Several large outbreaks of cholera have occurred throughout history around the world, and in Japan as well, epidemics took place repeatedly since the Edo period. Japanese people used to use the kanji characters 鉄砲 or 見急 because of its symptoms of diarrhea and vomiting, 虎狼痢 for its suddenness of death and 虎列刺 to write “cholera” phonetically.

Treatment of Cholera in Japan

In 1858, Japan had its second cholera outbreak brought from overseas. Breaking out in an American ship in May, it gradually spread in Nagasaki, Hiroshima and Osaka, and broke into the city of Edo in July. In a mass of confusion, OGATA Koan, a doctor, made efforts to translate foreign books regarding cholera and finally compiled them into a volume.

Korori chijun (Guide to the treatment of cholera)

Korori chijun

Koan made this report by writing down what J. L. C. Pompe van Meerdervoort, a Dutch naval doctor, taught him about cholera, as well as by translating books by the doctors Georg Friedrich Most, Karl Friedrich Canstatt and Johann Wilhelm Heinrich Conradi. It precisely explains symptoms and methods of treatment along with his own experiences. It took him only 4 or 5 days to edit it, as his goal was to distribute it to Japanese doctors as soon as possible to help treat cholera.

Ed., the Bureau of Temples and Shrines and the Sanitary Affairs Bureau, Korera yobo satoshi (Admonition for cholera prevention), the Home Ministry, 1880. [Y994-J12188]

Cholera had spread in 1879, with approximately 160,000 people infected and a toll of 100,000 lives. The Home Ministry produced this booklet to prevent the epidemic from spreading further. It mentions four causes of infection: air, water, food and drink, and contact with others. It also enumerates cautionary points for everyday life: Don’t dig a well near a toilet, don’t drink muddy water, don’t eat rotten food, avoid raw food in hot weather, and don’t eat even fresh food too much.

Cholera and food

Robert Koch, a German microbiologist, identified cholera bacteria in 1884. Even before this discovery however, people knew from experience that raw food and water caused infection. Cholera is particularly related to eating and drinking.

Aomono sakana gunzei okassen no zu (Battle between green vegetables and fish)

Aomono sakana gunzei okassen no zu

Illustrations which depict battles between personified nonhuman beings had appeared as a popular genre of nishiki-e (color woodblock prints) in the Muromachi period. This picture was influenced by a cholera outbreak in the 1850s, illustrating a battle between green vegetables and fish. Vegetables win a victory because of their lower affinity for cholera. In the year before this picture was drawn, fish did not sell at all while vegetable prices rose remarkably in the city of Edo.

Various folk remedies and faith cures were tried before the method of treatment was established.
For example, at the end of the Edo period, a newspaper introduced a remedy for cholera which said to “burn a cork to ashes and drink it.” People believed that cholera was provoked by a miasma or beat a drum and a bell and made a smoke signal to pray to confuse cholera.
In the Meiji period, a rumor spread that ramune soda would prevent cholera and alleviate the symptoms. Ramune soda gained in popularity because of the belief that carbonated drinks were safer than water.

Ed., Tokyo Seiryo Inryosui Dogyo Kumiai, Gyokai kaikoshi (Review of Japanese soft drink industry), 1935. [特220-525]

This material describes a history of the Japanese soft drink industry. A ramune soda maker looked back at 1886 as a most unforgettable year. Ramune soda sold well due to a heat wave in that year. Once a cholera epidemic occurred in Tokyo and the Tokyo yokohama mainichi shinbun newspaper said, “Drinking carbonated beverages will save you from getting cholera,” ramune soda inventory ran short.


Tuberculosis was raging in modern Japan. Although Robert Koch discovered the bacteria causing tuberculosis in 1882, there was no successful treatment for tuberculosis until streptomycin was announced to be isolated in 1944.

Tuberculosis affecting the entire nation

Tuberculosis had been present in Japan since long ago. Genji monogatari (The Tale of Genji) and Makura no Soshi have descriptions of symptoms inferred to be tuberculosis. However, it was not until in the Meiji period that tuberculosis affected the entire nation and became a serious problem in Japan.
With the development of the spinning industry, many female workers were gathered from rural areas. They were forced to work hard under unsanitary conditions and often got tuberculosis. Factory girls who had to quit their job went back to their home and infected others, which contributed to the spread of tuberculosis to some degree.

Eiseigakujo yori mitaru joko no genkyo (Current hygiene conditions of factory girls)

Eiseigakujo yori mitaru joko no genkyo
Comparison chart:
The causes of death of sick factory girls wishing to returning home

The author of this book, ISHIHARA Osamu, researched the sanitary conditions in the mining and manufacturing industry in Japan as a temporary employee of the Ministry of Agriculture and Commerce. He reported the health problems of factory girls by inspecting them with his own eyes, although business owners were usually left to carry out their own inspections. The book contains a record of the lecture Factory girls and tuberculosis held near the end of 1913. Multiple girls used the same bedclothes in turns and slept in cramped conditions. It explained that not only harsh work but also insufficient rest caused the spread of tuberculosis and that about 70 % of the causes of death of factory girls who died after returning home were due to tuberculosis or suspected disease.

ARIMA Yoriyoshi, Zettaiteki kekkaku yoboho (Absolute preventative measures against tuberculosis), included in Shakai kyoiku panfuretto, the 239 collection, 1936. [275.6-29]

Arima insisted that protective isolation, which was the mainstream treatment, would never eradicate tuberculosis. He described that people infected with tuberculosis were divided into three types: acute tuberculosis patients, chronic tuberculosis patients, and those with tuberculosis immunity. And he recommended a vaccination saying that “Once one gets tuberculosis immunity, no matter how virulent it is, they rarely become infected with it or develop it.”

Tuberculosis and literature

Well-known figures also got infected with tuberculosis. Since tuberculosis progresses relatively slowly, many records of it and literary works on it were made.

Hototogisu (The cuckoo)

Illustration by KURODA Seiki

Hototogisu was serialized in Kokumin shimbun newspaper in 1898 and later published as a book. Having heard about OYAMA Nobuko from her acquaintance, Roka wrote a novel, setting her as the model of the main character of the story, Namiko. Namiko, who grew up without her stepmother’s love, achieves happiness by getting married. However, shortly thereafter, she develops tuberculosis, is divorced and eventually dies. This story became so popular that it went through 100 editions in 1909. Combined with its tragic love story, Hototogisu gave tuberculosis a romantic image. Although the bacteria had already been identified when this novel was published, tuberculosis is described as both an infectious disease and a hereditary disease in Hototogisu, which shows people’s knowledge of tuberculosis at that time.

HORI Tatsuo, Kaze tachinu (The Wind Has Risen), included in Hori tatsuo sakuhinshu (The collected works of Hori Tatsuo), No.3, Kadokawa Shoten, from 1946 to 1948. [F13-H87-2ウ]

The main character accompanies his lover, who has a serious case of tuberculosis, to a sanatorium on a plateau. While fearing the shadow of death, they treasured every day, sharing the time left for them. The author Hori Tatsuo was himself affected by tuberculosis. This story is based on his experience of staying in a sanatorium in Shinshu (Nagano Prefecture) with his fiancée who had more severe symptoms. The main treatment in those days were aerotherapy, resting and trophotherapy.

These popular works of literature might provide a romanticized portrait of tuberculosis for people. But in reality, it forced patients into a hard struggle.

Byosho rokushaku (A Six-foot Sickbed)

Byosho rokushaku


Byosho rokushaku is an essay by MASAOKA Shiki, serialized in Nippon newspaper from May 5 to September 17, 1902, two days before he died. This material was made by himself collecting scraps of his articles from the newspaper, and includes his handwritings. He had been suffering from tuberculosis for many years, and used the pen name Shiki, a lesser cuckoo in Japan which is said to croak until vomiting blood. In his later years, the tubercle bacilli caused spinal caries and his back and buttock got large holes where pus oozed out. In his bedridden state, Shiki continued to compose haiku and tanka poems and write essays. Byosho rokushaku comprises many topics, such as comments on literature and criticism of painting, which seems to be unrelated to his state of disease, but also includes sentences showing his severe pain and sickness.

Malaria, Influenza

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