---
title: シャルコー生誕200年記念式典での講演
tags: 
author: [下畑享良](https://www.docswell.com/user/8003883581)
site: [Docswell](https://www.docswell.com/)
thumbnail: https://bcdn.docswell.com/page/LE3K3D29E5.jpg?width=480
description: 「Kinnosuke Miura and Jean-Martin Charcot: A Master-Disciple Legacy in Modern Japanese Neurology」という講演のスライドです．
published: July 05, 25
canonical: https://www.docswell.com/s/8003883581/K12VD2-2025-07-05-163527
---
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Kinnosuke Miura and Jean-Martin Charcot:
A Master-Disciple Legacy
in Modern Japanese Neurology
Takayoshi Shimohata, MD, PhD1
Makoto Iwata, MD, PhD2
1. Department of Neurology, Gifu University Graduate School of Medicine,
Japan
2. Medical Clinic Kakinokizaka


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Self-introduction
•
I am a Japanese neurologist and a professor at a national university. I am also a board
member of the Japanese Society of Neurology.
•
In May of this year, events such as exhibitions, symposiums, roundtable discussions, and
book publications were held in Japan to celebrate the bicentennial of Charcot’s birth.
•
Today, I would like to introduce Professor Charcot’s significant influence on Japanese
neurology through Dr. Kinnosuke Miura.


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*The Japan Neurological Society Special Program
“Charcot and Neurology”
A symposium on “Charcot and
Neurology” was held as a
special program for the 200th
anniversary of Charcot&#039;s birth
at the annual meeting of the
Japanese Society of Neurology
held on May 21, 2025.
Dr. Makoto Iwata (co-presenter)


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Exhibition corner celebrating the bicentennial of Charcot&#039;s birth
In conjunction with the symposium, a display area with exhibits related to
Charcot and Kinnosuke Miura was also set up.


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* Memorial book “The Century of Charcot (2025)”
This book was published as a record
of the roundtable discussion titled
“The Century of Charcot”.


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Introduction
•
During the pandemic caused by COVID-19, I treated many
patients with functional neurological disorders (FNDs).
•
I was interested in how Prof. Charcot dealt with the increase in
the number of patients suffering from hysteria during the
Franco-Prussian War.
•
During my study with Prof. Charcot, I became interested in the
teacher-student relationship between Prof. Charcot and his
Japanese student, Dr. Kinnosuke Miura.


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Dr. Miura regarded Charcot as a lifelong mentor.
• Dr. Miura was a Japanese physician, particularly
in the field of neurology.
• In 1890, he studied in Germany, France, and
Paris under Prof. Charcot.
• At the time, Prof. Charcot was 67, and Dr. Miura
was 28. Although he studied under Prof. Charcot
for less than 8 months, Dr. Miura regarded Prof.
Dr. Kinnoske Miura（1864-1950）
Charcot as a lifelong mentor.


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I wanted to know why Dr. Miura regarded Prof. Charcot as his
lifelong mentor despite his short study abroad period.
To understand this, we collected books written by Miura&#039;s descendants and examined
the documents in which Dr. Miura talked to Prof. Charcot.
Memoirs of a Medical Scientist&#039;s Life
Norihiko Miura (eldest son)
150 Years of Medical Scientists
Yoshiaki Miura (second son）
Memories of my grandfather,
Miura Kinnosuke
Yasusada Miura (grandson)


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Dr. Miura’s family around 1915.
Kinnosuke, his wife Noriko, his eldest son
Norihiko, and his second son Yoshiaki.


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Before
Miura met
Charcot
Charcot as
seen by
Miura
Miura after
returning to
Japan


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Background of Dr. Kinnosuke Miura.
• In 1864, Dr. Miura was born in Date City, Fukushima
Prefecture.
• He then moved to Tokyo in 1877. After studying German
at a foreign language school, he entered the Tokyo
Imperial University School of Medicine.
• In 1887, he graduated and became a research assistant to
Prof. Erwin von Bälz, publishing a paper on the “mydriatic
effect of ephedrine.”


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Dr. Miura was influenced by Bälz but was unable to
learn much about neurology.
• Erwin von Bälz（1849-1913）was a German Empire
doctor invited to Japan in 1876.
• He taught modern Western medicine to the Japanese
medical community for 27 years, laying the
foundations for modern medicine in Japan.
• Dr. Miura, who was 23 years old, studied pathology
and internal medicine as an assistant to Prof. Bälz.
• At the time, no departments in Japan specialized in
neurology.
Prof. Erwin von Bälz（1849-1913）


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At 26-28 (1890-1892), Dr. Miura went to Germany
at his own expense.
• Dr. Miura studied internal medicine with Prof. Carl Jakob Adolf Christian Gerhardt,
neurology with Prof. Oppenheim Hermann in Berlin, and neurology with Prof. Wilhelm
Heinrich Erb in Heidelburg.
• When Dr. Miura consulted Prof.
Gerhardt regarding his future interest
in studying neurology, Prof. Gerhardt
immediately recommended Prof.
Charcot and said he would introduce
Dr. Miura to Prof. Charcot.
Carl Jakob Adolf Christian Oppenheim Hermann
Gerhardt（1833-1902） （1859-1919）
Wilhelm Heinrich Erb
（1840-1921）


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At 28 (early 1892), he went to France to study,
which he had not planned.
• I assumed that Dr. Miura had a hard time because he did not understand
French, but he later stated the following in his lecture:
• “I had no choice but to listen to the various lectures at the Paris Medical
School from morning till night. After approximately one week, I became
accustomed to the lectures and began to hear them. You should take this
shortcut when going to France.”
• Dr. Miura mastered French quickly and wrote a paper on three patients with
hysterical monoplegia in 1892, the year he studied abroad.


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Dr. Miura said that Prof. Charcot was a kind man.
• Dr. Miura was invited to a dinner party at Charcot&#039;s residence, where distinguished guests
gathered and learned how to store wine and prepare a party menu from Prof. Charcot.
• In another episode, Dr. Miura politely declined when Prof.
Charcot recommended riding in his carriage on the way to
the hospital in the morning. However, Prof. Charcot further
recommended he ride with him, saying, “because the hospital
grounds are so large.” Whenever Dr. Miura described this
episode, he would always shed tears in the memory of Prof.
Charcot.


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Before
Miura met
Charcot
Charcot
as seen
by Miura
Miura
after
returning
to Japan


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Dr. Miura described Prof. Charcot&#039;s personality as follows:
“Both Pasteur and Charcot are soft and easy to get
along with. They are not arrogant. We are ordinary
students, but when we go and talk to them, they
talk to us like we&#039;re colleagues. However, they did
not seem to make such distinctions. Pasteur and
Charcot are kind to people, like their assistants.”
Louis Pasteur
（1822-1895）
Jean-Martin Charcot
（1825-1893）


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*Personality
Dr. Miura described
of Prof. Charcot
Prof. Charcot&#039;s
as seen personality
by Dr. Miuraas(2)
follows:
• Dr. Miura also said that Prof. Charcot liked to drink with
young students.
• One night, the ward at Salpêtrière Hospital was noisy until
late at night, so the chief nurse went to give them a warning;
however, when she opened the door, Prof. Charcot stood in
front of her, so she stepped back.
Marguerite Bottard (1822-1906)
• The next day, Prof. Charcot received a warning from her.
マルグリット・ボタール
Walusinski O. Eur Neurol. 2011;65:279-85.


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Dr. Miura spoke about the work carried out
by Prof. Charcot as follows:
• “In the West, there are two types of excellent clinicians: those who carefully
observe and gain experience and those who do a lot of work (such as writing
papers). Prof. Charcot was both of these. We should be like that, too.”
• “Prof. Erb only gave ordinary clinical lectures, and, unlike Prof. Gerhard, he was
not particularly detailed about ward rounds. Prof. Charcot examined patients in
detail.”


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Dr. Miura spoke about the diagnostic methods used
by Prof. Charcot as follows:
“Prof. Charcot placed great importance on observing things.
When observing, he first looks at the whole picture and then
moves on to the details. This was the same as when looking
at a specimen under a microscope; we first looked at the
whole picture at low magnification and then moved on to
high magnification. This was also the case with Prof.
Virchow, a German physician and pathologist.”
Rudolf Ludwig Karl Virchow
（1821ー1902）


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*Charcot&#039;s method of diagnosis
(Augenblicksdiagnose)
Semin Neurol 18:169-76, 1998
• Dr. Miura said that despite being French, Prof. Charcot often used the German term
Augenblickdiagnose (Augenblick = instantaneous).
• This is the sixth sense doctors have when they see a patient entering a room or a
diagnosis made instantly based on characteristic physical signs.
• Prof. Charcot would make this Augenblickdiagnose, keep it in mind, and then make a
final diagnosis after two weeks of detailed examination. The Augenblickdiagnose
often matched autopsy results.


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Dr. Miura also discussed Charcot&#039;s preparations
for the “Tuesday Lectures”.
• “Prof. Charcot would call patients to his room every
day, and for at least two weeks, he and his students
would observe the patients, after which they would be
opened to the public. I was fortunate enough to be
allowed to participate in these sessions, and I observed
patients with my professor”.
• “Prof. Charcot would then go home, look up the
literature, examine the patients again the next day, and
finally give a lecture in the lecture hall, so what he
talked about there was well-organized”.


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Before
Miura met
Charcot
Charcot
as seen
by Miura
Miura
after
returning
to Japan


# Page. 24

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After returning to Japan,
Dr. Miura sent two letters to Prof. Charcot.
Dr. Miura wrote to Charcot to
express his heartfelt thanks for
the kindness and hospitality
he had received while pursuing
his studies in Paris.
Miura K. Neurological Medicine 62:1-4, 2005


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Dr. Miura&#039;s letter to Prof. Charcot contained
important information on Japanese neurology.
Iwata M． Kagaku-igaku shiryo kenkyu 251:8-12, 1995
• The first letter reports on the places he visited and the diseases he had seen there.
• The second letter, a New Year&#039;s greeting for 1893, contained a very important note:
“I was now practicing general internal medicine, but in the future, I wished to focus
my practice on neurological diseases. ・・・・・ I will propose setting up a department
of neurological diseases in the hospital at our university&#039;s medical school.”
• In the same year (1893), Prof. Charcot passed away.


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In 1894, a proposal was made to the Imperial Parliament
to establish a neurology department.
Kuzuhara S．Rinsho Shinkeigaku 60:1-19, 2020
• Dr. Tai Hasegawa, who developed medical care in the Meiji era, proposed to the Imperial
Parliament that the Tokyo Imperial University should establish a new department and
ward for the study of neurological disorders, independent of ordinary internal medicine,
as in Europe (particularly France), with Dr. Kinnosuke Miura as Professor. The proposal
was referred to an investigation by nine members, but it was not approved.
• In 1895, Dr. Miura was appointed Professor in the First Department of Internal Medicine
at the Tokyo Imperial University. Subsequently, the establishment of the Department of
Neurology disappeared, and neurology gradually declined, partly because Dr. Miura
himself changed his position to focus on the establishment of internal medicine.


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It took 70 years for neurology
to become an independent field in Japan.
Iwata M． Kagaku-igaku shiryo kenkyu 251:8-12, 1995
• It was in 1964 that neurology, introduced from the United States after World War II,
became an independent academic discipline in Japan.
• However, 70 years earlier, Prof. Miura proposed that neurology should be established
as an independent academic discipline and have its own university course.
• Furthermore, the model for this was the French neurology established by his mentor
Prof. Charcot. If this had been realized, the course of Japanese neurology would
have differed entirely from what it is today.


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At the age of 31,
Dr. Miura became a professor.
A Takahashi．Neurological Medicine 51:1-12, 1999
A takahashi．Rinsho Shinkeigaku 53:926‒929, 2013
Dr. Miura energetically researched on diseases such as Kubisagari (dropped head
syndrome).
• This disease presents with a dropped head, ptosis,
mastication disorder, and weakness of the trunk and
extremities. It differs from myasthenia gravis due to its
regional and familial occurrence, paroxysmal nature, and
good prognosis.
• Prof. Miura thought it was worth reporting to Prof.
Charcot, so he traveled far away to see the patients.
• He spent a lot of time investigating the patients, but
when he heard the news of Prof. Charcot‘s death,
he became discouraged, lost interest in writing,
and wrote only one article in Japanese.


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He wrote a paper on hysteria.
• Miura K. Sur trois cas de monoplégia brachiale hystériques. Archives de neurologie.
xxv (75):321-356. 1893
スュール トロワ カ ドゥ モノプレジア ブラキアル イステリック
• This is a summary of 28 patients with hysterical monoplegia of the upper limbs
reported in France between 1885 and 1890, to which Dr. Miura added three patients
he had diagnosed. This paper was cited in Pierre Janet&#039;s doctoral thesis.
• The characteristics of each patient and the treatment process, which aimed to have
a psychological effect using static electricity and grip-strength meters, are described.
• Dr. Miura may have tried to carry on the core of Prof. Charcot&#039;s theory of hysteria
more than anyone.


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*Even after Prof. Charcot&#039;s death,
Dr. Miura followed his teachings.
• After Charcot&#039;s death, Dr. Babinski developed the concept of
pithiatisme, emphasizing that hysteria is a reversible functional
disorder caused by suggestion.
• Dr. Babinski was interested in distinguishing between hysteria and
organic diseases and used the Babinski sign to differentiate
between functional paralysis and organic paralysis.
• Dr. Miura was skeptical of this Babinski&#039;s ideas and remained
faithful to Charcot&#039;s teachings. Perhaps for this reason, he was
closer to Dr. Pierre-Marie than Dr. Babinski.
Joseph Jules François Félix Babinski
（1857－1932）


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In 1914, Prof. Miura gave
two of 24 lectures on hysteria.
Tuberculous meningitis due to optic nerve tuberculosis
Cerebellopontine angle tumor
Left homonymous hemianopia and left hemiplegia (suspected glioma)
Homonymous hemianopia with hemiplegia and aphasia
Paraphasia (a type of aphasia)
Thromboembolism due to mitral valve insufficiency
Pontine infarction
Multiple cranial nerve palsies
Neurosyphilis and central diabetes insipidus
Neurosyphilis (general paresis)
Amyotrophic lateral sclerosis (bulbar type)
Spinal cord hemorrhage (intraspinal hemorrhage)
Muscular dystrophy
Ophthalmoplegic migraine (migraine with tremor)
Hysteria (with tonic seizures)
Tetany (due to hypocalcemia, etc.)
Huntington’s disease or Sydenham’s chorea
Hysteria (with psychogenic seizures and conversion aphonia)
Spasmodic torticollis and chronic kidney disease
Intermittent claudication
Addison’s disease
Clinical diagnosis of liver disease
Liver cirrhosis
Considerations on acupuncture therapy
This is a list of the 24 lectures delivered by Prof. Miura, two of which were on the subject of hysteria.


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Dr. Miura also wrote papers on cerebellar ataxia and ALS.
• Marie&#039;s Hereditary Cerebellar Ataxia (1898)
• Considerations on Amyotrophic Lateral Sclerosis (1902)
• Both of these papers were written in German, and each pays tribute to the
achievements of Drs. Marie and Charcot, while including their patients, Dr. Miura
also discusses his own patients.
• Both papers demonstrated Dr. Miura&#039;s strong presence as a member of
the Salpêtrière School.


# Page. 33

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In his ALS paper, Prof. Miura mentioned his mentor Charcot.
• This article is a clinicopathological report
of two patients with ALS.
• It begins with the following statement:
• “Since 1865, my mentor, Prof. Charcot,
has been describing ALS as a special
disease, and since the end of 1872, when
he completed the description of this
disease, there has been no need to add to
the description of the disease.”
The cover of the book
Table of Contents of Vol.1


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As an educator, Prof. Miura told his students
and young staff members the following:
“Make sure to spend at least two hours a day reading books.”
“Even if Japanese scholars do good work, they are unable to
compete on the world stage because of their lack of language
skills and poor presentation methods, despite their best efforts.”


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Dr. Miura, after retiring from
his professorship in 1924.
A Takahashi．Neurological Medicine 51:1-12, 1999
A takahashi．Rinsho Shinkeigaku 53:926‒929, 2013
• Due to his close relationship with the imperial family, including his treatment of the Meiji
and Taisho Emperors, he was invited by the Imperial Household Agency Hospital as a
court physician.
• However, following the example of Prof. Charcot, who treated many ordinary patients,
he declined the invitation. He worked as the director of Doai Hospital, which was
established with American assistance after the Great Kanto Earthquake.


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Prof. Miura was appointed director of the Japan-France Society
and tried to become a “bridge” between Japan and France.
• The Japan-France Society was an
organization that aimed to promote
cultural, economic, and academic
exchanges between Japan and France.
• This postcard was written in 1948 and
replied to his acceptance of the
directorship.
Presenter&#039;s collection


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*The End of Professor Miura&#039;s Life
• In 1950 (at 87), Prof. Miura suddenly passed
away from a pontine hemorrhage.
• Prof. Miura&#039;s grave is in the Yanaka Cemetery in
Taito Ward, Tokyo. I visited it to pay my
respects and report on my presentation on the
200th anniversary of Charcot&#039;s birth.


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Discussion


# Page. 39

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Dr. Miura admired Prof. Charcot as a clinician.
• Dr. Miura believed that Prof. Charcot had two sides to his personality:
as a clear-thinking theorist and scientist and as a flexible and excellent clinician.
• Regarding the latter, even when there were few effective treatments available, Prof.
Charcot would try general treatments if there was a possibility that they would
improve symptoms.
• Prof. Miura also tried various treatments, just like Prof. Charcot.
• He was proud to have been a direct student of Prof. Charcot until his final years.


# Page. 40

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Prof. Charcot had a direct impact on clinical neurology
in Japan.
• Japanese clinical neurology is often mistakenly
thought to have originated from Prof. Tadao
Tsubaki and Prof. Yoshigoro Kuroiwa, who studied
in the United States after World War II but was
introduced from France long before:
(i) through Prof. Miura, a student of Charcot, and
(ii) through Dr. Tsunemaru Sato, who translated
Charcot&#039;s Tuesday Lectures into Japanese.
Dr. Tsunemaru Sato


# Page. 41

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These kanji mean “Prof. Charcot”.
This is a Japanese translation of
the Tuesday Lectures delivered by Dr. Sato.


# Page. 42

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Conclusion
• The French neurology established by Prof. Charcot was passed on to Prof. Miura along
with its spirit.
• Although Prof. Miura studied under Prof. Charcot for less than eight months, it greatly
impacted both Prof. Miura himself and Japanese neurology.
• On May 25, 1925, the Centennial anniversary of Prof. Charcot&#039;s birth, Prof. Miura sent
a telegram to Paris and sent a vase of flowers to be placed in front of Charcot&#039;s statue.
This year marks the 200th anniversary of Charcot&#039;s birth. We would like to take this
opportunity to examine Profs. Charcot and Miura’s achievements.
Thank you for your kind attention!!


