The Seed-Pox of 1849: The Day Kōan Started Japanese Public Health

In the winter of 1849 (Kaei 2), in Ōsaka. Ogata Kōan set up a 'Jōtōkan' (Pox-Removal House) at his home and began the full-fledged implementation of smallpox vaccination (seed-pox).

He was forty. Using cowpox seedling imported from the Netherlands, he first began inoculation from Tekijuku disciples and their families, and thereafter spread it to the general populace of Ōsaka.

He became one of the first physicians in Japan to establish an organized, continuous seed-pox enterprise.

In Edo-period Japan, smallpox was the most feared epidemic. Once infected, the mortality rate was about thirty percent; survivors were left with scars, blindness, and other after-effects.

It struck regardless of age and took the lives of children in massive numbers. It was one of the primary causes of the high infant mortality of the Edo period, and the greatest factor shortening the average life expectancy of the Japanese.

After Jenner of England announced cowpox inoculation in 1798, that technology had gradually been transmitted to Asia as well.

In 1849, Kōan obtained cowpox seedling imported from the Netherlands and began general inoculation at his home as the 'Jōtōkan.

' At first, fear and doubt among the populace toward seed-pox were strong; there was great resistance to the act of 'putting the pus of a cow into a person.

' Kōan showed safety by inoculating his own children first, and gradually gained trust.

Over the following several years, the number of seed-pox vaccinated persons in Ōsaka reached several thousand.

Kōan's Jōtōkan became the impetus for the establishment of similar seed-pox stations across Japan thereafter.

In 1858, the Kanda Otamagaike Seed-Pox Station (the origin of the later Faculty of Medicine of the University of Tokyo) was established in Edo, and the bakufu officially recognized seed-pox.

Kōan's decade of effort from 1849 led the bakufu's policy change. Until the Meiji government's nationwide compulsion of smallpox vaccination in the 1870s, the rails Kōan laid formed the basic shape of Japanese public health.

Smallpox is the only infectious disease that humanity has succeeded in eradicating; global eradication was declared by the WHO in 1980.

At the starting point of the more-than-century of vaccination enterprise leading to smallpox eradication in Japan (last case in 1955) was Kōan's Jōtōkan of 1849.

Japanese average life expectancy has extended dramatically, from around thirty years in the Edo period to over eighty today.

One of the medical foundations of this extension is the establishment of public health, and Kōan's judgment of 1849 was its starting point.