HISTORY OF MEDICINE AND CHANGES IN CONCEPT OF DIABETES-MELLITUS IN JAPAN

In Japan, diabetes mellitus was called 'Shoukachi', thirst disease, be fore the 18th century. Western medicine was first introduced by the Po rtuguese in the 16th century. During the period of National Isolation from the 16th to the middle of the 19th century, Nagasaki served as th e sole window of Japan, through which Dutch medicine came into Japan. After the Meiji Reform in the 19th century, German medicine was active ly introduced. There remains a record of a lecture by Prof. Aoyama on diabetes mellitus delivered in 1906, in which the restriction of carbo hydrate intake and a meat-rich diet was recommended. Prof. Sakaguchi, the successor of Prof. Aoyama and a pioneer of diabetes research in Ja pan, studied blood sugar profiles in healthy and diabetic subjects and invented a rice-meal test to examine glucose tolerance. In 1928, he w rote 'diabetes occurs by the deficiency of insulin, genetic factors ar e important, and the bodily need for insulin is increased with obesity '. He and his colleagues found that too low an intake of carbohydrate may impair glucose tolerance. After the 2nd World War, Japanese doctor s eagerly learned foreign medicine, especially from the United States, Since the 1940s, a new concept has arisen in which diabetes was defin ed by blood glucose values after glucose loading. But, in 1970, a Comm ittee of the Japan Diabetes Society (JDS) expressed an opinion that di abetes should not be solely defined by the results of the glucose tole rance test but should be considered as a disease or diseases with char acteristic metabolic and clinical features, based on deficient insulin action. This concept of diabetes was accepted also by the second JDS Committee on the diagnosis of diabetes in 1982.