Masazumi Harada has said that, "It may sound strange, but if this second Minamata disease had not broken out, the medical and social progress achieved by now in Kumamoto... would have been impossible. "Around this time, two other pollution-related diseases were also grabbing headlines in Japan. People with Yokkaichi asthma and itai-itai disease were forming citizens groups and filed lawsuits against the polluting companies in September 1967 and March 1968, respectively. As a group, these diseases came to be known as the four big pollution diseases of Japan.Slowly but surely, the mood in Minamata and Japan as a whole was shifting. Minamata patients found the public gradually becoming more receptive and sympathetic as the decade wore on. This culminated in 1968 with the establishment in Minamata of the Citizens Council for Minamata Disease Countermeasures, which was to become the chief citizens support group to the Minamata patients. A founding member of the citizens council was Michiko Ishimure, a local housewife and poet who later that year published Pure Land, Poisoned Sea: Our Minamata disease, a book of poetic essays that received national acclaim. 1969–1973
Official government recognition
Finally on 26 September 1968 – twelve years after the discovery of the disease (and four months after Chisso had stopped production of acetaldehyde using its mercury catalyst) – the Japanese government issued an official conclusion as to the cause of Minamata disease:

Minamata disease is a disease of the central nervous system, a poisoning caused by long-term consumption, in large amounts, of fish and shellfish from Minamata Bay.
The city was even dubbed Chissos "castle town," in reference to the capital cities of feudal lords who ruled Japan during the Edo period.The Chisso factory first started acetaldehyde production in 1932, with 210 tons that year. In 1951, production had jumped to 6,000 tons and eventually peaked at 45,245 tons in 1960. The factorys output historically amounted to between a quarter and a third of Japans total acetaldehyde production. The chemical reaction used to produce the acetaldehyde employed mercury sulfate as a catalyst. Starting in August 1951, the co-catalyst was changed from manganese dioxide to ferric sulfide. A side reaction of this catalytic cycle led to the production of a small amount (about 5% of the outflow) of the organic mercury compound methylmercury. As a result of the catalyst change, this highly toxic compound was released into Minamata Bay regularly between 1951 and 1968, when this production method was finally discontinued. 1956–1959
On 21 April 1956, a five-year-old girl was examined at Chissos factory hospital in Minamata. The physicians were puzzled by her symptoms: difficulty walking, difficulty speaking, and convulsions. Two days later, her younger sister also began to exhibit the same symptoms and she, too, was hospitalised. The girls mother informed doctors that her neighbours daughter was also experiencing similar problems. After a house-to-house investigation, eight further patients were discovered and hospitalised.