Biogenesis (8 page)

There is a condition known as hypothermia. The term comes from the Greek for “low body temperature” and usually signifies a pathological state where a loss of body temperature can end in freezing to death. It also, however, refers to rare instances where the patient’s metabolism stabilizes at a lower body temperature. “Idiopathic hypothermia” has been reported only sporadically worldwide, and an accurate portrait of the condition does not exist at the moment. Although the prevailing view is that the decreased metabolism leads to a longer lifespan, there is a high incidence of death from accompanying illnesses, and unlike with “idiopathic hyperthermia,” which has been shown to have no bearing on lifespans, as of yet no statistical data on the average convalescent is available. The catchall term “idiopathic” actually encompasses various pathological conditions that have been proposed, from genetic factors, mutations in the temperature-regulating abilities of the brain, and hormonal imbalances, to the production of chemical substances usually associated with hibernation. There are very few individual cases where a specific cause has been identified, and it is said that the condition may in fact be a conglomeration of several. Furthermore, there are cases where pigment production is affected, as it is in albinism, and research is currently underway to determine their connection.

Vogt-Koyanagi-Harada Syndrome and Takayasu Disease are among the relatively small number of illnesses discovered by Japanese, some of which, however, are considered to be medically significant. While not known as such among medical professionals, since it was not named after the person who discovered it unlike the preceding examples, it was a young Japanese doctor who made the earliest
known report worldwide of “idiopathic hypothermia.” An Internet MEDLINE search of the phrase will display the Japanese author name H. Yuhki. This refers to one Koho Yuhki (“Koho” being an alternative reading of “Hironori”), an army doctor who had been assigned to the Ashibetsu-Shinjo Clinic in Hokkaido in the mid 1920s. He was the first person in the world to report, in an article published in the German medical journal
ARZT
, the symptoms of a woman whose standard body temperature was 82.4°F. Normally, at that temperature, the heartbeat becomes irregular then ceases altogether, and respiration stops completely as well; the report flaunted the conventional medical wisdom of the era. Immediately after its publication, Imperial University Professor Koin Aoyama and Nursing Institute Director Iwao Otsuki, along with many other doctors considered to be authorities, offered to examine and shed light on the condition, but refusing all such requests Yuhki attempted to treat the woman on his own at a small clinic.

The all-too-shocking content of Yuhki’s objective evaluation of the condition, which included the possibility of an extended lifespan due to lower metabolism and the presence of hibernation-related substances, elicited a negative reaction and the title of “fraud” for the army doctor, who was denied public funding and forced to finance the treatment out of his own pocket. Then, on February 22, 1927, only one year after the paper was published, the evening edition of the
Hokkaido Daily
reported Yuhki’s death, along with that of the woman, from unknown causes. The truth of the matter, which some deemed a lovers’ suicide, remained obscure, but on February 22, 1997—exactly seventy years after his death to the day, oddly enough—a massive number of military medical documents that had been sealed subsequent to World War II at the former Army Library (now the Korin Museum) were found, and Yuhki’s treatment logs and journal saw the light of day along with other documents such as the autopsy reports on the victims of the Mt. Hakkoda March. In addition to diary-like entries he must have written each day, glosses on parts that he considered important at a later date appear in the same journal, making
for a rather unbalanced whole, but the record goes into great detail regarding the events of that time and could almost be considered a type of prose. What is more, after years of abiding by Yuhki’s order to keep her mouth shut, Nurse Tae Sugita (who still resides in Shinjo) was prompted by the stunning revelations to break her silence at long last, thereby supplying numerous new facts that have reconfigured the truth of what happened. Sugita, whose father had served as military support staff, was only sixteen at the time and more of a nursing apprentice than a nurse, but having witnessed the events as the doctor’s close assistant, she was able to leave behind valuable testimony prior to her death earlier this year. The following account of the incident that occurred in Shinjo, Ashibetsu Village, Hokkaido Prefecture, in 1926 is based on Yuhki’s diagnostic charts and journal and Sugita’s testimony.

Dr. Koho Yuhki, aged thirty-seven, was assigned to Army 7th Division in Asahikawa on October 1, 1925. A clinic had opened in Shinjo, where training for winter marches took place, and he had been ordered to head it. His job description, according to the recently discovered commission papers, was simply, “special medical research in the north.” Shinjo, a mountainous area in the vicinity of the village of Ashibetsu, had once been home to a military logging site and doubled as a training facility for new recruits. By Surgeon General Soraji Ishiguro’s orders, Yuhki was to research clinical treatments for frostbite, at the time a nearly incurable malady for which hardly any measures had been established. Although development of the prevention and treatment of frostbite was a significant priority for troops to be dispatched to northern fronts such as Russia, it was a condition rarely seen on the mostly temperate main island of Honshu. There were few researchers, and the need to experience colder climes is thought to have ushered the decision to post Yuhki there.

Thanks to nearly daily examinations of frostbitten soldiers brought to the clinic, Yuhki produced a string of research results, including the
fact that rapid thawing in a 113°F bath was preferable over gradual thawing and massages in the field, which were anathema. In addition, upon puncturing the blisters, filled with cloudy liquid, he tried several traditional ointments, compared their effects, and even developed a special medicine of his own concoction that he named the “H-47” and that used a mold extract. Although these were medical facts, at the same time they were military secrets that Yuhki was strictly prohibited from publishing, and thus he was limited to reporting his progress to Ishiguro. For this reason Yuhki is not known for his work on frostbite, but it was revolutionary for its time, being half a step ahead of the intense research that Russia was conducting to counter freezing climes.

It was on the day the coldest temperature ever to be observed in Japan was recorded in nearby Asahikawa (February 22, 1926) that Mitsuo Gondo, a soldier charged with bringing in firewood to the barracks each day, discovered a woman in the woodshed, where apparently she had fallen into a coma after entering to rest awhile. He carried her into the clinic. The medical chart describes the woman who had been brought in as having white hair and a deathly pale complexion and even notes that her torso was showing signs of stiffness. Nurse Sugita recalled that when she held the woman’s arm to take her pulse, it felt so cold that she assumed for a moment that the woman must have already frozen to death. When Yuhki examined the patient, however, he found a slow pulse and confirmed slight movements of her chest and thereby respiration, upon which he immediately undertook attempts to revive her. According to the paper Yuhki later published in German, upon her arrival at the clinic the woman’s body temperature was 75.2°F, her pulse twenty beats per minute, and her respiration rate three breaths per minute.

Although her condition seemed relatively stable, actively warming her somehow resulted in a lower blood pressure, as Yuhki noted in the medical chart: “Blood pressure dipped upon warming, perhaps because capillaries, constricted under low temperature, responded to
heating with overcompensating expansion.”

If her blood vessels had contracted to maintain blood pressure after her heart rate had slowed, then, assuming that the warming had not restored cardiac activity, blood vessels expanding indeed meant less resistance and lower pressure. Observation at room temperature was the only possible treatment for such symptoms whether or not they owed to a unique metabolism, and Yuhki was reduced to adopting the gradual warming method that he held to be anathema for frostbite patients, though, to be fair, the conditions were not identical. It was a little over two days later that the woman regained consciousness without any perceptible change in her condition, and Yuhki was in for an even greater surprise. While her mind seemed clear, and her overall condition stable, her body temperature never rose above 86°F, and her pulse, though it fluctuated, never exceeded thirty beats per minute.

According to Sugita’s recollections, Yuki was roughly five feet in height, pale enough to appear anemic, and presumed to be young, on account of the white hair that fell straight to the small of her back, though her real age was unclear. Communicating with her was somewhat awkward, but she could speak normally, as well as read and write. She retained, however, nearly no memories regarding herself, including her name, where she had lived, and how she had come to Shinjo, and it was recorded that she was in “an advanced state of amnesia.” A check was made against current missing persons reports on file with the police, but no one matching her description was found. Apart from her low body temperature, her dislike of sunshine, and her predilection for drinking cold water, she did not exhibit any salient physical abnormalities. Judging from the charts, exams of her blood including the sedimentation rate did not show the decreased red blood cell counts indicative of anemia. Unfortunately, given the period’s medical standards, no additional biochemical tests were performed, as interesting as they would have been.

The woman was given the name Yuki Shinjo as a matter of
convenience. “Shinjo” was where she had been found, and the common female name “Yuki” sounded like her custodian’s, but this became her real name when a resident registration form was later created for her. Fascinated by her strange symptoms, Yuhki wrote a petition to his superior, Ishiguro, requesting that the government shoulder all treatment and living costs for her as a scientific patient for frostbite research. Perhaps Yuhki’s naming it “idiopathic hypothermia” helped establish a robust connection to frostbite in Ishiguro’s mind, and he accepted the petition without a hearing.

At the same time, however, “Admitting her to a proper hospital for academic research would seem appropriate,” the surgeon general made his intention known.

“Since her circulation worsened upon aggressive heating, a warmer climate risks damage to the patient’s health,” Yuhki responded, turning down the request. Perhaps his insistence on continuing in Shinjo simply betrayed an eagerness to analyze the mysterious condition unaided. A new bed was build at his clinic using the ample research funding that he had obtained, and treatment began of its sole inpatient, Yuki.

It may be that no military value was recognized after all since Ishiguro permitted Yuhki to publish, in the German medical journal
ARZT
, the first paper ever to describe the strange symptoms. Today it is still possible to read Yuhki’s article in the May 1926 edition of
ARZT
remaining on file in the National Library. The simple, half-page symptom report proposes a new illness by the name of “idiopathic hypothermia” primarily characterized by low body temperature and a reduced pulse, and, as far as the content goes, it is quite commendable. At that time there were few contributions being made to such journals by non-Western authors, and a paper from Japan, which was behind in such matters, was a rarity, so it is not hard to imagine how the achievement won Yuhki much praise. As a matter of fact, he is the only non-Western author in that issue of
ARZT
. Of course, this was an
article in an academic journal intended for a select group of researchers, and Yuki, the woman, only became widely known after a
Japan News
academics reporter who had learned of the case study reported a “Strange Illness of the North” in the human interest section. Even after articles about her appeared in newspapers with a national circulation, not a single relation or acquaintance came forward.