The expedition of 1854 went ahead largely as planned, but was hampered by a lack of funding and the logistical difficulty of timing vaccinations. The details of this trip reveal why vaccinating the countryside was difficult to achieve without a publicly funded health infrastructure, and why vaccinations became such an important factor in building a centralized public health system in Japan.

The villages chosen for this first expedition were located along the coast of the Sea of Japan, about 10 ri (40 kilometers) west of Fukui. Gamō, a fishing village, had responded to a call by the domain government and applied for a vaccinators’ visit. The physicians planned to use this occasion to test the village relay method by including a few villages next to Gamō in their itinerary. Kasahara Hakuō headed this expedition himself. In the domain’s call issued to villagers, he was mentioned by name and given a new, official-sounding title (on-shutōka) to counter any perception among villagers that the domain would only spare inexperienced doctors to go to the countryside [Ban 1986, part 2, pp. 165-166].

The success of the mission hinged on timing. To make sure there would be enough child volunteers in Gamō, Hakuō and Okada Kihachirō had the village headman come to Fukui in advance and submit a name roster. The district governor also coordinated with two villages on the way to Gamō to serve as relay stations. On 3/29, sixteen children from the two way stations Hirao and Shimizubata arrived in the castle town to be vaccinated, and returned home later that day with instructions. Yet, Hakuō was so nervous that these “carrier” children might not actually show up in Gamō on time that he sent one of his colleagues to their villages just to make sure. In the morning of 4/6, the children from Hirao and Shimizubata punctually arrived in Gamō, and the doctors, who had come one day early and set up shop at Yōanji temple, vaccinated 56 children before the end of the day. They returned to Fukui that night to save money on accommodation.

Seven days later, the vaccinators made a second visit to Gamō. This time, they hoped to transfer the lymph to children from a neighboring village, Ōniu, to initiate a village relay. But they were unable to put that plan into practice because the number of local child volunteers far exceeded the number previously reported by the headman. Hakuō’s group ended up going to Gamō five times in a row to satisfy every request. But before they could initiate the village relay to Ōniu, the district governor temporarily halted the program because he wanted to reassess the financial situation. It turned out that only 60 out of 211 recipients of vaccinations in Gamō had donated the suggested amount of 10 monme of silver. The governor believed that in order to continue, he needed to put more pressure on potential donors. When the vaccination clinic thus sent out its next call for villages to apply, the text no longer explicitly mentioned the possibility of poor parents being exempted from donations.