June/4/2020
Throughout history, human beings have experienced a lot of infectious diseases such as the new coronavirus, smallpox, tuberculosis and measles.
Among all infectious diseases, smallpox was the first infectious disease that humans eradicated from the earth.
After overcoming a lot of difficulties, Kasahara Ryosaku was the first to introduce the smallpox vaccine into Fukui. His life was so dramatic that a novel called Snow Flowers (雪の花) was written about him.
Smallpox was a deadly and highly contagious disease. In the late 18th century, it killed anywhere from 200,000 to 600,000 people every year in Europe. Even if it didn’t kill you, it’d cause you to lose your eyesight and leave permanent scars on your face. In regions where smallpox was endemic, adults were immune to it, but children weren’t.
An English doctor named Edward Jenner (1749 – 1823) started a movement to combat smallpox. He published a paper on smallpox vaccines in 1798. Thanks to Jenner, humans had a smallpox vaccine for the first time.
Kasahara Ryosaku (笠原 良策) (1809-1880) was born in Fukui, Japan, in 1809. He started studying traditional Chinese medicine when he was 15 years old. He became a doctor when he was 24 years old.
However, his life took a dramatic turn when he was 28 years old. He happened to meet a doctor who was practicing Western medicine and saw for himself the advantages that Western medicine had. (At the time, Chinese medicine was mainly practiced in Japan.) At the age of 32, Kasahara started to learn Western medicine in Kyoto from Hino Teisai , who was the foremost authority on Western medicine.
Then, in 1845, Kasahara read a book about vaccinations that Jenner had invented. At the time, smallpox was killing around 300,000 people in Japan every year. Kasahara realized that if he used Jenner’s smallpox vaccine, he could save a lot of lives.
Even though he was only a town doctor, Kasahara bravely presented a petition to Matsudaira Shungaku, who was the lord of the Fukui domain, to import smallpox vaccine from China. Fortunately, Matsudaira was an open-minded, liberal lord. He accepted the petition. Matsudaira then presented the petition to the shogunate, which accepted it.
In 1848, Kasahara went to Nagasaki, which is in the west part of Japan, to get the smallpox vaccine. Before going to Nagasaki, he wrote the following poem.
“I am willing to sacrifice my life for others. I save people who shouldn’t die.”
On his way to Nagasaki, he went to Kyoto to see his teacher, Hino, and found that the vaccine had already arrived there from Nagasaki. Kasahara helped to open smallpox vaccination centers in Kyoto and Osaka.
After that, the major project of introducing the smallpox vaccine into Fukui that Kasahara had bet his life on started.
The vaccine was brought in as scabs from Nagasaki to Kyoto. (At the time, there were no modern vaccines like those that people use today. Instead, scabs were used as vaccines.) However, with scabs there was always the possibility that they’d be inactive. To avoid this, Kasahara used a more reliable method. He’d used one person to vaccinate another person. He used pus from a vaccinated child to vaccinate another child. He followed this method trying not to miss anyone.
Since Kasahara would use people to vaccinate other people, he looked for children as potential carriers of the vaccine. Kasahara found two children and their parents in Kyoto who were willing to go to Fukui with him. Kasahara’s wife, who was in Fukui, also found two children and their parents in Fukui. The two children and their parents all went to Kyoto.
After vaccinating the child in Kyoto, Kasahara, the four children and the eight parents went to Fukui, which is 200 kilometers from Kyoto. Since there was no public transportation at the time, they had to walk. In addition, there were mountains along the way and they even had to walk in heavy snow because of the season. This journey is written about in great detail in the novel Snow Flowers about Kasahara’s life. The following is an excerpt.
“The slope of the road became very steep. The group sank into two meters of snow. In addition, heavy snowstorms blocked their vision. The snow covered their faces and they couldn’t open their eyes. Seven adults walked chest-deep in the snow while carrying the children.
Meanwhile, some adults fell over a lot in the snow because of fatigue and cold. Kasahara shouted himself hoarse and lifted them each time.” (Translated by Taru)
When they were near Imajo, they couldn’t walk anymore because of fatigue. Some of the adults lay on the ground. They were in a desperate situation. However, miraculously they were rescued by the villagers, and were able to reach Fukui in the end.
Kasahara’s vaccines were distributed to other regions like Sabae, Tsuruga,Kanazawa and Toyama.
Kasahara soon built a temporary smallpox vaccination center next to his home where he and 10 other doctors worked. However, the people in Fukui didn’t know much about Western civilization or culture, so they wouldn’t accept this foreign type of vaccination.
Also, the other doctors who worked in the Fukui domain were jealous of Kasahara and tried to spoil his work by spreading false rumors. One particularly vicious rumor had it that one person who’d been vaccinated came down with smallpox and died. Lots of cruel words and rumors were directed against Kasahara. Some people even threw rocks and stones at him. He’d risked his life bringing the smallpox vaccine to Fukui. He suffered a lot because of people’s ignorance.
After Kasahara helped build a public smallpox vaccination center in Fukui, the tide turned. The construction of this center motivated a lot of other doctors to participate in the smallpox vaccination program. As a result, the number of people who were eventually vaccinated increased.
What’s more, Fukui had a smallpox epidemic the next year, and the children who’d been vaccinated didn’t get it. This also made more people decide to get vaccinated.
Kasahara’s dream finally came true.
Thanks to a lot of people, smallpox was officially declared eradicated in 1980.
The fight against smallpox enabled humans to invent a vaccine for a disease for the first time. The introduction of this vaccine into Japan helped to modernize the country. Johanees Pompe van Meerdervoort, a Dutch physician, and the doctors who practiced western medicine like Kasahara laid the foundation of Japanese modern medical science. Some long-standing faculties of medicine, such as the Faculty of Medicine at Juntendo University, Nagasaki University, University of Tokyo, Kanazawa University and Osaka University, originated from these smallpox vaccination centers, the Japanese Naval School or private schools of Western learning.
Kasahara was a martyr who suffered a lot, but never gave up his dream of introducing Western medicine, especially vaccinations, into Japan. He’s admired in Fukui and is a role model for the medical staff at the University of Fukui, School of Medical Sciences.
He isn’t well known outside of Japan, but I’m sure you’ll agree that he was a great man.
(References):
「雪の花」（吉村昭）（新潮文庫）
「由利公正生誕180年記念 笠原白翁生誕200年記念 歴史講座講演録」（講師：白崎昭一郎）（福井市・（財）歴史のみえるまちづくり協会）
「種痘伝来」（著：アン・ジャネッタ 訳：廣川和花、木曾明子）（岩波書店）
「小児を救った種痘学入門：ジェンナーの贈り物」（編著：加藤四郎）（創元社）
「福井県における公衆衛生の先駆者、笠原白翁」（大井田隆）（公衆衛生 Vol.52 No.7 1988年7月）
「ふるさと 福井の先人１００人」（編集：福井県教育委員会）
「福井藩における藩運営除痘館の開設とその運営」（柳沢芙美子）（福井県文書館研究紀要（１６））
「北陸医学史と大分・中津について」（古林秀則）（北陸医史 第36号 平成26年2月）
「福井大学医学部 白翁会ホームページ」https://sites.google.com/view/hakuoukai/home/白翁会について
「福井の幕末明治 歴史秘話 24」（福井県観光営業部ブランド営業課）
「西洋文化との出会い」（白崎昭一郎）（グラフフクイ、2003（Jul.）(426)（福井県）
「Occupational Health for Well-being, Dignity, and Creativity」(Akio Koizumi)(Industrial Health 2013,51,371-372)
「A Brief History of Jennerian Vaccination in Japan」(Akitomo Matsuki)(Medical History Volume 14 Issue2 April 1970)(Cambridge University Press 16 August 2012, pp.199-201)