Toan Matsuyama

Image: Keio University Fukuzawa Memorial Center for Modern Japanese Studies

It was on September 26, 1898, that Yukichi Fukuzawa collapsed from his first cerebral hemorrhage. After escaping critical condition and recovering, a celebratory alumni reunion was held on December 12. Approximately 400 Keio University alumni gathered at the Koyo-kan, which was located where Tokyo Tower stands today. The doctors who had devoted themselves to his treatment were also invited and received the gratitude of the attendees. Toan Matsuyama, representing the medical team, stated that the recovery was due to the professor's strong physical strength and not their own merit, and then spoke as follows.

"One contribution I made was that this face of mine became the thermometer for the professor's illness. When the professor's condition was bad, Matsuyama's face would become triangular; when it was good, it would become square. It is said that the many disciples who crowded the professor's entrance hall every day would divine the professor's condition based on Matsuyama's facial expression. If I have any merit, it is only for this one thing."

This episode clearly shows how the Keio Gijuku Shachu worried about the professor's condition, experiencing joy and sorrow while watching Matsuyama's expressions.

Matsuyama was the family doctor for Fukuzawa and his family, and was also something of a school doctor for Keio University.

Toan Matsuyama was born in 1839 into a family of doctors in Naka District, Kii Province (now Momoyama-cho, Kinokawa City, Wakayama Prefecture). In 1854, he went to Kyoto and studied Dutch studies under the Dutch-style physician Ryomin Shingu.

Later, he came to Edo, but having no connections and being at a loss, he met Ryozo Yamaguchi, a close friend of Fukuzawa since their days at Tekijuku. Yamaguchi told him, "You shouldn't go anywhere else; you must go to Fukuzawa's, so I will take you there." He met Fukuzawa and entered the Juku. This was in 1866.

Shortly thereafter, Fukuzawa went to the United States on his third overseas trip and brought back a large number of Western books. Matsuyama recalled that time as follows.

"Then the professor returned and gave me many books, saying I could take whichever I liked. The first one I took was Brinton, which I still have today. I translated and published it. For parts of the text I didn't understand, I asked Mr. Obata."

"Mr. Obata" refers to Tokujirō Obata. Even while Fukuzawa was in the U.S., Matsuyama had become close to him, saying, "I was still a newcomer, (...) but I gradually entered the Juku, stayed by Professor Obata's side, and was constantly receiving his teachings."

This translation was a part of Flint's medical textbook, published as "Chifusu Shinron" (New Theory on Typhus). When he showed the manuscript to Fukuzawa, he was told, "This is well done. Publish it immediately. I will lend you the funds." Fukuzawa lent him the total publication cost of 200 yen. This book is said to have "sold very well because, at any rate, it was the first time an English medical book had been translated, making it a rarity."

Matsuyama continued to translate and publish not only medical books like "Shogaku Jinshin Kyuri" (Elementary Human Physiology) but also "Chigaku Hajime" (Introduction to Geography) and "Kesshi Banpo Shiryaku" (Keightley's Universal History).

After the Juku moved to Shinsenza, Shiba in 1868, he was in charge of the "Reading Circle for Mr. Comings' Human Physiology." On the other hand, when he attended Fukuzawa's lectures on Wayland's economic theory, he said, "I would get so sleepy I couldn't help it, (...) it was just too difficult to understand, so I stopped listening to those lectures and instead did various translations, which led to me meeting the professor closely and receiving his teachings." Fukuzawa's study was on the second floor, and Matsuyama said he was "able to go up frequently to talk and listen to him personally."

Fukuzawa seems to have highly evaluated Matsuyama's efforts, as seen in letters to Ryozo Yamaguchi:

"Matsuyama is studying frequently and has made great progress, (...) I believe he will become a fine scholar of English studies within a year or two" (September 1867); "Matsuyama's progress is exceptional, and Koizumi and others are also promising fellows" (Intercalary April 1868).

In August 1868, Matsuyama moved to Yokohama, where he studied Western medical sciences directly by observing the treatments of the American doctor Hepburn and the Dutch doctor Meijer, and serving as an assistant to the British doctor Newton at the syphilis hospital established in Yokohama.

He also worked hard to spread Western learning. The following year, in 1869, he returned to his hometown in Wakayama and, together with Goryo Hamaguchi, worked to open a Western-style school, Kyoritsu Gakusha.

In December 1871, he was assigned for one year as one of the first teachers, along with Tokujirō Obata, to the Nakatsu City School, which opened at Fukuzawa's initiative.

Then, in 1873, he would found the medical school of Keio University. The catalyst was the following exchange between Masashiro Maeda and Fukuzawa around May 1873.

(Maeda) "I want to start studying German." / (Fukuzawa) "Why do you want to study German?" / (Maeda) "Because I want to become a doctor." / (Fukuzawa) "To study medical sciences, German is not essential. I will make it so that medical training can be done at the Juku as well."

Then, calling Matsuyama, who was living on the premises, Fukuzawa said this in the kitchen area:

"I intend to build an English-language medical school at the Juku. I will provide the funds, so would you be willing to give your time?"

Upon receiving Matsuyama's reply, Fukuzawa asked Masashiro Maeda, who was nearby, what he thought, and he agreed. Fukuzawa was delighted, saying, "Now, instantly, a teacher and a disciple have been made. We can start as early as tomorrow."

As this episode illustrates, the characteristic of the Keio University medical school was to provide education based on British and American medical sciences rather than German medicine. At that time, Western medical sciences could only be studied at a few public schools, which were biased toward German medicine. This spirit is also reflected in the purpose of establishing the medical school.

"We have founded this school based on the principle that by teaching the outlines of new medical sciences daily to the young medical students of the world, relying on the medical books of British and American authors, we may contribute somewhat to the progress of our culture."

In October of the same year, the Keio University medical school was established after submitting an "Application for Medical Practice" to Tokyo Prefecture, and classes were held in a newly built school building on the north side of the Mita Hilltop Square. In addition to Matsuyama as the principal, the main teachers included Matsuyama's nephew Ryoen Shingu and Takeshi Sugita. Practical education was conducted at the Sonseisha Clinic (later Matsuyama Hospital), which Matsuyama opened in Mita in April 1875. Those who taught there included Matsuyama, Gentan Sugita, Souetsu Kumagawa, as well as Faulds and Simmons.

The number of enrollees reached 81, 52, and 59 in 1874, 1875, and 1876, respectively. However, as medical education required more precision, vast funds were needed to prepare instruments, cadavers for practice, and hospitals. Ultimately, it led to closure in 1880.

Beyond the medical school, Matsuyama contributed to the expansion of Japanese healthcare in various ways.

In 1871, at the Western-style hospital he helped create in Yokohama with Ateki Hayashi, he served as the "Chief Medical Officer," and the hospital gained a reputation through Simmons' clinical practice. This hospital later changed its name to Yokohama Kyoritsu Hospital and Juzen Hospital, eventually becoming today's Yokohama City University Hospital.

In October 1878, he also merged an ophthalmology hospital he had opened with Kumagawa, where Simmons also practiced, to create Kyoritsu Hospital (closed in May of the following year).

Meanwhile, he also created organizations for doctors. In 1875, he formed the "Tokyo Medical Company," which could be called Japan's first medical society. Among the six managers, including Matsuyama, were Kumagawa, Masatane Ando (who studied at the Juku), and Motonori Tashiro from the Nakatsu Domain.

In 1877, he founded the "Tokyo Practitioners Assembly," which could be called Japan's first medical association, with Kumagawa, Ando, and others. Its purpose was to "improve medical customs and investigate academic arts" in response to the tendency of traditional Kampo doctors to be viewed as "entertainers" without recognizing their mission to save human lives.

Then, in 1880, Kanehiro Takaki, who had studied medical sciences in London, returned to Japan. Matsuyama met with Takaki, and the two hit it off, maintaining a cooperative relationship thereafter. Since Matsuyama's English/American-style Keio University medical school had closed for economic reasons, and the newly returned Takaki likely felt a strong bias toward German medicine, they must have had much in common.

The two immediately wrote a prospectus and sent it to over 20 doctors. Having gained supporters, they formed an academic organization called "Sei-i-kai" in January 1881. Takaki was elected president, and Matsuyama, Kumagawa, Shingu, and Tashiro were elected as managers. On May 1, they opened the "Sei-i-kai Training Center" and began classes in the second-floor hall of the Tokyo Medical Company.

Furthermore, through repeated meetings of volunteers, they founded the Yushi Kyoritsu Tokyo Hospital. As the name suggests, it was based on donations from volunteers; initially, Matsuyama, Takaki, Kumagawa, and the director Bunka Totsuka each donated 1,000 yen. When clinical practice began in August 1882, it is said that a large number of patients gathered at the gate of the temple being used as a temporary hospital to see Takaki and Matsuyama.

The Sei-i-kai Training Center later changed its name to Sei-i School and became the "Tokyo Jikei Hospital Medical School" in 1891. The Yushi Kyoritsu Tokyo Hospital received a grant and words of encouragement from Her Majesty the Empress in 1887, and was renamed "Tokyo Jikei Hospital" accordingly. This is today's Jikei University School of Medicine and its affiliated hospital.

I have deliberately recorded the names of the people involved in each of Matsuyama's achievements in detail. By overlapping those names, one can understand that Matsuyama and the people around him played a major role in both the Sei-i-kai Training Center, the origin of today's Jikei University School of Medicine, and the Yushi Kyoritsu Hospital, which led to the university hospital.

Regarding Matsuyama, the "Biography of Toan Matsuyama" states the following:

"The professor had a strong passion—a sort of creative fever or construction fever—and several times he cast aside his business to rush into the cultural construction of the early Meiji era. (...) As is clear from observing his career at the Kishu English School, Nakatsu City School, Yokohama Kyoritsu Hospital, Tokyo Kyoritsu Hospital, and this Yushi Kyoritsu Hospital, he would either entrust the succession to an old master or hand over the business for the sake of his juniors, without the slightest attachment. This is where he was a rare person of character."

Might Matsuyama's creative fever outside of government service have hidden his reverence for Fukuzawa? The key lies in the word "Kyoritsu" (public/jointly established) attached to the names of the schools and hospitals he created. These are the words also written in the "Keio Gijuku no Ki (Notes on Keio Gijuku)," which could be called Keio University's declaration of independence: "Following the system of those Kyoritsu schools, (...) we tentatively name it Keio Gijuku, taking it from the era name of its founding." Matsuyama was a person who, not stopping at his work as a doctor, poured his energy into building enterprises based on the spirit of "Kyoritsu," where people with shared aspirations cooperate for a public purpose.