In 1811, Ryozo Chiba (1789-1861) from Sendai Province enrolled in a private school of Shunrinken, presided by Seishu Hanaoka and wrote up a manuscript titled Nanki Seishu Sensei Nyugan Chyutu Koju (the title on the first page is Ben-nyugansho narabini Chiho Soko) in August 1811, only 6 months after enrollment. The manuscript describes Hanaoka's teachings about breast cancer surgery; signs and symptoms of breast cancer, differential diagnosis, preoperative care, administration of Mafutsusan, operative procedures, hemostatic techniques, wound suture; wound dressing, recovery from anesthesia with Mafutsusan, postoperative care, and prescriptions of drugs for internal and external use. After repeated transcriptions and the addition of various papers on other subjects, the title of the manuscript changed to Nyuganbenshio or Nyuganben. Chiba's original manuscript is considered important because the transcriber and the year of transcription of the manuscript are identified, and it unfolds the practice of Hanaoka's breast canicer surgery as of 1811.

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