“ As regards the effect of vaccination in reducing the prevalence of, and mortality from, small-pox, the following conclusions were arrived at, Dr Collins and Mr Picton alone dissenting: “ (1) That it diminishes the liability to be attacked by the disease. (2) That it modifies the character of the disease and renders it (a) less fatal, and (b) of a milder or less severe type. (3) That the protection it affords against attacks of the disease is greatest during the years immediately succeeding the operation of vaccination. ”

“ The standard laid down by the Local Government Board—the production, namely, of a total area of vesiculation of not less than half a square inch, divided among four separate vesicles or groups of vesicles, not less than half an inch from one another has for the most part proved easily attainable in practice, and it is much to be desired that in private as in public work the attainment of this standard should be aimed at in every instance.
The protection afforded by a primary vaccination tends gradually to diminish, and eventually to disappear more or less completely, with the lapse of time. ”

“ In a successful re-vaccination, the site of the operation may be distinctly reddened and somewhat irritable by the second day, while papules will probably make their appearance about the third to the fifth day. The papules may or may not develop further into vesicles and pustules. Occasionally a re-vaccination appears to fail altogether; but, as pointed out by the Royal Commission, it is advisable, as in the case of a primary vaccination, to make further attempts with lymph of known potency before concluding that the individual is really insusceptible. ”

“ That re-vaccination restores the protection which lapse of time has diminished, but the evidence shows that this protection again diminishes, and that, to ensure the highest degree of protection which vaccination can give, the operation should be at intervals repeated. (7) That the beneficial effects of vaccination are most experienced by those in whose case it has been most thorough. ”

“ Tubercle in its Various forms and leprosy have also been included in the list of possible complications of vaccination, though without any sufficient proof. The employment of calf lymph, treated with glycerin after the manner first advocated by S. Monckton Copeman, will obviate any such danger, for even if tubercle bacilli or the Streptococcus of erysipelas were by chance present in the lymph material when collected, it has been found experimentally that they are quite unable to survive prolonged exposure to the action of a 50% solution of glycerin in water. ”

“ On the other hand, small-pox is practically unknown among well-vaccinated children. When, quite exceptionally, such children have been attacked, the disease has been so trivial in character as to be liable to escape recognition altogether. (2) Medical men, nurses and other persons exposed to the disease habitually protect themselves by efficient re-vaccination, and when this precaution has been taken, never contract small-pox.
The clinical activity and bacteriological purity of the lymph employed for vaccination; the skilful performance of the operation itself ”

“ On his return to his native village of Berkeley in 1773, to practise as a medical man, he took every opportunity of talking over and investigating the matter, but it was not until May 1796 that he actually began to make experiments. ”

“ Society (1901-2) ; M'Vail, “Criticism of the Dissentient Commissioners' Report, " Trans. Epidemiological Society (1397) ; Reports of the Royal Commission on Vaccination (1889-1896) ; “The History and Effects of Vaccination, " Edinburgh Review, No. 388 (1899) ; Vaccination Law of German Empire (Berlin, 1904) . ”