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PubMed2001

[New studies on the history of anesthesiology--(7). What anesthetics were given to soldiers of the fifth regiment rescued from death march on Mount Hakkoda?].

Two hundred and ten soldiers belonging to the fifth regiment of the Japanese Imperial Army started their march on Mount Hakkoda in the early morning of January 23rd, 1902. In the afternoon, they unfortunately met with a bad weather of violent gale, heavy snowfall and biting coldness to lose their way to proceed to a small village Tashiro. In the following several days, many soldiers were frozen to death and only seventeen were rescued. They were brought to the Aomori Military Hospital for admission. Among them the First Lieutenant Kuraishi and two officers were almost free from frost bite but the Major Yamaguchi died next day and a soldier died two days after his admission without any surgical treatment. The remaining eleven underwent amputation of their frostbitten extremities under general anesthesia by open drop method with a mixture of chloroform and ether, because chloroform anesthesia per se was considered much more injurious than ether to patients with poor physical status. The Military Hospital announced that the Major Yamaguchi had died due to sudden cardiac arrest, but a lay view that he had committed suicide with his gun has widely prevailed, particularly since Jiro Nitta, a novelist, referred to it in his novel "Death March on Mount Hakkoda" in 1971. According to newly discovered manuscripts written by a military surgeon Ki-ichi Murakami who served in the rescue services, both hands of the Major Yamaguchi were heavily frostbitten and his fingers were strongly flexed unable to move the trigger of his gun. Considering situations including the dates of Sadae Nakahara's visit to Aomori who was a military surgeon of the Yamagata Military Hospital, the mysterious content of a telegram to Gentaro Kodama, the War Minister, from the General Shobun Tachimi, the 8th division commander and the sudden closure of the Hospital on February 2nd, when the Major Yamaguchi died, there is a possibility that high concentrations of chloroform vapour might have been compulsorily administered to the Major Yamaguchi to cause him cardiac arrest, which the executive members of the Japanese Imperial Army would have secretly expected.

Anesthesia, General↗
PubMed2001

[The skin, cold and winter sports].

Winter sports are responsible for various dermatoses which could be often avoided by simple preventive procedures. Both the severity and duration of cold exposure combined with wind speed, altitude and environmental hygrometric value govern the potential types of cold injuries.

Cold Temperature↗
PubMed1993

[Medical aspect of the winter march of the Fifth Regiment of the Eighth Military Division in the winter of 1902 - particularly concerning the cause of Major Yamaguchi's death].

Two hundred and ten military soldiers of the Fifth Regiment of the Eighth Division of the Japan Imperial Army joined a marching practice in the end of January, 1902, but 193 soldiers out of 210 died due to severe frost-bite during stormy weather and only seventeen, including Major Yamaguchi, were rescued to survive and brought to the Veteran's Administration Hospital at Aomori. This accident was most tragic and world-shaking for the Japanese people as well as for the Japanese Imperial Army. In December of 1991, an admission record of the Veteran's Administration Hospital at Aomori was found in the residence of Dr. Murakami of Aomori City. Judging from its handwriting, this record was written by a military physician Ki-ichi Murakami, Dr. Murakami's uncle. The record describes the details of seventeen patients, most of whom were severely injured and frost-bitten during the winter march. The content of this newly discovered record is similar to the report written by the military physicians of the Fifth Regiment which appeared in the Japan Imperial Military Medical Journal, but a more detailed description about Major Yamaguchi's vital signs, and symptoms of his frost-bite were found in the former. In the journal, Major Yamaguchi was reported to have died because of sudden cardiac arrest but Jiro Nitta described in his novel "Death March on Mount Hakkoda" that he committed suicide using his gun. However, this record strongly tells us that both of his hands, as well as both lower extremities, were severely frost-bitten and swollen and that he could not pull the trigger of his gun with his fingers. Since Jiro Nitta's novel has been published, it is widely accepted that Major Yamaguchi committed suicide with his gun. But we do not have any definite proof to substantiate his suicide. The present detailed survey on the medical references strongly suggests that he could not have pulled his gun's trigger by himself.

Frostbite↗
PubMed2000

[Occurrence and control of frost in Tilia amurensis and Fraxinus mandshurica young plantations].

The changes of minimum temperature periodical biological phenomena and frost in yound Tilia amurensis and Fraxinus mandshurica plantation stands were systematically analyzed based on the vertical gradient observation and plot investigation. Meanwhile, the resistance of Tilia amurensis to late frost was also studied. The results showed that the phenophase of T. amurensis was later than that of F. mandshurica. Influenced by significant temperature inversions in this area, the phenophase of T. amurensis and F. mandshurica changed regularly in different aspects and slope positions. The sprouts on west slope started earlier than that on east slope. The higher they grew on the slope, the earlier they sprouted, with the earliest sprout at the top of slope. Late frost in this area only took place when the trees were sprouting, but air temperature decreased significantly at the same time. The degree of injury from the late frost could be controlled effectively by selecting suitable site. Sites down the slope, especially the east slope, were not suitable for T. amurensis and F. mandshurica plantation in this research area. Chemical treatment and biological shading could prevent late frost injury through putting off sprout. Mixed plantations could prevent F. mandshurica and T. anurensis from late frost injury significantly, and the frost injury index and the proportion of the tree number of different injury grades were lower than those in pure stands.

Climate↗
PubMed2001

Pathophysiology of cold exposure.

The change in core temperature that occurs as a result of exposure to cold air or water affects all body systems. A decrease in core temperature induces shivering, then muscle stiffness; depresses the central nervous and respiratory systems; triggers cardiac arrhythmias and vasoconstriction; and affects body [figure: see text] fluid balance. Cold water immersion presents additional considerations, including the general shock effect on the cardiac and respiratory systems and the triggering of the diving reflex when the entire body is immersed. Basic education and precautions can prevent most cases [figure: see text] of accidental hypothermia; but when they do occur, treatment should include controlled rewarming, especially if the core temperature is below 32 degrees C.

Body Temperature Regulation↗
PubMed2001

Changing pattern of major lower limb amputations in Seinäjoki Central Hospital 1997-2000.

BACKGROUND AND AIMS: There is rather limited recent information on major amputations in Finland. Our objective was to describe the incidence of major lower limb amputations in a defined central hospital, the demographic characteristics of the amputees, diagnosis and situations leading to amputation, level of amputations and survival of the amputees after one year. MATERIAL AND METHODS: A retrospective study was undertaken on 156 patients with 169 lower limb major amputations from 1997 to 2000 at the Seinäjoki Central Hospital and Ahtäri District Hospital. RESULTS: The annual incidence of major amputations reduced from 29.5 to 15.2/100000 inhabitants. The mean age of the patients was 78.5 years but highest 80.1 in the year 2000. The reason for major amputation was chronic critical leg ischaemia with or without diabetes mellitus in 79.1% and acute ischaemia in 13.9%. The average below-knee (BK)/above-knee (AK) amputation ratio was 0.80 during the years 1997-1999 and the ratio was lowest 0.67 in year 2000. At the same year 2000 the amount of patients, whose condition was too poor for reconstructive surgery, was significantly higher than in 1997-1999. CONCLUSIONS: We suggest that BK/AK amputation ratio is decreasing in the future as the amputees tend more often to be institutionalized and immobile, and reconstruction is not an alternative and BK amputation is impossible or useless.

Age Distribution↗
PubMed1976

Cold injuries.

The management of patients with cold injuries of the hands may be extremely simple or relatively complex. The extent of the injury and the systemic response to the cold are the major influencing factors. In patients with extensive cold injuries, where all or a large portion of more than one extremity is cold or frozen and there has been a significant systemic response, treatment should be both systemic and local. Treatment should be directed toward both the preservation of tissue and maintenance of function of the damaged part. Minimal daily débridement and late amputation are important guidelines for care.

Critical Care↗
PubMed2003

Winter woes.

Explore the source record for details and available documents.

Cold Temperature↗