The Japanese Era

The ceding of Taiwan to Japan in 1895 had profound consequences. The Mieji era (1867 – 1912) had transformed Japan from a medieval state into a modern nation, modelled on western science and western ideas. Japan modelled its medical service on German medical science. German medical terminology and textbooks were adopted. Japan brought scientific medicine into Taiwan as the norm.

But there were immediate problems. Davidson writes, "The Japanese on their arrival in Formosa found nothing more urgently required than immediate improvement of sanitary conditions... the task of cleaning up the streets was a huge one. With the exception of a few missionary institutions there were no hospitals in the island and the sick were cared for by Chinese doctors with their antiquated and unscientific methods".

A Japanese sanitary team reported, in 1895, "In the streets of Taipei City there was dirty water flowing around the houses and courtyards. Because animals lived with human beings there was excrement everywhere – though there were public toilets. Wells provided drinking water but the containers were dirty ...In Tianan city it was usual that garbage and dirt were dumped everywhere along the street. Ditches were filled with dirty water and maloderous."

Such conditions led invariably to the spread of infectious diseases. Some were water- borne such as cholera, typhoid fever and dysentery; some were insect borne such as malaria (spread by mosquito) and bubonic plague (spread by rat fleas from plague infected rats). These diseases, in epidemics, caused havoc to the populace and to the Japanese occupying army. The total invading Japanese forces numbered 76,000, in the first year 164 men died in battle, 515 were wounded, but 4,600 died from epidemic diseases, and 21,000 were invalided at home.

The situation was so desperate that the Japanese governor Kodama sent to Tokyo for help. Kodama was an army general but his right hand man, in charge of civil government, was a doctor and hygienist Dr. Goto Sinpei. Dr. Goto sent for a friend and former colleague of his in Japan, an Edinburgh- born Scot, William Burton, who was a civil engineer and lecturer and had lived in Japan for 6 years building sewerage systems there.