GENERAL HEADQUARTERS
SUPREME COMMANDER FOR THE ALLIED POWERS

APO 500
13 December 1948

AG 701 (23 Aug 48) PH
(SCAPIN - 1949)

MEMORANDUM FOR	JAPANESE GOVERNMENT.
SUBJECT	Responsibilities of Japanese Government Relative to Physical Examination, Immunization. Medical Care, Hospitalization and Other Benefits for Japanese Nationals Employed for the Occupation Forces.

1. Reference is made to:
a. Memorandum to Japanese Government, file AG 710 (22 Sep 45) MG, SCAPIN 48 dated 22 September 1945, subject: Public Health Measures.
b. Memorandum to Japanese Government, PHMJG-5, dated 16 December 1946, subject: Responsibility for Medical Care, Hospitalization and Disability Benefits for Japanese Nationals on Duty with the Occupation Forces.
c. Memorandum to the Ministry of Welfare, Japanese Government, PHMJG-15, dated 18 March 1947, subject: Physical Examination, Immunization and Medical Care of Japanese Nationals Employed for Occupation Forces.
d. Memorandum to Ministry of Welfare, Japanese Government, PHMJG-35 dated 5 August 1947, subject: Clarification and Interpretation of PHMJG-15.
e. Memorandum for Japanese Government AG 400.12 (31 Mar 48) CE-GD, SCAPIN 1872, subject: Expenditure from Funds Appropriated for Occupation Force Requirements.
2. References as indicated under 1b and 1c and 1d above are hereby rescinded.
3. The cost of medical care requirements to be met by the Japanese Government as the employer under applicable Japanese Law with regard to Japanese Nationals employed for the Occupation Forces may be charged to Termination of War Funds subject to the provisions of SCAPIN 1872 referred to in le above.
4. SCAPIN 1872 requires that no expenditures be made from funds appropriated for Occupation Force requirements unless fully covered by authorized procurement instruments and receipts Compensation for injury and/or death incurred in line of duty and contributions to various forms of health insurance for the employee are obligations of the Japanese Government as employer. The procurement instrument under which the individual is employed is, therefore, adequate authority for payment of such obligations where performance of the requirements of that instrument have been properly receipted. Such expenditures may be charged to funds appropriated for payment of labor directly employed for Occupation Forces.
5. In those cases where provisions of the law do not specify the method nor extent of medical care to be provided the employee, any requirement for such care, or service in connection therewith, which is above the minimum required by law, must be covered by separate and specific procurement instrument and receipt. The construction, equipping, operation and maintenance at government expense of any facility to be used exclusively for administration of medical care, treatment, or service to Japanese Nationals employed for the Occupation Forces can be accomplished only by issuance of appropriate procurement instrument and receipt. The part time or non-exclusive use by Occupation Forces' agencies of facilities to provide certain medical services such as physical examination, inoculations, etc., will be procured and receipted for on a service basis.
6. The Preventive Vaccination Law, the Food Sanitation Act, the Venereal Disease Prevention Law, and the Tuberculosis Preventive Law provide protection and medical care to the Japanese people generally. The cost of such services provided Japanese Nationals employed for the Occupation Forces will be borne as stated in these laws. Since Termination of War Funds will not be involved, no procurement instrument will be issued for such services.
7. If any expenditure from funds appropriated for support of the Occupation Forces is required in connection with the responsibilities of the Japanese Government as the employer under applicable Japanese Law, and as specifically stated in paragraphs 3 and 5 above, procurement instruments and receipts must be issued to cover such expenditures. The application of this procedure will include, but may not be limited to, the following requirements with regard to physical examination, immunization, and the control of communicable diseases:
a. Persons Involved:
(1) Food handlers and domestic employees, such as cooks, waiters, waitresses, kitchen employees, maids, houseboys, etc.
(2) Office workers, such as clerks, typists, interpreters, translators, receptionists, etc., including elevator operators.
(3) Others: This includes drivers, mechanics, stevedores, custodian employees of office buildings and other laborers.
b. Nature of Physical Examination: The physical examination will ordinarily consist of a thorough physical inspection for the presence of communicable diseases (skin, eyes, nose, mouth and throat), plus such laboratory procedures as may hereinafter be specified. More detailed physical examinations together with complete history and applicable laboratory procedures will be made when deemed desirable or necessary in the opinion of the examining physician. Examination of female genitalia will not be performed except when properly indicated by history or otherwise considered necessary by the examining physician.
c. Initial Physical Examination. Prospective employees prior to employment or assignment to duty will be examined as follows:
(1) Personnel listed under paragraph 7 a (1) above.
(a) Physical inspection.
(b) Chest x-ray.
(c) Serological test for syphilis.
(d) Stool examination (microscopic).
(e) Stool culture,
(2) Personnel listed under paragraph 7 a (2).
(a) Physical inspection.
(b) Chest x-ray.
(c) Serological test for syphilis.
(3) Personnel listed under paragraph 7 a (3) above.
(a) Physical inspection.
d. Follow-up Physical Examination. During the course of employment employees will be re-examined as follows:
(1) Food handlers in hospitals and billet messes will receive a physical inspection, stool examination and stool culture monthly.
(2) Other food handlers listed under paragraph 7 a (l) will be re-examined similarly every three months.
(3) X-ray of the chest and serological test for syphilis will be repeated as indicated for cause.
e. X-ray of the Chest.
(1) X-ray of the chest will be made as directed in paragraph 7c at the time of employment of all personnel listed in paragraphs 7 a (1) and 7 a (2) and may be made of other employees or may be repeated whenever indicated for cause.
(2) 35 mm film "indirect examination" will be considered acceptable for screening purposes. Full size "direct" chest plate will be made whenever indicated by positive, doubtful or suspicious findings on smaller film.
f. Serological test for syphilis.
(1) Serological test for syphilis will be made as directed in paragraph 7c at the time of employment of all persons listed under paragraph 7 a (1) and 7 a (2) and may be made of other employees or may be repeated whenever indicated for cause.
(2) The Murate or the Ide Test will be considered acceptable for screening purposes. Positive or suspicious findings will be carefully checked. When facilities are available for the performance the Kahn or Wasserman Test will be used for this purpose.
(3) A single positive serological test for syphilis will not be interpreted as a diagnosis of syphilis. Any person on whom such a positive finding is made will be studied carefully and a proper diagnosis made on the basis of history and physical examination as well as repeated serological tests. A determination of the state of infectivity or absence thereof will be made at the same time.
g. Immunization. A certificate of successful vaccination against smallpox within three years will be required of each employee.
h. Records:
(1) Permanent clinical records of all examinations and immunizations performed will be maintained in connection with the employment records. These records will include all pertinent findings and diagnoses as well as a record of treatment when treatment is indicated. These records will be available for inspection by authorized Allied and Japanese Officials.
(2) The applicant, when found physically qualified for employment, will be given a health card on which card will be recorded the following:
(a) Name, address and other suitable identification of the employee.
(b) Immunization Record.
(c) Date or dates of examination and signature of the examining physician.
(3) Under no circumstances will diagnosis, treatment, recommendations for change of employment, etc., be entered upon the health card and given to the employee.
(4) The health card will not be given to the employee unless or until physically qualified for employment. Whenever it is recommended that an employee be laid off during the course of treatment for a remedial defect, his health card will be withdrawn and kept with the clinical record at the place of treatment until such time as he is considered physically fit to return to duty.
1. Interpretation of Findings:
(1) Sound professional judgment must be used in interpreting results of physical examination and laboratory procedures and in making recommendations based thereon.
(2) Intestinal Parasites: Persons found to be infested with intestinal parasites will be given an adequate course of treatment according to applicable law and will be re-examined after completion of treatment to determine freedom from the parasite or organism involved.
(3) Tuberculosis: Any person on whom a diagnosis of active tuberculosis is made will be immediately relieved from duty and arrangements will be made promptly to place him under proper treatment.
(4) Venereal Diseases:
(a) Gonorrhea and Chancroid: Any person found to be suffering from gonorrhea and/or chancroid will immediately be placed under treatment according to the Venereal Disease Prevention Law and will not be issued a health card until found free of disease or diseases in question.
(b) Syphilis: Any person in whom a diagnosis of syphilis is definitely established should immediately be placed under treatment according to the Venereal Disease Prevention Law in the manner prescribed except when contra-indicated on medical grounds. In the case of new syphilis or in any other case in which the disease is in an infectious stage, the patient will be relieved from duty until the disease is no longer infectious. As long as the patient remains under treatment, he willnot be discharged for the reason of the disease alone. The record of treatment will be dated and initialed by the treating physician or authorized ad inistrative official of the clinic at the time of each treatment.
(5) Other Communicable Diseases. Any employee found to be suffering from or found to be a carrier of a reportable communicable disease will be immediately relieved from duty and placed under proper treatment under applicable law until free from the disease and/or until the probability of communicating the disease has passed.

FOR THE SUPREME COMMANDER:

R.M. LEVY,
Colonel, AGD,
Adjutant General.