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470of medication.Tanaka entrusted Juntendo to his pupil and adopted child, Doan Okamoto. He came to Tokyo, where he was appointed court physician to the emperor, and in 1871, became both the faculty and supervisor of Daigaku Toko. However, everything did not run smoothly because this was a period of great upheaval, and organizations were changed one after the other in a short period. Daigaku Toko also changed its name several times: Toko (1871), Igakusho (1872), Tokyo Igakusho (1874), and Faculty of Medicine, University of Tokyo (1877). The demands of the role constantly shifted, and Takanaka had to face many obstacles.Amid these difficulties, Takanaka struggled to spread the use of treatments based on Western medicine. At the time, Daigaku Toko had a 5-year course to train medical students and to educate them in foreign languages, and a 3-year course to train physicians using texts translated into Japa-nese. Takanaka preserved this system and made arrangements to train a large number of physi-cians. When German physicians in Japan reduced the numbers of students and removed short-term education courses, Takanaka protested in newspa-pers.Furthermore, in relation to the availability of medical treatment, Takanaka changed the name of the medical facilities affiliated with Toko from 病院 byouin to 医院 i’in in 1872. It is thought that he did this to suggest from the name that the institution was a facility, 院 in, to heal, 医 i, patients, rather than a facility for sick, 病 byou.In response to the fact that there were extremely small facilities providing treatment in Western medicine compared to the number of patients requiring treatment, Takanaka published a petition in 1872 to establish a private organization. This petition was accepted, and Hakuaisha Hospital was built. In the newspaper advertisement for this hospital, it was written that Hakuaisha was neither a hospital attached to a public institution of educa-tion nor a hospital affiliated with the military; rather, it was the first city hospital, and people suffering from illness were invited to receive treatment there. Further, Takanaka requested the Imperial Household Agency to donate funds to construct a large, 300-bed hospital of the Tokyo Prefectural government, that was established in 1873.Moreover, he believed that making healthcare provisions in Tokyo, wherein the population was rapidly increasing, was important, and therefore he himself opened a hospital named Juntendo; the facility in Sakura in the care of Doan Okamoto was then entrusted entirely to him. The Juntendo in Tokyo was built in 1873, which was near the Akihabara station now. It featured a large-scale (at the time) hospital with 50 beds. Japan’s first nursing specialist Kane Sugimoto, who had been overseeing nursing at the Toko’s hospital, moved to Juntendo in 1873 and took charge of the nursing program. Immediately after its opening, the number of patients visiting Juntendo rapidly increased, and although extra beds were added, this soon proved insufficient, and the hospital moved in 1875 to its current location in Yushima. Immediately following the move, Takanaka fell ill. However, his pupils from Sakura assisted in managing the hospital, and Takanaka’s adopted son Susumu Sato returned after studying in Germany to manage the hospital. Once Takanaka recovered, he took charge of internal medicine. Susumu took charge of the surgery, and the hospital began accepting a consid-erable number of inpatients and outpatients.After Takanaka opened Juntendo in Tokyo, many institutions followed suit and built private hospitals to meet the demand for treatment in Western medicine in conjunction with public hospi-tals. Even after many hospitals started to be constructed, Juntendo continues to be known as a large-scale hospital with excellent physicians conducting cutting-edge therapies.Juntendo’s founder Taizen Sato and his successor Takanaka Sato implemented and taught Western medicine at the end of the Edo era and during the transition from Edo shogunate to the Meiji era, respectively. The social environment and state of medical treatment and education during their periods differed, and their medical treatments and teachings also differed.Taizen studied Western medicine and performed Western-style surgeries during the period focused on Eastern medicine in a country that did not allow international travel and trade. When conducting surgery, rather than relying only on his ideas and experience, he followed and learned from Dutch Conclusion