[Kyoto Prefectural Hospital "Tenko-in" for the mentally disabled: its opening, development, and abolition]

The aim of this article is to investigate various attempts made at the first hospital for the mentally disabled in Japan. The prefectural government opened the hospital "Tenkyo-in" in the Nanzenji-Hojo, a temple in a residential area in Kyoto on 25 July, 1875. New rules on nursing, medical examination and medical fees, such as doctor's fees and hospital charges, were established. The doctors' services for Kyoto residents required no charge from 1876. The hospital's therapeutic concepts depended on the knowledge and opinions of Langegg Junker, a German teacher invited by the Kyoto Ryo-byoin. His idea adapted "moral treatment" which was popular in Britain. Diagnostic methods in this hospital were formed around the model based on the concept described in "insanity", an article written by Henry Maudsley in 1872. By promoting these ideas, the hospital was able to help many patients return to their lives in their own residences. The hospital was closed on 21 September, 1882, because the hospital faced a big financial deficit and because prefectural policies were changed. The hospital was founded as a facility of public health service in Kyoto in the age of modernization of Japan. It introduced a new idea for mental health and treatment, which had a strong impact on hospital care of psychiatric patients afterwards.