At the end of the 7th century, Chinese medicine was widely spread in the upper class of Japanese society, and Japanese emperors developed a medical based view on epidemics. At the beginning of the 8th century, emperors determined to reform by imitated the Tang to build a state ruled by law.They determine the way of TCM to relieve the epidemic in the form of legislation, and used medical measures in outbreaks on many occasions.However, with the spread of smallpox and other epidemics during the Tenpei year, Japan's backward medical level and poor medical resources were unable to cope with the epidemic, and the emperors turned to the epidemic as calamity. From the late 8th century to the end of 10th century, Japanese emperors responded with Buddhist, Shinto, and Confucian measures. Medical relief gradually became obsolete at the national level. But at the individual level of the emperors, they attached great importance to the use of Chinese medicine for epidemic prevention and treatment, in the mid to late 9th century, medical prevention measures were established in the court through legal means.
7世纪末中国医学在日本上层社会广泛传播，使日本统治者形成了基于医学的疫病观。8世纪初统治者锐意改革，模仿唐朝建设律令制国家，立法以中国医药救疫，多次在疫情中使用医药措施。然而随着天平年间天花等大疫的传入与流行，日本落后的医学水平与贫弱的医疗资源无力应对疫情，统治者转而将疫病视作灾异。8世纪后半叶至10世纪结束前，日本统治者持灾异疫病观，以佛教、神道、儒家措施应对疫情，医药对策在国家救疫层面逐渐荒废。但是，日本统治者在个人层面重视以中国医药防疫、治疫，在9世纪中后期用法律的形式确立宫廷医药防疫措施。.