The Publication and Dissemination of Books on Cowpox Vaccination and Changes in the Perception of Vaccination in Early 19th Century China - Focusing on Xiyang Zhongdou Lun (Western Vaccination Theory) and Yindulue (A Brief Treatise on Vaccination).

In 1805, Alexander Pearson administered the cowpox vaccine, which had been transported to Macau, to the Chinese people, marking the beginning of the first cowpox vaccinations in China. Under the patronage of Zheng Chongqian, Pearson published Yingjili-guo Xinchu Zhongdou Qishu (A Wonderful Book on the Newly Discovered Method of Vaccination in England), the first book on cowpox vaccination in China, while concurrently passing down the vaccination method to four Chinese individuals: Liang Hui, Qiu Xi, Zhang Yao, and Tan Guo. Notably, Qiu Xi authored Yindulue (A Brief Treatise on Vaccination), successfully spreading awareness of cowpox vaccination throughout China, and its influence was so immense that it was reprinted dozens of times throughout the 19th century following its first publication in 1817. However, looking strictly at the first half of the 19th century, the process of spreading the cowpox vaccination method was far from easy. The area where it was introduced was the southernmost region of China, and the process of expanding its reach and propagating outward from there was sluggish. During this period, the greatest catalyst for the dissemination of cowpox vaccination was Qiu Xi's Yindulue. Although works like Zhongdou Qishu and Xiyang Zhongdou Lun existed prior to Yindulue, it was Yindulue that achieved massive success by providing appropriate solutions to various practical problems that arose during the spread of cowpox. Qiu Xi's interpretation of cowpox vaccination using traditional medical theories, an approach for which he is highly credited, was a continuation and development of the attempts made in Xiyang Zhongdou Lun. Unlike Huang Anhui, who attributed the cause of smallpox to "heart fire" (xinhua), Qiu Xi focused on "fetal toxin" (taidu), a concept easily understood by the general public, which seems to have garnered much greater public consensus. However, the enduring popularity and widespread use of Yindulue can also be attributed to other practical aspects presented in the text, such as the operational guidelines for vaccination bureaus-including establishing vaccination cycles for lymph (dumiao) harvesting and managing gratuities-as well as implementing measures to prevent infectious diseases to ensure the safety of the lymph, and improving preservation methods to extend its storage life. The dissemination process of cowpox vaccination is also closely tied to the reprinting of Yindulue, and an analysis of the texts included in the book reveals several key facts. First, the introduction of cowpox vaccination to Beijing around 1828 was a milestone event in its dissemination. This meant that the spread of vaccination did not rely solely on moving northward from the stronghold of Guangdong, but rather, transmission originating from Beijing also played a major role. While Guangdong was a remote region at the southernmost tip of China, Beijing was the capital of the Qing Dynasty and the political and economic center, which gave it a far greater sphere of influence. Second, within Yindulue and the broader dissemination process, subtle signs of a perceptual shift began to emerge, moving away from traditional medicine that emphasized culture toward a modern mindset that prioritized trials and results. Although the vaccination technique was wrapped in the outer garment of traditional medicine in terms of its technical aspects, underneath lay a latent shift in perception that approached the experimental medicine pursued by Western medical science. This created a peculiar entanglement between the West and China, and between modernity and tradition, reflecting a facet of the 19th-century Chinese intellectual world. This complexity is evident because, alongside the main text written by Qiu Xi, Yindulue contains various writings left by a diverse range of figures who took the lead in printing and promoting the book.