(CNN) An incident involving a medical emergency in a sumo ring is rocking Japan, the latest blow to hit the ancient sport in recent months.
The Japan Sumo Association was forced to apologize after female medics were told to leave a dohyo, or sumo wrestling ring, where they were giving treatment to a stricken local official.
Maizuru city Mayor Ryozo Tatami, 66, was delivering a speech in a gym near Kyoto during a sumo tournament Wednesday when he suddenly collapsed in the ring, the mayor's office said.
Several women rushed to treat him, but the referee repeatedly asked them to leave the ring, which they did.
In the sumo tradition, women are never allowed in the dohyo. Japan's first female governor, Fusae Ota of Osaka, tried and failed to convince the Japan Sumo Association to let her in the ring to crown the winner of a tournament in 2000.
A video of the latest incident has attracted more than 1 million views on YouTube and caused a backlash when it aired on Japan's TV talk shows.
On Twitter, observers criticized the referee for appearing to prioritize tradition when someone's life was potentially at stake.
"An unbelievable remark at (an) every-second-counts situation," tweeted one user. Another said the episode would harm the image of sumo wrestling.
A spokesperson for the city of Maizuru told CNN that the mayor was carried to a hospital and diagnosed as having suffered a stroke, but his condition is said not to be life-threatening.
"We really appreciate the women who provided the first aid. We don't know who they were, but would like to thank them directly," the spokesperson said.
After the incident, the Japan Sumo Association issued a statement apologizing for the referee's actions.
"During their treatment, the referee made announcement several times saying, 'Could woman please step out from the ring.' He called [them] out while he was upset, but it was an inappropriate response in a life-threatening situation," said the statement, attributed to the association's chairman, known as Hakkaku.
Sumo is an ancient and traditional sport with a rigid ceremony that has remained largely unchanged for centuries, though viewership has declined in the past two decades.
In recent months a series of scandals have tarnished the sport's reputation. A former yokozuna, the top rank in sumo, was forced to retire in December after accusations that he assaulted a younger wrestler.