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 that it was not geographical distance per se that prevented vaccinations from being performed in the countryside. Rather, it was a combination of geography and low concentrations of the kinds of bodies that could carry and transplant the vaccine. These two factors made it difficult to move the bodies of children and vaccinators to the right place at exactly the right time.

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 test the village relay method on this occasion by including a few villages next to Gamō in their itinerary. Kasahara Ryōsaku led this expedition himself. In the domain’s call to villagers, he was mentioned by name and given a new, official-sounding title (go-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, Kasahara 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, Kasahara 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 be 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 fifty-six 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 trip 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 (among them children from other nearby villages) far exceeded the number previously reported by the village headman. Kasahara’s group ended up going to Gamō five times in a row to satisfy every request from the "pox bases" available to him. 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. This decision interrupted the chain, and the vaccinators had to start over again when they made a second expedition to the coast in the fifth month.

On 5/6, two additional fishing villages, Ōniu and Koniu, petitioned for a vaccinators’ visit and the district office ordered Kasahara Ryōsaku and his team to go. These villages were located only 2 ri northeast of Gamō (see the map above for locations), but because the chain of bodies had been disconnected, the clinic in the castle town needed to initiate another relay. On 5/13, twenty children from Koniu and nearby villages thus traveled to Fukui and reconnected the coast through the movement of their vaccinated bodies.

Vaccinations in Koniu were timed for the seventh day after the carrier children’s vaccinations. On 5/20, Kasahara and his colleagues vaccinated seventy-one children, and another twenty on their follow-up visit on 5/26. Kasahara’s notes also show that he had arranged through the district office for fifteen children from Ōniu to come to this second event in Koniu so they would be available as vehicles when the vaccinators visited the next station on the tour, Ōniu. Had the village relay continued as planned, the vaccinators would have gone to Ōniu two times and invited children from the next village such as Hatanaka to the second event so that vaccinations could have been continued in Hatanaka, and so on.