[Jennerian vaccination introduced via the trans-Siberian route by Goroji Nakagawa--his influence on the first successful vaccination by Teisai Hino in Kyoto].

Goroji Nakagawa, a head guard of Itrup Island, was unwillingly brought to Siberia on a Russian vessel in 1807 and he returned to Japan with two Russian vaccination books after five years' stay in Siberia in 1812. He learned how to practice the Jennerian method in Yakutsk and Okhotsk just before his return to Japan in that year. One of the two Russian books was translated into Japanese by Sadayosi Baba, a translator of the Tokugawa shogunate, and was titled "Tonka Hiketsu", but it remained unpublished. Sen-an Tosimitsu, a physician of Mikawa, obtained a manuscript of "Tonka Hiketsu" and published it with the modified title "Rosia Gyuto Zensho" in 1850. As Nakagawa did not write down anything about his method of vaccination, the details of the method have not been known to us and this has resulted in an underestimated evaluation of him in the history of Jennerian vaccination in Japan because his method was introduced and transmitted only to the limited area of the northern part of Japan with no significant influence on the spread of the Jennerian method in Japan. The author reevaluated his vaccination method by careful examination of the documents describing Nakagawa's method to find that he had essentially followed the method described in the Russian book; however, how he made vaccine lymph or crust is still unknown to us. As there is no hearsay evidence of deaths by his method, it is suggested that he might have employed cowpox vaccine, not small pox lymph or crust. Nakagawa's method was conveyed to Teisai Hino, a leading physician in Kyoto, via Yuzo Shiratori, one of the disciples of Nakagawa, and after repeated failures with the Dutch method Hino was successful in the final trial of vaccination using cowpox crust, supposedly with the Russian method, in September of 1849. Hino's vaccine lymph was widely distributed among various districts of western Japan to promote further prevalence of the vaccination. Considering these facts, Nakagawa's method had a significant influence on the subsequent wide prevalence of Jennerian vaccination in Japan.