The mass medical examination for hypertension to dwellers in agraian districts of Shizuoka Prefecture had been conducted for three years. Yearly changings of hypertensive level and findings in electro-cardiographs, ocular bottoms and urins of those who were taken medical examinations continuously for three years were investigated, and the health care of the hypertensive patients who were found out by the examination was also studied. The results of the investigations are as follows : 1) About the group of the subjects examined continuosly for three years : The fall of the hypertensive level of this group was not noticed in the first health care year, but in the second year of it the fall of the level was admitted except 70 year of age group. This difference seems to be based on the fact that in the first health care year medical guidance for subjects was done only once, on the contrary, in the second year of it the guidances were conducted more frequently checking subjects at least once a month. Considering from the fact stated above, the guidance obtained from only one medical examination didn't give the satisfactory effect, but the repeated guidances, for instance, monthly hypertensive checkings seemed to be more effective to the improvement of the hypertensive level of the subjects, Concerning the changes of the findings in various medical examinations, a little of improvements in electrocardiographs, ocular bottoms were seen, but the improvements of findings in urin could not be noticed. 2) About the result of the investigation into the rate of taking medical treatments : A) There were some subjects who didn't recieve any medical treatments even though they were diagnosed as patients who should recieve the treatments. The reason why they didn't recieve the treatments was based on the lack of subjective symptoms. B) In case that the hypertensive patients were directed for only once afterx the mass examination, half of the patients stopped the treatments within 2 months. Seeing the facts were, the one time's health guidance just after the examination was not so effective, but further guidances, for instance, 3 months after the inspection was assumed to be more effective in view of preventing the patients stopped the treatments. 3) It seemed to be necessary to elevate the treatment rate of the hypertensive group for improving the hypertensive level. 4) It was easy to make down the hypertension of the newly found group, in comparison with that of old group. 5) The rate of changing into the hypertensive group from the normal group in the first health care year under the 3 years inspections was 32.7°0, and old people were apt to become hypertensive.
For the prevention of influenza, immunization through vaccination appears to be the only method presently available. Following the Asian innfluenza (A2 type) epidemic in 1957, a new epidemic of influenza caused by a new type A virus (Hong Kong type) with special antigenic structure unlike the previous A2 type broke out here in July 1968. During this outbreak of Hong Kong influenza, the authors selected an area which had not been invaded by the first wave and inoculated a population with a vaccine containing A2 Hong Kong virus strain and a control group with a placebo to await the arrival of the Hong Kong influenza, During the second wave of the epidemic of Hong Kong influenza in this country, the same infection appeared in this area, so that it became possible to study the effect of the vaccine from the viewpoint of incidence and serological responses. The following results were obtained. The epidemic of Hong Kong influenza was seen in this area from December 1969 to January 1970. This corresponded to one after vaccine inoculation. The maximum effect of the vaccine was expected to be obtained around this time . In view of the rather short duration of the immunicty after inoculation of this vaccine, it is dangerous to assume an overall effect based on these values. However, the frequency of appearance of symptoms of a common cold was significantly higher in the controls than in the inoculated group. Influenza-like illness occurred 4 times more frequently in the controls than in the inoculated group, definitely indicating a protective effect of the present vaccine. Based on these facts, the present commercial vaccine appears to be of some significant preventive value if sufficient time elapses between vaccination and subsequent exposure to offending viruses. However, the effect of the present commercial vaccine appears to last only 3-4 months after inoculation. In the use of present vaccine, another inoculation towards the end of December or the beginning of January as a 3rd additional immunization is recommended, in order to prevent an epidemic from arising during November to May.
Through our experience of more than ten years, a curriculum of public health course for medical students has been confirmed to meet students' needs for learning intensive ideas of comprehensive medicine. Under a circumstance of increasing use of medical care in urbanizing communities, more attention should be paid toward organization of regional medical care systems, enhancement of administrative function in health programs, and establishment of health care activities for individuals and small groups like families, schools and occupational groups. Social role of physicians in these fields should also be emphasized. Students' group works with seminars are expected to supplement lectures.