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If this was the line taken about smallpox, the microbe of which has never yet been run down and exposed under the microscope by the bacteriologist, what must have been the ardor of conviction as to tuberculosis, tetanus, enteric fever, Maltese fever, diphtheria, and the rest of the diseases in which the characteristic bacillus had been identified! When there was no bacillus it was assumed that, since no disease could exist without a bacillus, it was simply eluding observation. When the bacillus was found, as it frequently was, in persons who were not suffering from the disease, the theory was saved by simply calling the bacillus an impostor, or pseudo-bacillus. The same boundless credulity which the public exhibit as to a doctor’s power of diagnosis was shown by the doctors themselves as to the analytic microbe hunters. These witch finders would give you a certificate of the ultimate constitution of anything from a sample of the water from your well to a scrap of your lungs, for seven-and-sixpence. I do not suggest that the analysts were dishonest. No doubt they carried the analysis as far as they could afford to carry it for the money. No doubt also they could afford to carry it far enough to be of some use. But the fact remains that just as doctors perform for half-a-crown, without the least misgiving, operations which could not be thoroughly and safely performed with due scientific rigor and the requisite apparatus by an unaided private practitioner for less than some thousands of pounds, so did they proceed on the assumption that they could get the last word of science as to the constituents of their pathological samples for a two hours cab fare.
ECONOMIC DIFFICULTIES OF IMMUNIZATION
I have heard doctors affirm and deny almost every possible proposition as to disease and treatment. I can remember the time when doctors no more dreamt of consumption and pneumonia being infectious than they now dream of sea-sickness being infectious, or than so great a clinical observer as Sydenham[101] dreamt of smallpox being infectious. I have heard doctors deny that there is such a thing as infection. I have heard them deny the existence of hydrophobia as a specific disease differing from tetanus. I have heard them defend prophylactic measures and prophylactic legislation as the sole and certain salvation of mankind from zymotic disease; and I have heard them denounce both as malignant spreaders of cancer and lunacy. But the one objection I have never heard from a doctor is the objection that prophylaxis by the inoculatory methods most in vogue is an economic impossibility under our private practice system. They buy some stuff from somebody for a shilling, and inject a pe
Even if the germ were identified, complete precautions would hardly pay. It is true that microbe farming is not expensive. The cost of breeding and housing two head of cattle would provide for the breeding and housing of enough microbes to inoculate the entire population of the globe since human life first appeared on it. But the precautions necessary to insure that the inoculation shall consist of nothing else but the required germ in the proper state of attenuation are a very different matter from the precautions necessary in the distribution and consumption of beefsteaks. Yet people expect to find vaccines and antitoxins and the like retailed at “popular prices” in private enterprise shops just as they expect to find ounces of tobacco and papers of pins.
THE PERILS OF INOCULATION
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[102] have shewn that the appalling results which led to the hasty dropping in 1894 of Koch’s tuberculin[103] 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 drunke
101
Thomas Sydenham (1624 — 1689) English physician and pioneer in treating diseases.
102
Noted immunologist and a friend of Shaw (1861 — 1947); partial model for Doctor Ridgeon in the play.
103
German bacteriologist and Nobel laureate Robert Koch (1843 — 1910) developed tuberculin, a substance to diagnose tuberculosis.
104
Measurement of the amount of opsonin in the blood; opsonin is a constituent of the blood that helps phagocytes (such as white blood cells) destroy disease.