The trouble does not end with the matter to be inoculated. There is the
question of the condition of the patient. The discoveries of Sir Almroth
Wright have shown that the appalling results which led to the hasty
dropping in 1894 of Koch's tuberculin were not accidents, but perfectly
orderly and inevitable phenomena following the injection of dangerously
strong "vaccines" at the wrong moment, and reinforcing the disease
instead of stimulating the resistance to it. To ascertain the right
moment a laboratory and a staff of experts are needed. The general
practitioner, having no such laboratory and no such experience, has
always chanced it, and insisted, when he was unlucky, that the results
were not due to the inoculation, but to some other cause: a favorite
and not very tactful one being the drunkenness or licentiousness of
the patient. But though a few doctors have now learnt the danger of
inoculating without any reference to the patient's "opsonic index"
at the moment of inoculation, and though those other doctors who are
denouncing the danger as imaginary and opsonin as a craze or a fad,
obviously do so because it involves an operation which they have neither
the means nor the knowledge to perform, there is still no grasp of the
economic change in the situation. They have never been warned that the
practicability of any method of extirpating disease depends not only on
its efficacy, but on its cost. For example, just at present the world
has run raving mad on the subject of radium, which has excited our
credulity precisely as the apparitions at Lourdes excited the credulity
of Roman Catholics. Suppose it were ascertained that every child in the
world could be rendered absolutely immune from all disease during its
entire life by taking half an ounce of radium to every pint of its
milk. The world would be none the healthier, because not even a Crown
Prince--no, not even the son of a Chicago Meat King, could afford
the treatment. Yet it is doubtful whether doctors would refrain from
prescribing it on that ground. The recklessness with which they now
recommend wintering in Egypt or at Davos to people who cannot afford to
go to Cornwall, and the orders given for champagne jelly and old port in
households where such luxuries must obviously be acquired at the cost of
stinting necessaries, often make one wonder whether it is possible for a
man to go through a medical training and retain a spark of common sense.
This sort of inconsiderateness gets cured only in the classes where
poverty, pretentious as it is even at its worst, cannot pitch its
pretences high enough to make it possible for the doctor (himself often
no better off than the patient) to assume that the average income of an
English family is about 2,000 pounds a year, and that it is quite easy
to break up a home, sell an old family seat at a sacrifice, and retire
into a foreign sanatorium devoted to some "treatment" that did not
exist two years ago and probably will not exist (except as a pretext
for keeping an ordinary hotel) two years hence. In a poor practice the
doctor must find cheap treatments for cheap people, or humiliate and
lose his patients either by prescribing beyond their means or sending
them to the public hospitals. When it comes to prophylactic inoculation,
the alternative lies between the complete scientific process, which can
only be brought down to a reasonable cost by being very highly organized
as a public service in a public institution, and such cheap,
nasty, dangerous and scientifically spurious imitations as ordinary
vaccination, which seems not unlikely to be ended, like its equally
vaunted forerunner, XVIII. century inoculation, by a purely reactionary
law making all sorts of vaccination, scientific or not, criminal
offences. Naturally, the poor doctor (that is, the average doctor)
defends ordinary vaccination frantically, as it means to him the bread
of his children. To secure the vehement and practically unanimous
support of the rank and file of the medical profession for any sort of
treatment or operation, all that is necessary is that it can be easily
practised by a rather shabbily dressed man in a surgically dirty room in
a surgically dirty house without any assistance, and that the materials
for it shall cost, say, a penny, and the charge for it to a patient with
100 pounds a year be half-a-crown. And, on the other hand, a hygienic
measure has only to be one of such refinement, difficulty, precision and
costliness as to be quite beyond the resources of private practice, to
be ignored or angrily denounced as a fad.