We have conducted an experimental study, in the form of both laboratory experiment and field study, with a view to investigating what kinds of injuries the rural people of Tb-hoku District suffer from especially in such places among the mountains as Shinshu, during the coldest season, and to knowing how it may be improved by the introduction of stoves into their family life. As the field we chose Saguchi-buraku, Yachiho-mura, Minami Saku-gun, Nagano Prefecture (a small village 800 meters above the sea). And for the purpose of the experiment we divided the 27 families who were living solely on farming into two groups, one group provided with stoves and the other, the control group, without stoves. a) In the laboratory experiment, the laboratory was kept at 2°-4°C., same as the room temperature in the farm-houses in the coldest season in that district. In this experiment we have obtained the same results as those published in our previous reports on coldness and cold injury, that is, we evidenced such acute cold injuries as the rise of blood pressure, increase of pulse rate, etc., and also such other injuries as the increase of blood sedimentation rate, appearance of blood “sludging” phenomenon of conjunctive bulbi, etc. By staying in the laboratory at 4°C. only for half an hour, the patients with coronal artery sclerosis showed unfavourable changes in ECG findings. b) As mentioned above, we selected 27 families of similar composition, of annual income and of farming scale, from an tig those of Saguchi-buraku who are living solely on farming, and then divided these 27 amilies into two groups, one group provided with stoves (15 families) and the other without them, a control group. Thereupon, all the family members were examined several times, before, during and after the coldest season, as to their physical and mental conditions. It was a matter for regret that the stoves were provided only for two months of the coldest season, but we have succeeded in obtaining some promising results that would corroborate the good effects of stoves on farmers life. 1) The results of various physical examinations carried out before and after the coldest season (blood pressure determination, electrocardiogram, phenol red test, blood sedimentation rate, capillary fragility test, gastric juice examination, eye-ground pictures, pressure of arteriae centralis retinae, cold pressure test, blood flow over conjunctiva bulbi, etc.) failed to show satisfactorily convincing difference between the two groups. It may be because the favourable effects on health, which stoves would have produced during the established period, had been blurred once the season was over. However, the fact that the aggravation of eye-ground pictures was definitely less frequent in the subject group than in the control group is considered to be the result worth special mentioning. On the other hand, it was distressing to population, esp. those over 40 years old, who lived in the ordinary stoveless houses during the coldest season. 2) Besides, the personal interviews conducted in the midst of the coldest season drew out attention to the marked decrease of neurological symptoms in the subject group. Furthermore, such favourable effect continued to spring time. Another good effect was that the family began to have a happy circle, esp. around the stove. Moreover, in the subject group it has been proved that winter diseases esp. the cases of common cold decreased to less than one third. When we think of the saying “Common cold opens the gate to all diseases.” this fact may also be consideredtobean important good effect.
From June to September, 1961, our working survey parties visited the stomach cancer patients (chiefly those proved as such by surgical operation) admitted to 22 major hospitals in Nagano Prefecture, and by the direct interview method tried to find out according to the uniform working system the environmental factors which might have something to do with the onset of that disease. As the control group we selected the 104 persons hospitalized for their circulatory disorders, especially hypertensive diseases, and investigated them in the same way. The results were analysed in various ways. To obtain urban data to be used in comparison, we conducted an identical investigation in regard to the 64 stomach cancer patients admitted to the hospital attached to the Cancer Research Institute in Tokyo. The items of inquiries were so established as to include a large variety of what have been generally regarded as causative agents' for stomach cancer and such elements in rural life as considered to have something to do with stomach diseases in general. The analysis of such environmental factors or life factors which might the contribute to the development of stomach cancer, conducted in comparison with the control data obtained from the hypertensive group, produced the following results: 1) The stomach cancer group was recognized, in comparison with the control group, to be more correlated with poor physique. and the inheritance of cancer diseases. 2) Differing from the control group, the history of the symptoms of “stomach disorder” was significantly correlated with the d velopment of stomach cancer. These symptoms, with the 20 years' history, were significantly more frequently observed in the stomach cancer group. This fact may be said to evidence the existence of precancerous changes or so-called precursor of cancer in the clinical sense. 3) However, the proven cases of previous stomach diseases (stomach ulcer, chronic gastritis, polyp, etc. which are called precancerous changes) were not so many, contrary to our expectation, and even as late as “3 years before”, such diseases were less than 10 per cent respectively. The existence of correlation between such diseases and the Borrman's Classification, which is said to correspond to the former, was not very clear. We consider that in the development of various kinds of gastritis, stomach ulcer, etc. there would exist some common environmental factors, and there may also be the interchange of one with another among such diseases. Moreover, such factors are imagined to be working in a complex mechanism to develop stomach cancer. Such complicated circumstances might have caused us to fail in obtaining the consistent results. In this case we refrained from going too far into this problem, by quoting varied pathological theories concerning the etiology of and the interrelationship among gastritis, stomach ulcer and stomach cancer. What we should like to specially mention here is that we take the clinical standpoint in the interpretation of those categories. If we discuss such problems sometimes from pathological, sometimes from anatomical and sometimes from clinical viewpoint, confusion will be the unavoidable issue. 4) As regards the factors of eating habit, we noticed first of all “gluttony”. Especially, it was an interesting discovery that what was really important was the habit of heavy feeding practised “10 years ago “or” 20 years ago” in “status” there appeared no difference between the two groups in regard to the habit of heavy feeding. It may be because many patients, feeling their “stomach out of order”, were obliged to eat less. Anyway, the result of this survey appears to suggest that the evils of previous gluttony cannot be rectified even if they, feeling ill, restrict their feeding in consternation. Besides, it was proved to be the typical life factor of rural people.
For the purpose of grasping the present status of stomach cancer in Hokkaido, we have made an analysis of the findings of the mass examination on stomach cancer and those of the short-term health evaluation.The following is the results of such analysis: 1) No regional distinction was recognized in Hokkaido in the incidence of stomach cancer; 2) Re.stomach cancer, there seemed to be a predilection for males; 3) By age, it appeared in the forties and continued to increase as the age advanced.
We have made a survey of the prognosis and the condition of rehabilitation of surgically operated stomach cancer patients, by sending questionnaires to our ex-patients, who were surgically operated upon at our hospital in the past 11 years and for whom death certificates were not issued from us. The number of survivors comprised 10.6% of all surgically operated cases of stomach cancer, and that of the cases who survived their operation by 5 years amounted to 13.9%. Percentages are somewhat low compard with other results so far reported. One third of the cases whose death was notified by the answer to such questionnaire had been able to resume their work for a while. As for the survivors, two thirds of them were actually working and one half of the survivors were leading a normal life. Of all the working cases, most of those who were feeling they were not up to such work but were obliged to strain themselves to it were found among farmers. The number of patients who turn up for medical check-up after the operation decreases with the lapse of time, while the percentages of medically treated cases were about the same with those operated upon more than and those less than 5 years ago.
We have conducted a study of stomach cancer on the basis of death certificates filed within the province of the Asahikawa Heaith Center, covering the ten years from 1951 to 1960. Mortality from all cancers and that from stomach cancer within that province are both of them lower than those of the whole nation and of Hokkaido. The mortality from stomach cancer is, in both sexes, a little higher in rural than in urban districts. In both sexes, more than half of the stomach cancer patients died within 6 months of its onset. The mortality curve makes a peak on the 6th month of the ailment, and the succeeding downward curve makes another sharp climb around the end of one year. As for the place of death, most of the patients died at home; few of them were admitted to hospitals or clinics, especially so with rural women.