dwell upon the alleged fact that neither water-supply, nor drainage, nor contaminated food produce small-pox, and urge that what is commonly understood by sanitation has little effect upon it (par. 153). But what may be termed the fundamental principle of sanitation is the avoidance of _overcrowding_; and this is shown by an overwhelming body of evidence invariably to influence small-pox mortality quite irrespective of vaccination.[22] Yet the remarkable contribution to the mass of evidence in the “Reports” which brings out this fact most clearly, receives no notice whatever in the _Final Report_. CHAPTER VI SUMMARY AND CONCLUSION As the diverse aspects of the problem which has been discussed in the preceding pages are somewhat numerous and complex, owing to the vast mass of irrelevant but confusing matter with which it has been encumbered at every step of its progress for nearly a century, a brief summary of the main points here referred to, and a statement of their bearing on the essential problem, will now be given. I have first shown the nature of the tests which seemed to the early enquirers to establish the protective influence of vaccination, and have given the facts which the two greatest living specialists on the subject—Professor Crookshank and Dr. Creighton—consider to prove the fallacy or insufficiency of all the tests which were applied. This is followed by a statement of the abundant evidence which in the first ten years of the century already showed that vaccination had no protective power (pp. 10-12). But the heads of the medical profession had accepted the operation as of proved value, and the legislature, on their recommendation, had voted its discoverer £30,000 of public money, and had besides, in 1808, endowed a National Vaccine Establishment with about £3,000 a year. Reputations and vested interests were henceforth at stake, and those who adduced evidence of the failure or the dangers of vaccination were treated as fanatics, and have been so treated by the medical and official world down to the appointment of the last Royal Commission. I next give the reasons why doctors are _not_ the best judges of the effects, beneficial or otherwise, of vaccination, and follow this by proofs of a special capacity for misstating facts in reference to this question which has characterized them from the beginning of the century down to our day. The successive annual reports of the National Vaccine Establishment give figures of the deaths by small-pox in London in the eighteenth century, which go on increasing like Falstaff’s men in buckram; while in our own time the late Dr. W. B. Carpenter, Mr. Ernest Hart, the National Health Society, and the Local Government Board make statements or give figures which are absurdly and demonstrably incorrect (pp. 13-18).[23]