1 Sep 2019
There are many punchlines to which cartoonists would return time and again when addressing the topic of medicine, but “doctors differ” was without doubt the most popular. We see an early version of it in the background of the penultimate entry in William Hogarth’s series Harlot’s Progress where the famous patent medicine huckster of Covent Garden, Dr. Richard Rock, argues with a rival, the French doctor (and fellow-quack) John Misaubin, over the appropriate treatment for late-stage venereal disease, each angrily insisting on their preferred treatment. As the old saying went, while doctors differ, the patient expires—and so it is here. Our protagonist, Moll, dies while the two men squabble.
Drs. Rook and Misaubin are positively genteel in their disputations compared to the majority of those that followed in this vein. Here, for example is Isaac Cruikshank’s version, in which wigs are town off and medicines sent flying while the poor, unattended patient quietly expires.
The Drawing Blood exhibit included one of my favorite entries in this well-trod subgenre of medical cartooning. In the 1813 etching by Charles Williams below, four doctors battle over the proper treatment of a patient. The doctor on the floor exclaims, “I say it is an exfoliation of the glands which has fallen on the membranous coils of the intestines, and must be thrown off by an emetic,” while those still standing argue in turn for their own diagnoses and preferred treatments: “I say it is a pleurisie in the thigh, and must be sweated away”; “I say it is a nervous affection of the cutis, and the patient must immediately lose eighteen ounces of blood, and then take a powerful drastic”; “I say it is an inflammation in the os sacrum, and therefore fourteen blisters must be immediately applied to the part affected and the adjacents.” The documents in each of their pockets identify them as synonymous with their preferred treatments: “Dr. Emetic,” “Dr. Sudorific,” “Dr. Drastic” (who, the document tells us, lives appropriately on “Cloacina Row”—Cloacina being the Roman goddess of sewer cleansing), and “Dr. Blister.”
The point of the critique is clear enough: the doctors have arrived at the patient’s bedside with diagnosis and prescription already predetermined. Looking only for one treatment (from which presumably they stand to profit) they find only diseases that are said to be best treated by those same regimens. Meanwhile, our patient, having just relieved himself on the commode, finds himself much improved. “I say,” he proclaims, “Dame Nature has relieved me both of the Cause & Effects while these learned disputants are deciding the nature of my complaint—so I’ll e’en be off to save both my money and my Life.”
The punchline would continue long after the era of modern medicine begins, as we will see in a later post. After all, more accurate diagnoses and more effective treatments do not eradicate professional rivalries or suspicions regarding the profit motive in medicine. But for now, a couple more examples of this seemingly timeless joke:
Jared Gardner is a professor and patient at the Ohio State University.