Australians drink, get drunk, fall down -- no problem?

The blood oozes crimson from a jagged gash in the man’s head onto the starched white hospital sheet. A booze-fueled bar brawl has left his face shredded, his brain damaged.

Across the emergency room, a clammy-skinned patient who smells like a brewery curls into a fetal position on his gurney, recovering from a near-fatal combination of alcohol and pills.

On a Saturday, St. Vincent’s Hospital in the heart of Sydney’s night life district becomes, in Dr. Gordian Fulde’s weary words, “a war zone” of Australia’s alcohol casualties.

This is Monday.

Australia has long been known as a nation of beer-loving boozers. But now the government, fed up with what it sees as a growing crisis of out-of-control drinking and subsequent violence, has decided it’s time for a change.

In the last six months, a barrage of measures have been rolled out: a multimillion-dollar campaign against binge drinking, a heavy tax on premixed drinks popular with young people, a ban on late-night revelers entering certain bars.

The actions have ignited fierce debate and revealed a sharp divide.

“We’ve got to change our drinking culture and habits. It’s not negotiable,” Fulde says. “We’ll drink ourselves off this lovely continent if we don’t.”

Others say the government’s war on alcohol abuse is ineffective or unnecessary, a cheap political ploy based on a grossly exaggerated stereotype of Australians.

Bricklayer Cameron Waite, who rolled into one of Australia’s ubiquitous drive-through bottle shops to pick up his afternoon allotment of beer, said the government attack on binge drinking amounted to an attack on his country’s culture: “They’re trying to change Australia.”

And therein lies the question: Does Australia need to change?

More important, does it want to?

This is, after all, a country whose former Prime Minister Robert Hawke once held the Guinness world record for chugging beer: 2 1/2 pints in 11 seconds.

It’s a country where some cellphones come programmed with text messages that read, “Let’s go to the pub. Mine’s a large gin and tonic.” And where former cricket star and sports legend David Boon -- aka the Keg on Legs -- is best known for a 1989 flight from Sydney to London during which he drank 52 cans of beer.

Throughout its history, Australia’s leaders have taken on drinking with limited success.

Rising concern led to a temperance movement in 1832.

In 1916, a new law ordered bars in New South Wales state to close at 6 p.m. That was a disaster. Men leaving work at 5:30 rushed the pubs and frantically chugged, getting as tanked as possible before spilling onto the street, a practice known as the “six o’clock swill.” Crime rates soared. In March, Prime Minister Kevin Rudd announced a $34.7-million campaign against bingeing, complete with an advertising blitz and grants to community groups.

Reaction was mixed.

“It’s a bit rich for a man who got famously stonkered at a lap-dancing club in New York five years ago to be lecturing the rest of us on binge drinking,” said Sydney Morning Herald columnist Miranda Devine.

Rudd apologized for his visit to the New York strip club and admitted he had too much to drink.

In April, his government went ahead with an increase in the tax on premixed alcoholic drinks, which are sweet, bottled drinks popular among young people.

A slew of protest groups popped up on Facebook, including Aussies Against the Alcohol Tax Increase, which has attracted more than 68,000 members.

“Binge drinking is a big problem, and young people shouldn’t be smashing themselves,” the group’s founder, Justin McCoy, says. “But people wanting to have a drink after work shouldn’t be punished just for the actions of a few.”

In May, the southern state of Victoria joined the battle with a three-month ban on people entering Melbourne pubs after 2 a.m., prompting a protest that drew thousands. Men in business suits screamed into bullhorns alongside cheering senior citizens and people in their 20s. “This is government by moral panic!” one speaker declared.

Officials let the ban expire after three months and are looking at other solutions, such as placing more officers on the streets.

Last month, New South Wales Premier Nathan Rees heralded what he called a “new era” by imposing strict conditions on about 50 of the state’s most notorious pubs, including shorter business hours and the mandatory use of plastic cups after midnight, rather than glasses.

Attacks with broken glass rose 7.1% from 2003 to 2007 in New South Wales, and alcohol-related, nondomestic assaults were up 7.8% from 2004 to 2007, according to the state.

“It isn’t about stopping people at the end of a hard day,” Rees told reporters. “What it is about is stopping drunken behavior that ends in violence.”

Walter Tuarae, the 40-year-old owner of Melt, a bar in Sydney’s notoriously rowdy Kings Cross nightclub district, sits on a stool on a Friday night nursing a tall glass of water. No one here is throwing up or throwing punches.

Tuarae is frustrated by what he sees as a misplaced, overblown response to an age-old issue.

“Some of the best ideas are born out of a few beers and a few glasses of wine,” he says. “It’s an attack on the very social fabric of this country.”

Tuarae says he learned how to handle alcohol when he was young; he had his first beer at a family barbecue when he was 12. If the government wants people to cut back on drinking, he says, it should focus less on regulations and taxes and more on getting families to teach their kids limits.

Still, the tax on premixed drinks appears to have at least temporarily cut sales, says University of Melbourne sociologist Robin Room. The 2 a.m. pub lockouts may do nothing to quell the violence, but at least they have people paying attention, he says.

But raising taxes doesn’t address the underlying culture, warns Milton Lewis, a historian of medicine and public health at the University of Sydney and author of “A Rum State: Alcohol and State Policy in Australia.”

Australians actually aren’t the world’s biggest drinkers; Ugandans are. The World Health Organization ranks Australia a distant 34th in per capita alcohol consumption. Aussies drink less than the British, but slightly more than Americans.

Figures from the Australian Bureau of Statistics and the Distilled Spirits Industry Council of Australia say the country’s per capita consumption fell in the 1990s and has held steady since.

“There is a sort of line being spun by our political masters that there is this sort of mass drinking culture in Australia, which there is, but it’s not unique to Australia,” says Dr. Paul Haber, head of alcohol studies at Royal Prince Alfred Hospital in Sydney.

Still, the image of the boozy Australian persists.

“It’s interwoven into our culture. We work hard and we play hard. And I think that’s an image that we like of ourselves,” says Richard Midford, associate professor and project leader with the National Drug Research Institute.

Critics of the efforts to lock out pub patrons say history shows they will fail.

“There’s going to be absolute mayhem out there,” Tuarae says from his bar stool. “You pour those people out into the streets at 2 a.m. . . . God forbid what’s going to happen.”

Upstairs, Erin Marsh, a 26-year-old radio announcer from Sydney, sips a pineapple daiquiri. Australia clearly has a binge drinking culture, she says. Less clear is how to fix it.

“I just don’t know what the government can do because, really, at the end of the day, it’s about changing a social trend,” Marsh says. “And how do you do that?”

A young woman leans over and ejects the contents of her stomach onto the sidewalk. It’s 2 a.m. on a Saturday morning in Kings Cross. The street has become a slalom course of discarded beer bottles, trash and vomit.

Tom Evreniadis, a street musician who has worked this neighborhood for eight years, plucks his guitar while keeping an eye on the crowd.

“Whether they’ve been binge-drinking all night or whether they’re on some pills or drugs, you don’t know what you’ve got,” he says. “And the aggression is -- “

A beach ball whacks him in the head, interrupting him. A glassy-eyed stranger on the sidewalk laughs maniacally. Evreniadis tosses the ball back and continues, “Like you see, they’ve got a lot of aggression to let out.”

Nothing will stop them, he says. Prohibition? That never worked anywhere.

He pauses for a moment.

“There is no cure,” he says finally. “It really is the culture. You do see your father drinking. He does put a beer in your hand when you’re 6. . . . You can’t stop it today.”

A group of unsteady men lurch by. Evreniadis grins and launches into a rendition of the Eagles’ classic “Desperado.”

“Desperadohhh,” he croons after them. “Why don’t you come to your senses?”

The men stop to listen. They laugh. Then they turn and stumble off into the night.