The Doctor's Dilemma: Preface on DoctorsShaw, Bernard
Philosophy
The Doctor's Dilemma: Preface on Doctors
Shaw, Bernard
Physicians
who would order the entire disappearance of some disease from their
armies, and bring it about by the simple plan of changing the name
under which the cases were reported, or for our own Metropolitan Asylums
Board, which carefully suppressed all the medical reports that revealed
the sometimes quite appalling effects of epidemics of revaccination,
there is no saying what popular reaction might not have taken place
against the whole immunization movement in therapeutics.
The situation was saved when Sir Almroth Wright pointed out that if you
inoculated a patient with pathogenic germs at a moment when his powers
of cooking them for consumption by the phagocytes was receding to its
lowest point, you would certainly make him a good deal worse and perhaps
kill him, whereas if you made precisely the same inoculation when the
cooking power was rising to one of its periodical climaxes, you would
stimulate it to still further exertions and produce just the opposite
result. And he invented a technique for ascertaining in which phase the
patient happened to be at any given moment. The dramatic possibilities
of this discovery and invention will be found in my play. But it is one
thing to invent a technique: it is quite another to persuade the medical
profession to acquire it. Our general practitioners, I gather, simply
declined to acquire it, being mostly unable to afford either the
acquisition or the practice of it when acquired. Something simple,
cheap, and ready at all times for all comers, is, as I have shown, the
only thing that is economically possible in general practice, whatever
may be the case in Sir Almroth's famous laboratory in St. Mary's
Hospital. It would have become necessary to denounce opsonin in the
trade papers as a fad and Sir Almroth as a dangerous man if his practice
in the laboratory had not led him to the conclusion that the customary
inoculations were very much too powerful, and that a comparatively
infinitesimal dose would not precipitate a negative phase of cooking
activity, and might induce a positive one. And thus it happens that the
refusal of our general practitioners to acquire the new technique is
no longer quite so dangerous in practice as it was when The Doctor's
Dilemma was written: nay, that Sir Ralph Bloomfield Boningtons way of
administering inoculations as if they were spoonfuls of squills may
sometimes work fairly well. For all that, I find Sir Almroth Wright,
on the 23rd May, 1910, warning the Royal Society of Medicine that "the
clinician has not yet been prevailed upon to reconsider his position,"
which means that the general practitioner ("the doctor," as he is called
in our homes) is going on just as he did before, and could not afford
to learn or practice a new technique even if he had ever heard of it.
To the patient who does not know about it he will say nothing. To the
patient who does, he will ridicule it, and disparage Sir Almroth. What
else can he do, except confess his ignorance and starve?
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account