청말 의료선교사의 눈으로 본 두창과 종두법 = Smallpox and Vaccination Viewed From Medical Missionaries' Perspective in Late Qing Dynasty

다국어 초록 (Multilingual Abstract)

This paper comparatively analyzes Chinese people's and foreign medical missionaries' perceptions on vaccination and their effects on the transmission of Jenner's vaccine, from the records of Chinese smallpox and vaccination in the late Qing dynasty, which medical missionaries left. Furthermore, it also examines how the traditional knowledge system interacted with the modern one, by exploring medical missionaries, Chinese people, vaccination and variolation.
The Jenner's vaccine is a vaccination method for preventing smallpox by using the smallpox virus extracted from cows. Chinese people already knew the concept of vaccination through variolation, so Jenner's vaccine was the best method for introducing the modern medicine. Medical missionaries who first introduced the modern medicine into China also intended to demonstrate the superiority of the modern medicine and show Christian mercy to Chinese people, by using Jenner's vaccine.
Medical missionaries left a variety of records regarding the prevalence of smallpox and vaccination. In China, smallpox was an infectious disease that was always prevalent in all areas. Chinese people believed that they could not but experience smallpox once at least in their life. In addition, it can be found that vaccination and re-vaccination for missionaries were emphasized, since smallpox was a disease which also seriously threatened foreigners.
Medical missionaries made various efforts to extend Jenner's vaccine, by publicizing it through a variety of media and freely vaccinating people in vaccine stations or mission hospitals constructed in cooperation with local merchants, elites and officials. In addition, medical missionaries and mission hospitals secured vaccine lymph, by using their domestic and foreign networks and contributed to extending Jenner's vaccine by instructing Chinese physicians about how to use Jenners' vaccine. On the other hand, an aspect of East-West cultural exchange can be observed, in that vaccine stations were built in the traditional Chinese temples and Chinese people and foreign medical missionaries performed vaccination together.
Jenner's vaccine was, however, not easily practiced. At the initial stage, medical missionaries also experienced many difficulties. The vaccination was often failed, due to corruption of vaccine lymph and lack of knowledge and experience about native vaccinators and use of unhygienic tools. Medical missionaries made efforts to increase the success rate of Jenner's vaccine, by continuously investigating why the vaccination was failed and exchanging information with each other.
Chinese people's high reliability of variolation was an obstacle to the extension of Jenner's vaccine. Medical missionaries introduced various cases of variolation, indicating that variolation was generally conducted at that time. In such record, they emphasized the advantage of vaccination, listing the cases of victims who were dead or lost their eyesight due to variolation. Different from them who recognized that the variolation and the traditional notions about it should be abandoned, however, Chinese people who learned Jenner's vaccine from them attempted to accept it within the traditional notions which they had long trusted and preserved. In particular, YindouLue(引痘略) applied the taidu (胎毒) theory, the Yin-Yang theory, periods of vaccination and the restriction on foods after vaccination to Jenners' vaccine. Medical missionaries, however, could not understand such a restriction and explained Chinese people that Jenner's vaccine, different from variolation, could be applied to them regardless of any seasons and it was not necessary to choose foods after vaccination. On the other hand, xieqi(邪氣), a traditional medical concept was also used to explain the causes of smallpox, where the germ theory did not still appear.
In order to extend the use of Jenner's vaccine, medical missionaries thus criticized variolation, while using the traditional concept. In spite of such an effort, however, it was not easy to help Chinese people understand the Western way of thinking, since there was a cultural gap which could not be narrowed, between medical missionaries and Chinese people, as in the case of perceptions on re-vaccination and pockmarks. The issue of how to narrow the cultural gap between them is directly related with the localization of the Western modern medicine with the main focus on Jenner's vaccine.

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