"Byoin" in Modern Japan: Focusing on the Terminological Introduction of "Hospital" and the Complex Formation of Its Concept.

This paper aims to clarify when the term of Byoin (hospital) was introduced and how its concept was developed in modern Japan. The word "Byoin" was introduced in Japan in 1787 for the first time, but it had not been in use until early 1860s. Instead, various medical institutions performing the functions of modern medical facilities, such as Yojosho (A place for preserving health), Shijuku (private school), called by traditional names as ever. Japanese intellectuals already adopted the word Byoin and the concept of western hospital in early 1860s when their national delegates were dispatched to Europe to revise the treaties forged with western powers. Japanese translations of hospital appeared in English-Japanese/Japanese-English dictionaries published in the 1860s. For instance, the word Byoin (hospital in Japanese) was first published in a dictionary published in 1867 and unclearly connected to the words, hospital, infirmary. This paper will argue that the concept of Byoin was sophisticated through Meiji government's efforts to implement reforms distinguishing medical facilities based on their capacity of inpatients and quality. The first medical law (Isei) proclaimed by the Meiji government in 1874 articulated regulations for a hospital in eight different articles. The government established hospitals in various parts of the country, following its newly established modern medical care policies. However, in this process, Iin (hospital/clinic), another term for "hospital" appeared. Regional differences and financial issues made standardizing the concept of a hospital even more difficult. In response to the widely embedded confusion, the Japanese government made an effort to clarify the concept of a hospital, setting up provisions regarding the size of medical facilities. As a result, the word Byoin finally came to be used for a hospital with more than ten beds, while a clinic with beds below ten was called Shinryojo (clinic). On the other hand, Iin meant a medical facility less qualified than a hospital since 1933 when Japanese government made a harder restriction on the usage of Byoin.