the 1,568 (20%) suffering from infectious diseases, and the number of beriberi patients decreased to 1,693 (21%). 1,096 injured patients (14%) were hospitalized and they were diagnosed with the latest medical equipment such as the X-ray.
With the onset of the Russo-Japanese War, in Hiroshima City, the headquarters and seven branches of Hiroshima Yobi Byouin (“Hiroshima Reserve Hospital;” it was not called “Hiroshima Army Reserve Hospital” during the Russo-Japanese War) were established after March 6th. The hospitals accommodated 10,000 people. Expansion continued; for example Eiju Byouin (“garrison hospital”) in Yamaguchi, Hamada, and Tadonohi branch offices were all reformed. On November 1st, Ninoshima Rinji Rikugun Kenekijo (“Kinoshima quarantine station research hospital”) was established, consisting of the first disinfection facility, which was constructed during the Sino-Japanese War, and a second, newly constructed, disinfection facility.
22,498 (10%) out of the 224,213 patients accommodated in Hiroshima Yobi Byouin recovered. In addition, beriberi patients reached 69,921 (31%) but infectious diseases decreased to 7,469 (3%). On the other hand, 73,953 people (33%) were wounded, exceeding the number of beriberi patients. This reflected the fierce fighting and advances in the development of firearms. The decrease in infectious diseases was due to the thorough disinfections at Eba Bunin (the Eba branch), where infected patients were brought, and due to the fact that the Ninoshima Quarantine was established early enough to prevent an influx of infected patients into the city. However, with regard to beriberi, top army military surgeons did not recognize that the white rice diet caused the disease, and refused to adopt barley rice. Because doctors went along with the surgeons’ line of thinking, and devoted themselves to the discovery of a beriberi-causing germ, almost no effect of treatment was observed３）.
During the Meiji era, there were no large hospitals except the army hospital and the Hiroshima Prefectural Hospital in Hiroshima City. However, after the World War I, hospitals intended for employees and their families were founded along with the development of industry and of Hiroshima as a central city in the Chugoku region４）. During wartime, Hiroshima Rikugun Byouin established its first and second branches in Motomachi, as well as its Eba, Mitaki and Oono branches. Additionaly, in June 1945, in preparation for a mainland battle, Hiroshima Rinji Daiichi Rikugun Byouin (“Hiroshima First Army Special Hospital”), Hiroshima Rinji Daiini Rikugun Byouin (“Hiroshima Second Army Special Hospital”), and Oono Rikugun Byouin (“Oono Army Hospital”) were created, setting up a three-hospital system with branches attached to each hospital. Naturally, Ninoshima Army Quarantine was also opened. Meanwhile, the Japanese Red Cross Hospital Hiroshima Branch (later: Hiroshima Red Cross Hospital), which was affiliated with the military hospitals, had been founded in 1939, and Hiroshima Rikugun Kyousai Byouin (“Hiroshima Army Mutual Aid Hospital”) had been established in 1942. Different in nature from these hospitals, however, were the hospital and clinic established in Hiroshima’s manufacturing branch of Mitsubishi Heavy Industries and the Hiroshima Shipyard (Eba) in 1944. Furthermore, Hiroshima Prefectural Medical College was founded, with Hiroshima Prefectural Hospital as an affiliated hospital, on February 13, 1945. At many of these medical institutions, nurses were trained.
As explained, there were many medical institutions in Hiroshima City during the war. However, among these, Daiichi and Daini Rikugun Byouin and Hiroshima Prefectural Hospital were destroyed by the atomic bombing. Hiroshima Red Cross Hospital and Hiroshima Teishin Hospital (“Hiroshima Posts and Telecommunications Hospital”) were burned out, leaving only their concrete parts, and other hospitals were also damaged to a considerable degree. In addition, many medical workers worked at these hospitals and clinics. 2,168 (91%) out of 2,370 people excluding military officers suffered from the atomic bomb. Furthermore, 270 doctors out of 298, 132 dentists out of 152, 112 pharmacists out of 140, and 1,654 nurses out of 1,780 were reportedly exposed to the A-bomb５）.
The reason why there were many victims and deaths was because medical workers were obliged to engage in air defense based on the Air Defense Law established in 1937. In Hiroshima, medical professionals were forced to be engaged in air defense and aid based on Air Defense Work Order, which was issued by the Hiroshima prefectural governor and had prohibited healthcare professionals from evacuating. As the air strikes became fierce, the Hiroshima Prefectural Medical Association asked for evacuation, claiming “We cannot fulfill our obligations as doctors in the city” but it was declined６）. As a result, many medical professionals stayed in Hiroshima and were exposed to the A-bomb. This was not only misery of these medical workers and their bereaved families, but also greatly hampered medical treatment for the survivors.

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1) With regard to the Sino-Japanese War, refer to Takeshi Chida (2009, June),“Nissinn Senso Ki ni Okeru Hiroshima no Iryou to Kango”, (Medical Treatment and Nursing Care in Hiroshima during the Sino-Japanese War),in Hiroshima Igaku ( Hiroshima Medicine) Vol.6 No.,pp.315-330
2) With regard to the North China Incident, refer to Yuko Okamoto, Hatsue Sakamura, Hiroshi Sumida, and Takeshi Chida (2009), “Hokushinjihenki no Hiroshima Rikugun Yobibyouin ni Okeru Iryou to Kango”(Medical Treatment and Nursing Care in Hiroshima during the North China Incident Period), Hiroshima Kokusai Daigaku Kangogaku Journal, (Nursing Journal of Hiroshima International University), Vol.7, No.1, pp.15-25
3) Regarding the Russo-Japanese War, refer to Takeshi Chida (2009),“Gunto Hiroshima to Senji Kyuugo”(Military City Hiroshima and Rescue in War Time) in Fumitaka Kurosawa and Toshinobu Kawai (Ed.), Nihon Sekijujisha to Jindoenjo (Japan Red Cross and Humanitarian Aid), University of Tokyo Press, pp.141-171
4) City of Hiroshima(Ed.) (1958), Sinshu Hiroshimashi: Dainikan Seijihen (Hisotry of the City of Hiroshima Vol.2: On Politics), p.593
5) Hiroshima Prefecture (1972),“Hachigatsu Muika Hiroshimashi Kushu Higai narabini Taisaku Sochi ni Kansuruken: Shouhou”(Damage and Measures against Air Strikes in Hiroshima on August 6th : Detailed Report) in Hiroshima Kenshi:Genbaku Shiryouhen (History of Hiroshima Prefecture: Details on the Atomic Bombing), p.148
6) Hiroshima Atomic Bomb Casualty Council (Ed.)(1961), Hiroshima Genbaku Iryoshi (History of Medical Care for A-bomb Survivors) p.205

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