This content was created by Maren Ehlers. The last update was by Kate McDonald.

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Bodies and Structures 2.0: Deep-Mapping Modern East Asian History

Highway Map of Echizen Province in the Late Tokugawa Period

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Bodies, Society, and Smallpox Vaccinations in Echizen Province
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 2007, 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, 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 vaccinia 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.
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 in that category tell stories about vaccinations in Echizen province and each can 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 andThe 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. I recommend starting with these two introductory pathways.
Click here for a list of references for this module, which is also available from the module's Conclusion page.
The author wishes to thank Yanagisawa Fumiko, Usami Masaki, Nagano Eishun, Peng Hao, Brigid Vance, Justin Churchill, two anonymous peer reviewers, the providers of images, and of course Kate McDonald, David Ambaras, John Corrigan, and all participants of the Bodies and Structures project for their feedback and advice on aspects of this module. All shortcomings remain my own.
Introducing the Vaccine to Ōno Domain
The transmission to Ōno domain is a typical example of vaccine sharing between domains in Echizen province. But whereas in Fukui domain the initiative for importing the vaccine came from a town doctor, the lord of Ōno himself actively promoted Dutch Learning and used domain doctors to bring the treatment to his domain. In this case, the interests of domain physicians and their network fell in line with the designs of their domain lord.
The two leaders of Ōno's vaccination program, Tsuchida Ryūwan and Hayashi Unkei, were both domain physicians in direct service of the lord. The lord had sent them to Osaka in 1845 to study with two prestigious scholars of Dutch medicine, Ogata Kōan and Kō Ryōsai. Unlike Fukui's ruler, Ōno's lord Doi Toshitada had a sustained interest in Dutch Learning. Whenever he was in Edo on tours of duty for the shogunate, he occasionally invited prominent scholars such as Sugita Seikei, Koseki San’ei, and Takami Senseki to his mansion for personal lectures. Toshitada also encouraged Dutch Learning among his vassals and personal physicians. Besides, he probably had a strong personal motive for bringing the smallpox vaccine to Ōno. In the spring of 1849, smallpox claimed the life of his infant son and heir, shortly before the vaccine reached Japan’s shores. Though neither Tsuchida Ryūwan nor Hayashi Unkei had studied with Kasahara Ryōsaku, their training in Osaka imbedded them in the same scholarly lineages as Kasahara and Kasahara's teacher Hino Teisai.
News of the vaccine's importation quickly reached Toshitada. In the 10th month of 1849, before the vaccine had even arrived in Fukui, he entrusted Tsuchida Ryūwan with some funds from his private purse to bring the vaccine to Ōno [source]. Early in 1850, domain physician Hayashi Unkei as well as town doctor Nakamura Taisuke went to Fukui to formally ask Kasahara Ryōsaku for a transmission. Like all the other physicians who received transmissions from Kasahara, the two men had to sign the vaccinators’ oath. This copy of the oath shows both men’s signatures under the date of 2/14.
While in Fukui, Hayashi Unkei and Nakamura Taisuke vaccinated the “small child of a tobacco dealer” and brought the toddler back to Ōno. After seven days they transferred the lymph to three more children, and from there to another three and so on to build the foundation for a self-sustaining program [Hakushinki, letter from Nakamura Taisuke and Hayashi Unkei to Kasahara Ryōsaku, 1850, 4/1, p. 106].
In the following years, Ōno's vaccinators benefited from their participation in Kasahara's regional network of vaccinators in Echizen province and beyond. But they also maintained their connections to physicians of Dutch Learning in other places. According to Ogata Kōan's records, Ōno's physicians seem to have received a retransmission from Kōan's clinic in Osaka in 1851 [Osaka no jotōkan].
Explore vaccinations in Ōno domain through The Territorial Approach to Vaccinations: Ōno Domain or Vaccinating the Nishikata Exclave. Or, use the link below to return to “Vaccine Stories.”