The Legacy & Evolution of Preventive Medicine at Keio University

"Preventive medicine" refers to medical care aimed at healthy individuals to prevent illness before it occurs. It is said that the term "health" (lit.kenkou) as a medical term in Japan was first used by Ogata Koan, a scholar of Western studies in the late Edo period. Keio founder Yukichi Fukuzawa, who studied under Koan at Tekijuku in Osaka, played a significant role in popularizing the term during the Meiji era. He first used the term "health" in his book Things Western (Seiyō Jijō), published in 1866, and continued to use it frequently in his other works, including the bestseller An Encouragement of Learning (Gakumon no Susume). Fukuzawa instilled the importance of health into the daily lives of Japanese people during the wave of modernization that washed over Japan in the late 19th century.

Fukuzawa himself was meticulous about maintaining his health, never neglecting his daily routines of walking, rice pounding, and iaido—the martial art of drawing one's sword. When it came to educating children, he advocated for "training the body before nurturing the mind," prioritizing food and nourishment over buying fine clothes for his children. Fukuzawa also helped popularize beef and milk, which the Japanese rarely consumed before the Meiji era. With objective proof of their nutritional and health benefits, he became an opinion leader on health at the time.

Dr. Shibasaburo Kitasato gained international fame for his pure culture of tetanus bacteria and the development of serum therapy during his studies in Germany. After he returned to Japan in 1892, Fukuzawa spared no effort in assisting and advising Kitasato in his research on infectious diseases. To repay Fukuzawa's kindness, Kitasato devoted himself to establishing a school of medicine at Keio University. He served as the first Dean of the School of Medicine and Director of the Keio University Hospital, continuing to dedicate himself to their development long after Fukuzawa's death. Fukuzawa and Kitasato shared the belief in the importance of prevention in medicine. In his "Treatise on Medical Ethics," a collection of speeches, Kitasato wrote that illness should be prevented before it occurs, asserting that "prevention is primary, treatment is secondary." He made significant contributions to improving and expanding public health in Japan.

The Building for Preventive Medicine and Public Health, still present on Shinanomachi Campus, was completed in 1929 in the architectural style of the day. The building housed the departments of preventive medicine, public health, and parasitology. This department of preventive medicine was the first of its kind in Japan and embodied Kitasato's principles, representing a forward-looking approach to the future of medicine. Kitasato is said to have taken great pride in this department of preventive medicine.

While not common knowledge, the pavement outside the Building for Preventive Medicine and Public Health still bears hexagonal traces where incendiary bombs rained down on Shinanomachi Campus. These marks are believed to be from the air raid early in the morning of May 24, 1945. At that time, most of the major buildings were made of wood, resulting in the loss of about two-thirds of the School of Medicine and Keio University Hospital. Amidst the countless incendiary bombs raining down from the sky above, the nurses safely evacuated all 180 inpatients, both seriously afflicted and slightly injured alike. Meanwhile, students extinguished and discarded incendiary bombs from the roofs of the Building for Preventive Medicine and Public Health and Kitasato Memorial Medical Library, which were made of reinforced concrete, ultimately protecting the structures. Thanks to the valiant efforts of those doctors, nurses, and students, the Building for Preventive Medicine and Public Health still stands today. Its antiquated yet dignified presence speaks volumes about the importance of medical education and research at Keio University over the years.

Preventive medicine includes screenings to check for the presence of illness. The history of screenings at Keio University Hospital began with cancer screenings at the Keio‌ Cancer‌ Center‌ Foundation, established in 1966. Four years later, the Keio Health Counseling Center was founded, offering comprehensive medical exams, known in Japanese as ningen dock. In 2012, the Center for Preventive Medicine was established inside Keio University Hospital. In November 2023, the center relocated to Azabudai Hills to expand and further develop its preventive medicine capabilities, increase appointment availability, and improve the quality of its medical services by introducing the latest medical equipment.

The decision to move into the heart of the city from Shinanomachi Campus, where the university hospital is located, was made for good reason. The new location at Azabudai Hills, with its concept of creating a "Modern Urban Village" under the two pillars of "Green" and "Wellness," is the ideal setting for the future-driven preventive medicine that Keio University aspires to provide. In the future, through a partnership with Mori Building Co., Ltd., which is developing the Azabudai Hills project together with Keio University, the Center for Preventive Medicine will work together with organizations such as fitness clubs and restaurants to support the health of the individuals who live and work there. A joint research laboratory will also be established by Keio University and Mori Building. The goal is to promote interdisciplinary development in preventive medicine by recognizing health issues at diverse life stages and broadly sharing wellness and well-being research outcomes with society. With this new location at Azabudai Hills, Keio University's passion for preventive medicine will continue for the next century and beyond.

*This article appeared in Stained Glass in the 2024 winter edition (No. 321) of Juku.