In Japanese scholarship, the notion of public health is closely associated with modernisation and the adoption of Western medicine in the nineteenth century, which influenced the centralisation of medical affairs and the establishment of hospitals. This article aims to challenge this assumption. A closer look at Japan's medical history shows that government institutions caring for the sick and destitute existed before the introduction of Western concepts of medicine. Furthermore, Japan had other ways of providing welfare, in addition to establishing hospitals. These included government-sponsored medical manuals designed to deliver healthcare via published texts, an aspect of welfare that has been neglected in the history of public health in Japan. This article fills this gap by illuminating and grasping lesser-known strands of healthcare delivery to enhance our understanding of the relationship between the state and medicine in early modern Japan. In particular, it examines welfare initiatives implemented by the tenth shogun, Tokugawa Yoshimune (r. 1716–1745), a prominent and well-researched figure in the history of Tokugawa Japan and a key player who laid the foundations of welfare in this era.

在日本学术界，公共卫生的概念与现代化和十九世纪西医的采用密切相关，影响了医疗事务的集中化和医院的建立。本文旨在挑战这一假设。仔细研究日本的医学史就会发现，在西方医学概念引入之前，照顾病人和贫困者的政府机构就已经存在。此外，除了建立医院之外，日本还有其他提供福利的方式。其中包括政府资助的医疗手册，旨在通过出版的文本提供医疗保健，这是日本公共卫生史上被忽视的福利方面。本文通过阐明和掌握医疗保健服务中鲜为人知的部分来填补这一空白，以增强我们对近代早期日本国家与医学之间关系的理解。它特别考察了第十代将军德川吉宗（在位，1716-1745 年）实施的福利举措，德川吉宗是日本德川历史上一位杰出且经过深入研究的人物，也是奠定这个时代福利基础的关键人物。