He has taught the jury and the judge, and even his own counsel, to
believe that every doctor can, with a glance at the tongue, a touch
on the pulse, and a reading of the clinical thermometer, diagnose with
absolute certainty a patient's complaint, also that on dissecting a dead
body he can infallibly put his finger on the cause of death, and, in
cases where poisoning is suspected, the nature of the poison used. Now
all this supposed exactness and infallibility is imaginary; and to
treat a doctor as if his mistakes were necessarily malicious or corrupt
malpractices (an inevitable deduction from the postulate that the
doctor, being omniscient, cannot make mistakes) is as unjust as to
blame the nearest apothecary for not being prepared to supply you with
sixpenny-worth of the elixir of life, or the nearest motor garage for
not having perpetual motion on sale in gallon tins. But if apothecaries
and motor car makers habitually advertized elixir of life and perpetual
motion, and succeeded in creating a strong general belief that they
could supply it, they would find themselves in an awkward position if
they were indicted for allowing a customer to die, or for burning a
chauffeur by putting petrol into his car. That is the predicament the
doctor finds himself in when he has to defend himself against a charge
of malpractice by a plea of ignorance and fallibility. His plea is
received with flat credulity; and he gets little sympathy, even from
laymen who know, because he has brought the incredulity on himself. If
he escapes, he can only do so by opening the eyes of the jury to the
facts that medical science is as yet very imperfectly differentiated
from common curemongering witchcraft; that diagnosis, though it means in
many instances (including even the identification of pathogenic bacilli
under the microscope) only a choice among terms so loose that they would
not be accepted as definitions in any really exact science, is, even at
that, an uncertain and difficult matter on which doctors often differ;
and that the very best medical opinion and treatment varies widely from
doctor to doctor, one practitioner prescribing six or seven scheduled
poisons for so familiar a disease as enteric fever where another will
not tolerate drugs at all; one starving a patient whom another would
stuff; one urging an operation which another would regard as unnecessary
and dangerous; one giving alcohol and meat which another would sternly
forbid, et