The Doctor's Dilemma: Preface on Doctors eBook

This eBook from the Gutenberg Project consists of approximately 99 pages of information about The Doctor's Dilemma.

The Doctor's Dilemma: Preface on Doctors eBook

This eBook from the Gutenberg Project consists of approximately 99 pages of information about The Doctor's Dilemma.
saw in the street was horribly pitted with smallpox, and that all this disfigurement has vanished since the introduction of vaccination.  Jenner himself alluded to this imaginary phenomenon before the introduction of vaccination, and attributed it to the older practice of smallpox inoculation, by which Voltaire, Catherine II. and Lady Mary Wortley Montagu so confidently expected to see the disease made harmless.  It was not Jenner who set people declaring that smallpox, if not abolished by vaccination, had at least been made much milder:  on the contrary, he recorded a pre-vaccination epidemic in which none of the persons attacked went to bed or considered themselves as seriously ill.  Neither Jenner, nor any other doctor ever, as far as I know, inculcated the popular notion that everybody got smallpox as a matter of course before vaccination was invented.  That doctors get infected with these delusions, and are in their unprofessional capacity as members of the public subject to them like other men, is true; but if we had to decide whether vaccination was first forced on the public by the doctors or on the doctors by the public, we should have to decide against the public.

STATISTICAL ILLUSIONS

Public ignorance of the laws of evidence and of statistics can hardly be exaggerated.  There may be a doctor here and there who in dealing with the statistics of disease has taken at least the first step towards sanity by grasping the fact that as an attack of even the commonest disease is an exceptional event, apparently over-whelming statistical evidence in favor of any prophylactic can be produced by persuading the public that everybody caught the disease formerly.  Thus if a disease is one which normally attacks fifteen per cent of the population, and if the effect of a prophylactic is actually to increase the proportion to twenty per cent, the publication of this figure of twenty per cent will convince the public that the prophylactic has reduced the percentage by eighty per cent instead of increasing it by five, because the public, left to itself and to the old gentlemen who are always ready to remember, on every possible subject, that things used to be much worse than they are now (such old gentlemen greatly outnumber the laudatores tempori acti), will assume that the former percentage was about 100.  The vogue of the Pasteur treatment of hydrophobia, for instance, was due to the assumption by the public that every person bitten by a rabid dog necessarily got hydrophobia.  I myself heard hydrophobia discussed in my youth by doctors in Dublin before a Pasteur Institute existed, the subject having been brought forward there by the scepticism of an eminent surgeon as to whether hydrophobia is really a specific disease or only ordinary tetanus induced (as tetanus was then supposed to be induced) by a lacerated wound.  There were no statistics available as to the proportion of dog bites that ended

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The Doctor's Dilemma: Preface on Doctors from Project Gutenberg. Public domain.