Epidemiological Observation of the Causes of Death of Inhabitants in the Yamanashi Kyoto District from the Middl Edo Era to the Present According to Necrologies

Abstract

When 19, 900 persons that died in the Yamanashi Kyoto district during the 289 years from the middle Edo era to the present according to the necrologies available at 7 temples in the district in which diseases as causes of death are scarcely entered were classed into two age groups, ie, one aged not less than 10 years and the other aged less than 10 years, and by each month, the death curves in the two groups showed the respective characteristic patterns. A survey was also made by a similar method on 8073 persons that died during 82 years and are entered in the necrology of an O temple in the Hida district in which diseases as causes of death are entered. As a result. the death curves of the two groups in this district showed the respective characteristic patterns according to the kinds of infections. When the death curves due to small pox, typhoid, measles, dysentery, which were so obtained were compared with the death curves in the Yamanashi district, it was found that these infections followed very close courses in the two districts, though there were some lags between the districts. In both the Yamanashi and the Hida district, it was noted that the major causes of death in the aged group were typhoid, cholera, influenza, famine, battle, and those in the younger group, small pox, measles, dysentery. Moreover, each kind of disease, showing its characteristic pattern, was often recognizable. Severe famine and big battles were overlapped or complicated by these diseases, to make the disasters more serious. The disease structure in the pre-war period was fundamentally altered from about 1955 on. The deaths due to infection and tuberculosis and those of neonates that had persisted since the Edo era drastically decreased, to be taken over chiefly by adult diseases in the post-war period. Seasonal alterations in the causes of death in the year show such a pattern that the peak deaths due to infection and and the peak deaths of neonates in summer that had persisted to and including the Meiji era have been overcome, to disappear in and after 1955. Annual and decadal alterations in the causes of death were then examined epidemiologically, and this disclosed the status of outbreak of infections and the occurrence of famine that had varied from district to district. Long-term alterations in the distribution of these causes of death by age showed the predilect ages of deach due to infection, death due to famine and death in battle, the frequencies of them, and the complications by them, and further disclosed alterations in the disease structure. When the causes of death in the Hida Takayama district were compared with those in the Yamanashi Kyoto district, the disease structures in the two districts during the past about 300 years proved basically close to each other, but there was marked difference in the occurrence of famine or in the outbreak of cholera between the two districts. We have proposed a method which is capable of unraveling the causes of death of inhabitants all over Japan during the period of from the middle Edo era to the present, based on the actual reliable status of death according to the necrologies, even if not filled in with diseases as causes, witn reference to the local history and to the chronological tables of Japanese and local histories as presented in the foregoing.