메이지 초기 일본의 ‘독일 의학’ 채택에 관한 비판적 재검토: 사가라 지안(相良知安)의 ‘의권(醫權)’ 구상과 의사 전문직화 기획을 중심으로

This article critically reconsiders existing explanations for the adoption of “German medicine” in early Meiji Japan and reconstructs the institutional and political context of that decision by focusing on Sagara Chian’s conception of medical authority (iken) and his project of medical professionalization. Previous studies have explained the shift largely in terms of the academic superiority of German medicine, the German provenance of Dutch-learning medical texts, the advice of foreign advisers such as Verbeck and Bauduin, political or ideological affinity between Japan and Prussia, or factional conflict surrounding William Willis. Yet these explanations do not sufficiently clarify why the final outcome took the form of a German-style institutional model combining university-based medical education, state examinations and licensure, a hierarchical professorial order, and state regulation of medical practice. This article first shows that, in the aftermath of the Boshin War, the British model represented by William Willis enjoyed strong political legitimacy within the new Meiji government. It then traces the appointments of Sagara Chian and Iwasa Jun, the proposal and collapse of the dual-employment proposal, and the subsequent politics of separation and compromise, arguing that the crucial issue was not a simple confrontation between pro-British and pro-German camps but a contest over who would control medical education, institutional design, and the authority to certify physicians. It further demonstrates that Sagara understood “Germany” not as a repository of superior medical techniques but as an institutional model linking the university, state licensure, hierarchical academic authority, military medicine, and hygienic administration. In this light, the adoption of “German medicine” in early Meiji Japan is best understood less as passive reception of a purportedly superior foreign medicine than as an institutional choice through which the modern Japanese state sought to reorganize physicians into a state-managed and state-certified profession. This reinterpretation sheds light not only on the formation of the Meiji state and its professional order but also on the broader genealogy of modern medical education in East Asia, including colonial Korea.