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Memoirs of John Abernethy

CHAPTER III.
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"nunquam ita quisquam bene subducta ratione ad vitam fuit

quin res, ?tas, usus, semper aliquid apportet novi

aliquid moneat; ut illa qu? te scire credas, nescias:

et qu? tibi putaris prima, in experiundo repudias."

?

ter. ad. a. 5, sc. 4.

"never did man lay down so fair a plan,

so wise a rule of life, but fortune, age,

or long experience made some change in it,

and taught him that those things he thought he knew,

he did not know, and what he held as best

in practice, he threw by."

colman.

circumstances, in themselves apparently unimportant, often determine the selection of a profession. few boys can do exactly what they please, and the pros and cons are seldom placed before them in a way to assist them in determining the just value of the reasons on which their choice may have proceeded. they are not, indeed, unfrequently dealt with as if, whilst not incompetent to make choice of a profession, they were held incapable of weighing the circumstances by which alone such choice could be judiciously directed. the absurdity of this appears, when we think a moment of what it involves, which is nothing less than expecting them to do what is impossible; viz. to form an opinion on a subject when the main facts in relation to it are withheld from them. be this as it may, every day shows us that men are too frequently dissatisfied with the profession which they follow.18 the question of our boyhood recollections—

"qui fit m?cenas ut nemo quam sibi sortem,

seu ratio dederit seu fors objecerit, illa,

contentus vivat?"11

is just as applicable as ever; and although human nature has almost everything ascribed to its natural infirmities, yet it appears quite as sensible, and not a whit less humble, to conclude, that paths chosen without consideration naturally lead to disappointment. the evil, like most others, carries with it the elements of self correction.

parents are slow to encourage their children to select paths which they themselves have trodden with regret. this tends to distribute their professions to other families. mutual interchanges of this kind serve to protect the interests of society, by, in some degree, limiting the number of cases in which men have failed to select the pursuits best adapted to them.

in almost all pursuits of life, success is determined, much more than many are disposed to imagine, by the homely qualities of steadiness and industry. we are apt—and sometimes not improperly—to ascribe peculiar excellence to peculiar powers. yet the more insight we obtain into the histories of men, the more we perceive how constantly the most brilliant have been aided by the more homely qualifications to which we have adverted.

no doubt some minds are so constituted as to be moderately certain of success or distinction in almost any pursuit to which they might have been directed; and we are disposed to think that abernethy's was a mind of that order; but there is abundant evidence to show that his talents were at least equalled by his industry. one paper of his, which contains a beautiful and discriminative adjustment of a difficult point of practice in injuries of the head—which contains no intrinsic evidence of such industry—was not published until after he had attended to every serious injury of the head in a large hospital for almost twenty years;19 besides examining the bodies of all the fatal cases. nor can we estimate this industry properly, without recollecting that all this time he was only an assistant surgeon, whose duties, for the most part, neither required nor permitted him to do more than to observe the treatment; and that, therefore, the whole of this industry was simply in the character of a student of his profession12. all biography is full of this kind of evidence; and art, as well as science, furnishes its contribution. who could have imagined that the peculiar, chaste composition, the easy and graceful touch of sir augustus callcott, could have owed so much to industry as it undoubtedly must have done? it is known, for example, that he made no less than forty different sketches in the composition of one picture. we allude to his "rochester." had abernethy been allowed to choose his profession, he, no doubt, would have selected the bar. it is impossible to reflect on the various powers he evinced, without feeling that, had he followed the law, he would have arrived at a very distinguished position. "had my father let me be a lawyer," he would say, "i should have known every act of parliament by heart." this, though no doubt intended as a mere figure of speech, was not so far from possibility as might be imagined, for it referred to one of his most striking characteristics; viz. a memory alike marvellously ready, capacious, and retentive—qualities common enough separately, but rare in powerful combination.

we may have opportunities by and by, perhaps, of further illustrating it. we will give one anecdote here. a gentleman, dining with him on a birthday of mrs. abernethy's, had composed a long copy of verses in honour of the occasion, which he repeated to the family circle after dinner. "ah!" said abernethy, smiling, "that is a good joke, now, your pretending to have written those verses." his friend simply rejoined, that, such as they were, they were certainly his own. after a little good-natured bantering, his friend began to evince something like annoyance20 at abernethy's apparent incredulity; so, thinking it was time to finish the joke, "why," said abernethy, "i know those verses very well, and could say them by heart13." his friend declared it to be impossible; when abernethy immediately repeated them throughout correctly, and with the greatest apparent ease. to return. however useful this quality might have been at the bar, abernethy was destined to another course of life—a pathway more in need, perhaps, of that light which his higher qualifications enabled him to throw over it, and which "his position" "in time" afforded him an opportunity of doing just when it seemed most required. he probably thus became, both during life and prospectively, the instrument of greater good to his fellow-creatures than he would have been in any other station whatever.

i have not been able to discover what the particular circumstances were which determined his choice of the medical profession. it is probable that they were not very peculiar. a boy thwarted in his choice of a profession, is generally somewhat indifferent as to the course which is next presented to him; besides, as his views would not have been opposed but for some good reason, a warm and affectionate disposition would induce him to favour any suggestion from his parents. sir charles blicke was a surgeon in large practice; he lived at that time in mildred's court, and abernethy's father was a near neighbour, probably in coleman street.

abernethy had shown himself a clever boy, a good scholar; and he was at the top of wolverhampton school before he was fifteen. sir charles blicke was quick-sighted, and would easily discover that abernethy was a "sharp boy." all that abernethy probably knew of sir charles, was, that he rode about in his carriage, saw a good many people, and took a good many fees, all of which, though perhaps presenting no particular attractions for abernethy, made a prima facie case, which was not repulsive.21 accordingly, in the year 1779, being then fifteen years of age, he became bound an apprentice to sir charles, and, probably, for about five years.

this first step, this apprenticing, has a questionable tendency as regards the interests of the public and the profession. it exerts, also, a considerable influence on the character and disposition of the boy, which we must by and by consider. it is a mode of proceeding which, we fear, has done not a little to impede the progress of surgery as a science, and to maintain that handicraft idea of it suggested by the etymology of the word. where one man strikes out a new path, thousands follow the beaten track. a boy, with his mind ill-prepared, having no definite ideas of the nature and objects of scientific inquiries, and almost certainly uninstructed as to the rules to be observed in conducting them—knowing neither any distinction between an art and a science—a boy thus conditioned is bound for a certain number of years! to a man of whom he knows little, and to a profession of which he knows nothing. he takes his ideas and his tone from his master; or, if these be repulsive to him, he probably adopts an opposite extreme. if the master practise his profession merely as an art, he furnishes his pupil with little more than a string of conventionalisms; of which, if the pupil has talent enough to do anything for himself, he is tolerably certain to have a great deal to unlearn.

we believe the system is in course of improvement; it is high time it was put an end to altogether. apprenticeships might not have been an inauspicious mode of going to work in former times, when there existed barber-surgeons. this alliance of surgery and shaving, to say nothing of the numerous other qualifications with which they were sometimes associated, might conceivably enough have furnished some pretext for apprenticeships; since dickey gossip's definition of

"shaving and tooth-drawing,

bleeding, cabbaging, and sawing,"

was by no means always sufficiently comprehensive to include the multifarious accomplishments of "the doctor." i have myself22 seen, in a distant part of this island, within twenty-five years, chemist, druggist, surgeon, apothecary, and the significant &c. followed by the hatter, hosier, and linen-draper, in one establishment; but as we shall have to discuss this subject more fully in relation to abernethy in another place, we may proceed.

sir charles blicke had a large and lucrative practice. he had the character of taking care to be well remunerated for his services. he amassed a considerable fortune; but we incline to think that the ideas of the profession which abernethy derived from his experience of his apprenticeship were not very favourable. the astute, business-like mode of carrying on the profession, which seems to have characterized sir charles blicke's practice, could have had few charms for abernethy. mere money-making had never at any time much attraction for him, and, at that period of his life, probably none at all; whilst the measured pretensions of surgery to anything like a science could hardly have been, at times, otherwise than repulsive.

the tone in which he usually spoke of sir charles's practice did not convey a very favourable idea of the impression which it had left on him. in relating a case, he would say: "sir charles was at his house in the country, where he was always on the look out for patients." on another occasion, speaking of patients becoming faint under peculiar circumstances, he observed: "when i was an apprentice, my master used to say: 'oh, sir! you are faint; pray drink some of this water.' and what do you think was the effect of his putting cold water into a man's stomach under these circumstances? why, of course, that it was often rejected in his face."

sir charles's manipulatory and operative proceedings seem, however, to have represented a tolerably adroit adoption of the prevailing modes of practice; while his medical surgery consisted chiefly of the empirical employment of such remedies as he had found most frequently successful, or, at all events, somehow or other associated with a successful issue; with the usual absence of any investigation of the cause of either success or failure. by a mind like abernethy's, this sort of routine would be very soon acquired, and, in a short time, estimated at its real value.23 still, while a clear head is all that is necessary to the reception of what may be positive and truthful, it requires a vivid perception and a cultivated understanding to detect error. many things, however, would creep out in abernethy's lectures, showing that, young as he was, even during his apprenticeship, he was not only a real student, but he had begun to think for himself.

he mentions a case of "locked-jaw," that occurred as early as 1780 (the first year of his apprenticeship), which he appears to have noted with great accuracy. he mentions the medicine that was given to the man, the unusually large doses, and, lastly, the enormous quantity of it which was found in the stomach after death. it was opium, and amounted to many drachms.

we also find him engaged in inquiries involving much more extended views than were in that day generally associated with the study of surgery. he very early participated in those researches which had for their object to determine the relation of the digestive functions to one of the most recondite affections of an extremely important organ (the kidney).

"when i was a boy," said he, "i half ruined myself in buying oranges and other things, to ascertain the effects of different kinds of diet in this disease."

the same researches show how early also he began to perceive the importance of chemistry in investigating the functions of different organs, and in aiding, generally, physiological researches. we have heard a contemporary and a lecturer on chemistry attest abernethy's proficiency in that science. as his investigations proceeded, he had the still higher merit of taking just and sober views of the relations of chemistry to physiological science.

we mean that whilst he fully recognized the importance of it, he entirely avoided that exclusive reliance on it which is too often created by some of the more striking demonstrations of chemical science; that one—idea—tendency, which unconsciously wrests it to the solution of phenomena which, in the present state of our knowledge, it is wholly inadequate to explain. we have alluded to the foregoing facts touching the impressions derived from his apprenticeship, and his early disposition for philosophical research, because both will be found to have relations to his subsequent24 labours and peculiarities. diligent as he was, we suspect he found, during his apprenticeship, little of those attractions which make labour and industry sources of happiness and pleasure.

as a matter of course, he would have been allowed to attend any lectures which were given at the hospital to which sir charles blicke was surgeon (st. bartholomew's), and this would bring him in contact with mr. pott, who delivered a certain number of surgical lectures there.

there were no courses of anatomical lectures given at st. bartholomew's at that period; but anatomical lectures were delivered regularly at the london hospital, by dr. maclaurin and sir william blizard, and afterwards by sir william blizard alone. as sir charles blicke lived in mildred's court and subsequently in billiter square, abernethy would be about equidistant from the two hospitals, both of which he attended. we incline to think that it was in attending these lectures, and perhaps especially those of sir william blizard, that he first found those awakening impulses which excited in him a real love for his profession.

it was about this time, we think, that he began to have more enlarged ideas of the nature and objects of surgical science; a state of mind calculated to enable him to thoroughly understand and appreciate mr. hunter, and to deduce from the principles which he was shadowing forth, those relations and consequences which we shall endeavour popularly to explain; principles which, though originally directed to the treatment of so-called surgical maladies, were found equally to affect the practice of medicine.

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