Taking courage from the Dutch
Anthony Daniels THE VACCINATORS: SMALLPDX, MEDICAL KNOWLEDGE AND THE 'OPENING' OF JAPAN by Ann Jannetta Stanford University Press, £28.95, pp. 245, ISBN 9780804754897 © £23.16 (plus £2.45 p+p) 0870 429 6655 Globalisation is not as new as we sometimes like to think. Within a mere five years of the publication in 1798 of Jenner's tract about vaccination, Dr Francisco Xavier de Balmis set sail to the Spanish colony of New Spain (Mexico) with a view to introducing vaccination there. Having done so successfully, he sailed on to the Philippines, Macau and Canton with the same aim in view. Vaccination arrived about the same time in Java by way of Mauritius. No modern consumer product has spread more rapidly.
Vaccination, however, was late in reaching Japan. This was not because there was no need for it: on the contrary, it has been estimated that about a fifth of Japanese children died of smallpox before the age of five. The reason for the late arrival of vaccination was the two-and-a-half-centuryold isolation of Japan under the rule of the Tokugawa shoguns.
Japan's only contact with the rest of the world during that time was through the few Dutch merchants who were allowed to reside there and wait for Dutch ships, never very numerous, to arrive, bringing trade goods. But Western ideas, including those about medicine, filtered into Japan by means of translated Dutch books. News of vaccination reached Japan comparatively early, but the procedure was not performed until 1849, only four years before the arrival of the American commodore Matthew Perry.
The Dutch had tried to introduce vaccination to the Japanese, but the cowpox material that they sent, in the form of dried lymph from cow-pox vesicles, did not survive the journey from Batavia in Java. Eventually, the Japanese asked for the dried crusts of cow-pox lesions, and this worked.
By this time, a considerable cadre of Japanese doctors who, for some reason not entirely clear, had decided that Western medicine was superior to the Chinese medicine that was traditional in Japan, and had trained in its methods despite official disapproval and discouragement, were ready to spread vaccination throughout Japan, and did so within only a few months. It was an impressive achievement, and only 30 or so years later Japanese scientists were to make many important contributions to bacteriological science, the most important medical science of the time.
The Japanese doctors were convinced of the efficacy of vaccination by what they had read, not what they had seen: it was an extraordinary and rather rare triumph of reason over ignorance and prejudice. The work of the translators from the Dutch was therefore crucial in the modernisation of Japan, of which vaccination was a precursor. Vaccination's evident efficacy must have convinced many Japanese that they needed to learn from the foreign barbarians, and therefore helped smooth the way for the Meiji restoration.
One of the ironies upon which the author of this fascinating book does not remark is that at about the time vaccination reached Japan and spread rapidly there passionate opposition to it was growing in its home country, an opposition that was to become a mass movement and to receive support from notable intellectuals, among them Alfred Wallace and George Bernard Shaw. The anti-vaccinationists published a masscirculation magazine continuously for nearly 70 years, and accused vaccination of causing everything from epidemics of smallpox to leprosy. There was nothing comparable in Japan.
On the contrary, vaccination played an essential role in developing Japanese medical institutions. Its two most famous medical schools, for example, started off as vaccination hospitals. And the fact that vaccination spread not as the result of a government decision or policy, but rather as a consequence of an informal network of highly motivated and surprisingly well-informed doctors, in a state in which governmental control was supposed to be absolute, had a social and political effect far beyond the merely medical one.
Some of the detail in the book may be redundant for the general reader, but the account of the discovery and spread throughout the world of vaccination, and of the very long role of the Dutch in the history of Japan, is admirably clear. After reading The Vaccinators you might also understand a little better why the Japanese were able to adopt so much so quickly from the West, even after centuries of isolation, without losing their unique character.
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