Koishikawa Yōjōsho Opens for Poor Patients

In 1722, the shogunate opened a treatment facility inside its Koishikawa medicinal garden. Town physician Ogawa Shōsen had proposed care for people too poor to obtain treatment, using Yoshimune’s suggestion box. The initial capacity was forty patients.

Tokyo’s library exhibit describes a difficult opening: prospective patients feared being used to test medicines and stayed away. Officials invited town headmen to inspect the facility and its treatment, then relaxed admission conditions. Applications increased until the available space could no longer accommodate them. The facility subsequently expanded.

Physicians serving there included Hayashi Ryōteki. In 1729, he and the herbal specialist Niwa Shōhaku compiled Fukyū ruihō on Yoshimune’s orders. It presented obtainable medicines and simple treatments in accessible Japanese, with illustrations of plants. The hospital and the book addressed different limits to care: one provided a place for eligible poor patients, while the other carried medical instructions to readers elsewhere. Limited capacity and admission rules continued to bound the hospital’s reach.