The case of Dr Masajiro Miyazaki: Japanese-Canadian healthcare in World War II.

The forcible relocation of Japanese-Canadians (Nikkei) during World War II has been widely examined; however, little scholarly attention has been paid to the impact of relocation on the medical services provided to, and by, the Nikkei. This article highlights the issue of providing sufficient medical care during forcible relocation and the experiences of one Nikkei physician, Dr Masajiro Miyazaki. His story illustrates both the limitations in the healthcare provided to the Nikkei community during relocation and the struggle for Nikkei medical professionals to continue their practice during the war. The agency of the Nikkei-who constantly balanced resistance and adaptation to oppressive conditions-comes to the forefront with this case study. Dr Miyazaki's personal records of forcible relocation, as well as his published memoir, reveal aspects of the lived reality of one Nikkei physician who was not included in the government discourse, or in the dialogue among his fellow Nikkei physicians, such as inter-racial medical care. It is evident through this case that there was great diversity in the level of medical care which the Nikkei received during their relocation in Canada. Furthermore, Dr Masajiro Miyazaki's story proves that healthcare professionals, from doctors to nurses' aides who were both Nikkei and white, provided extraordinary medical services during the forcible relocation, despite significant constraints.

[The emergence of nurses in the health market in Paris in the eighteenth century]. / L'émergence des garde-malades dans le marché de la santé à Paris au XVIIIème siècle.

At the end of the seventeenth century, the lexicographer Antoine Furetière limited the definition of nurses to those who cared for new mothers. However, in the private sphere, they cared for patients with all sorts of illnesses. It was only in 1816 that Doctor Marc proposed a precise definition of their activity. This paper examines the shift from nurses being considered as domestic healthcare workers to them being seen as skilled professionals whose role involved administering paramedical care.Because they were not part of a particular occupational community, nurses escaped the traditional categories of analysis of urban work. While the studies on health in the eighteenth century considered them to be like relations or friends of the patients, or to practice in hospitals, in the expenses lists recorded for post-mortem procedures they appear as new actors offering specific services.Nurses played a part in spreading a "culture of dependency," which was reflected in some medical texts and in some private writings by patients, making it possible to define the expectations and risks of the profession. The absence of testimonies from nurses themselves is revealing of their dependence on physicians.

"I Was Doctor": White Settler Women's Amateur Medical Practice in East and South-Central African Communities, 1890-1939.

Professional medicine in colonial British Africa has been extensively examined by historians. Few scholars, however, have adequately considered the role that white settlers without medical training played in the provision of colonial health care in local African communities. This article addresses the gap by exploring amateur medical treatment by white settler women in East and South-Central African communities between 1890 and 1939, primarily in highland areas of Kenya and Southern Rhodesia. It examines the types of conditions treated, what techniques and equipment were used for treatment, and where treatment was carried out. It also explores medical identity in settler women's memoirs. Last, it considers the degree of choice exercised by patients in these amateur medical encounters. Overall, this article situates white settlers' amateur treatment in African communities as an important strand of colonial health care and as an intimate contact zone between white settlers, colonial medicine, and local people.

Santayana's Axiom: The South Dakota State Medical Association and Medical Practice Legislation in 1929 and 2017.

In 1928 members of the South Dakota State Medical Association (SDSMA or the Association) held a special meeting in Huron to consider a basic science bill that conformed "…in its entirety to the conditions existing in our state." Their draft bill proposed a standardized examination for all practitioners of the healing arts. A legislative committee, with its attorney, "…was in Pierre during the early part of the 1929 legislative session to make sure the bill was properly launched and in effective channels." Shortly after its introduction, the bill was withdrawn due to opposition from one SDSMA district whose legislative representatives were among the most influential in the legislature. A similar bill promoted by the SDSMA in 1933 also failed. It would be another six years before a basic science bill was enacted by the legislature. Eighty-nine years later, a bill governing the practice of certified nurse practitioners (NP) and certified nurse midwives (NM), including a board independent of the South Dakota Board of Medical and Osteopathic Examiners, was considered (Senate Bill 61). Introduced by a senator who characterized herself as representing the "House of Nursing," the bill challenged "…the overarching role that medicine thinks and perceives that they may have regarding advanced practice nursing practice." SB 61 passed in the senate and house and was signed by the governor. For this legislation in the 1930s and in 2017, the SDSMA's interest was defining and maintaining control of medical practice under the twin rubrics of quality and patient welfare. In both circumstances, legislators and other health care professional organizations contested not only the SDSMA's motivations, but also the evidence supporting their efforts. Our research explored (1) whether the collective viewpoints and conduct of the legislature, the SDSMA, and non-physician medical professionals are comparable in the two circumstances; and (2) if the circumstances are comparable, can we derive a useful concept or theme that could help guide the SDSMA in the future?

[Medical movement in Mexico. To 50 years. Open file]. / Movimiento médico en México. A 50 años. Expediente abierto.

Gutiérrez-Samperio hace una excelente narrativa del movimiento denominado «blanco¼ hace medio siglo, encabezado por médicos y otros trabajadores de salud, principalmente enfermeras. Es importante revisar los logros y limitaciones que dicho fenómeno alcanzó. Por ejemplo, actualmente el residente que cursa una especialidad cuenta con un reconocimiento institucional, universitario y de profesiones al término de su formación, además de tener una beca económica (probablemente insuficiente) y días de vacaciones programados.

[The Population Provision with Physicians in the Russian Empire in XIX--Early XX Centuries].

The article presents data concerning number of physicians and their supply to population of the Russian Empire in 1809-1913. It is reasonable to affirm that health care system of the Russian Empire during this period had no opportunities to efficiently implement function of health care.

[The becoming of the Soviet health care in Russian province in 1920s].

He article presents the analysis of infrastructure of health care and its manpower potential in 1920s. The analysis is limited by the territory of the Eniseiskaia gubernia (Krasnoiarskii' kraii) as an example for developing a notion about occurrences in life not only ofparticular region but of a whole country. The Soviet government finally established in the Enisei'i'skaia gubernia later (in January 1920) than in in the rest of the European part of the country. This was the reason of implementing on the territory with accelerated rates the experience ofSoviet development cumulated during the years of military communism (October 1917-1920). Exactly during this period the general nationalization of curative institutions and pharmacies was implemented. The traditional autonomy of physicians made way to the «Soviet employee¼ status and the state monopoly to social policy and practice was made official. The article is based on documents of the State archives of the Krasnoiarskii' kraii and published sources. These materials permitted to discover limitedness of the material and human resources inthe sphere of medical care and services. To verify existing in the scientific publications notion that in 1920s the elimination of differentiation between urban and rural citizen in receiving medical services and establishment in full measure qualitative and accessible medical care failed. The discrepancy between declared program of medical care and real possibilities of its implementation became the main deterrent. The absence of unified system of settling, social territorial isolation of settlements, immense scale of territory required huge material expenses for getting over space and developing infrastructure of health care in the kraii.

[The life of Choe Ung-sok: with a focus on his design for and role in the health care system immediately after the liberation].

Born in Pyongyang in 1914, Choe Ung-sok was a physician who lived through the Japanese colonial era (1910-1945), rule by the United States Army Military Government in Korea (USAMGIK; 1945-1948), and national division (1948). Influenced by socialism and social hygiene/social medicine during his studies in Japan, he played the role of representing the socialist camp in the discussions related to the construction of a heath care system immediately following the Liberation (1945). His key arguments were: first, the nationalization of the medical system and the implementation of nationwide programs to eradicate diseases; second, the provision of free medical services through the expansion of social insurance; third, the reeducation of the medical personnel; fourth, the provision of social sciences education to the medical personnel and the reorganization of medicine into preventive medicine; fifth, the nationalization of pharmaceutics; sixth, the laborers' establishment of autonomous medical organs (affordable clinics, medical consumers' unions through cooperatives); and seventh, the reduction of work hours to 6-8 hours, technical improvement, respite from research, and guarantee of economic life for the medical personnel. Influenced by the medical systems of the Soviet Union and Japan, such arguments stood in opposition to the right wing's plan for the construction of a relatively passive health care system at the time but, in the end, failed to be realized in southern part of Korea under the USAMGIK. Subsequently, he defected to northern part of Korea and came to participate in the task of constructing North Korea's health care system. Choe's life and design for a health care system provide examples through which one can confirm the nature of social hygiene/social medicine both during the Japanese colonial era and before and after the Liberation and the contents of the design related to a health care system as held by the socialist faction. In addition, they show that, immediately after the Liberation, there existed a broad spectrum of imagination and arguments concerning the desirable health care system. Following the division of the Korean Peninsula, South Korea witnessed the instatement of a regime that established anti-communism as the state policy and the strong influence of the United States in politics, economy, and culture. The consequent frustration of Choe's design for a health care system and his defection to North Korea frustrated the creation of a National Heath Service (NHS) in South Korea, reinforced the tendency to view NHS and social insurance as "socialist" or "communist" methods, and led to the restriction of the scope of subsequent discussions related to health care system. In conclusion, the course of Choe's life and thought went beyond the life of an individual during a period in which diverse ideologies collided through the Japanese colonial era, Liberation, and national division and symbolically demonstrates one important path of the process of constructing a health care system on the Korean Peninsula.

The Great Migration and Healthcare to Black America.

The Great Migration, the movement of 6,000,000 black Americans from the South to the great urban centers of the eastern seaboard, the industrial Midwest, and West Coast port cities from roughly 1915-1970, was one of the defining demographic events in American history. It dwarfed the 100,000 49ers who swarmed westward in search of gold, the incarceration of 110,000 Japanese to concentration camps in the American interior during World War II, and the 300,000 Okies who escaped the Dust Bowl to California. In the words of writer Isabel Wilkerson, "[It] swept a good portion of all the black people alive in the United States at the time into a river that carried them to all points north and west."Blacks crammed into urban districts rife with crime and communicable disease, subjecting them to risks of death far higher than their proportion of the population. Without access to adequate inpatient hospital facilities, they received care in public hospitals run by hospital staffs that excluded black physicians from their membership and medical schools that refused admission to black students. The untenable health station of Black America was one of the leading causes of the civil rights movement of the 1950s and 1960s, activism that succeeded in integrating the hospitals and medical schools by federal acts passed in 1964 and 1965 that transformed American medicine.

[The becoming of public medicine in the second half of XVIII-first half of XIX centuries. Report II. The development of public systems of training of medical manpower and charity provision to socially unprotected groups of population].

The present report considers the history of becoming of concept of medical police in second half of XVIII century. This concept became one of the most important instruments of public management in Austria, France, Prussia and Russia. Two directions of activity of public authorities in the area of implementation of medical police are discussed i.e. control of frauds and development of public systems of training of medical manpower and charity provision to socially unprotected groups of population. The historiographical data is presented concerning the development of public systems of training of medical manpower, reform of university medical education, implementation of hospital reform.

Origins of the physician assistant movement in the United States.

The 1960s saw a rethinking of health care delivery in the United States. The physician assistant (PA) emerged from that reconceptualization, along with the nurse midwife (CNM) and the nurse practitioner (NP). The PA, CNM, and NP were the product of demand for greater health care access, especially for the nation's poorer citizens. All three groups benefited from federal activism in health workforce policy. The PA had one characteristic not shared with the new nursing professionals: a connection in the public's mind with returning Vietnam War veterans. Several energetic trailblazers--notably Eugene Stead, Richard Smith, E. Harvey Estes, and Henry Silver--conceived and promoted their particular versions of the PA. The boosters of this new health professions movement worked through existing medical education programs and federal health care initiatives. Their efforts, sometimes informed by models of nonphysician health care abroad, received critical support from private philanthropy. Then, in 1969, the American Medical Association (AMA) rather unexpectedly gave its official approval to the concept of the PA. As optimistic as the originators of the PA movement were, even they did not anticipate the critical role PAs would play in health care delivery well into the new century. US physician assistants also continue to influence medical providers in other areas of the world. This paper re-examines the history of the physician assistant movement at the 50th anniversary of the concept. The authors use archival sources, policy analyses, interviews with principal figures, and secondary historical literature to explain the establishment of the PA movement in the 1960s and analyze its continuing influence.

[The scientific practical input of Zemstvo physician N.I. Teziakov into the development of sanitary service in Saratovskaya gubernia].

The article considers, in historical perspective, the short biographic data relating to Zemstvo physician N.I. Teziakov. The major issues concerning the development of sanitary service in Saratovskaya gubernia in the beginning of XX century are covered. The scientific practical input of N.I. Teziakov into the development of zemstvo medicine and sanitary work is demonstrated.

"HEALTH FOR ALL". THE MEDICAL SYSTEM IN WALLACHIA UNDER PROTOMEDICUS NICOLAE GUSSI 1848-1859.

The main objective of this study is to provide an overview of the evolution of the medical system in Wallachia between 1840 and 1860 and the very important role of physician Nicolae Gussi (1802-1869), protomedicus of Wallachia between 1840 and 1859, to transform medicine into a modern public service, accessible to the entire population. Particularly, we will refer to the medical reform project of 1853, which Gussi implemented during the time he headed the medical-sanitary administration. We will insist on the details of the project because it was designed to create a network of county hospitals that would improve the health of the population and, in the medium and long term, would reduce mortality and increase life expectancy. Another dimension of the study aims at the tenure of physicians in county hospitals and describes the medical services they provided to patients, particularly from the poor population.

Barefoot Doctors and the "Health Care Revolution" in Rural China: A Study Centered on Shandong Province.

Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them. This paper explores the rise and development of barefoot doctors based on a case study of Shandong province. I argue that the promotion of barefoot doctors was a consequence of the medical education revolution and an implementation of the Cultural Revolution in rural public health care, which significantly influenced medical services and development in rural areas. First, barefoot doctors played a significant role in accomplishing the first rural health care revolution by providing primary health care to peasants and eliminating endemic and infectious illnesses. Second, barefoot doctors were the agents who integrated Western and Chinese medicines under the direction of the state. As an essential part of the rural cooperative medical system, barefoot doctor personnel grew in number with the system's implementation. After the Cultural Revolution ended, the cooperative medical system began to disintegrate-a process that accelerated in the 1980s until the system's collapse in the wake of the de-collectivization. As a result, the number of barefoot doctors also ran down steadily. In 1985, "barefoot doctor" as a job title was officially removed from Chinese medical profession, demonstrating that its practice was non-universal and unsustainable.

[The influence of the devotion movement on the health care in North Korea].

Since the early 1960s, North Korea has conducted 'devotion movement' under the directorship of Kim Il Sung across the nation. As a matter of fact, the movement was not a novel invention at all. When North Korean Temporary People's Polity was established in 1946, North Korea emphasized the importance of the devoted care of health personnel. It meant to reform the people's thought and mind along with complementing the lack of human and material resources. Thought reform was not a peculiar phenomenon observed in North Korea only. It was particularly stressed out among communist countries, including the Soviet Union. However any other communist country stresses the importance of thought reform. Devotion movement should be viewed as part of this process. As shown in many cases, the extent and degree of devotion movement and care are beyond our imagination, which does not intend to mean that North Korean health personnel's attitude towards patients is superior to the counterparts in South Korea. Indeed human being's behavior cannot be understood without taking account of society in general. The question can be raised as to whether or not North Korean health personnel's devoted care is really voluntary. To put aside the testimony that the most powerless group in a society can fall prey to victims, if social environment, whether directly or indirectly, is action on the people's thought and mind even in a subtle way and thus influence one's decision power, it is hard to highly evaluate the devoted care in North Korea. Moreover it seems like that the internal conflict exists surrounding devotion. In conclusion, I think that North Korean devotion movement has enforced health personnel to reform their thought and mind to adapt to North Korean regime and has played an important role to accomplish the purpose of North Korean Labor Party to realize essential constituents of its health system, in such a situation in which essential medical supplies are severely lacking. But it seems like that it plays reverse action to develope sound North Korean health system.

[The medical and pharmaceutical profession and the mutual care system in the writings of Jaime Vera (1859-1918)]. / Profesión y asistencia médico-farmacéutica en los escritos de Jaime Vera (1859-1918).

This article presents the perspectives of the physician and politician Jaime Vera y López (1859-1918), co-founder of the Spanish Socialist Workers' Party, on the medical profession, medical practice, and healthcare systems. It compares the Report (Informe) that he presented to the Comisión de Reformas Sociales (1884) with his later writings published in the socialist press ("Farmacia y cooperación obrera,, 1914 and "La locura en los niños. Camino del remedio", 1916). We observe the discrepancies between the political-programme documents and the articles centring on professional questions and highlight how his theoretical focus is modified when applied to matters of medical practice.

Minority politics in the house of medicine: the physicians forum and the New York County Medical Society, 1938-1965.

The late 1930s challenged laissez-faire medicine. Recognition of serious inadequacies in the distribution of medical services stirred activists who questioned fee-for-service delivery and posited a national health program, including health insurance. The AMA and its components--state and county medical societies--counterattacked, mobilizing money and their powerful political arsenal to fight government intrusion in private medicine. The Physicians Forum, initially under the leadership of Ernst P. Boas, emerged as a formidable element within the New York County Medical Society (the largest component of the AMA). The Forum provoked discussion of medical indigence and economics, upsetting the Society leadership with independent candidate slates and telling the public that doctors spoke with more than one voice. For 25 years, the Physicians Forum altered the dynamics of the Medical Society of the County of New York. While the Forum effort to institutionalize minority opinion in the councils of medicine failed, the interchange between County regulars and Forum insurgents broadened the medical reform agenda and moved the County Society in directions that historically it had avoided. Although medical economics formed an unbridgeable chasm between County regulars and rebels, Forum members demonstrated that medicine was not monolithic, that "majority opinion [was not] ... unanimous opinion," and that doctors must speak to issues of medical and social policy.