||Surviving source materials relating to education in 19th-century regional medical schools (igakkō) are rare, partly because a lack of interest among following generations, and partly because of the short life span of many of those institutions. Ōe Okuji’s (1864–1919) ancestors served as physicians in the domain of Nakatsu for more than 150 years. His father, Untaku (1822–1899), a widely respected man with many disciples, successfully switched from Sino–Japanese to Western-style medicine during those dramatic decades of the late Tokugawa era. Having grown up in the early years of the Meiji Restoration, Okuji was the first in his family to receive a Western-style education, at the Ōita Prefectural Medical School, from which he graduated in 1886. Some of his books and lecture notes are held by the Ōe Medical Archive (Nakatsu), to which one of the items is unique. This is copy of a manuscript entitled “Illustrated Physical Diagnosis – Illustrations” (Shindan zusetsu – zufu). The accompanying booklet “Illustrated Physical Diagnosis” (Shindan zusetsu) was published in 1879 by Yoshimatsu Bunji. While the first volume of Yoshimatsu’s print can be found in two libraries, the second volume containing the illustrations has vanished. Had Yoshimatsu’s work simply been a translation of the foreign book the “Manual of Physical Diagnosis” published in 1878 in New York by the pathologist Francis Delafield (as is suggested by Yoshimatsu’s title), this disappearance would not be a problem. However, being well aware of Delafield’s shortcomings, Yoshimatsu added extensive explanations, each of which covered almost half a page. Furthermore, comparing Ōe’s copy with Delafield’s manual reveals that Yoshimatsu produced a completely new set of illustrations. Yoshimatsu started with so-called anatomical “fugitive sheets” taken from Delafield’s book. These superimposed hinged flaps enable readers to observe the interior of a human body as if they were conducting a dissection. The earliest examples of such sheets occurred in European books during the early 16th century. Around 1680, a copy of the Dutch edition of Johannes Remmelin’s famous “Catoptrum microcosmicum” arrived in Nagasaki. For decades, handmade copies circulated among Japanese physicians until a copy was printed as the “Dutch Anatomical Atlas of the Whole Body” (Oranda zenku naigai bungō-zu) in 1772, shortly before publication of the epoch-making “New Book on Anatomy” (Kaitai shinsho). Hence, physicians in 19th-century Japan were already familiar with this kind of anatomical representation. Delafield’s manual contains only a set of superimposed flaps, but Yoshimatsu extends it by producing a series of pictures showing the location of organs and certain abnormalities. He also includes drawings of several types of stethoscopes, a spirometer, a cyrtometer, a stethogoniometer, a stethometer, and Étienne-Jules Marey’s famous sphygmograph. Most of these diagnostic instruments were recent inventions and their depiction added greatly to the practical value of Yoshimatsu’s booklet. The early years of the Meiji government greatly affected everyone involved in medicine. However, elements of tradition facilitated the adoption of new concepts relating to the human body and illness and treatment, and also stimulated the involvement of the authorities in questions of medical education and practice. Although revolutionary in content, Yoshimatsu’s publication also exhibits traits of Japan’s long tradition of absorbing foreign knowledge. Eleven years after the government decided to suppress traditional medicine in favor of the Western medical paradigm, Yoshimatsu did what Japanese physicians had been doing since they first encountered “Dutch medicine” in the 1650s: he collected more information, and critically assessed new knowledge from abroad before using it to revise his text. The young student Ōe Okuji had his own ways of coping with difficult circumstances. Because of substantial cultural obstacles to the dissection of human corpses in Japan, he had limited opportunities to observe an autopsy during his years in Ōita. Therefore, he used printed materials to make anatomical drawings. Motivated by Yoshimatsu’s illustrations, Ōe recreated his figurative sheets with great accuracy. His finished copy was bound at a local branch of the famous book dealer Murakami Kanbei (Kyōto). Ōe was undoubtedly proud of the work to which he impressively dedicated much time and effort that he would not easily have forgotten.