In 1849, Japanese physicians imported the smallpox vaccine from Batavia through the Dutch trade factory in Nagasaki. Although Japanese specialists of Western medicine had learned of the vaccine’s existence as early as 1803 [Jannetta, The Vaccinators, p. 57-58], restrictions on foreign trade and the difficulty of transporting the vaccine over long distances in hot climates had prevented its importation for several decades. But once the vaccine reached Japan, a network of physicians trained in Western medicine quickly transmitted it all over the country. By the end of the Tokugawa period in 1868, vaccination clinics were operating in many towns and cities with governmental support. Vaccinations represented the first organized instance of preventative medicine in Japan [Umihara 2014, p. 209-10], and became an important steppingstone for the development of modern public health after the Meiji Restoration.

This module explores the vaccine's introduction to Japan as an intervention into notions of space and time. The intervention began on a microscopic scale--the life cycle of the cowpox virus, which set the conditions for anyone hoping to spread and perpetuate it over time. Because the substance could not survive for long outside the human body, it had to be moved to another unvaccinated body every six or seven days. Such transfers required human involvement, and it was here that the biological process surrounding the cowpox virus began to translate to a larger scale--the scale of human social interactions.

To accommodate the pace set by the vaccine, the people who handled, received, and promoted vaccinations had to simultaneously navigate geographical, social, and biological spaces. They had to rethink existing notions of territoriality and the structure of professional and social networks to ensure the smooth sharing of knowledge and vaccines. They had to reimagine human bodies as vehicles for transmission and consider methods of moving bodies across space. They also had to experiment with new forms of documentation and built environments to ensure precision of timing and movement throughout the vaccination process. These innovations both built upon and challenged the fragmented polity and compartmentalized social structure of Tokugawa Japan.

For a short introduction to the Tokugawa period, read this page. 

This module focuses on Echizen province, a region on the Sea of Japan whose territory was divided between many different overlords. Physicians from Echizen played a pioneering role in bringing smallpox vaccinations to Japan. But what did they do to perpetuate vaccinations over time? The module invites the reader to explore a number of "vaccine stories" from this province that highlight the transformative power of vaccine transmission. Many of these stories involve some form of border-crossing--from town to village, from domain to domain, from commoner to outcaste, and from licensed to unlicensed handlers.

Roadmap to the Module
Most of the content in this module is organized under Vaccine Stories. The six pathways under that label all tell stories about vaccinations in Echizen province and can each be read in a linear way. However, the reader is encouraged to move off the suggested pathways and seek out new connections between sites. 

The first two pathways--The Spatio-Temporality of Virus and Vaccine and The Networks and Vehicles of Vaccine Transmission--lay out basic ways in which configurations of space and time conditioned smallpox vaccinations in Tokugawa Japan. Each of these problems resurface in the Vaccine Stories and I therefore recommend starting with these two introductory pathways. 


The author wishes to thank Yanagisawa Fumiko, Nagano Eishun, Peng Hao, Brigid Vance, Justin Churchill, two anonymous peer reviewers, the providers of images, and of course Kate McDonald, David Ambaras, and all participants of the Bodies and Structures project for their feedback and advice on aspects of this module. All shortcomings remain my own.