X. In search of the Minamata disease

In general, Minamata disease was characterized by symptoms typical of methyl mercury poisoning, and it was described and recognized in patients who developed these same severe symptoms between 1953 and 1960. The Kumamoto University Medical Department, which became the centre for examining patients, was, as such, under constant criticism from many parties that had a vested interest in opposing the university's organic mercury cause-and-effect theory. In order to protect themselves from excessive criticism of this sort, the medical department tended to designate patients as disease victims only if the patients exhibited the most classic symptoms of the disease, such as narrowing of the visual field, lack of motor co-ordination, and damage to the sensory nerves. In the case of the second Minamata disease in Niigata, careful epidemiological surveys were made of the disease and it was discovered that the disease symptoms varied to a great extent, depending on the severity of the poisoning. In spite of the fact that they knew full well that they were victims of the disease, many patients did not apply for recognition as official Minamata disease victims because of local community pressure or because of economic interactions and dependence on the fisheries industry. Furthermore, there were many people in the various communities around Minamata who were aware that their friends and neighbours unknowingly had the same symptoms as the recognized disease patients, but were not examined by the committee of doctors set up to designate disease victims. This committee was set up to decide who should receive sympathy money from the Chisso Company, and as a result was under pressure to make very careful screenings so as to limit the number of recipients. There was a rule maintained by the committee that any death from the disease should not be designated a disease-related death. Therefore the medical evaluations were cursory, with a resulting reduction in the number of patients that Chisso had to compensate. This helped to keep the company economically viable, for the entire Minamata community was dependent on it.

Teruo Kawamoto, a fisherman who lived in an area where there were many Minamata disease patients, decided to take not only his own case, but also that of his father who died in 1966, to the examination committee for designation as Minamata disease victims. He presented these cases to various medical institutions, and also to the Human Rights Protection Committee, but was always treated as one who was merely seeking an easy source of income. Not only was his own case rejected, but that of his father was determined non-admissible on the grounds that there was no way that a person already dead could be examined for a particular disease. On the basis of these experiences, he visited other people who complained of the same symptoms, and presented their cases also for designation as patients, but all these applications were rejected. He then learned that there were other avenues of appeal, and, with the support of the Minamata Disease Research Group, made a request to the Ministry of Public Welfare (later to become the Environment Agency) that the cancellation by the Kumamoto Prefecture committee of his application for designation as a disease patient be reversed. Kumamoto Prefecture responded to this initiative by indicating that medical diagnostic decisions, other than those provided through the prefectural committee, could not be accepted as a basis for patient designation. The Minamata Disease Research Group countered with detailed samples and analyses which proved beyond a shadow of reasonable doubt that the results of any thorough medical examination in the Kawamoto cases would provide a wholly adequate base for designation as Minamata disease victims. However, the symptoms of non-Minamata disease pathological processes were often used to mask the symptoms of pathologies caused by methyl mercury poisoning. For example, high blood pressure and diabetes were frequently designated as causes of patients' symptoms when in fact the cause was mercury poisoning.

However, in 1971, on the basis of evidence supplied by the Minamata Disease Research Group, the Environment Agency decided that patients should be designated victims of the Minamata Disease if the symptoms of organic mercury poisoning were present to any discernible degree. This governmental agency introduced changes in the patient examination ground rules and made official attitudes fairer, as contrasted to earlier procedures which had been unduly influenced by political pressures that had been brought to bear. An unavoidable change in the circumstances affecting the fated symbiotic relationship between the Chisso Company and the Minamata community then came about because the number of Minamata disease patients increased. All this was the result of the work of only 100 persons, but the news of the official change in the social and medical ground rules quickly spread across the nation. The most obvious factor was the management crisis that the Chisso Company would face if there were a great increase in the number of designated Minamata disease patients. Furthermore, the news of the Niigata disease victims' victory in the civil court increased the fear of economic instability among the citizens of Minamata City who were dependent on the Chisso Company. Re-examination of patients began, and victims who had once been rejected were able to get themselves designated as disease patients. But the Chisso Company still refused to enter into direct negotiations with the patients' organization, and continued to insist on the third-party method of interaction. The citizens of Minamata feared an increase in the number of designated patients, concerned that increased reparations would further compromise the economic viability of the company, thereby jeopardizing their own prospects for a viable economic future. These citizens brought pressure to bear on patients who were demanding adequate compensation. The majority of the people living in Minamata City were in favour of maintaining the viability of the company and thereby the general welfare of the city. Furthermore, many of the citizens feared that they might also be disease victims, and this fear provoked persecution of the minority Minamata disease patients' organization. This new patients' movement, which was basically in favour of direct negotiations with Chisso Company directors, found its own development greatly impeded by opposition from public opinion as well as by obstructionism from the company and city administration. Under this kind of pressure, some of the patients changed their minds and decided to co-operate with the third-party negotiations. As a result the disease victims were divided again into the previous "trust" and "lawsuit" factions.