"Spreading Knowledge in order to Nip Illness in the Bud, and an Idea of "Mibyo" (or Pre-Symptomatic State)."

  The Japan Pre-Symptomatic Medical System Society
Dr. Yoshihiro Fukuo

The medical cost of the whole Japanese nation is icreasing year on year. With the arrival of a more aged society, this trend is escalating further. In the age as such, the question arises of whether or not the insurance system covering the entire Japanese, which was established in 1961, still works. In order to achieve a smooth transfer of this system into the next century, a proposal to set up a new system was made from the medical community itself. In response to this trend, an association by the name of The Japan Pre-Symptomatic Medical System Society, was established four years ago. We carried out an interview with Dr. Yoshihiro Fukuo, managing director of the association, asking him about expectations of functional food.
――Please tell us the meaning of "mibyo" which you have proposed.

Maintain and extend the state of "mibyo" (or pre-symptomatic state) for a certain length of time so as to cut the national cost of medical care.

Fukuo: "Mibyo" means the condition in which an illness has not yet manifested itself. To be more specific, when a person does not experience subjective symptoms of a disease but an anomaly is nevertheless found when medical examinations are carried out. If the abnormality were to be left as is, it would inevitably develop into an illness later. The word "mibyo" or "pre-symptomatic state" in English, describes such a situation. There is a book entitled "The Yellow Emperor's Classic of Internal Medicine" that explains the nature and principles of all creation including medicine and science, which was written almost 20 centuries ago in the Han Dynasty in ancient China. In that book can be found descriptions of "Joi," "Chui" and "Gei." The last one of these stands for doctors who treat those who are already ill, and the first one means those who can treat people even in the pre-symptmatic stages. In China, the concept of the pre-symptomatic condition has developed such that medicine and a person's daily food are considered equally important in making a sick body well again.

Now, Japan has entered the era of an aging society with a declining birth rate. Old bedridden people would increase further in number if the situation were left as it is, and that would clearly lead to a failure in the area of medical expenses. Some doctors including myself believed that coexistence of medical treatment and economics would be important in the future, establishing a "Tokyo Mibyo (Pre-Symptomatic) Association"; the origin of the society four years ago was as a place where researchers in economics and those in medicine could get together in order to study the symbiosis of the two elements.

We proposed to extend the period of the pre-symptomatic state, or a condition between health and disease, longer so as to reduce the number who were confined to bed. Once a person became sick, his productivity would fall. But, if he is in the pre-symptomatic state, he is still in a condition where he continues to be productive, even though medical expenses might be required. It is vital to extend such a situation as long as possible from the aspect of medical economics as well.

――How do you define the scope of the pre-symptomatic state?

There is a basic idea of symbiosis, that men live together with diseases.

Fukuo: The pre-symptomatic state includes hypertension, hyperlipaemia, diabetes, obesity, arteriosclerosis, osteoporosis, anaemia, and so on. HIV positivity is also included. So its scope is very broad. Furthermore, the pre-symptomatic state has an aspect that differntiates it from preventive medicine. Infectious diseases belong to the category of preventive medicine. But the pre-symptomatic state has a wider reach. There is a notion of 'let's go along with sickness', in other words, there are at bottom thoughts of coexistence with it. There is such a concept behind it that, if a person does not manifest illness, that would be enough.

Once a person got sick, it is hard for him. But, that also creates difficulties for those around him. So, it is necessary to have a check-up examination in order to identify illness within his body, and have such abnormality treated as early as possible. It would be fundamental to improve living habit or use health food in order to rectify such problems. It is essential for everyone to act as a doctor, caring for the pre-symptomatic themselves, to understand the mechanism and structure of a human body, and to know about their own nutritional state. It is important to raise the level of people's awareness in this way.

――Could you explain the relation between immune power and the pre-symptomatic state?

There is a notion to enhance the immune power so as to not allow illness to manifest itself, even if you were infected by some virus, and then to live out your natural life.

Fukuo: Taking as an example, an HIV positive individual or a carrier of type B hepatitis can be categorized as being in the pre-symptomatic state. If, with an immunomodulator, such a person does not develop the illness, and can spend an ordinary life, that is sufficient and will do. So an immunomodulator could be defined as a drug which drives towards the pre- symptomatic state. Given a person who came to have HIV, it is enough if he could live out his allotted span, maintaining the pre-symptomatic situation without developing the disease. When preparing a medicine, let's do so taking such ideas into consideration. This is the point of our idea.

Is it necessary for doctors themselves to study more about health foods for the sake of their patients?

Fukuo: I believe that the need for health foods will increase in the future, for use as a countermeasure against life-style related diseases, as defined by the Ministry of Health and Welfare. But it is a mixture of wheat and tares. To add more words, one problem is that doctors themselves do not have an accurate knowledge of such foods. I have recently been asked various questions by my patients about health foods. But nothing is taught about it in faculties of medicine in the universities, so physicians themselves do not have a good knowledge of it either. Hence a gap develops between doctors' notions and what is really going on. This does not help anything at all. I think that physicians have to study health food more. If ordinary people are knowledgeable about it, it is crucial for doctors to know more about it than them. Based on this thought, we considered that physicians should be required to have an opportunity to study it, and we are planning to have a symposium in Hiroshima, Japan, next year.

Now, functional foods draw the attention of many people. Each individual makes an effort to be a doctor leading his body into the pre-symptomatic state on his own, so as to know the real condition of his body. Then he will have understanding of the kind of food he has to take in order to change his condition. Thus, he carries out his own health management. I think it is important that everyone would be able to conduct themselves like this.

◆Profile Dr. Fukuo

After graduating from Nippon Medical School in 1972, he joined the Second Internal Medicine department of the school, then taking a doctoral degree in microbiology and immunology in 1978. Since 1990 until now, he has had the position of Assistant Professor of Second Internal Medicine of the school. He has carried out basic research into the relation between the immune system and arteriosclerosis, with the main emphasis being on clinical studies of arteriosclerosis and hyperlipaemia, and cell biology. His article entitled "Ishi No Me, Hito No Me, Mibyoi Shugyo" ("Eyes of a doctor, eyes of an ordinary person, who has been practising pre-symptomatic medicine" in English) appears serially as a special limited article published by Kyodo News, a news distribution and publishing company. He has written many books, including "Karada No Wakaru Hon" and "Men'eki Kara Mita Domyakukoka" (translated as "A book plainly illustrating a human body" and "Arteriosclerosis studies from the viewpoint of the immune system", respectively).

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