The Japanese Association of Rural Medicine (JARM) was established in 1952. In those years, the living standards of rural communities were poor, contagious diseases were prevalent and rural people fell with malnutrition. As the Japanese economy began to grow at a high pace in or around 1960, rural communities have drastically changed, enabling farmers to enjoy a better life. With farmers having access to jobs other than agriculture, their cash incomes increased, rural manpower drifted to cities, and the number of farming families has since been on the downswing. It is inconceivable that agriculture, which forms part of the primary industry, will die out, and authoritative sources agree that there will appear an international food crisis toward the 21st century.
When it comes to “agricultural medicine” in Japan, I must point out, more than anything else, that deaths in labor accidents become increasingly frequent. The safety measures are inadequate, so are the measures to compensate for labor accidents. In the ongoing development of agricultural technology, meanwhile, it is noted that there appear new types of health disorders and diseases. They include pesticide poisoning, greenhouse diseases, abortions caused by vibrating cultivators and pollinosis. The future question is to compensate for them as “agricultural diseases.” As regards “rural health, ” it must be pointed out that there are cases of family disruption and many cases with stress diseases in the midst of the ongoing trend in which farmers try to have access to better side jobs. The most crucial issue is the rapid pace at which aging is in progress in rural communities. How do we deliver care to bedridden old people and those with dementia? How to organize such community care? Those are questions we have yet to find solutions.
In the past, there were struggles against diseases caused by pollutants (such as Minamata Disease and Itai-Itai Disease). There will be the need for a positive campaign for the protection of water and green in the rural environment. Environmental issues have to be taken up in an international perspective. On the question developing countries is a major causative factor. We are no longer able to discuss about agricultural medicine and rural health without relevance to the developing world.

In second thoughts over the conventional method of farming with chemicals, premised on the massive use of pesticides and chemical fertilizer, organic farming, the necessity of which was advocated several years ago, is now in wide use across Japan. There are calls for checks into the effects of organic farming on man's health in a medical perspective.
Given those calls, I and colleagues of mine made studies, such as a fact-finding survey on the health status of people engaged in organic farming, a check into the effects of agricultural chemicals on human bodies and a series of animal tests which would be essential to the check.
On the basis of the findings, we assessed the way organic farming is today and discussed the necessity of pursuing organic farming. This issue may well be characterized as a pursuit of the way agriculture ought to be not only in Japan but elsewhere in the world in the future as well. It is not just a social issue for farm producers and consumers. It also constitutes a global environmental issue on soil and nature.
Though we have just taken the first step in striving to solve this question, we have taken to heart the importance evolving organic farming as a national movement along with the people.

Clinical cases of poisoning (hazard) from agricultural chemicals frequency have been reported since 1967.
The clinical cases of poisoning (hazard) decreased not always yearly. It seems that there were periods of organophosphorus (Parathion, EPN), of organic mercury and organochlorine (DDT, BHC, Endrin) in the poisoning (hazard) and environment pollution from agricultural chemicals. But, it is now a period of herbicide (Paraquat).
1) The clinical cases surveyed during this three years period totaled 326 cases, including 185 males and 141 females.
2) By age, the highest incidence was shared by people in their 50's.
3) By month, the incidence is the highest in July.
4) Nicotine sulfate and organophosphorus (Sumithion) shares the highest pacentage during pesticide spraying. But Paraquat (herbicide) shares the most highest percentage in suicides and attempted suicides. There were twenty-nine casces by paraquat among forty-one death cases during thrre years period.
5) According to the types of diseases, acute poisoning shared the highest portion with 58%, which is followed by dermatitis with 40%.

Statistical analyses were made on a total of 242 clinical cases of skin disordersfrom agricultural chemicals in Japanese farmers, using data recorded by physicians on standard forms in 41 hospitals and other medical institutions during the 1982-89 period. The majority of the cases were acute dermatitis (72.3%), followed by chronic dermatitis (19.0%), chemical burns (7.4%) and photosensitive dermatitis (2.1%). Organophosporus insecticides were the most frequent inducer of occupational skin lesions (24.8%), followed by sulfur fungicides (20.7%), polyhaloalkylthio-fungicides (16.1%), and soil disinfectants (7.9%). Main factors contributing to the onset of skin lesions were insufficient clothing on the part of users (46.7%), carelessness (21.9%), unsuitable weather (strong wind) (9.9%) and so forth. Epidemiological features such as sex, age, season, complications, affected sites and prognoses were also analyzed and discussed.

A total of 630 clinical cases of occupational skin disorder from agricultural chemicals werestatistically analyzed in Japanese farmers who were recorded by physicians on a standard form from41 hospitals and other medical institutions during the 1972-81 period. The majority of the cases wereacute dermatitis (66.7%). This was followed by chronic dermatitis (24.3%), chemical burns (8.4%) andphotosensitive dermatitis (2.2%). By type to chemicals, the number one skin hazard was sulfurfungicides (32.2%), followed by organophosphorus insecticides (28.6%), polyhaloalkylthio-fungicides (11.4%), and copper fungicides (7.1%). Factors contributing to the onset of any disorder of the skinwere mainly defenseless on the part of users (41.3%), carelessness (20.2%), poor health condition(14.6%), and so forth. Other epidemiological features by sex, age, season, complications, sites of skindisorder, prognosis, etc. were also analyzed and discussed.

1)We reproduced a problem–based learning (PBL) tutorial at our school and developed our own PBL tutorial, which we call "Fujita–style PBL." This is a clinical problem-solving type of PBL, in which both a monitoring room and small–group learning rooms are used.
2)To maintain the present number of PBL lessons despite the limited number of tutors, one tutor supervises several groups simultaneously. Coordinators observe the progress of PBL from a monitoring room and support the tutors.
3)Students learn the given scenario and identify their learning issues. After they study the learning issues by themselves, the students return to tutorials to explain their learning issues. Thereafter, each group's findings are presented to the groups supervised by one tutor.