“We can see a very ancient flame dying out before our eyes,” Ms. Himukai said in a separate interview. “But traditions have to change with the times.”

Junichi Tonosaki, a historian in the prefectural museum in Aomori, where Mount Osore is located, said the number of itako had fallen from about 20 a decade ago. He said they began gathering at Mount Osore in the last century as their numbers began to dwindle, to make it easier for customers to find them. The volcano’s 1,200-year-old temple is believed by many here to be a gathering point for souls of the dead before Buddhist reincarnation.

Mr. Tonosaki and other historians say itako and other shamanistic mediums were common across Japan in medieval times, when this was often the only occupation available for the blind. But they were suppressed in the late 19th century, as Japan built a modern nation. In recent times, they have survived only on the geographic margins, in rural northern Japan and on the southern island of Okinawa.

Shojiro Kurokawa, 82, can remember as a child in the 1930s when residents of his and other nearby villages would trek to the temple to hold weeklong festivals of all-night dancing, singing and séances. In those days, he said, there were more than 100 itako.

“This is an era when children ignore their parents and forget about the dead,” said Mr. Kurokawa, who runs an inn near the temple that caters to visitors of the spiritual mediums.

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Now, there are so few itako that visitors routinely wait in line for several hours to see one. Itako charge 3,000 yen, or about $30, for each spirit called in a roughly 10-minute ceremony.

One family of three came from Tokyo, a day’s drive away. Masako Toyama, 68, said she came to speak with her husband, who died suddenly last summer of cancer. She, her son and his wife said it was their first visit to Mount Osore. She said she knew of the itako from growing up in northern Japan.

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“They were a scary but also soothing presence,” Ms. Toyama said. “Japanese still need this sort of emotional support.”

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“I wanted to give the itako a try, to see if this is real,” said the son, Shinji Toyama, a 41-year-old salaryman at a medical testing firm.

When the Toyamas’ turn finally came after six and a half hours of waiting, they seemed almost taken aback by the itako’s modern appearance, in pink-tinted glasses and a flower-patterned shirt.

The itako, Setsu Aoyama, began by lifting a long strand of dark beads and began a short chant: “I call the spirit who died on July 11,” the date Ms. Toyama’s husband, Shigeto, died.

In the same rhythmic cadence, swaying her head with eyes shut, she assumed the voice of Shigeto. “I didn’t go to a doctor soon enough,” she intoned. “Men don’t listen to things like that.”

Ms. Himukai, the 40-year-old itako, says she enters a trance in which she feels the presence of the spirit and its mood, which she expresses in her own words. She said she decided to begin the three-year period of study to become a spiritual medium as a teenager, after an itako near her rural village cured her of an ailment that doctors could not fix.

She said she felt guilty about not going to Mount Osore. However, she said she may no longer be able to attend because of health problems, including a chronic stomach ailment. Instead, she said she wanted to write a book or make a movie about the itako.

“The end can also be the beginning of something new,” said Ms. Himukai, who wore a plain gray suit with pants and spoke in a whisper.

After the ceremony, the Toyamas had mixed reactions. The widow said her heart had been put at ease. But the younger generation was less convinced.

“I didn’t feel like it was really my father in front of me,” said Shinji, the son. But he said he wanted to come again next year, to try a different itako. “Maybe we just had beginner’s bad luck by choosing the wrong one.”