Hoc autem de quo nunc agimus id ipsum est quod utile

“Trace Science, then, with Modesty thy guide;
First, strip off all her equipage of pride;
Deduct what is but vanity of dress,
Or learning’s luxury, or idleness,
Or tricks to show the stretch of human brain,
Mere curious pleasure, or ingenious pain.”

Lecturing after a fashion is easy enough; _teaching_ is a very
different affair. The one requires little more than good information,
some confidence, and a _copia verborum_; the other establishes
several additional requisitions. These requisitions, when rendered
comparatively easy by nature, are seldom perfectly matured without art
and careful study. The transmission of ideas from one mind to another,
in a simple, unequivocal form, is not always easy; but, in teaching,
the object is not merely to convey the idea, but to give a lively
and lasting impression—something that should not merely cause the
retention of the image, but in such connection as to excite another
process, “thought.”

There was no peculiarity in Abernethy more striking than the power he
possessed of communicating his ideas, and of sustaining the interest
of the subject on which he spoke. For this there is no doubt he was
greatly indebted to natural talent; but it is equally clear that he had
cultivated it with much care. His ability as a lecturer was, we think,
unique. We never saw his like before: we hardly dare hope we shall
again.

There is no doubt that a great part of his success depended on a
facility of giving that variety of expression, and that versatility
of manner, which falls within the province of what we must call
dramatic; but then it was of the very highest description, in that it
was perfectly natural. It was of that kind which we sometimes find in
an actor, and which conveys the impression that he is speaking his
own sentiments, rather than those of the author. It is a species of
talent which dies with its possessor, and cannot, we think, be conveyed
by description. Still there were many things in Abernethy that were
observable, and such as could hardly have been acquired without study.

If we examine any lecturer’s style, and ask ourselves what is his
fault, we shall find very few in whom we cannot detect one or more.
When we do this, and then reflect on Abernethy, we are astonished
to find how many he avoided. We shall endeavour to make this as
intelligible as we can, by citing some of the points which our
attention to different lecturers have suggested.

“Simplicity” has struck us as a feature which, in some sense or
other, is very commonly defective. Simplicity appears so important,
that perhaps, by not a very illegitimate extension of its meaning, it
might be made to include almost all the requisitions of this mode of
teaching. Let us think of it in relation to language and illustration.
In all sciences, the _facts_ are simple; the laws are yet _more
so_; increasing knowledge tends to impress on us an ever-increasing
and comprehensive simplicity. In explaining simple things, no doubt
language should be simple too. If we employ language unnecessarily
technical, we use symbols to which the learner is unaccustomed.
He has not to learn the facts _only_; but he has the _additional
labour_ of something allied to learning it in a foreign language. The
_unnecessary_ use of technicalities should then surely be avoided.
Abernethy was obliged to use them, because there were often no other
terms; but he always avoided any needless multiplication of them. When
they were difficult or objectionable, he tried some manœuvre to lighten
the repulsiveness of them.

There are many muscles in the neck with long names, and which are
generally given with important parts of surgical anatomy. Here he used
to chat a little; he called them the _little_ muscles with the _long_
names; but he would add, that, after all, they were the best-named
muscles in the body, because their names expressed their attachments.
This gave him an excuse for referring to what he had just described,
in the form of a narrative, rather than a dry repetition. Then, with
regard to one muscle, that he wished particularly to impress, the name
of which was longer than any of the others, he used to point it out as
a striking feature in all statues; and then, repeating its attachments,
and pointing to the sites which they occupied, say it was impossible to
do so without having the image of the muscle before us.

In other parts of the Lectures, he would accompany the technical name
by the popular one. Thus he would speak of the pancreas, or sweetbread;
cartilage, or gristle. Few people are aware how many difficulties are
smoothed by such simple manœuvres. Nothing interests people so much as
giving anything _positive_. We think it not improbable that many a man
has heard a lecture, in which animals have been described with whose
habits he had been perfectly familiar, without having recognized his
familiar acquaintances in the disguise afforded by a voluminous Greek
compound. Abernethy seemed always to lecture, not so much as if he was
telling us what he _knew_, as that which _we_ did _not_ know. There was
an absence of all display of any kind whatever.

To hear some lecturers, one would almost think that they adopted the
definition of language which is reported of Talleyrand—that it was
intended to conceal our ideas. Some make simple things very much
otherwise by the mode of explaining them. This reminds us of a very
worthy country clergyman, in the west of England, who, happening to
illustrate something in his sermon by reference to the qualities of
pitch, thought he should help his rustic congregation by enlarging a
little on the qualities of that mineral. He accordingly commenced by
saying, “Now, dear brethren, pitch is a bituminous substance:” rather a
difficult beginning, we should think, to have brought to a successful
conclusion.

Sometimes we have heard a very unnecessary catalogue of technicalities
joined with several propositions in one sentence. It is hardly to
be imagined how this increases the difficulty to a beginner; whilst
it impresses the excellence of that simplicity and clearness which
were so charming in Abernethy. We give an example of this defect. The
lecturer is describing the continuation of the cuticle over the eyes
of the crustacea, as lobsters, &c.: “The epidermis (the cuticle) in
the compound eyes of the crustacea passes transparent and homogeneous
over the external surface of the thick layer of the prismatic corneæ,
which are here, as in insects, generally hexagonal, but sometimes
quadrangular; and to the internal ends of the prismatic corneæ are
applied the broad bases of the hard, tapering, transparent lenses,
which have their internal truncated apices directed to the retinal
expansions of the numerous optic nerves.”

The high respect we entertain for the lecturer here alluded to,
withholds us from attempting to supply a more homely version of the
foregoing passage. But what an idea this must give to a student who
reads it in “the outlines” of a science of which he is about to
commence the study. There is nothing whatever difficult in the ideas
themselves; but what a bristling _chevaux-de-frise_ of hard words,
what a phalanx of propositions! We fear we should never arrive at the
knowledge of many of those beautiful adaptations which all animals
exemplify, if we had to approach them by such a forbidding pathway.

As contrasted with simple facts thus obscured by an unnecessary
complexity of expression, we may see in Abernethy how a very
comprehensive proposition may be very simply expressed. Take almost the
first sentence in his Surgical Lectures, the germ, as it were, of a
new science: “Now I say that local disease, injury, or irritation, may
affect the whole system; and conversely, that disturbance of the whole
system may affect any part.”

We have sometimes thought that lecturers who have had several desirable
qualifications have materially diminished the attraction of them by
faults which we hardly know how to designate by a better term than
vulgarity, ill-breeding, or _gaucherie_. Now Abernethy had, in the
first place, that most difficult thing to acquire, the appearance of
_perfect ease, without_ the slightest _presumption_. Some lecturers
appear painfully “in company;” others have a self-complacent
assurance, that conveys an unfavourable impression to most well-bred
people. Abernethy had a calm, quiet sort of ease, with that expression
of thought which betokened respect for his task and his audience, with
just enough of effort only, to show that his mind was in his business.

He had no offensive tricks. We have known lecturers who never began
without making faces; others who intersperse the lecture with unseemly
gesticulations. Some, on the most trivial occasion, as referring to
a diagram, are constantly turning their backs _completely_ to the
audience. This is, we know, disagreeable to many people, and, unless a
lecturer is very clear and articulate, occasionally renders his words
not distinctly audible. Even in explaining diagrams, it is seldom
necessary to turn quite round; the smallest inclination towards the
audience satisfies the requisitions of good breeding, reminds them
agreeably of a respect with which they never fail to be pleased, and of
the lecturer’s self-possession.

There are, indeed, occasions when the lecturer had better turn a
little aside. Not long ago, we heard a very sensible lecturer, and a
very estimable man, produce an effect which was rather ludicrous—a
very inconvenient impression when not intended. He had been stating,
very clearly, some important facts, and he then observed: “The great
importance of these facts I will now proceed to explain to you;” when
he immediately began to apply the pocket-handkerchief he had in his
hand most elaborately to his nose, still fronting the audience. It had
the most ridiculous effect, and followed so closely on the preceding
remark, as to suggest to the humorously inclined that it was part of
the proposed explanation.

Some think it excusable to cast their eyes upwards, with an expression
of intense thought, or even to carry their hands to their heads or
forehead for the same purpose. But this conveys a painful feeling to
the audience, whose attention is apt to be diverted from the subject by
sympathy with the apparent embarrassment of the lecturer. Sometimes it
conveys the impression of affectation, which of course is one form of
vulgarity.

Abernethy was remarkably free from anything of the kind. The
expression of his countenance was, in the highest degree, clear,
penetrative, and intellectual; and his long, but not neglected,
powdered hair, which covered both ears, gave altogether a philosophic
calmness to his whole expression that was peculiarly pleasing. Then
came a sort of little smile, which mantled over the whole face, and
lighted it up with something which we cannot define, but which seemed a
compound of mirth, archness, and benevolence.

The adjustment of the quantity of matter to the time employed in
discussing it, is an important point in teaching. A lecture too _full_,
is as objectionable as a lecture _too long_. If the matter is spread
too thinly, the lecture is bald and uninteresting, and apt to fall
short of representing any integral division of a subject; if it be too
thick, it is worse, for then all is confused and difficult. A man’s
brain is like a box packed in a hurry; when all is done, you neither
know what you have got, nor what you have forgotten.

Here again Abernethy was in general very happy. Various circumstances
would sometimes, indeed, in the Anatomical Course, oblige him to put
more into one lecture than was usual; but he had always, in such a
case, some little manœuvre to sustain the attention of his audience.
No man was ever a more perfect master of the _ars est celare artem_.
Everything he did had its object, every joke or anecdote its particular
errand, which was in general most effectively fulfilled.

The various ways in which Abernethy managed to lighten up the general
lecture, or to illustrate single points, can hardly be conveyed by
selection of particular examples. There was a sort of running metaphor
in his language, which, aided by a certain quaintness of manner, made
common things go very amusingly. Muscles which pursued the same course
to a certain point, were said to travel sociably together, and then to
“part company.” Blood-vessels and nerves had certain habits in their
mode of distribution contrasted in this way; arteries were said to
_creep_ along the sides or between muscles. Nerves, on the contrary,
were represented as penetrating their substance “_without ceremony_.”
Then he had always a ready sympathy with his audience. If a thing was
difficult, he would, as we have said, anticipate the feelings of the
student. This is always encouraging; because, when a student finds a
point difficult, if he is merely diffident, he is depressed; if he is
disposed to be lazy, he finds too good an excuse for it.

Abernethy’s illustrations were usually drawn from some source already
familiar; and if they were calculated to impress the fact, he was not
very scrupulous whence he drew them. This would sometimes lead him
into little trippings against refinement; but these were never wanton.
Everything had its object, from the most pathetic tale down to the
smallest joke. When the thing to be impressed was not so much single
facts or propositions, as a more continued series, he had an admirable
mode of pretending to con over the lecture in a manner which he would
first recommend students to do—something after this fashion: “Let me
see—what did he say?” “Well, first he told us that he should speak of
Matter in general; then he said something about the Laws of Matter,
of Inertia, &c. Well, I did not understand much of that; and I don’t
think he knew much about it himself;” and so on. There would now be a
general smile; the attention of the class would be thoroughly alive;
and then he would, in this “conning over,” bring forward the points
he most wished to impress of the whole lecture. A very striking proof
of how much power he had in this way, came out in a conversation I
had with Dr. Thomas Rees. This gentleman knew Abernethy well, and, in
kindly answering some inquiries I made of him, he spoke of his power
in lecturing. Amongst other things, he said: “The first lecture I ever
heard him give, impressed me very much; I thought it admirable. His
skill appeared so extraordinary! At the conclusion of the lecture,”
said Dr. Rees, “he proposed to the students to con over the lecture,
which he proceeded to do for them.” Dr. Rees then continued repeating
the heads of the lecture, and this after at least thirty, perhaps forty
years.

Lecturers will sometimes endeavour to illustrate a point which is
difficult or obscure by something more difficult still, or something
borrowed from another branch of science. Sometimes the illustrations
are so lengthy, or intrinsically important, that a pupil forgets _what
principle_ it was that was _to be illustrated_. When we are desirous
of learning something about water or air, it is painful for a pupil
to be “reminded” of the “properties of angles,” which it is an even
chance he never knew. It is equally uncomfortable to many an audience,
in lectures on _other subjects_, to have the course of a cannon-ball,
which three pieces of string would sufficiently explain, for mere
purposes of illustration, charged with the “laws of projectiles,” the
“composition of forces,” &c. We are of course not thinking of learn_ed_
but learn_ing_ audiences. To the former, lectures are of no use; but
we allude to learners of mixed information and capacity; like young
men who have been residing with medical men in the country; who come
to a lecture for information, and who require to be interested, in
order that they may be instructed. Abernethy’s illustrations were
always in simple language. Rough ridden sometimes by a succession of
many-footed Greek compounds, the mind of a student loves to repose on
the refreshing simplicity of household phrases.

Abernethy had stories innumerable. Every case almost was given with the
interest of a tale; and every tale impressed some lesson, or taught
some relation in the structure, functions, or diseases of the body. We
will give one or two; but their effect lay in the admirable manner in
which they were related.

If he was telling anything at all humorous, it would be lighted up by
his half-shut, half-smiling, and habitually benevolent eye. Yet his eye
would easily assume the fire of indignation when he spoke of cruelty or
neglect, showing how really repulsive these things were to him. Then
his quiet, almost stealthy, but highly dramatic imitation of the manner
of some singular patient. His equally finished mode of expressing pain,
in the subdued tone of his voice; and then when something soothing or
comfortable had been successfully administered to a patient, his “Thank
you, sir, thank you, that is very comfortable,” was just enough always
to interest, and never to offend. Now and then he would sketch some
patient who had been as hasty as he himself was sometimes reported to
be. “Mr. Abernethy, I am come, sir, to consult you about a complaint
that has given me a great deal of trouble.” “Show me your tongue,
sir. Ah, I see your digestive organs are very wrong.” “I beg your
pardon, sir; there you are wrong yourself; I never was better in all my
life,” &c. All this, which is nothing in telling, was delivered in a
half-serious, half-Munden-like, humorous manner, and yet so subdued as
never to border on vulgarity or farce.

His mode of relating cases which involved some important principle,
showed how really interested he had been in them. A gentleman having
recovered from a very serious illness, after having failed a long time
in getting relief, was threatened, by the influence of the same causes,
with a return of his malady. “He thought,” said Abernethy, “that if he
did not drink deeply, he might eat like a glutton.” He lived in the
country, and Mr. Abernethy one day went and dined with him. “Well,”
said Mr. Abernethy, “I saw he was at his old tricks again; so, being
a merchant, I asked him what he would think of a man who, having been
thriving in business, had amassed a comfortable fortune, and then went
and risked it all in some imprudent speculation?” “Why,” said the
merchant, “I should think him a great ass.” “Nay, then, sir,” said
Abernethy, “thou art the man.”

On another occasion, a boy having suffered severely from disease of the
hip, Abernethy had enjoined his father to remove him from a situation
which he was unfitted to fill, and which, from the exertion it
required, would expose him to a dangerous recurrence of his complaint.
The father, however, put the boy back to his situation. One day,
Abernethy met both father and son in Chancery Lane, and he saw the
boy, who had a second time recovered, again limping in his walk. After
making the necessary inquiry—”Sir,” said he to the father, “did I not
warn you not to place your son in that situation again?” The father
admitted the fact. “Then, sir,” said Abernethy, “if that boy dies, I
shall be ready to say you are his murderer.” Sure enough, the boy had
another attack, and did die in a horrible condition.

This story, and others of a similar kind, were intended to impress
the paramount importance of keeping diseased parts, _and joints
especially_, in a state of _perfect repose_; and to prevent a
recurrence of mischief, by avoiding modes of life inappropriate to
constitutions which had exhibited a tendency to this serious class of
diseases.

He was remarkably good on the mode of examining and detecting the
nature of accidents; as fractures and dislocations. In regard to the
latter, he had many very good stories, of which we will presently cite
a ludicrous example. He could, however, throw in pathos with admirable
skill when he desired it. The following lamentable case he used to tell
to an audience singularly silent. He is speaking of the course of a
large artery.

“Ah,” said he, “there is no saying too much on the importance of
recollecting the course of large arteries: but I will tell you a
case. There was an officer in the navy, and as brave a fellow as ever
stepped, who in a sea-fight received a severe wound in the shoulder,
which opened his axillary artery. He lost a large quantity of blood;
but the wound was staunched for the moment, and he was taken below. As
he was an officer, the surgeon, who saw he was wounded severely, was
about to attend him, before a seaman who had just been brought down.
But the officer, though evidently in great pain, said: ‘Attend to that
man, sir, if you please; I can wait.’ Well, his turn came; the surgeon
made up his mind that a large artery had been wounded; but, as there
was no bleeding, dressed the wound, and went on with his business. The
officer lay very faint and exhausted for some time, and at length began
to rally again, when the bleeding returned. The surgeon was immediately
called, and, not knowing where to find the artery, or what else to do,
told the officer he must amputate his arm at the shoulder joint. The
officer at once calmly submitted to this additional, but unnecessary
suffering; and, as the operator proceeded, asked if it would be long.
The surgeon replied that it would soon be over. The officer rejoined:
‘Sir, I thank God for it!’ But he never spake more.”

Amidst the death-like silence of the class, Abernethy calmly concluded:
“I hope you will never forget the course of the axillary artery.”

His position was always easy and natural—sometimes homely, perhaps.
In the Anatomical Lecture, he always stood, and either leant against
the wall, with his hands folded before him, or resting one hand on the
table, with the other perhaps in his pocket. In his Surgical Lecture,
he usually sat, and very generally with one leg resting on the other.

He was particularly happy in a kind of coziness, or friendliness of
manner, which seemed to identify him with his audience; as if we were
all about to investigate something interesting _together_, and not as
if we were going to be “Lectured at” at all. He spoke as if addressing
each individual, and his discourse, like a happy portrait, always
seemed to be looking you in the face. On very many accounts, the tone
and pitch of the voice, in lecturing, are important. First: That it may
not be inaudible; nor, on the contrary, too loud. The one of course
renders the whole useless; the other is apt to give an impression of
vulgarity. We recollect a gentleman who was about to deliver a lecture
in a theatre to which he was unaccustomed. He was advised to ascertain
the loudness required, and to place a friend in the most distant part,
to judge of its fitness; but he declined it as unnecessary. When he had
given the lecture, which was a very good one, on a very interesting
subject, he was much mortified in finding that he had been inaudible to
at least one half of the audience.

Abernethy was very successful in this respect. His voice seldom rose
above what we may term the conversational, either in pitch or tone;
it was, in general, pleasing in quality, and enlivened by a sort of
archness of expression. His loudest tone was never oppressive to those
nearest to him; his most subdued, audible everywhere. The _range_
of pitch was very limited; the expression of the eye, and a _slight
modulation_ of the voice being the means by which he infused through
the lecture an agreeable variety, or gave to particular sentiments
the requisite expression. There was nothing like declamation; even
quotations were seldom louder than would have been admissible in a
drawing-room. We have heard lecturers whose habitually declamatory tone
has been very disagreeable; and this seldom fails to be mischievous. A
declamatory tone tends to divert the attention, or to weary it when
properly directed. On almost every subject, it is sure to be the source
of occasional bathos, which now and then borders on the ridiculous.
Conceive a man, describing a curious animal in a diagram, saying,
“This part, to which I now direct my rod, is the point of the tail,”
in a sepulchral tone, and heavy cadence, as if he had said, “This
is the end of all things.” Another inconvenience often attending a
declamatory tone, as distinguished from the narrative or descriptive,
is the tendency it has to make a particular cadence. Sometimes we have
heard lecturers give to every other sentence a peculiar fall; and this
succession of rhythmical samenesses, if the lecturer be not otherwise
extremely able, sends people napping.

Another fault we observe in some lecturers is, a reiteration of
particular phrases. In description, it is not easy always to avoid
this; but it seldom occurred in any disagreeable degree in Abernethy.
We have heard some lecturers, in describing things, continually
reiterating such phrases as “We find,” “It is to be observed,” in such
quick and frequent succession, that people’s sides began to jog in
spite of them.

Provincial or national idiom, or other peculiarity, is by no means
uncommon, and generally more or less disagreeable, Abernethy was
particularly free from either. He could, in telling stories, slightly
imitate the tone and manner of the persons concerned; but it was always
touched in the lightest possible manner, and with the subdued colouring
and finish of a first-rate artist. His power of impressing facts, and
of rendering them simple and interesting by abundance and variety of
illustration, was very remarkable, and had the effect of imparting an
interest to the driest subject. In the first place, he had an agreeable
mode of sympathizing with the difficulty of the student. If he were
about to describe a bone or anything which he knew to be difficult,
he would adopt a tone more like that in which a man would teach it to
himself than describe it to others. For example, he would say, perhaps:
“Ah! this is a queer-looking bone; it has a very odd shape; but I
plainly perceive that one may divide it into two parts.” Then pointing
with a probe to the division he proposed, he would begin, not so much
to _describe_ as to _find_, as if for the first time, the various
parts of which he wished to teach the names and uses; the description
being a kind of running accompaniment to his tracing of the bone, and
in a tone as if half-talking to himself and half to the audience.

Every one feels the value of order, and clearness of arrangement.
Of Abernethy’s, we have already spoken generally: simplicity, and
impressing the more essential facts, were his main objects. He showed
very frequently his perception of the importance of order, and would
often methodize for the students. He knew very well that A B C was much
more easily remembered than Z K J; and he would sometimes humorously
contrast the difference between a man whose knowledge was well packed,
and one whose information was scattered and without arrangement. This
he usually did by supposing two students under examination. The scene
would not _tell_ upon paper; but it never failed to create a good deal
of mirth in the theatre, during which he would contrive to repeat the
facts he meant to impress, without the tedium of mere reiteration.

Various people have been more or less deeply impressed with different
parts of his lectures, most persons having their favourite passages. In
his anatomical course we were never more pleased than by his _general_
view of the structure of the body. He adopted on that occasion the
synthetical plan, and in imagination put the various parts together
which were to be afterwards taught analytically. In his surgical
course, the manner in which he illustrated the practical points, and
his own views in the “Eventful History of a Compound Fracture,” was, we
think, the most successful triumph, both as to matter and manner, which
we have ever witnessed.

An abundance of resource and manœuvres of the kind we have mentioned,
gave a great “liveliness” to his lecture, which _in its quiet form so
as not to divert or disturb_, is a great difficulty in lecturing.

We have heard an excellent lecturer whose only fault, we think, was
want of liveliness and variety. Few men could in other respects lecture
comparably to him. Nothing could surpass the quiet, polished manner
of this accomplished teacher. His voice, though not good, was by no
means unpleasing. His articulation elaborately distinct, and free from
all provincialism. His language invariably correct and appropriate;
the structure of his sentences strikingly grammatical; and they fell
in such an easy, though somewhat too rhythmical succession, as to be
at once graceful and melodious. His arrangement, always simple and
clear. Nothing was more striking than the deferential manner in which
he approached a philosophical subject. “I like ——,” said one who
had often heard him, “because he is always so gentlemanly. There is
nothing off-hand, as if he thought himself very clever, but a kind of
unaffected respect for himself and his audience, which obliges one to
pay attention to him, if it were only because you feel that a man of
education is speaking to you.”

What, it may be said, can such a man want? Why he wanted liveliness
and flexibility. His voice measured forth its gentlemanly way with
all the regularity of a surveying rod. Various and interesting as his
subjects were, and handled with consummate ability, he must certainly
have _taught_; yet we think he sent away many of his audience passive
recipients, as distinguished from persons _set on thinking_ what they
had heard “into their own.”

He performed his task like a good man and a scholar; but still it was
like a task after all. It was something like a scholar reading a book,
always excepting the beautifully clear illustrations for which his
subject gave him abundant opportunity. He wanted that animation and
interest in his subject by which a lecturer inoculates you with his own
enthusiasm. He was the most striking example in our experience of the
importance of liveliness and variety, and of making a lecture, however
well delivered, just that thing which we _cannot_ find in a book. The
life-like, the dramatic effect was wanting; and it was to this alone
that we can ascribe what we have not unfrequently observed in the midst
of a generally attentive audience, a few who were “nodding” their
assent to his propositions.

Now Abernethy’s manner was perfect in these respects. He had just got
the “cheerfully, not too fast” expression, that we sometimes see at
the head of a musical composition. His manner was so good, that it
is difficult to convey any idea of it. It was easy, without being
negligent; cheerful, without being excited; humorous, often witty,
without being vulgar; expeditious, without being in a bustle; and he
usually took care that you should learn _the thing_, before he gave the
_name of it_; and understand it, before he expatiated on the beauty or
perfection of its adaptation to the ends it seemed designed to serve.

He was particularly chaste in the manner in which he spoke of design,
or other of the Attributes so frequently observable in natural
arrangements. It is a great mistake, we think, and not without
something akin to vulgarity, to usher in any description of the
beauties of nature by a flourish of such trumpets as human epithets
form—mere notes of admiration. Nature speaks best for herself. The
mind is kept in a state of excitement by too frequent _feux de joies_
of this kind; the frequent recurrence of such terms as “curious!
strange! wonderful!” on subjects where all is wonderful, have a sort of
bathos in the ears of the judicious, while to the less critical they
produce a kind of disturbed atmosphere, which is unfavourable to the
calm operations of the intellect.

Abernethy was generally very careful in these matters. I give one
example. He is speaking of cartilage, or gristle, which covers the
ends of the bones where they form joints, and has explained its great
elasticity, the use of it in preventing jarring; and contrasted the
_springiness_ of youth with the easily jarred frame of age. “Well,”
he adds, “this cartilage is fibrous, and they say that the fibres are
arranged vertically; so that the body may be said to be supported on
‘_myriads of elastic columns_.'” That was the beauty by which he wished
to impress that which he had previously _taught_.

When marvellousness is too much excited, many say, “Ah, how clever
that gentleman is! what an interesting lecture! what a curious thing
that was he showed us!” But when you inquire what _principle_ or _law_
was intended to be illustrated, you find that the sensual or the
imaginative faculty has alone been excited, and has galloped off with
that which was intended for the intellect. If persons are examined as
to a particular point of the lecture, they are apt to say: “Well, that
is just what I wanted to know; would you explain it?”

It would seem that it is a great mistake to excite marvellousness
or our external senses very vividly, when we desire to concentrate
the intellectual faculties. That breathless silence, with eyes and
mouth open, that “_intenti que ora tenebant_” condition, excited by
marvellousness, is very well for the story of Æneas, or Robinson
Crusoe; but it is out of place, when we are endeavouring to augment our
intellectual possessions.

We require, in fact, a calmer atmosphere. The desire to interest and
hold the attention of our audience is so natural, that it is very apt
to escape one that this may be done _on terms not consistent_ with our
real object—the interesting the intellect; and this fault is perhaps,
of all, the worst; because it is never a greater failure than when it
appears to be successful. All other faults in lecturing, if serious, in
one respect tell their own tale in the thinning audience.

The learned author of the “Philosophy of Rhetoric” has observed that “A
discourse directed to the understanding will not admit of an address to
the passions, which, as it never fails to disturb the operation of the
intellectual faculty, must be regarded by every intelligent hearer as
foreign indeed, if not insidious.” He had before said, “that in such a
discourse you may borrow metaphor or comparison to illustrate it, but
not the bolder figures, prosopopœia and the like, which are intended
not to elucidate the subject, but to _create admiration_.”

“It is obvious,” he continues, “that either of the foregoing, far from
being subservient to the main design (to address the intellect), serves
only to distract the attention from it[67].”

This judicious writer, however, in the first sentence makes a
distinction, which requires, perhaps, to be received with some caution.

There is no discourse that is solely intellectual; the driest
mathematical proposition interests our _feelings_. The pleasure of
truth, what is that? Not merely intellectual, certainly. It is a
pleasure derived _from_ the intellect, no doubt; but it is a _feeling_
entirely distinct. So, in addresses to the passions, if they are
successful, the presiding influence of the intellect is very obvious;
this away, a discourse soon merges into bombast or fustian, a something
which neither impresses the feelings nor the passions as desired.

The true desideratum, as it appears to us, is accuracy of adjustment,
not separation. In intellectual operations, the feelings are to be
subservient to the accomplishment of the objects of the intellect. In
discourses, where the passions or feelings are most appealed to, or
most prominent, the intellect must still really guide, though it may
appear to follow.

Notwithstanding that so much of Abernethy’s lecturing was on anatomy,
and therefore necessarily addressed to the eye, yet he seldom offered
any _illustration_ to the external senses. He was always endeavouring
to impress the mechanical arrangement of parts, by reference to their
uses and surgical relations. Even in speaking of light, he would be
suggestive beyond the mere perception of sense. He used to say, of
refraction of light, when the refracting medium was, as it commonly
is, the denser body, “that the ray seems as if attracted”—a very
suggestive phrase to any one who has thought much on the subject of
light. It is a curious thing to observe how confused the ideas of many
people are on phenomena of light; and we are afraid that the cause is,
that the illustrations to the eye are given _too soon_. If people were
made to _understand_ by a simple illustration what they are about to
_see_, it is probable they would have much clearer ideas. The intellect
having gone before, the eye no longer diverts it from its office; and
the eye would then be merely _impressing_, by means of a physical
representation, an established idea.

“Suavis autem est et vehementer sæpe utilis jocus et facetiæ.”—CIC.
DE ORAT.

Abernethy’s humour was very peculiar; and though there was of course
something in the matter, there was a good deal more, as it appeared
to us, in the manner. The secret of humour, we apprehend, lies in the
juxtaposition, either expressed or implied, of incongruities, and it is
not easy to conceive anything humourous which does not involve these
conditions. We have sometimes thought there was just this difference in
the humour of Abernethy, as contrasted with that of Sidney Smith. In
Smith’s, there was something that, told by whom it might be, was always
ludicrous. Abernethy’s generally lay in the telling.

“The jest’s propriety lies in the ear
Of him who hears it, never in the tongue
Of him that makes it,”

although true, was still to be taken in rather a different sense from
that in which it is usually received. The former (a far higher species
of humour) may be recorded; the dramatic necessities of the other
occasion it to die with the author. The expression Abernethy threw into
his humour (though of course without that broadness which is excusable
in the drama, but which would have been out of place in a philosophical
discourse) was a quiet, much-subdued colouring, between the good-nature
of Dowton, and (a little closer perhaps to the latter) the more quiet
and gentlemanly portions of Munden.

Few old pupils will forget the story of the Major who had dislocated
his jaw.

This accident is a very simple one, and easily put right; but, having
once happened, it is apt to recur on any unusual extension of the lower
jaw. Abernethy used to represent this as a frequent occurrence with
an hilarious Major; but as it generally happened at mess, the surgeon
went round to him and immediately put it in again. One day, however,
the Major was dining about fourteen miles from the regiment, and, in a
hearty laugh, “out went his jaw.” They sent for the medical man, whom,
said Abernethy, we must call the apothecary. Well, at first, he thought
that the jaw was dislocated; but he began to pull and to show that he
knew nothing about the proper mode of putting it right again. On this,
the Major appeared to be very excited, and vociferated inarticulately
in a strange manner; when, all at once, the doctor, as if he had just
hit on the nature of the case, suggested that the Major’s complaint was
in his brain, and that he could not be in his right mind. On hearing
this, the Major became furious, which was regarded as confirmatory of
the doctor’s opinion; they accordingly seized him, confined him in
a strait-waistcoat and put him to bed, and the doctor ordered that
the barber should be sent for to shave the head, and a blister to be
applied “to the part affected.”

The Major, fairly beaten, ceased making resistance, but made the
best signs his situation and his imperfect articulation allowed, for
pen and paper. This request, being hailed as indicative of returning
rationality, was complied with; and, as soon as he was sufficiently
freed from his bonds, he wrote—”For God’s sake send for the surgeon of
the regiment.” This was accordingly done, and the jaw readily reduced,
as it had been often before. “I hope,” added Abernethy, “you will never
forget how to reduce a dislocated jaw.”

We think that what we have said of the style of his humour cannot be
very incorrect, from knowing that the impressions of one of his oldest
pupils and greatest admirers were almost identical with the foregoing.
I recollect it being said of John Bannister, that the reason his acting
pleased everybody was that he was always a gentleman; an extremely
difficult thing, we should imagine, in handling some of the freer parts
of our comic dialogues. Abernethy’s humour (exceptionally indeed, but
occasionally a little broad) never suggested the idea of vulgarity;
and, as we have said, every joke had its mission. Then, at times,
though there was not much humour, yet a promptness of repartee gave it
that character.

“Mr. Abernethy,” said a patient, “I have something the matter, sir,
with this arm. There, oh! (making a particular motion with the limb)
that, sir, gives me great pain.” “Well, what a fool you must be to do
it, then,” said Abernethy.

One of the most interesting facts in relation to Abernethy’s lecturing,
was, that however great his natural capacity, he certainly owed very
much to careful study and practice; and we cannot but think that it
is highly encouraging to a more careful education for this mode of
teaching, to know the difficulty that even such a man as Abernethy had
for some few years in commanding his self-possession. To those who only
knew him in his zenith or his decline, this will appear extraordinary;
yet, to a careful observer, there were many occasions when it was
easy to see that he did not appear so entirely at ease _without some
effort_. He was very impatient of interruption; an accidental knock
at the door of the theatre, which, by mistake of some stranger, would
occasionally happen, would disconcert him considerably; and once,
when he saw some pupil joking or inattentive, he stopped, and with a
severity of manner I hardly ever saw before or afterwards, said: “If the
lecture, sir, is not interesting to you, I must beg you to walk out.”

There were, as we shall hereafter observe, perhaps physical reasons
for this irritability. He never hesitated, as we occasionally hear
lecturers do, nor ever used any notes. When he came to any part that
he perhaps wished to impress, he would pause and think for a second
or two, with his class singularly silent. It was a fine moment. We
recollect being once at his lecture with the late Professor Macartney,
who had been a student of Abernethy’s[68]. Macartney said, “what can
it be that enables him to give so much interest to what we have so
often heard before?” We believe it to have been nothing but a steady
observance of rules, combined with an admirable power _matured by
study_.

That which, above everything, we valued in the whole of Abernethy’s
lectures, was what can hardly be expressed otherwise than by the
term, tone. With an absence of all affectation, with the infusion
of all sorts of different qualities: with humour, hilarity, lively
manner, sometimes rather broad illustrations, at other times, calm
and philosophical, with all the character of deep thought and acute
penetration; indignation at what was wrong or unfeeling, and pathos in
relation to irremediable calamity; still the thing which surpassed all,
was the feeling, with which he inoculated the pupils, of a high and
conscientious calling. He had a way which excited enthusiasm without
the pupil knowing why. We are often told by lecturers of the value of
knowledge for various purposes—for increasing the power and wealth of
the country—for multiplying the comforts and pleasures of society—for
amassing fortunes, and for obtaining what the world usually means by
the term distinction. But Abernethy created a feeling distinct from and
superior to all mere utilitarian purposes. He made one feel the mission
of a conscientious surgeon to be a high calling, and spurned, in manner
as well as matter, the more trite and hackneyed modes of inculcating
these things. You had no set essay, no long speeches. The _moral_
was like a golden thread artfully interwoven in a tissue to which it
gives a diffusive lustre; which, pervading it everywhere, is obtrusive
nowhere.

For example, the condition attached to the performance of our lowest
duties (operations), were, the well-ascertained inefficacy of our
best powers directed to judicious treatment; the _crowning_ test—the
conviction that, placed in the same circumstances, _we would have the
same operation performed on ourselves_. Much of the suggestive lies
in these directions. Our sympathies toward the victims of mistake or
ignorance, excited by the relation of their sufferings, were heightened
by the additional mention of any good quality the patient might have
possessed, or advantage of which he might have been deprived; and thus
that interest secured which a bare narration of the case might have
failed to awaken.

A father, who, in subservience to the worldly prospects of his son,
placed him in a situation to which he was unequal, and thus forgot his
first duty, the health of his offspring, was the “murderer” of his
child. Another victim, we have seen, was as “brave a fellow as ever
stepped,” &c.

Humanity and Science went hand in hand. His method of _discovering_
the nature of dislocations and fractures, by attention to the relative
position of parts, was admirable; and few of his pupils, who have
had much experience, have failed to prove the practical excellence
of them. He repudiated nothing more than the too commonly regarded
test, in fractures, of “grating, or crepitus.” Nothing distinguished
his examination of a case more than his gentleness, unless it was the
clearness with which he delivered his opinion.

To show how important gentleness is—a surgeon had a puzzling case
of injury to the elbow. He believed that he knew the nature of the
accident, and that he had put the parts right; but still the joint
remained in a half-straight position; and the surgeon, who knew his
business, became alarmed, lest something had escaped him, and that
the joint would be stiff. He proposed a consultation. The joint was
examined with great gentleness, and after Abernethy’s plan. The boy
experienced no pain. Everything appeared in its natural position. The
surgeon said: “Now, my boy, bend your arm a little, but no farther
than just to reach my finger; and not as much as that, if it gives you
any pain.” This the boy did very gently. After waiting a few minutes,
the surgeon again told him to bend it a little more, and upon the same
conditions; and so on, until, in a very short space of time—perhaps
eight or ten minutes—the arm had been completely bent. The boy had
been alarmed, and the muscles had become so sensitive that they held
the parts with the most painful tenacity; but, beyond this, there was
nothing the matter.

We cannot help thinking that Abernethy’s benevolence had a great
influence in directing some of his happiest contributions to practice.
We consider that every sufferer with that serious accident, fracture
of the neck of the thigh bone within the joint, owes a great portion
of any recovery he may have, to Abernethy. It was he who was the real
means of overthrowing a dangerous dogma, that such cases could not
unite by bone, and who opposed the practice consequent on it, by which
reparation by bone became impossible. There was hardly any subject
which he touched, of which he did not take some view more or less
original; and his reasoning was always particularly simple and to the
point. No man, we believe, ever exceeded him in the skill he possessed
in conveying ideas from one mind into another; but he did a great deal
more: those who really studied him were sent away thinking, and led to
work with a kind of pleasure, which was in some sense distinct from any
merely practical or professional interest.

He contrived to imbue you with the love of philosophical research
in the abstract—with an interest in truth for its own sake;
you found yourself remembering the bare facts, not so much from
conscious _efforts_ of memory, as from the suggestive interest of the
observations with which they were so frequently associated. In going
over one of his Lectures alone, they seem to grow and expand under your
own reflections. We know not how to express the effect they produced:
they seemed to give new pleasure on repetition, to purify your thoughts
scarcely less than they animated your onward studies.

In studying their more suggestive passages, you would now and then feel
surprise at the number and variety of important practical relations
arising out of a single proposition. We are here merely stating our
own early impressions of his power. What we always really felt was,
that, great as was the excellence of these Lectures in a scientific
or professional sense, there was something more excellent still in
the element they contained of intellectual expansion and of moral
improvement.

We cannot indeed say that they had no faults; but we should be hard
driven to point them out: and although we feel how short our attempt
to give some idea of his mode of proceeding must fall of doing him
justice, still, if there be any truth at all in our representation, it
is quite clear that his negative excellences alone must have implied
no ordinary powers. But we must conclude: “Quid multa? istum audiens
equidem sic judicare soleo; quidquid aut addideris aut mutaveris aut
detraxeris, vitiosius et deterius futurum.”

HOR. Is it a custom?

HAMLET. Ay, marry, is’t:
But, to my mind, though I am native here
And to the manner born, it is a custom
More honoured in the breach than the observance.

HAMLET, Act I, Sc. IV.

If a moralist were to divide his catalogue of immoralities into such
as were of general commission, and such as occurred in the conduct of
the various trades and professions, we fear the latter division would
suggest no flattering position to humanity. An elevation somewhat above
gifted creatures it might be; but still we fear it would be at so low a
level as to afford Man but a humiliating indication of the height from
which he had fallen. He would, in too many instances, perhaps, find his
real _claims_ to his high destiny about equal to the shadowy difference
between a creature who fulfils _some_ only of his responsibilities,
and one who has no responsibilities to fulfil. We should like to hear
some grave philosopher discourse on Fashion: it is surely a curious
thing, for there is a fashion in everything. It is very like habit; but
it is not habit neither. Habit is a garment, which takes some time to
fit easily, and is then not abandoned without difficulty. Fashion is a
good fit _instanter_, but is thrown aside at once without the smallest
trouble. The most grotesque or absurd custom which slowly-paced
habit bores us with examining, is at once adopted by fashion with a
characteristic assentation.

Morals are by no means free from this kind of conventionalism: so
much the contrary, that few things evince more strongly the power of
fashion. It might be imagined that the multiplication of examples would
tend to teach the true nature of the thing exemplified; but it would
not seem so with error; “_tout au contraire_.” Arts or acts, which are
tabooed as vicious in the singular number, become, in the plasticity of
our moral grammars, very tolerable in the plural. Things that the most
hardy shrink from perpetrating _single-handed_, are regarded as easy
“compliances with custom” when “joint-stock” vices; practices which,
when partial, men are penetrating enough to discover to be unchristian,
or sufficiently sensitive to regard as ungentlemanly, pass muster with
marvellous lubricity when they become universal. We can anathemize,
with self-complacent indignation, vices in which we have no share; but
we are abundantly charitable when we discuss those in which we have a
common property; and, finally, moral accounts are settled very much to
our own satisfaction, as Butler says, by compounding

“For sins we are inclined to,
By damning those we have no mind to.”

After all, society keeps a pretty good “look-out” after offences
distributed in common. The law is tolerably comprehensive of things
which are of general commission; and mankind, sooner or later, contrive
to catch, or successfully oppose, the numerous little enormities which
slip through the finest of our legal meshes.

“Raro antecedentem scelestum,
Deseruit pede pœna claudo.”

From all this it results that moral obliquities, which fall within the
observation of society, make but an up-hill game; that which is _felt_
to be prejudicial to the interests of all men, is easily determined
to be vicious. But here again there is much in fashion. Society has
often determined that the immorality of a thing is not to be measured
by the nature of the act, nor the motive even on which it has been
founded, so much as by the more refined test afforded by the _position_
of the _actor_. One man may, like a sort of commercial megatherium,
gorge, with railway velocity, provisions which a once-breathing, fond
affection and a cold world had alike determined to be the life-blood of
widows and orphans, and yet have noblemen and others for his associate!
he may perhaps be a legislator in a great nation; whilst the poor
starveling, who steals for the vulgar purpose of satisfying hunger, may
be sent to the treadmill, where he may solve at leisure the problem
thus set him, by “the most enlightened nation on earth.”

Again, vices which have a known influence in disturbing the relations
of society are in various ways opposed by the more _public_ influence
of religion. So that in the end a man finds—although he may arrive at
the conclusion, only by exhausting all other views before he hits on
those which lead to it—that honesty is as good a way of getting on as
any other; or he may advance perhaps even on this utilitarian creed so
far as to agree with Tillotson: that people take more trouble to get to
Hell, than would suffice to carry them to Heaven. The immoralities of
trades and professions lie in a very different position, and involve
peculiarities which favour their growth and perpetuity.

They are committed in secret;—people are proverbially cautious of
attacking the weak positions of others, who feel that their own are
ill-defended. This, and the established manœuvres of each calling,
enable an individual to do a good deal “off his own bat,” without, as
one of our bishops happily expressed it, “being caught out.” In trade
we are sometimes informed that a thing cannot be sold cheaper; that the
price asked is already less than the cost; and people are appropriately
addressed as idiots, who every day appear to believe that which common
sense shows to be impossible.

Your purveyors will sometimes tell you that they are not living by the
prices they charge; although you have just ascertained that the same
article may be bought at infinitely less cost in the next market. The
other day, a watchmaker told us that our watch wanted a good deal of
looking to, and, amongst other things, “no doubt cleaning;” but this he
discovered, we suppose, by some recondite mesmeric process in a book,
which recorded when it had been cleaned last, without looking at the
watch at all.

As regards professions, lawyers are said to defend right and wrong with
indiscriminate avidity, with the encouraging prospect of obtaining more
fruit in maintaining one wrong cause, than establishing twenty right.

Then the _real nature_ of these things is, like too many in other
sciences, obscured by a cloudy nomenclature. We hear of “customs of
the trade,” “secrets of the trade,” or “profession,” applied to things
which the moralist only recognizes under very different designations.
Sophisms thus secured, and which appear to minister to a man’s
interests, have their true colours developed with difficulty; to say
nothing of it not being easy to discover that which there is no desire
to examine.

If any man should be so “peculiar,” or “crotchety,” as to consider that
names are of little import, and that “Vice is vice, for a’ that,” and
venture to anathematize any custom, or even refuse to be an accessory,
in declining to wink at it, he may encounter charges of violating
professional confidence, of being deficient in a proper _esprit de
corps_, and be outvoted, for no better reason than that he cannot
concur in the dogma, that a _vicious sophism is more valuable than a
simple truth_; nor agree with the currier, “that leather is the best
material for fortification.” He may possibly be let off by conceding
his connivance; which is little better than declining to be thief, as
too shocking; but having no objection to the more lubricated position
of the receiver.

But does any one for one moment believe that all this can be hung
on any trade, or profession, with no effect? Or that it will not
have a baneful influence on every calling, and that in proportion
as its _real_ and _proper_ duties are beneficent and exalted? Now,
whilst we claim for the medical profession a character which, in its
single-mindedness and benevolence, yields to no other whatever, we fear
it is not entirely free from these technical besettings.

In the medical profession, we trust, that which we, for want of a
better term, designate as technical immoralities are exceptions.
Exceptional they may be, and we sincerely hope they are; but, in
a crowded island, exceptions, even if _relatively_ few, may be
_absolutely_ numerous; and whenever they occur, especially if men hold
any position, one case of compromise of duty does more harm than a
hundred of the most inflexible adhesions to it can remedy. Suppose a
patient apply to a surgeon with a complaint requiring one operation,
and his fears incline him to another; he is informed it is improper for
his case: that so far from relieving him, it will indefinitely increase
his sufferings. The patient reiterates his wishes; the surgeon declines
doing that which he would not have done in his own person. On lamenting
what he believes to be the consequences of the patient’s determination,
to a brother surgeon, he is met by: “What a fool you must be to throw
away —— guineas; if you don’t do it, somebody else will.”

He is too right in his prediction, and so is the surgeon who refused
to operate, and he has lost a large fee; he receives the verification
of his prediction subsequently from the patient, who exclaims, “Sir,
I never have a moment’s ease!” and when, after weeks of suffering,
the patient dies, the surgeon consoles himself with the melancholy
satisfaction of not having contributed to sufferings which he was
called in too late to remedy.

The more plastic practitioner has, it is true, taken fifty or a hundred
guineas, it may be, out of the one pocket, and put it into his own; but
in what way are mankind benefited? or does any one really think that
the apparent gainer can ultimately be so? The fault in this, as in many
other cases, is the ignorance of the public. There is nothing in the
foregoing sketch that was not as easily intelligible to the commonest
understanding, as that two and two are equal to four! And is it no evil
that one man should pay so large a sum for so plain a piece of honesty?
or that another should be rewarded, as the case may be, for ignorance,
or a compromise of his duty?

Let us take another case. A gentleman was called on to give a
certificate; he examined the case, and found that the wording of the
certificate called on him to certify to that which was diametrically
opposite to the fact. He naturally declined, and, as the point was of
some importance, went to the parties to explain. He was then informed
that two professional men had, the previous day, given the certificate
without hesitation. He is complimented on his conscientiousness,
but never employed again by that family; and he has the further
satisfaction of hearing that his place is supplied by one of his
more accommodating brethren! We fear that in such a case there is a
balance to be adjusted between the several persons, and an appropriate
appellation to be discovered besides. We respectfully leave it to the
reader’s judgment to adjust the one, and to draw on his aptitude for
nomenclature to supply the other.

Again, a man is called in to a consultation; he disapproves of the
treatment, but declares to the friends of the patient that every thing
has been very properly done. In another case of consultation, finding
that every thing has been really conducted properly, he commences an
_apparently_ different treatment, but essentially the same, without
giving his confiding brother the benefit which his acquiescence in his
views would necessarily imply.

In an operation, where the course is doubtful and the opinion various,
the choice is left to the patient—that is, the decision of how the
surgeon is to act is to be determined by him who is confessedly really
least capable of judging. Can it be right to perform a _doubtful_
operation under such circumstances? Should not the patient reflect
that the _temptations_ are all on one side? The attempt to dispense
with the operation is laborious, time-consuming, anxious, encouraged
perhaps only by small, minute accessions of improvement, interspersed
with complaints of tedium and delay, and the result admitted to be
doubtful; the operation, on the other hand, is a work of a few minutes,
the remuneration munificent, the _éclat_ productive, and the labour
nothing. All this and much more no man can entirely prevent; the real
cause is the ignorance of the public, which a very little of the labour
they bestow on many far less important subjects would easily and
quickly dispel.

If these and multitudes of similar things are evils; if they contribute
to debase a profession and to charge the conscientious with unthankful
office and unrequited labour, and to confer fame and profit on a
triumphant chicanery; we surely must feel indebted—not only as
professional men, not merely as patients, but in a far higher and
wider sense—to a man who, availing himself of a commanding position
for the highest purposes, endeavoured, by precept and example, to
oppose all such proceedings, and to cultivate a high _morale_ in the
conduct of the profession. Now no one more sedulously aimed at this
than John Abernethy. Although we shall not, we trust, be accused of
underrating the obligations we owe him in a professional or scientific
sense, we think that, great as they are, they are at least equalled
by those arising out of that duty-to-your-neighbour spirit which was
so universally diffused through every thing he taught, and which, in
his intercourse with his pupils, he never on any occasion failed to
inculcate. We will endeavour to render what we mean intelligible, and
perhaps we cannot do this better than by selecting a few illustrations
from observation of “Abernethy in Consultation.”

Consultation. We are to have a consultation! What a sound is that! How
many a heart has been set thumping by this one word. We doubt whether
there be any in the English language that has more frequently disturbed
the current it was intended to calm. But consultations must be. Already
the carriage of a physician has arrived, a tremendous rap has been
given at the door, the interesting visitor is already in the library.

Another rap, louder somewhat than the former, announces another
physician, or a consulting surgeon. The general practitioner,
taking advantage of his intimacy with the family, may have perhaps
very sensibly walked in without knocking at all. They are now all
assembled in the library, and, having remarked on a “Storm Scene” by
Gaspar Poussin, which hangs over the fire-place, we leave them to the
preliminaries of a consultation.

Presently they are introduced to the patient, on whom the knocking has
already had some effect. A short pause, and they are again assembled
in the library. In a few minutes the bell rings, and the father of a
fine young woman is summoned to hear their decision. As he proceeds,
he stealthily removes a straggling tear that, with all care, would
get out of bounds, enters the library, and hears the result of the
consultation. Neatly enveloped _honoraria_ are presented to the
consultants, the bell has rung, Thomas has shown the gentlemen to their
respective vehicles, and and so ends the consultation.

The father, a widower, returns to the drawing-room, and his second
daughter says: “Well, papa, what do the doctors say of Emily?” “Well,
my dear, they say that Emily is very ill; that she requires great
care; that they cannot say positively, but hope she may ultimately do
well. They entirely coincide with our friend Mr. Smith Jones as to the
nature of the disease, and think his treatment of the case has been
highly judicious. They say there are some points on which the case may
turn, but of which they cannot speak positively to-day; but they hope
to be able to do so when they meet again, which they are to do the day
‘after to-morrow.’ They all seem to consider the nervous system very
much affected. They say we must keep Emily very quiet. She is to have
any light diet she desires, and to have some new medicine to-morrow.
The cod-liver oil, they say, has done her all the good now that it is
calculated to do, and she is this evening to take a composing draught.”
The family are silent, and so ends the consultation.

What! and are all consultations like that? No, reader, we hope not.
Many a valuable life has, we believe, been saved or prolonged by
consultation; and perhaps many more would be, if people would only
_think a little more before_ they act in such important matters.

But how is this to be, when men and women who _do_ think will dive into
all other branches of knowledge, more or less, and neglect all inquiry
into laws, a _general_ knowledge of which may easily be acquired, and
of which ignorance is so frequently visited by no less punishment
than the premature separation of our dearest ties, and the loss or
impairment of that which is acknowledged to be the first of temporal
blessings. There are many things in consultations, which require
putting right, which do not depend on any one man, or on any one class.
What are we to say to a man who admits the ability, and approves of
the investigative power and practice of another, but who cannot call
him in because he _orders so little medicine_? Or of the mode in which
the public treat another, who, wishing to practise as a gentleman, and
to be paid for his brains rather than his bottles, makes no charge for
the latter; and yet who informed us that, having tried this for three
years, he lost so many families by it, that if he had not relinquished
the plan, he should have wanted bread for his own? Or who shall we
blame, when one man, calling in another to a patient, finds that the
other feels no scruple in repaying the _prestige_ which he thus owes
to his confiding brother by taking the patient from him the first
opportunity; albeit that he occupies what should be, and, we trust, as
the rule is, a higher walk in the profession.

We have seen so much feeling arising from this practice, and we hold it
as so serious an error, that we regard it as _tending more than any one
thing whatever_ to injure the position and character of the consulting
branches of the profession.

Again, how inconsiderate must be the adoption of that custom which
first of all institutes an inquiry to ascertain whether there is
any difference of opinion, and yet accompanies it with trammels,
the tendency of which is to oblige men to _appear_ to agree. When
coincidence of opinion is _alone safe_, who can be expected to differ?
The public have allowed lawyers to differ without that difference
involving any reproach. They have also proverbially determined that
“doctors do.” Yet that which they consider as an almost necessary
rule in the one case, in the other they are very prone to visit, in
regard to some one of the dissentients, as a proof of professional
inferiority. A great deal of mischief results from this state of
things; it indefinitely increases the difficulty of obtaining a _really
honest_ and unreserved opinion, and leads to other consequences which
tend to impair that mutual confidence between man and man, which should
be the very life-blood of a fine profession.

We recollect a case, on the nature of which two surgeons were
consulted; and when the patient—a young lady—had been withdrawn, the
_father_ requested to know if there were any objection to his being
present at the conference. The surgeon to whom he seemed to address
himself said, “None on my part;” to which the other _seemed_ also
to assent. When the consultation was over, the surgeon who had thus
_seemed_ to consent addressed the other, saying: “If ever we meet
again, sir, our consultation must not be in the presence of the friends
of the patient.” This was said in a tone to which the other had not
been accustomed; but, as a lady had just then entered the room, no
reply was made. The next morning, however, the gentleman was called
on to re-consider the tone in which he had thus addressed his brother
consultant, when a satisfactory explanation settled the matter.

Such things, however, are extremely disagreeable, and illustrate how
much more easy it is to go straightforward than by any zigzag route.
What! could not a father hear the honest opinion of two men concerning
his child, until results of the consultation had been shorn down,
certain parts thrown out, and the rest dovetailed together so as to be
made a symmetrical nondescript, adapted to the requisitions of a vulgar
conventionalism?

In another case, in a consultation on a disease as plainly scrofulous
as it was possible to be, the family attendant had pronounced that it
was _constitutional_, but _not_ scrofula. This was, it appeared, a
miserable assentation to the prejudices of the family, for the result
proved that he knew better. Nevertheless, a consultation had taken
place already with a very eminent surgeon, without the family being
any the wiser in regard to the nature of the disease. The case not
progressing, another surgeon was consulted, who, being asked what
he considered the disease to be, replied that it was scrofula. Upon
this, considerable surprise and uneasiness were manifested on the part
of the family; and the surgeon, wondering what, in so plain a case,
could be the doubt, took occasion to see the former medical attendant,
and to ask him what he thought of the case; when he said that it was
clearly scrofula, and that he had _never known the children_ of certain
temperaments to which he considered the parents to belong, wholly
without a tendency to that disease; so that he had all along been
blinding the parents, so far as his opinion and that of another eminent
man went, to the real nature of the malady.

An occurrence, singular, as we hope, took place one day in
consultation, showing how comfortably the most questionable things
may appear to sit on a man’s conscience, if only supported by some
_supposed_ sanction from custom. Two surgeons met to consider a case.
They differed as to its nature and treatment; as thus—the one thought
a certain remedy necessary, and that any prospective consequences on
its employment merged into the necessity of the moment; the other
thought that remedy wholly unnecessary, and therefore held even the
_possibility_ of any prospective mischief, an insuperable objection to
its use; conceding, however, that it _might_ possibly, if the treatment
were conducted cautiously, be so managed as to secure the patient
from the consequences in question; and that, if the patient preferred
that course, after the matter had been fairly stated to him, he would
superintend the plan.

Having retired into another room to consult, they were now again
introduced to the patient, when the junior was somewhat startled to
hear his senior begin thus: “Well, sir, we have considered your case,
and we perfectly agree as to the nature of it.” Thinking that this
unexpected exordium might possibly be preliminary to some explanation
of the points on which they differed, the surgeon waited a minute to
hear what followed; but finding that his brother was irremediably
misrepresenting the matter, he said: “Stop, let us understand each
other!” and then stated what had really happened, and the exact nature
of their respective opinions; on which the other, in the coolest manner
possible, said: “Yes—exactly, you are quite right!” and so ended the
consultation.

There is, no doubt, some fault on all sides. The public are too
uninformed on these important subjects, and therefore do much that
is equally against their own interests and the preservation of that
dignity and respect which should ever attach to a high-missioned
profession. But is the profession itself free from blame? Do they
never themselves minister to this wretched system of double dealing?
We fear there is but one answer to this question. We are not careful,
for obvious reasons, to multiply examples of such things; but we are
convinced that there must be a change; and since the profession cannot,
as too many of the public may, plead ignorance—for this and a thousand
other reasons, they should lead the way. We only claim for ourselves
what we readily concede to others—the expression of our opinion—when
we say that consultations should be _bonâ fide_ examinations of the
case, and should be followed by _bonâ fide intelligible_ explanations
of it to the _patient_ or his _friends_, according to the obvious
suggestions of prudence or humanity in the individual case. When the
treatment is correct, the most honest proof should be afforded of it;
namely, the continuance of the plan of the attendant in ordinary,
unobscured by the farce or form of a prescription; or, if _additional_
appliance only is adopted, in such a case its subordinate character
should be honestly explained.

Where there is difference of view, if it be material, that also should
be candidly stated; and if this be done with _real fairness_, our
experience has convinced us that it may be effected without damage
to either party. In other differences of opinion, the public never
think it necessary to impute ignorance or incapacity: let them, _for
their own sakes_, repudiate this construction in regard to the medical
profession. Lastly, let them for ever abandon the practice of paying
any man for his bottles, the number of which will often be an inverse
ratio with his skill and judgment.

To return to Abernethy. No doubt his manner varied in consultation; but
of “Manner” we shall speak in a separate chapter. We will here record
our impressions as to “Abernethy in consultation;” the conditions
which seemed to secure a considerate opinion from him; the good sense
and reasonableness of those conditions; the practical result of the
observance of them, and the effect they were calculated to produce on
the public, in giving to consultations that efficiency by which they
should be characterized—an efficiency which _every one_ begins to
perceive to be necessary, and which must be equally to the advantage of
the public and the elevation of the profession.

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