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