This chapter tracks the rapid transmission of the cowpox vaccine throughout the Japanese Islands in the summer and fall of 1849. A detailed chronology shows how ranpō physicians (physicians who practice Western-style medicine) employed social networks to distribute cowpox vaccine, to educate physicians on how to use it and to establish private vaccination clinics. Opperhoofd Joseph Henrij Levyssohn, Otto Mohnike, and their Japanese collaborators in Nagasaki—principally Dutch interpreters and ranpō physicians—initiated the dissemination of vaccine from Kyushu, but the national diffusion of vaccination was carried out by ranpō physicians who lived in Japan's many towns and villages. The speed and extent of the diffusion of vaccination reveal the national scale of Japan's vaccination network.
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