The Modern Epidemic: A History of Tuberculosis in Japan by William Johnston

Abstract

856 Book Reviews TECHNOLOGY AND CULTURE technological points, such as assertions that the tunnel could be de­ stroyed by enemy action, are similarly unframed by references to contemporary technology. (Moreover, few of the illustrations pro­ vide any insight into technical matters.) Thus we have a book dealing with quite sophisticated technologies that provides the reader virtu­ ally no historical context for them. Read as an adjunct to other works on tunneling or the Channel Tunnel this volume may be useful, but I think that many readers—especially historians of technology—will find that Channel Tunnel Visions raises far more questions than it an­ swers. Darwin H. Stapleton Dr. Stapleton is the director of the Rockefeller Archive Center and compiled The History of Civil Engineering Since 1600: An Annotated Bibliography (New York: Gar­ land, 1986). The Modem Epidemic: A History of Tuberculosis in Japan. By William Johnston. Cambridge, Mass.: Harvard University Press, 1995. Pp. xvii+432; tables, appendices, notes, bibliography, index. $45.00 (cloth). What 20th-century disease kills people slowly over many years and is usually not discovered until the malady is far advanced? Which affliction stigmatizes its victims, so that those in the last stages of their lives frequently are shunted off to die among fellow patients? What epidemic was ignored for years by societies and their govern­ ments, despite its costs to the economy and humanity? Ifyou answeredAIDS, you are wrong. As WilliamJohnston demon­ strates in The Modem Epidemic: A History of Tuberculosis inJapan, the most deadly disease in the 20th century (indeed, more deadly than in the 19th) has been tuberculosis. Expertly utilizing a wide variety ofjournals, statistics, and literary works, Johnston describes the tu­ berculosis epidemic inJapan in all its facets—social, economic, polit­ ical, and cultural. The result is the most thorough and fascinating account of a modern epidemic in Japan currently available in En­ glish. After describing the symptoms and transmission of the disease, Johnston outlines the course of the epidemic (1890-1950). Particu­ larly interesting and valuable is the author’s analysis of the disease’s impact on industry. Focusing on silk and cotton factories,Johnston shows how tuberculosis found many victims among the young women who labored long hours with little sustenance. Once their affliction was discovered, furthermore, these workers were dismissed by their bosses because they presented a danger to healthy workers. After dismissal, the sick returned to their homes all over Japan, TECHNOLOGY AND CULTURE Book Reviews 857 spreading tuberculosis to every village and town.Johnston’s analysis presents the “underside” ofJapan’s rapid industrialization, a facet which is too frequently overlooked. One reason it was so terrible to contract tuberculosis inJapan was the social stigma attached to the malady. Since the disease was thought to be a death sentence, even close family members who suf­ fered from the affliction might be locked away in a dark, poorly ven­ tilated, little-used room to die. The stigma attached to tuberculosis was so strong that physicians altered or hid their diagnoses rather than risk losing clients by telling them the truth. The prejudice against victims of tuberculosis was particularly potent in the closed villages of rural prewar Japan. Johnston narrates the most wellknown case, wherein a tuberculosis sufferer murdered thirty people in 1938 because his village had ostracized him. For the literate in Japanese society, tuberculosis came to have a different meaning. At first poets and novelists avoided admitting hav­ ing the disease like everyone else, but eventually they used the mal­ ady to question traditional values. An early story narrates how, in defiance of accepted social norms, a man fell in love with a tubercu­ lar woman. Descriptions of the wretched treatment of sufferers and condemnations ofdoctors for profiting from the illness are also com­ mon themes. In Japan, as in other advanced nations, authors some­ times aestheticized the wasted appearance of the afflicted. Johnston devotes most of The Modem Epidemic to an examination of the government’s role during the epidemic. This section will be ofinterest to readers wishing to understand the institutional context for contemporary Japanese medicine. Johnston’s thesis is that the government did not really exert maximum effort to fight the disease until the 1930s, when...