After Kasahara had delivered the vaccine to Fukui and set up his clinic, he immediately offered to share it widely with medical specialists in nearby domain territories. He probably did so for the same reason he had accommodated his colleagues in Osaka: because he hoped to create a reservoir and build a professional vaccinators' network with common goals and standards, one that would share knowledge, suppress competitors, and challenge domain administrators if necessary. Besides, as noted, Kasahara was driven by a strong commitment to eradicate smallpox from the Japanese islands.
Kasahara wanted to ensure that only trained specialists performed vaccinations. He feared that parents would otherwise lose confidence in the treatment and hesitate to grant doctors access to their children's bodies. A few weeks after his return to Fukui, on 1/17, 1850 (lunisolar calendar), he wrote to specialists of Dutch medicine in towns and territories in the surrounding Hokuriku region with an offer to share the vaccine. Physicians from Fuchū (a subfief of Fukui domain) were the first to receive a transmission. In subsequent weeks, colleagues from Toyama (Toyama, a branch domain of Kaga), Kanazawa (Kaga domain), Tsuruga (Obama domain), Sabae (Sabae domain), Ōno (Ōno domain), Daishōji (a branch domain of Kaga), Maruoka (Maruoka domain), Kanazu (Fukui domain), and Katsuyama (Katsuyama domain) either brought children to Fukui or received visits of children from Fukui, whose bodies were to serve as vehicles for the vaccine (click on the pins on the map to locate these places). Before vaccination, these physicians had to receive instructions and sign an oath at the domain office that they would observe all technical requirements and not prioritize personal gain.
The newly minted vaccinators joined the vaccinators' society (sha) and set up chapters (so-called shachū) in their respective towns and territories. Initially, each chapter had only a handful of members, but together, they formed a professional organization that transcended domain borders and was capable of providing retransmissions. Other functions of the organization included the sharing of information and suppression of uncontrolled transmissions. A semi-autonomous, self-regulating network of medical professionals was thus taking shape with only minor support from domain governments. At the same time, effective collaboration with domain leaders was one of the network's most important functions.
Ogata Kōan's network in Osaka
In Osaka, Ogata Kōan, the head of the local vaccination clinic who had received a transmission from Kasahara in 1849, kept a similar record of physicians with whom he had shared the smallpox vaccine, continuing up until 1869. His list included 168 transmissions, mostly to physicians in Osaka and surrounding provinces, but some as far away as Edo and Nagasaki. On one occasion (1851), Ogata transmitted vaccines to the Hokuriku region—to Ōno domain, where vassals enjoyed close ties to Ogata's academy of Western Learning (Katō et al. 2013, 87). This case illustrates the openness of the vaccinators' network and its many overlaps with the network between scholars of Dutch=Western Learning.
For a translation of the vaccinators' oath, move on to the next station on this pathway. Or explore how the network mediated relations between vaccinators of different domains.