The Vaccinators: Smallpox, Medical Knowledge, and the 'Opening' of Japan

by Ann Jannetta

In Japan, as late as the mid-nineteenth century, smallpox claimed the lives of an estimated twenty percent of all children born—most of them before the age of five. When the apathetic Tokugawa shogunate failed to respond to this health crisis, Japanese physicians, learned in Western medicine and medical technology, became the primary disseminators of Jennerian vaccination—a new medical technology to prevent smallpox. Tracing its origins from rural England, Jannetta investigates the transmission of Jennerian vaccination, via various foreign and domestic networks, to and throughout pre-Meiji Japan. Relying on Dutch, Japanese, Russian, and English sources, the book treats Japanese physicians as leading agents of social and institutional change, showing how they used traditional strategies involving scholarship, marriage, and adoption to forge new local, national, and international networks in the first half of the nineteenth century. With an interesting parallel to the recent SARS crisis, The Vaccinators details the appalling cost of Japan's almost three-hundred-year isolation and examines in depth a nation on the cusp of political and social upheaval.

Genres: History, Nonfiction, Japan

264 pages, Hardcover

First published May 23, 2007

Reviews

[Philipp · Rating 4 out of 5]

Focusing on the activities of a generation of physicians who took up the practice of Western medicine and mobilized support for Jennerian vaccination, this book claims that the process of importing this new technology, exceedingly slow and fraught with difficulties, created a new social and intellectual elite during the first half of the nineteenth century. This new elite comprised groups that operated first at the far periphery of Tokugawa society—rangaku scholars, ranpō physicians, and Dutch interpreters. It survived the fall of the Tokugawa house to take a central role in creating the political, social, and intellectual infrastructure of the modern Japanese state.

What an interesting story - it details how the smallpox/cowpox vaccine made its way to Japan starting from Edward Jenner's discovery to the establishment of a government-wide (federal) vaccination policy. So much to learn!

- Jenner's vaccination trials where he gave cowpox to children, then infected them with smallpox weren't as risky as I always thought. Most people in the country-side were aware of the cowpox/smallpox link. Variolation, the practice with which you infect kids with smallpox when they're the healthiest, was extremely common, so Jenner's trials weren't much of an addition.

- Getting cowpox for vaccinations to Japan was surprisingly hard. The virus doesn't survive heat very well, and doesn't survive very long in scabs. The solution was very fun - they'd infect a child with cowpox, then let the virus replicate in the body while the minor disease runs its course, after 8 days is the ideal time to take out new cowpox viruses and transfer to the next child. Ships would take a handful of children, vaccinate the first, wait 8 days, vaccinate the second, wait 8 days, vaccinate the third, and so on, until the ship was at its destination, where the 'last' child became the cowpox source for the destination.

- The biggest driver of vaccinations in colonies was the Catholic Church!

To insure compliance in the Spanish colonies, the Catholic Church would play a major role. When an infant was baptized, the priest would require the godparents to return within six months to have the child vaccinated, offer an indulgence authorized by the Pope, and have a physician or priest record the child’s vaccination in a special parish registry. Bishops would inspect parish records during diocesan visits, and other colonial officials would encourage the acceptance of vaccination by both example and decree. Each Audiencia would require priests to submit an annual report on the progress of immunization in each parish, which the Audiencia could then report to the king.

How interesting!

- Japan's borders to the world were closed off at this time, which is why it took more than 50 years from Jenner's experiments until a proper vaccination scheme worked in Japan. This transformation was driven by Dutch (and one German) doctors working with Japanese doctors around Nagasaki, followed by the Japanese doctors building an amazing nation-wide information network (which survived some political persecution and executions when the German acquired an illegal map of Japan). This network is credited with being the birth of Japanese universities, with some universities directly tracing their ancestry back to vaccination clinics.

The book itself is aimed at historians/academic/laypeople with a strong interest, I think, just look at this sentence:

The Taki family was adamantly opposed to Western-style medicine, and was largely responsible for the escalating prohibitions against its practice in the 1840s. Taki Motokata and Tsujimoto Shōan had administered the Igakkan at that time, and their deaths in the early months of 1857 suggested that a major source of bakufu opposition to vaccination had been removed.

In a pop-history book this sentence would not survive an editor.

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