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medical texts’ surgical methods. Receiving written consent before surgery, making treatment fees uniform and public, and even providing patient-cen-tered medical treatment were extremely rare at the time.When Takanaka was active, the country was no longer closed to the world; contact with foreign physicians became possible at the end of the Edo shogunate. The new government standardized medical treatment and education across the country. This was a period focused on the transition to medical treatment based on Western medicine. It was in this environment that Takanaka adminis-tered medical treatment and education. Whether regarding the reform of Sakura han medical admin-istration, the educational curriculum of Daigaku Toko, or the establishment of Western-style hospi-tals in Tokyo, Takanaka consistently championed expanding treatments in Western medicine.Regarding the medical education under these two directors, both emphasized the implementation of Western medical practice. Compared to Teki-juku, a medical school established in Osaka around the same time, we can understand what makes Juntendo unique.Tekijuku was established in 1838 by Koan Ogata, and many physicians from across the country came to study. Koan practiced Western medicine with a focus on internal medicine, contributing signifi-cantly to vaccination efforts in Osaka, and is highly renowned for his many translations of Western medical texts. Though he trained his students to become highly skilled in Dutch and taught medi-cine, some students did not aim to become physi-cians, only to study Dutch and decipher texts. Sensai Nagayo, a graduate of Tekijuku who estab-lished public health administration in the Meiji era, reflected that it was difficult to become sufficiently skilled in medical techniques while in Tekijuku.The following is a list of notable students of Juntendo and Tekijuku active in the early Meiji era:Tekijuku:Yukichi Fukuzawa (1835–1901): Philosopher of Japan’s enligthenmentKeisuke Otori (1833–1911): Military scholar, diplomatMasujiro Omura (1824–1869): Founder of modern militarySensai Nagayo (1838–1902): Proponent of public health administrationKensai Ikeda (1841–1918): President of Faculty of Medicine, University of TokyoJuntendo:Chian Sagara (1836–1906): Decided the adoption of German medicine. Related to the administration of medical educationJun Iwasa (1835–1912): Decided the adoption of German medicine. Court physician to the emperor.Toyo Sasaki (1839–1918): Established private hospital KyoundoKoki Watanabe (1848–1901): Tokyo prefectural governorTai Hasegawa (1842–1912): Principal of Igakuko, Director of Bureau of HygieneCompared to the number of notable people from Juntendo active in medicine, those from Tekijuku active outside medicine stands out. Both schools trained many talented individuals who were active during the early Meiji era and the Edo era, times when studying Western medicine and foreign languages was not easy. For this reason, the Prime Minister of the Meiji government, Shigenobu Okuma, later noted “Tekijuku of the West and Juntendo of the East.”Tekijuku was closed in 1869, and Tekujuku’s leader(s) moved to the hospital established by Osaka’s prefectural government, Igakuko. The successors of this hospital and school are the current Faculty of Medicine, Osaka University, and its affiliated hospitals.Other than this, of the institutions of medical treatment and education that existed in the early Meiji era, the Faculty of Medicine, University of Tokyo, and the Nagasaki University School of Medicine also have their origins in organizations from the Edo era; however, their managing bodies and systems were not constant. Control of the Faculty of Medicine, University of Tokyo, fell to the Edo shogunate after the Otamagaike Institution for Vaccination, the Meiji government, and the Ministry of Education before it became a national university. The Nagasaki University School of Medicine is the successor of the Nagasaki Hospital 471