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State Sen. Buddy Carter is fluent in coastal water policy, legislative wrangling and the Republican political networks coursing through the 1st Congressional District.

Surgeon Bob Johnson speaks the language of anti-Washington grievance with the sharp tongue of a former Army Ranger.

Their increasingly personal battle ahead of Tuesday's GOP runoff has drawn national attention as the next chapter in the "tea party" vs. "Republican establishment" fight — as the conservative Club for Growth and U.S. Chamber of Commerce business lobby have taken opposing sides.

It’s a fight, as well, between a coastal Georgia lifer who has held elected office for 20 years and stresses county sheriff endorsements and a transplanted first-time politician who touts the backing of national conservative figures such as former vice presidential nominee Sarah Palin and U.S. Sen. Mike Lee, R-Utah.

The two men are seeking to replace 11-term U.S. Rep. Jack Kingston, a Savannah Republican who is running for the U.S. Senate. Carter won the most votes in a six-way May GOP primary, with Johnson in second. The Democratic runoff pits Richmond Hill Realtor Amy Tavio and UPS manager Brian Reese of Savannah — but the district has a heavy Republican lean.

Carter, 56, a pharmacist who was mayor of Pooler before going to the General Assembly, finds it “ludicrous” to be called “liberal” — as Johnson and the Club for Growth regularly label him. He wants to ditch the law known as Obamacare, eliminate the federal Department of Education, send home immigrants who are here illegally and balance the budget. The National Rifle Association endorsed him.

But Carter also cautions against the “extreme right-wing” currents in Washington that could harm his constituents. Conservative pressure groups advocated against bills this year that included the deepening of the Port of Savannah and relief for homeowners from pending spikes in flood insurance premiums.

Johnson, 64, a head and neck cancer surgeon, says he has plenty of local endorsements from veterans, doctors and gun shop owners, just not the politicians who know Carter.

He does not universally fit the tea party mold. Johnson said he supports the port project and giving coastal homeowners relief on their flood insurance bills, and he jokes that his desire to provide better health services for the mentally ill “gives me a little bit of that liberal Democrat bent.”

He quickly added, for a small group at a pizza parlor in Brunswick last week: “Is somebody recording that? Buddy Carter’s going to have a TV ad on that tomorrow.”

The ad that stuck in Johnson's craw — and has proved memorable for voters here — features Johnson's loose tongue complaining about Transportation Security Administration pat-downs at airports.

“I’d rather see another terrorist attack — truly, I would — than to give up my liberty as an American citizen,” Johnson said in February.

Johnson says he was employing hyperbole and apologized for the remark. At a heated forum in St. Marys on Saturday he turned it back on Carter.

“Come on, Buddy,” he said. “I’m an Army Ranger. I spent a whole lifetime healing the sick and saving people from danger. Shame on you for impugning my character.”

“It has everything to do with judgment,” Carter replied, adding that Kingston would never say something “embarrassing” like that.

Johnson was asked about the remark in Brunswick as well.

“Look, I’m not a polished politician,” he said. “So I don’t watch every single word I say. Boy, I sure learned a big lesson that day.”

Johnson’s rhetoric, if careless at times, also taps into the anger of many conservatives at all things Washington.

He vows not to vote for John Boehner for speaker and pledges to limit himself to six years in the House, while Carter will not commit to either. In touting term limits to supporters at a Savannah Denny’s, Johnson started riffing on longtime members of Congress.

Retiring Rep. John Dingell, D-Mich., “was a predatory crook.” And Johnson was dismayed by longtime Sen. Thad Cochran, R-Miss., who narrowly won a GOP runoff last month.

“How can a man with early dementia, 76 years old, honestly go to the American people and say, ‘Nobody here in this whole state can do this job as well as I can. I want Democrats to come out and vote for me’?” Johnson said. “This is shameful. It’s corrupt. It’s really marginally criminal behavior.”

At the St. Marys forum, Johnson referred to Barack Obama as a “stupid, erratic president.” Carter had a milder diss: “We’ve got a guy in the White House right now calling the shots who — I’m sorry — I have no confidence whatsoever in.”

The U.S. Chamber of Commerce endorsed Carter as the “proven, demonstrated and tested” advocate for business, in the words of executive director Eileen Braden during a visit to Savannah last week. But Braden would not immediately commit to spending money on the race to counter the Club For Growth’s $358,000 TV buy — a huge sum for a House race.

Carter said the Club for Growth’s ad campaign “has an impact,” puting him on the defensive about his General Assembly record.

Carter had his own rhetoric used against him, too. Last year he said of the Affordable Care Act that “some of the things that have happened so far are not so bad.”

Cue conservative outrage, even though Carter’s next line — excluded from the attacks, of course — was “but the worst part is yet to come.” That was before the bumpy debut of the health insurance exchanges.

In an interview, Carter defended the statement.

“Letting your children stay on your insurance till you’re 26, covering pre-existing conditions, those are Republican principles, Republican ideas that were incorporated into Obamacare,” Carter said.

“And those were the things that were first started. And when it first started, it wasn’t that bad. But lo and behold, when it got started, it got worse. It got terrible. It got horrible.”

Both candidates say they want to repeal the law.

Johnson also attacks Carter on the stump for his personal wealth. Carter owns three pharmacies in the Pooler area, and financial disclosures show he is worth between $10 million and $24 million. Johnson's assets are valued between $1.2 million and $4.2 million.

“He’s the only pharmacist I know who’s worth almost $20 million,” Johnson said. “This has got to change. I don’t resent someone making a lot of money in business, but when they operate their business in the context of cozy government relationships, you ought to start getting your sniffer going and figure out what’s going on.”

Carter served on a state Senate committee overseeing health care, pushed bills relating to the pharmacy industry and accepted Medicaid reimbursements from the state — then belatedly reported the payments. Carter said he was using his expertise to improve health policy, and Medicaid reimbursements are so stingy he does not make any money on those prescriptions.

Carter garnered 36.2 percent of the vote in the May primary, with Johnson’s 22.7 percent narrowly besting St. Simons Island businessman John McCallum, who has endorsed Carter. With state Rep. Jeff Chapman of Brunswick also out, the southern end of the district could prove decisive for the two Savannah-area candidates.

Near the Florida line in St. Marys, Richard Frizzell, a retired Army colonel who teaches at Coastal College of Georgia, said all the flying mud disturbed him.

“Where the hell is this campaign going? It can’t get any lower than the gutter,” a neighbor told him recently. Frizzell replied, “Oh no, we can get in the sewer in a minute.”