BCG vaccine extensively used even in countries where efficacy against pulmonary tuberculosis is negligible. A number of possible reasons for the variable efficacy of BCG in different countries have been proposed. None have been proven, some have been disproved, and none can explain the lack of efficacy in both low-TB burden countries (US) and high-TB burden countries (India). The reasons for variable efficacy have been discussed at length in a WHO document on BCG. BCG has protective effects against some non-tuberculosis mycobacteria. BCG has been one of the most successful immunotherapies. BCG vaccine has been the "standard of care for patients with
Inoculation Needham states that this information comes from the "Zhongdou xinfa" (種痘心法) written in 1808 by Zhu Yiliang, centuries after the alleged events. 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