The Doctors Dilemma: Preface | Page 9

to be entertained and delighted: we go to be tormented
and maimed, lest a worse thing should befall us. It is of the most
extreme importance to us that the experts on whose assurance we face
this horror and suffer this mutilation should leave no interests but our
own to think of; should judge our cases scientifically; and should feel
about them kindly. Let us see what guarantees we have: first for the
science, and then for the kindness.
ARE DOCTORS MEN OF SCIENCE?
I presume nobody will question the existence of widely spread popular
delusion that every doctor is a titan of science. It is escaped only in the
very small class which understands by science something more than
conjuring with retorts and spirit lamps, magnets and microscopes, and
discovering magical cures for disease. To a sufficiently ignorant man

every captain of a trading schooner is a Galileo, every organ-grinder a
Beethoven, every piano-tuner a Hemholtz, every Old Bailey barrister a
Solon, every Seven Dials pigeon dealer a Darwin, every scrivener a
Shakespear, every locomotive engine a miracle, and its driver no less
wonderful than George Stephenson. As a matter of fact, the rank and
file of doctors are no more scientific than their tailors; or, if you prefer
to put it the reverse way, their tailors are no less scientific than they.
Doctoring is an art, not a science: any layman who is interested in
science sufficiently to take in one of the scientific journals and follow
the literature of the scientific movement, knows more about it than
those doctors (probably a large majority) who are not interested in it,
and practise only to earn their bread. Doctoring is not even the art of
keeping people in health (no doctor seems able to advise you what to
eat any better than his grandmother or the nearest quack): it is the art of
curing illnesses. It does happen exceptionally that a practising doctor
makes a contribution to science (my play describes a very notable one);
but it happens much oftener that he draws disastrous conclusions from
his clinical experience because he has no conception of scientific
method, and believes, like any rustic, that the handling of evidence and
statistics needs no expertness. The distinction between a quack doctor
and a qualified one is mainly that only the qualified one is authorized to
sign death certificates, for which both sorts seem to have about equal
occasion. Unqualified practitioners now make large incomes as
hygienists, and are resorted to as frequently by cultivated amateur
scientists who understand quite well what they are doing as by ignorant
people who are simply dupes. Bone-setters make fortunes under the
very noses of our greatest surgeons from educated and wealthy patients;
and some of the most successful doctors on the register use quite
heretical methods of treating disease, and have qualified themselves
solely for convenience. Leaving out of account the village witches who
prescribe spells and sell charms, the humblest professional healers in
this country are the herbalists. These men wander through the fields on
Sunday seeking for herbs with magic properties of curing disease,
preventing childbirth, and the like. Each of them believes that he is on
the verge of a great discovery, in which Virginia Snake Root will be an
ingredient, heaven knows why! Virginia Snake Root fascinates the
imagination of the herbalist as mercury used to fascinate the alchemists.

On week days he keeps a shop in which he sells packets of pennyroyal,
dandelion, etc., labelled with little lists of the diseases they are
supposed to cure, and apparently do cure to the satisfaction of the
people who keep on buying them. I have never been able to perceive
any distinction between the science of the herbalist and that of the duly
registered doctor. A relative of mine recently consulted a doctor about
some of the ordinary symptoms which indicate the need for a holiday
and a change. The doctor satisfied himself that the patient's heart was a
little depressed. Digitalis being a drug labelled as a heart specific by the
profession, he promptly administered a stiff dose. Fortunately the
patient was a hardy old lady who was not easily killed. She recovered
with no worse result than her conversion to Christian Science, which
owes its vogue quite as much to public despair of doctors as to
superstition. I am not, observe, here concerned with the question as to
whether the dose of digitalis was judicious or not; the point is, that a
farm laborer consulting a herbalist would have been treated in exactly
the same way.
BACTERIOLOGY AS A SUPERSTITION
The smattering of science that all--even doctors--pick up from the
ordinary newspapers nowadays only makes the doctor more dangerous
than he used to be. Wise men used to take care to consult doctors