imagine that modern surgery and
anesthesia have made operations much less serious matters than they
really are? When doctors write or speak to the public about operations,
they imply, and often say in so many words, that chloroform has made
surgery painless. People who have been operated on know better.
The patient does not feel the knife, and the operation is therefore
enormously facilitated for the surgeon; but the patient pays for the
anesthesia with hours of wretched sickness; and when that is over there
is the pain of the wound made by the surgeon, which has to heal like any
other wound. This is why operating surgeons, who are usually out of the
house with their fee in their pockets before the patient has recovered
consciousness, and who therefore see nothing of the suffering witnessed
by the general practitioner and the nurse, occasionally talk of
operations very much as the hangman in Barnaby Rudge talked of
executions, as if being operated on were a luxury in sensation as well
as in price.

MEDICAL POVERTY

To make matters worse, doctors are hideously poor. The Irish gentleman
doctor of my boyhood, who took nothing less than a guinea, though he
might pay you four visits for it, seems to have no equivalent nowadays
in English society. Better be a railway porter than an ordinary English
general practitioner. A railway porter has from eighteen to twenty-three
shillings a week from the Company merely as a retainer; and his
additional fees from the public, if we leave the third-class twopenny
tip out of account (and I am by no means sure that even this reservation
need be made), are equivalent to doctor's fees in the case of
second-class passengers, and double doctor's fees in the case of first.
Any class of educated men thus treated tends to become a brigand class,
and doctors are no exception to the rule. They are offered disgraceful
prices for advice and medicine. Their patients are for the most part so
poor and so ignorant that good advice would be resented as impracticable
and wounding. When you are so poor that you cannot afford to refuse
eighteenpence from a man who is too poor to pay you any more, it
is useless to tell him that what he or his sick child needs is not
medicine, but more leisure, better clothes, better food, and a better
drained and ventilated house. It is kinder to give him a bottle of
something almost as cheap as water, and tell him to come again with
another eighteenpence if it does n