A Reexamination of Dr. Masanao Goto's Leprosy Treatment in Hawai'i: New Insights from Japanese and Hawaiian Sources

Leprosy (Hansen's disease) care in late 19th-century Hawai'i involved complex interactions between Western medicine, traditional practices, and diverse patient experiences. This study re-evaluates the contributions of Dr. Masanao Goto, a Japanese physician whose treatment gained significant patient popularity, by focusing on its health and social welfare implications. Utilizing previously under-examined Japanese sources-including family records and hospital documents-alongside Hawaiian and English archives, this historical research analyzes Goto's work in Hawai'i (1885-1895) and the dynamics of cross-cultural medical encounters. The analysis reveals a three-way dynamic between patients seeking relief, a non-Western practitioner offering a holistic paradigm, and a shifting medical establishment that increasingly prioritized bacteriological cures. Dr. Goto's holistic regimen, centered on chaulmoogra oil integrated with (a system of traditional Japanese medicine adapted from classical Chinese medicine) principles and medicated baths, provided tangible symptomatic relief and profound hope. While initially supported by the Kalākaua administration, his work later clashed with the "reformist" Board of Health following the political upheaval of 1887. Patient support, however, was a powerful force, culminating in an 1894 petition from 861 Kalaupapa residents to appoint him their permanent physician. Dr. Goto's work, embraced by patients, highlights the critical importance of patient-centered perspectives and the agency of non-Western practitioners. The organized patient movement for his care serves as a historical precedent for medical sovereignty, offering valuable insights into integrating diverse medical traditions pertinent to achieving health equity in contemporary Hawai'i.