Towards the end of the Edo period, a new type of doctor was added to those practicing traditional Chinese medicine, and its practitioners began to be appointed to the Tenyakuryo: this type comprised doctors, for example Mitsuaki IRAKO, who followed the trends in Western (specifically, Dutch) medicine.
江戸時代の後期になると、伝統的な漢方医学に加え、伊良子光顕などオランダ医学の流れを汲む者も登用されるようになった。