SMON and other socially induced diseases in Japan

Abstract

This article is an analysis from two health sociological points of view, of a disease that occurs particularly in Japan called “SMON” (Subacute M yelo- O ptico N europathy). SMON is known- to be a disease caused by a particular kind of medicine called “chinoform” (clioquinol) which is prescribed by doctors to treat abdominal disorders. However for a long time, many people were afraid of SMON because the cause of this strange disease was not known and they also suspected infectious disease. Many patients suffered not only physical loss, but also economical, social and psychological damages. However, after August 1970, when a chinoform theory that this disease was caused by a particular kind of medicine became influential and was substantiated, a drastic change in the people's attitude took place. Thereafter the issue focused on the harmful effects of pharmaceuticals and the nation's medical system. The main focus of this article is patients' difficulties and damages caused by SMON, especially their economical, social and psychological conditions. Because SMON is a man-made disease, it is necessary to analyze not only the problems of the patients and the community but also the problems on the providers, namely the doctors who prescribed the medicine, the pharmaceutical companies that manufactured and marketed the medicine and also the administrative system that issued permission for marketing the medicine. Next, the social measures and counter-measures against these diseases in Japan are analyzed, particularly those cases in which the diseases resulted directly from social causes. The following topics are discussed in sequence: (1) the basis for measures taken against diseases, (2) problems of social aid and compensation, (3) certification of patients and diagnostic criteria, and (4) delay of aid and compensation and other factors. Social factors and conditions directly affect the outbreak and spread of not only SMON but also of other new types of diseases and injuries. Since social factors and social conditions cause ill health and because society is responsible for measures to maintain and improve health, as well as to provide health services and medical care, it is argued that recognition of these social factors is urgently required.