@article{oai:rekihaku.repo.nii.ac.jp:00001288,
 author = {長田, 直子 and Osada, Naoko},
 journal = {国立歴史民俗博物館研究報告, Bulletin of the National Museum of Japanese History},
 month = {Feb},
 note = {application/pdf, 医師による医療が村でも広まった近世後期、人々は病に罹ったとき医師をどのように選択したのか。本稿では、都市近郊農村である多摩地域名主の日記鈴木平九郎『公私日記』を取り上げ、近世後期から幕末期にかけての患者側の医師選択について、江戸との関わりを含めて考察を試みた。
近世後期の多摩地域も他地域と同様に多数の医師がいた。幕末期には江戸の蘭学塾で蘭学を学ぶ者も現れていた。そうした状況の中で、鈴木家や鈴木家の親せき達は通常かかりつけとも言うべき医師に頼っていた。かかりつけ医師は、たんに地域的条件のみによらず、親戚関係・文化関係などによって決められていた。しかし、専門性の必要な眼科や外科、また病気の進行状態によって遠くの専門医やかつて江戸で開業していた蘭方医に診療を求めた。ただし、かかりつけ医師の存在は患者にとって大きく、遠方の医師にかかってもその傍らでかかりつけの医師に頼っていた。
さらに、この地域の人々は病が重くなると、江戸という選択肢を選んでいた。彼らが頼る江戸の医師達は蘭学塾の師匠、または藩医や当時外科で名が知られていたトップクラスの医師達であった。しかし、それらの医師達でさえ、患者の病状によっては、選択され、江戸を抜けてさらに評判の医師の元に医師替えをされることもあった。患者側はたんに江戸の医師を求めるのみならず、シビアな判断で医師選択を行える状況になっていたのである。多摩地域の患者達が求める江戸の医師達は、蘭方医が多かった。この背景として、多摩地域と伊東玄朴及び象先堂門人とのつながりが考えられた。また、江戸の人々とのつながり、時期的背景、経済的背景に加えてこの地域が甲州街道沿いかつ都市近郊農村であったことも背景としてあったとおもわれる。この地域の患者による医師選択には地域的特色があらわれていたのである。, The aim of this article is to examine how inhabitants of rural areas chose doctors when they got sick in the nineteenth century. There were many ways to cure disease in the Edo period. In the nineteenth century, village doctors increased in number to cope with villager's needs. As scholars engaging in Dutch learning opened their private schools in Edo, more and more local doctors came to be trained at the schools. Thanks to this development there were many medical doctors working in villages, who had mastered Chinese or Dutch medical learning. So in rural area's people could ask for help to doctors when necessary. People could even choose better doctors to cure their disease. How did they choose their doctors for themselves?
This article focuses on the choice of the medical doctor from the view point of patients and their families, depending on one of the village headman's diaries, “Koshi nikki” as the main source of information. His village was located on the “Koshu Kaido” in North Tama region, in the western suburbs of Edo.
Usually, people depended on their home doctors when they got ill. They chose their home doctor for various reasons. The home doctors were chosen because of their close local, or blood, or marital ties, or cultural relationship, or other reasons. But when people got eye disease or injured, they relied on specialists. And their physical problems got worse, the more often they tended to change doctors. They relied on their home doctors and also the urban doctors.
When patients couldn't get well, they wanted to see urban famous doctors. But they chose doctors with quite practically. They didn't choose the doctor even if he was one of the most famous doctors in Edo. And they sought for more effective doctor and visited him. Many of the doctors chosen by them were doctors who mastered Dutch learning. But this does not necessarily mean that people chose doctors because they learned Dutch medicine. What were the backgrounds behind? One of the major facts in the background was the influence of “Sho-sen-do” which was strong in this particular region. “Sho-sen-do”was the private school of a Dutch medical doctor, Ito Genboku. So his pupils were active in this region. Of course there were other facts, economical, regional, historical condition, human relationship, and characteristics to the suburb of Edo, in the background.},
 pages = {317--342},
 title = {近世後期における患者の医師選択 : 『鈴木平九郎公私日記』を中心に（第二部　蘭学の地域的展開と交流）},
 volume = {116},
 year = {2004},
 yomi = {オサダ, ナオコ}
}