How These Doctors Love One Another!

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How These Doctors Love One Another!
written by George Bernard Shaw

I WARMLY recommend to those who love a good polemic the controversy lately concluded on the subject between Colonel Sir William Watson Cheyne and Colonel Sir Almroth Wright. Sir William stands at bay in the third-line trench of Antisepticism, and tries to defend that last ditch against his victorious and contemptuous antagonist. He admits that the sterilization of wounds by antiseptics is impossible if you let the wound get a day ahead of you, but still maintains that you can sterilize it by first intention, as it were, if you can shove in the germicide soon enough after the bayonet. But Sir Almroth will not have antiseptic surgery at any price. His intellectual scorn for his opponent gives a stimulating vituperativeness to his part of the debate which makes it highly entertaining, if somewhat cruel, reading. It was Lessing who, according to Heine, not only cut off his adversary's head, but held it up to shew that there were no brains in it. Sir Almroth, knowing that this is an anatomical impossibility, puts Sir William Watson Cheyne's brains on his operating table, and shews that Sir William has never learnt how to use them—never squarely faced even such vital questions as, "What is the exact weight of a little piece of cheese?" He shews that Sir William has no conception of scientific method, and that though he has no standards of quantity or of anything else, he yet makes statements that have no ascertainable meaning except with reference to fixed standards, falling short even of the clergyman who, when reading the lessons, informs the congregation that an omer is the tenth part of an ephah. Indeed, Sir Almroth often loses sight of the controversy in hand in his preoccupation with .the defects of Sir Watson's ratiocination; for Sir Almroth has such a devouring interest in and curiosity about the pathology of controversial cerebration, and takes such a delight in playing with it, that if Sir William challenges him to a duel (and the controversy at one moment reached a crisis at which no other reply seemed possible) he will write a most interesting pamphlet on the rationale of duelling, ending with an ingenious new technique of fencing, before he takes the field. I have in my own manner, timidly as becomes a layman' hinted more than once that the notion that a medical or surgical degree implies qualification in modern science could not exist if the nation understood either science or conventional surgery and medicine; but never would I dare to handle a medical baronet, a Hunterian professor, as medalled, in-despatches-mentioned consultant to the Forces, a M.B., C.M.. C.B, F.R.C.S. F.R.S., LLD and D.Sc. (Oxon), as Sir Almroth handles him. I shall not be believed unless I give a sample. Here is a typical one:

"CHEYNE. Another point, which I confess had not occurred to me until I came across it in the course of my experiments, is also of importance: viz., that the antiseptic is used up in killing bacteria.

"WRIGHT. We have here a generalization which ranks in the order of obviousness with the adage that you cannot both eat your cake and have it, and with the scientific platitude that you cannot carry out a chemical operation without expending chemicals.

"CHEYNE. The difficulty of obtaining a proper depth of agar has been overcome in a very ingenious manner by taking a metal ring, placing it on a sheet of glass, and superimposing on it another similar sheet; and though when two men work together it is not usual to refer to any one man's share in particular, still I think I ought to say that it was devised by Mr. Edmunds; and I shall speak of it as Mr. Edmunds's cell.

"WRIGHT. Some day we shall be told that the difficulty of carrying sugar into one's tea has been overcome in a very ingenious manner by the device of sugar-tongs; and that, in connection with it, this or that re-inventor's name ought to go down to posterity.

"CHEYNE. Lister observed the very curious phenomenon that if blood were drawn aseptically into a glass flask sterilized by heating, the clot which formed did not contract and squeeze out serum, as is the case when blood is received into an ordinary nonsterilized glass vessel. I fancy bacteriologists are not familiar with this fact.

"WRIGHT. Everyone who has drawn blood into a sterile syringe, and, of course, every laboratory worker, knows that this is fiction. Let us tell Sir Watson Cheyne that the method of serum therapy, and indeed the whole serum industry, depends upon the fact that blood, when drawn into a vessel sterilized by heating, does contract and squeeze out serum. [Here Sir William may be conceived as dropping senseless. His colleague proceeds:] So far, my task of criticism has been simple as child's play. For we have up to this remained entirely in the domain of the particular and the concrete, referring our author's utterances to the touchstone of fact. Let us now, rising to a more abstract and general point of view, deal with those three intellectual requisites of a scientific worker in which Sir Watson Cheyne comes, as it appears to me, hopelessly short. [Sir Almroth -proceeds to demonstrate that Sir William exhibits all the characteristic symptoms of scientific imbecility, including the substitution of adjectives and adverbs for numerals, and describes his apparently learned remarks on hypochlorites as patter.]"

Sir William Watson Cheyne's opinion of Sir Almroth Wright's scientific competence will never be known to us in its fulness, because he withdrew from the controversy on the ground that it had entered the region of the unprintable. Only lack of space prevents me from adding Dr. Hadwen's opinion of both of them, Dr. Hadwen representing as a thinker the chronic indignation of humanitarian common sense at the attempt of his profession to exempt the pursuit of cures from the restraint of the moral law, and as a practitioner that clinical common sense which keeps the nose of the theorist hard down on the grindstone of practice. Cheyne merely challenges Wright's practice as to wounds; Wright retorts that Cheyne cannot use his mind; but Hadwen execrates most of his colleagues as liars and inhuman scoundrels as well as bedside bunglers. Here we have no vulgar attack by our Dulcamaras, our Sequahs, our Mother Seigels, our Count Matteis, on a dignified and learned profession. We have the most highly qualified members of that profession throwing their gold medals at one another's heads; clubbing one another with their professorial chairs; strangling one another in their pigtails of capital letters; and denying one another's clinical efficiency, mental competence, and moral rectitude.

Fortunately, nothing is more false than the proverb that when doctors differ patients die. On the contrary, when doctors differ wounded soldiers get well, and even general practitioners are forced to think instead of to dogmatize and pontificate. When doctors agree we are face to face with a conspiracy of pretentious ignorance with that sordid side of trade unionism which is forced by common need to struggle for its livelihood even to the point of saying, "Thou shalt die ere I starve." As long as we are fools enough to make healing and hygiene a matter of commerce, and give joint-stock companies powerful vested interests in blood poisoning (note the passage about "the whole serum industry" in my last quotation above from Sir Almroth Wright), we shall get the worst of that alternative; and serve us right! When it comes to American States having to pass laws making it illegal for general practitioners to take commissions from the operating surgeons called in on their own suggestion, it is time to inquire whether Colorado produces a special type of human nature, and, if not, whether the same abuse, in less crude forms, may not help to boil our own pots in Harley Street.

The End

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