The Netherlands and Japan: From Rumor to Realization
“As I thought about it afterward, I first heard about [the vaccine] from a Dutch person in Nagasaki. I then obtained a book from a Russian in Matsumae. Now in Uraga an English man wants to give me a book and scabs. I had heard about this vaccination three separate times. How odd.” --Interpreter Baba Sajuro (Jannetta, 2007, p. 75)
In 1600, the daimyo (feudal lord) Tokugawa Ieyasu won the decisive battle of Sekigahara, and shortly afterwards unified Japan under a military government known as the Tokugawa Shogunate or bakufu, putting an end to over a century and a half of internal strife in the country. Through the 1630s, the shogunate promulgated a series of edicts that secluded Japan from foreign affairs in order to better regulate commerce and minimize foreign influences, especially Christian missionaries. Because of this policy, known as sakoku, foreign trade was only permitted in the remote port city of Nagasaki, and even then, only Dutch and Chinese merchants were permitted to dock there. Such restrictions did not totally sever Japan from scientific developments outside the country, but because Nagasaki was a merchant town, not a center of learning, few intellectuals made their way to the city to translate and study foreign books. The few that did travel there were often physicians.
Traditionally, Japanese medicine was heavily inspired by Chinese practices. Indeed, variolation was imported to Japan via Chinese physicians sometime during the seventeenth century (although it was not until the eighteenth that the practice became even marginally popular). Medicine was also considered a hereditary profession, and doctors guarded their techniques jealously, like trade secrets. Physicians who drew upon learning gained from the study of Western medical texts were politicized and known as ranpo (Dutch-method) physicians.
Dejima In Nagasaki Bay
Landscape painted sometime between 1800 and 1825, depicting two Dutch merchant ships and many Chinese trading junks near the island of Dejima
Vasily Mikhailovich Golovnin
Portrait of Russian explorer Vasily Mikhailovich Golovnin, painted by Orest Kiprensky sometime between 1814 and 1816
However, before knowledge of vaccination could encounter these structural problems, it had to arrive on Japanese shores. In 1803, teenage interpreter Baba Sajuro recorded that he heard from the Dutch warehouse master that a more efficacious means of preventing smallpox had been discovered abroad. Talk between traders was not enough to take action, however; Sajuro would not get an opportunity to print a formal account of vaccination until he became involved in the Golovnin Incident, a diplomatic crisis in which the Russian explorer Vasily Mikhailovich Golovnin was taken prisoner by the shogunate from 1811-1813 for trespassing too far into Japanese territory. Amidst negotiations for Golovnin's release, Japanese officials came into possession of a Russian tract on vaccination, and Sajuro (part of the diplomatic team) worked with Golovnin himself to begin work on a translation. The work was not done by the time Golovnin was released, so Sajuro, both unfamiliar with Russian and unsure of the value of the translation, held off on completing his work until 1820. Sajuro's sudden death in 1822 prevented his translated treatise from reaching a wide audience, but the manuscript was circulated amongst his colleagues and it was finally published in 1849.
Portrait of the Cock Blomhoff Family
Group portait of the household of Dutch merchant Jan Cock Blomhoff (seated on far left), painted by Ishizaki Yushi in 1817
The advent of more substantial Japanese engagement with smallpox was marked by the 1817 arrival in Nagasaki of Jan Cock Blomhoff, the new Dutch warehouse master. Unlike his predecessors, Blomhoff was knowledgeable about the value of vaccines and ordered shipments of cowpox lymph from Batavia (the capital of the Dutch East Indies, now Jakarta, Indonesia). His efforts to introduce vaccination were foiled by political interference and expired lymph; even after he enlisted the help of local ranpo physicians Minato Choan and Mima Junzo, Blomhoff failed to successfully vaccinate his patients. Nevertheless, Blomhoff built up significant goodwill with his Japanese collaborators, and his successor, German physician Philipp Franz von Siebold, seized on this capital in 1824 to open a small medical school to teach interested local physicians about Western-style medicine, including vaccination. Von Siebold was found to be in possession of plant samples, clothing, and (most damningly) Japanese maps in 1829, and he was subsequently deported and some of his Japanese students were arrested or executed on suspicion of treason, yet this "Siebold Incident" only increased interest in Western knowledge. Although temporarily shattered and increasingly distrusted by the shogunate, von Siebold's followers created a school of thought (Siebold-ryu in Japanese parlance) that continued to transmit Western medical knowledge.
Indeed, while the path to becoming a ranpo physician was rigorous-- you had to become fluent in Dutch in order to read foreign medical texts-- those who stayed the course entered a burgeoning and close-knit field more open to social mobility than traditional Chinese-style medicine. It was not a coincidence that many of the leading physicians in ranpo networks were born to either peasant families or low-ranking samurai. Japanese medicine was about as efficacious as Western medicine in the early nineteenth century, when European doctors still relied on dangerous practices like bleeding and purging and novel surgical methods were largely impractical, so the attention of ranpo scholars often fell upon recent breakthroughs such as vaccination. Subsequently, ranpo physicians began lobbying Dutch traders (with the help of influential patrons like Hotta Masayoshi, the Lord of Sakura domain) to sell them cowpox scabs, cannily recognizing from past failures that cowpox lymph would likely expire during the voyage from Batavia to Nagasaki. The hypothesis that scabs would work where lymph had failed was proven in 1849 when Narabayashi Kensaburo vaccinated two groups of children: one with lymph, the other with dried scabs. Only the latter took. Finally, Japan had a viable strategy for vaccination.