From Kyoto to Fukui
The first vehicle was a special container he had himself developed: two matching rectangular plates of curved glass that could hold the pus between them. Second, he recruited two pairs of parents with young children for arm-to-arm transfers. Ultimately, arm-to-arm transfer turned out to be unnecessary in this case, but it subsequently became the preferred method of transmission due to its reliability. The author of "Gyūtō Kaihei" (Uncovering Cowpox) from 1852 argued that scabs should only be used in rare cases, for example for long-distance transfers, because they were more likely to result in "false" pocks and did not offer the same degree of protection as direct transmission [Umihara 2014, p. 196].
The transmission from Kyoto to Fukui began on 11/16. On that day, Hakuō vaccinated two children from Kyoto. After confirming that pustules had begun to develop on their arms, he took them to an inn in Nagahama on Lake Biwa, on the way to Fukui. On 11/22 the children's pustules had ripened, and Hakuō transferred lymph from their arms to two more children from Fukui, who had traveled all the way to Kyoto for this purpose together with their parents. The family from Kyoto then returned home, whereas Hakuō and the second family embarked on a strenuous hike back to Fukui through a snowstorm across Tochigi Pass [Senkyōroku]. On 11/24, the party reached the highway station of Imajō, where a physician from Fuchū was already waiting with three local children in tow. Hakuō vaccinated one of these children as a back-up. On 11/25, upon arrival in the castle town of Fukui, he vaccinated further children. He probably used the lymph from the glass container at this time, as the traveling children would not yet have been ready for transfer [Sugihara].
By year’s end of 1849, the smallpox vaccine had reached Fukui, a town of about 30,000 people. But would the local physicians be able to keep it in circulation?
