at the start of the sanatorium, it was a lawless area with wandering vagabonds. however, order and safety were gradually established by his efforts. he used a free hand considerably admitted the director of the sanatorium. with the exception of kyushu sanatorium, kumamoto, directors of leprosy sanatoriums came from police, since wandering leprosy patients included criminals. however, physicians took the parts of directors later in other sanatoriums. imada exceptionally stayed long as the director of the sanatorium for 17 years.