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This paper aims to examine the spread of paragonimiasis and the Japanese colonial government's response to it. To consolidate colonial rule, the Japanese colonial government needed medications to cure paragonimiasis. When Dr. Ikeda Masakata invented acid emetine to cure paragonimiasis in Manchuria in 1915, emetine treatment carried the risk of emetine poisoning such as fatigue, inappetence, heart failure, and death. Nonetheless, Japanese authorities forced clinical trials on human patients in colonial Korea during the 1910s and 1920s. The emetine poisoning accident in Yeongheung and Haenam counties in 1927 occurred in this context. The Japanese government concentrated on terminating an intermediary host instead of injecting emetine to repress endemic disease in Japan. However, the Japanese colonial government pushed ahead with emetine injections for healthy men through the Preliminary Bureau of Land Research in colonial Korea in 1917. This clinical trial simultaneously presented the effects and the side effects of emetine injection. Because of the danger emetine injections posed, the colonial government investigated only the actual condition of paragonimiasis, delaying the use of emetine injection. Kobayashi Harujiro(1884–1969), a leading zoologist and researcher of endemic disease for three decades in the Government General Hospital and Keijo Imperial University in colonial Korea, had used emetine while researching paragonimiasis, but he did not play a leading role in clinical trials with emetine injections, perhaps because he mainly researched the intermediary host. Government General Hospital and Keijo Imperial University therefore faced limitations that kept them from leading the research on endemic disease. As the health administration shifted the central colonial government to local colonial government, the local colonial government pressed ahead with emetine injections for Korean patients. Emetine poisoning had something to do with medical power's localization. Nevertheless, the central colonial government still supported emetine injections with funds from the national treasury. The emetine poisoning accident that occurred simultaneously in two different regions resulted from the Japanese colonial government's support. This accident represented the Japanese colonial rule's atrocity, its suppression of hygiene policies, and its disdain for colonial inhabitants. The colonial government sought to accumulate medical knowledge not to cure endemic disease, but to expand the Japanese Empire.