Page "Inoculation" Paragraph 9

The first clear and credible reference to smallpox inoculation in China comes from Wan Quan's ( 1499 – 1582 ) Douzhen xinfa ( 痘疹心法 ) of 1549, which states that some women unexpectedly menstruate during the procedure, yet his text did not give details on techniques of inoculation.

Inoculation was first vividly described by Yu Chang in his book Yuyi cao ( 寓意草 ), or Notes on My Judgment, published in 1643.

Inoculation was reportedly not widely practised in China until the reign of the Longqing Emperor ( r. 1567 – 1572 ) during the Ming Dynasty ( 1368 – 1644 ), as written by Yu Tianchi in his Shadou jijie ( 痧痘集解 ) of 1727, which he alleges was based on Wang Zhangren's Douzhen jinjing lu ( 痘疹金鏡錄 ) of 1579.

From these accounts, it is known that the Chinese banned the practice of using smallpox material from patients who actually had the full-blown disease of Variola major ( considered too dangerous ); instead they used proxy material of a cotton plug inserted into the nose of a person who had already been inoculated and had only a few scabs, i. e. Variola minor.

This was called " to implant the sprouts ", an idea of transplanting the disease which fit their conception of beansprouts in germination.

Robert Temple quotes an account from Zhang Yan's Zhongdou xinshu ( 種痘新書 ), or New book on smallpox inoculation, written in 1741 during the Qing Dynasty ( 1644 – 1912 ), which shows how the Chinese process had become refined up until that point: