Opinionum commenta delet dies, naturæ judicia confirmat

“La première chose qui s’offre à l’Homme quand il se regarde, c’est
son corps. Mais pour comprendre ce qu’elle est, il faut qu’il la
compare avec tout ce qui est au-dessus de lui, et tout ce qui
est au-dessous, afin de reconnoître ses justes bornes.”—PASCAL,
PENSÉES, NATURE DES HOMMES, vol. ii, p. 57.

Abernethy, in impressing any anatomical fact, would sometimes say
that we carried about with us in our own bodies excellent means of
refreshing our impressions on many points of anatomy; but we may say
this in a much more extensive sense with regard to the interpretation
of that for which anatomy is alone useful—namely, the _uses_ or
_functions_ of the body. It would be very possible for any observant
person, who was moderately versed in the ordinary principles of
correct reasoning, to detect many defects in medical investigations
and practice; in the correction of which many of Abernethy’s practical
contributions consisted; but the mind, restlessly impatient to arrive
at conclusions, often overlooks the most important facts, and deduces
inferences _directly_ from the evidence of the eye or other senses,
without submitting it to such test as the intellectual faculty can
alone supply. Nothing can exceed the mischief of this in serious
matters, nor the absurdity of it, when we _think awhile_.

We should hardly refrain from laughter if we saw a man try to see with
the point of his nose, or endeavour to examine the odour of a rose by
his ear, or to listen with his eye; yet this is not a whit more absurd
than to try to deduce conclusions from the impressions furnished by
the eye, which can alone be afforded by the rational faculty. Nothing
is more common than this sort of fallacy, nothing more easy than its
correction; but then people must bestow at least a little of that time
on their highest faculties which they so lavishly expend on inferior
powers. How much time we consume, for example, in the study of various
languages—those instruments for the communication of ideas—as
compared with that bestowed on the collecting and marshalling of
ideas themselves; which is little better than grasping at the shadow,
and losing the substance; or, to use a humorous illustration, like a
friend of our own, who, having a new dog, sent his servant forthwith
to purchase sundry articles for him, in the shape of kennel, chains,
engraved collars and food; all of which, at some expense, he safely
accomplished to his master’s satisfaction, expressing his sorrow at the
same time for having accidentally lost the dog!

It is curious, however, to observe how the real business of the human
mind is shadowed forth in the very abuses of its powers; nothing so bad
but it is charged with a certain quantity of good; no error so great
but carries with it the element of its own correction. The mind in its
greatest aberrations is followed by the shadow of its real duty, which
as it were waits on the time when clearer views shall burst on it.
Nothing shows the real tendencies of mind more than its restless desire
to arrive at _some_ conclusion, _some_ tangible evidence of its highest
functions. It is the impulse of this instinct—the ungoverned abuse of
a high faculty, impatient for illegitimate fruition—which lies at the
bottom of much false reasoning, and which blinds men, even of great
power, to obstacles which are luminously evident to the most ordinary
capacity. Important as the next series of illustrations cited by
Abernethy are, the conclusions he deduced from them were the necessary
sequences of clear and correct reasoning on familiar and established
facts.

The illustrations in question were those afforded by various cases
of injuries of the head, in which certain consequences, however
exceptional they may be, are too commonly referred to the abstract
nature of the injury. We _see_ that a man has a blow, we _see_ that he
does not recover in the usual way in which we have known many others to
recover; but we do not, perhaps, _consider_ that if a similar—nay,
perhaps an identical force produces very different effects in different
cases, the cause will probably not be in the nature or direction of
the force so much as the condition of the body. Now the value of these
cases of Abernethy’s consists, first, in impressing the influence
of this condition as modifying—in other words, _sustaining_—the
disturbance consequent on injuries (in their origin) purely mechanical;
and secondly, in showing that, in the cases in question, _that
condition_ depended on a disordered state of the digestive organs.
We hardly know any cases more valuable than those in question. When
a patient receives a blow, and, the _immediate_ consequences having
subsided, there still remains an impairment of sense or motion, the
most usual thing, and no doubt very often the true view, is to refer
it all to lesion of nervous structure. It is therefore of the highest
consequence to know the facts of these cases. They not only prevent
the hasty institution of treatment which would be injurious; not only
secure the patient from being abandoned in despair; but supply at
the same time the clues to a rational treatment, and the hope of a
favourable issue.

There can now be few observant surgeons who have not met with cases in
illustration of these circumstances; and yet I know not to whom the
perusal of Mr. Abernethy’s cases might not be useful. It is not without
regret that I forego transcribing at least one of them; forgetful how
impossible it is to do Abernethy full justice in a work intended for
all readers. In his “Book,” the cases in question begin at page 97, and
occupy but a few pages.

The next class of cases, from which Abernethy illustrates the
prevailing influence of the digestive organs, receives additional
importance from the _imperfect_ manner in which the phenomena have been
interpreted in a vast variety of diseases; like small-pox and others,
ascribed to the action of particular poisons. We may possibly have an
opportunity of saying something more on this subject; but we may remark
that when any disease has been presented to the physician or surgeon,
supposed to be the result of specific poisons, it is just the last
case in which any special attention is paid to the digestive organs.
Now Abernethy observed that disorders of the digestive organs would
sometimes _produce_ diseases resembling maladies said to result from
specific poisons. This is about the first indication or hint of that
which, duly carried out by an advancing science, will, we trust, ere
long, demonstrate what to _us_ has long appeared only part of a general
law. Of this we may by and by say a little more, when we endeavour to
show the small quantity of truth which there is mixed with some of
the prevailing errors; and how their occasional success results from
blundering, as it were, on small portions of the principles enunciated
by Abernethy.

In the meantime, we may refer to the illustration afforded by
small-pox of the remarkable influence of the digestive organs in
diseases called specific. We adduce this, because it is one which is
popularly familiar, and a disease that, had it been studied under any
but one particular phase, would have proved, of all others, the most
instructive. There is no malady, under certain circumstances, more
extensively fatal.

In the Spanish conquest in America—a history scarcely less interesting
in a medical than in a moral point of view—it seems that not all the
cruelties of the Spaniards were more destructive than the small-pox. In
less than a century after the arrival of Columbus, it was computed that
it had destroyed more than half the population; and in one year (1590),
it so spread along the coast of Peru, that it swept away nearly the
whole of the Indians, the Mulattoes, and the Mestichos, in the cities
of Potosi and De la Hay[31].

As is well known, before the discovery of vaccination, persons were
_inoculated_ with the small-pox, because it was found that the disease
could _be thus rendered_ comparatively harmless; whilst, if it was
taken naturally, as it was termed, it was always serious, and too
frequently extremely fatal. The preparation for inoculation consisted
of _measures addressed to the digestive organs_. Now the effect may be
judged of by this fact: Inoculation was at first violently opposed;
and, in reply to the alleged safety of it, an opponent wrote to prove
that _one_ in _one_ hundred and eighty-two had died of it. I wish we
could say so of many other diseases.

That such persons had, nevertheless, the genuine malady, was proved
by the fact they were capable of infecting others (unprepared) with
the disease in its most malignant form. But our notions of the mode in
which the laws of the animal economy deal with injurious influences
of this kind, are mischievously conventional. What quantities, for
example, of mercury, in its different forms, have been administered in
almost all diseases; and yet unquestionably there is a great deal of
false reasoning in regard to this poison. Effects are attributed to it
_as mercury_, which only belong to it in _its general character of an
injurious agent_. All the (so-called) specific effects of it, most of
which are become popularly familiar, may occur without any mercury at
all. We have seen them induced by aloes, by scammony; and in a case
where no medicine had been given, and where the only detectable poison
was one which was to be sure bad enough, an enormously loaded liver.

We are obliged to say but little here in connection with this subject.
Abernethy’s cases were very important in relation to the influence of
the digestive organs, although he did not see the generalization to
which, as it appears to us, they help to conduct the pathologist. The
subject is too extensive for discussion here. We will attempt something
of a popular view of it, when we endeavour to explain the fallacy to
which we have already referred.

Abernethy next adduces various illustrations from cases of other
diseases; as indurations, tumours, carbuncles, scrofulous affections,
and others; in proof of the dependence of a “numerous and dissimilar
progeny” of so-called local diseases, on that “fruitful parent,”
disorder of the digestive organs. Of one of the most interesting
and remarkable cases of tumour, Mr. Abernethy did not live to see
the termination. It was of a lady who consulted him previous to the
proposed infliction of an operation. She had been recommended by my
father, in the country, to consult Abernethy before submitting to
it; because he disapproved of it, as did Abernethy—not because they
doubted of the nature of the disease, but because it was not confined
to the part on which it was proposed to operate.

The lady used to call on Abernethy when she came to town; and after his
death she came to me—as she said, just to report her condition. She
had at times various disturbances of her digestive organs; but always
from some imprudence; for, although habitually very simple in her
habits, she would be sometimes careless or forgetful.

She died at a very advanced age—between seventy and eighty—but
there had been no return of the disease for which she had originally
consulted Abernethy, nor had she undergone any operation. It is a
significant circumstance, too, that she had a sister who died of cancer.

The whole of the cases are, however, scarcely less valuable. In the
fifth section, he treats of disorders of parts having continuity of
surface with the alimentary canal, certain affections of the nose, of
the eye, and of the gullet or œsophagus. His observations on the latter
are especially valuable. They strike at that meddling practice which
is too common in the treatment of diseases of these parts. Many of us
have recommended a practice which, without neglecting either, relies
_less_ on manipulatory proceedings, and more on measures directed to
the general health, in such cases; as producing effects which are not
to be obtained by other means; but, if we are to judge from the medical
periodicals, without much success; so inveterate is the habit of
imagining that, whatever the causes of disease may be, if the _results_
be but _mechanical_, mechanical means can alone be applicable. Public
attention, and the perusal of such cases as those of Abernethy, can
alone correct these errors.

Lastly, he describes the results of his dissections as bearing on the
whole subject. Here he shows, that whilst disordered function may
take place coincidentally with, or as a consequence of, change of
structure, yet that such change, so _as to afford visible or detectable
departures_ from natural appearances, is by no means necessary, in
_organs which, during life_, had afforded the most incontrovertible
evidence of impaired function. He also shows that disease has
_terminated_ in _disorder_ which had its original seat in the
digestive organs. And again—that, in cases where the cause of death
had been in the abrogated _function_ of the brain, he found no actual
_disease_ in that organ, but in the _abdominal viscera_. He very justly
observes that the conclusions he has drawn can be _neither_ ascertained
nor disproved by anatomical evidence _alone_. He mentions especially,
and illustrates by a remarkably successful case, how _diseases of the
lungs_ may be engendered by disorders of the digestive organs, and
_entirely_ subdued by correction of that disorder.

He speaks also suggestively of the possibility of that which is
certainly now an established fact. He says: “In cases of diseased
lungs, where no disease of the digestive organs is discovered, yet
considerable _disorder_ does exist, and may continue for many years
without any _organic_ disease being _apparent_; it is possible that
such disorder may excite disease of the lungs, and thus produce a
_severer_ disease of the latter organs than what existed in the
former. Accurate attention to the _digestive organs may determine
this important subject, and lead to the prevention and cure of the
sympathetic diseases which I have mentioned_.” “This attention must
not be merely of that general kind which adverts only to the quality
of the ingesta, &c., but one which more strictly observes whether the
viscera” (that is, reader, not merely the stomach, not merely the
digestive organs, but the whole viscera of the body) “and whether these
secretions are healthy or otherwise.” After speaking of the heart also,
as affected by the digestive organs; and of the infinity of diseases
which arise from the reciprocal disturbance excited between them and
the brain;—he says: “But even these are not the worst consequences.
The disorder of the sensorium, excited and aggravated (by the means
which he has described), affects the mind. The operations of the
intellect become enfeebled, perplexed, and perverted; the temper
and disposition, irritable, unbenevolent, and desponding. The moral
character and conduct appears even to be liable to be affected by these
circumstances. The individual in this case is not the only sufferer,
but the evil extends to his connections and to society. The subject,
therefore, appears to me to be of such importance, that no apology
need be offered for this imperfect attempt to place it under general
contemplation.” Here is that suggestion which, when carried out, leads
to the detection of cases of insanity which depend on disturbances of
the digestive organs.

Lastly, as if, notwithstanding his own previous attention to the
important question of the influence of the digestive organs in
disease, he felt that the inquiry had grown upon him in consequence of
Mr. Boodle’s endeavour to concentrate his attention to the subject,
he concludes by expressing his past obligations to Mr. Boodle; for
he says, with admirable modesty and candour, “for Mr. Boodle first
instructed me how to detect disorders of the digestive organs, _when
their local symptoms were so trivial as to be unnoticed_ by the
patient.” He urges Mr. Boodle to publish also his own observations on
the subject, because any remarks from one who observes the progress of
disease “with such sagacity and accuracy, cannot but be interesting.”
We are quite aware how feeble our attempt has been to do justice to
this admirable book. But nothing can do that but a careful study of the
various principles which it either suggests, dimly shadows forth, or
deeply and beautifully unfolds.

Through not a very short life, we have had ample opportunity of testing
these principles by the bedside, and of endeavouring to connect some
of them with the laws in obedience to which they occur; and we are
free to declare our impression that when the book is studied with the
requisite previous knowledge, and freedom from preconceived opinion;
and when tested and carried out in _principle_, as distinguished from
any adhesion to mere matters of _detail_; we think it infinitely more
valuable than all other professional works whatever. In examining
the truths it unfolds, or in our humble endeavours elsewhere at a
more analytical or extended application of them, like Abernethy, we
have rested our reasoning wholly on facts and observations which are
acknowledged and indisputable.

Whilst other views have only led to a practice in the highest degree
empirical, or, what is worse, conjectural, those of Abernethy’s lead
often directly, but always _when duly studied_, to a practice at once
clear, definite, and in the sense in which we shall qualify the word
“positive,”—that is, one which gives us the power (when we really have
the management of the case) of predicting the success or failure; which
is at least a ripple indicative of a coming science.

In order, however, to carry out this clearly, we shall at once add what
we think necessary to the profession and the public on the subject.
The _general relation_ of Abernethy’s labours to a real and definite
science will be better developed in our concluding Summary; when we may
have an opportunity of stating what further appears to have been done,
and what is yet required. It will have been perhaps already observed
that Abernethy’s views involve a few very simple propositions: first,
that disturbance of a _part_ is competent to disturb the whole system;
and conversely, that disturbance of the _whole system_ is competent to
disturb any _part_. That the disturbance may _commence_ in the brain or
nervous system, may then disturb the various organs, and that these may
again by reflected action disturb the brain, and so reciprocally; and
that in all these cases tranquillity of the digestive organs is of the
very first consequence; not merely from its abstract importance, but
from the influence it exerts on the state of the nervous system.

With respect to any influences immediately directed to the nervous
system, these we apprehend to be few and simple; some kinds of
medicine, are, no doubt, in particular cases useful, none are
susceptible of _general_ application. None of them are _certain_;
and sedatives of all kinds, which appear to have the most direct
influence on the nervous system, either require to be employed with
the utmost caution, or are in the highest degree objectionable. But
there are other _direct_ influences, certainly; and very important
they are. Quiet, avoidance of disturbing external impressions, whether
of light, sound, temperature, &c. whether in fact of mind or body;
but, in the majority of mankind, how few of them we can, in a strictly
philosophical sense, command. We are therefore driven to other sources
of disturbance; and in the digestive organs we find those on which we
can exert great influence, and in which tranquillity, however procured
or under whatever circumstances, is _certain_, _pro tanto_, to relieve
the whole system. This Abernethy attempted, and with a success which
was remarkable in no cases more than those which had resisted all more
ordinary modes of proceeding; by general measures, by simplicity of
diet, by occasional solicitation of this or that organ, by air and
exercise, and measures which were directed to the general health. No
doubt in some cases he failed, and so we shall in many; but let us look
boldly at the cause, and see whether we do not fail a great deal more
from our own ignorance than from any natural impossibility.

To examine the question, we must for the moment forget our admiration
of Abernethy; be no longer dazzled by his genius, but look only to our
duty; endeavour to discover his defects, or rather those of the state
of the question when he left us, and see what further investigation has
afforded in aid of supplying them.

In the first place, we must examine a little further that proposition
which we have seen both in Hunter and Abernethy under different forms.
Hunter says the disturbance of the organ sympathizing is sometimes more
prominent than that of the organ with which it sympathizes. Abernethy
says that the organ primarily affected is sometimes very little
apparently disturbed, or not even perceptibly so.

Now, from both these statements, we find that there may be no signs
in the primarily affected organ; which, practically rendered, is
nothing more or less than saying that in many cases we must not seek
for the primarily affected organ where _the symptoms are_; and this
is a great fact: because, although it does not necessarily teach us
what we must do, it exposes the broken reed on which so many rely. Now
the further point, which, as we would contend, time and labour have
supplied, is first this—that what Hunter had mentioned as one feature
in the history of the sympathies of different organs, and Abernethy as
an occasional or not unfrequent occurrence, is, in disorders of any
standing, and with the exception of mechanical injury, _in fact the
rule_—the _symptoms_ of disorder being almost _never_ in the primary
organ; nay, even organic change (disease) is for the _most part_ first
seen in a _secondarily_ affected organ. In regard to primarily affected
parts, the skin only excepted, they will be found, in the vast majority
of cases, to be one or other of the digestive organs.

I will endeavour to render the cause of this intelligible. A minute
examination of what happens in a living person, especially if it
be extended to some thousands of cases, will soon disclose to the
most unlettered person a few instructive facts, showing that Nature
has a regular plan of dealing with _all_ injurious influences,
which, however _various_ many of the _details_ may be, is in general
character exquisitely simple, surprisingly beautiful, and intelligibly
conservative; and that the various modes on which she exercises this
plan, from the cradle to the grave, are, in _frequency, directly in
the order of their conservative tendency_. Let us explain. There is no
dearth of illustration; the _facts_ are bewilderingly abundant; the
difficulty is which to choose, and how to give them an intelligible
_general expression_. Let us take a single case. We know that if a mote
gets into the eye, there is irritation, immediately there is flow of
blood to the part, a gland pours forth an abundant supply of tears,
and the substance is probably washed out. Very well; we say that is
intelligible. But suppose you have the vapour of turpentine, or any
other irritant, the same thing happens; but still you cannot give quite
the same _mechanical_ explanation.

Again—substances which affect the mouth, nose, and stomach, will
irritate the eye without any contact, and cause a flow of tears.

Lastly, you know that affections of the mind will do this, and where
even we have no _mechanical_ irritant at all.

In _all_ these cases there has been activity of the vessels of the eye,
and in all it has been relieved by secretion. Now this is the universal
mode throughout the body; all irritation of the organs is attended by
secretion; and where this is done, there is no disorder; or rather,
the disorder is relieved: but if organs are irritated _continuously_,
another thing happens, and that is, that an organ becomes unable to
secrete constantly more than is natural, and then _some other_ organ,
less irritated in the commencement, takes on an additional duty—that
is, the duty of the animal economy is _still done_, but _not equally_
distributed.

This is the state in which most people are in crowded cities, and
who live in the ordinary luxury or the ordinary habits of civilized
society, according to the section to which they may belong. It is easy,
in such cases, to detect those differences which distinguish this state
from what is called condition or perfect health, as we have elsewhere
shown[32].

But of course there is _a limit to this power_ in organs of taking on
additional or compensating actions; and when this limit is exceeded,
then those actions are instituted which we call Disease. The site is
_seldom found_ to be that of the original disturbance; and usually
for a very plain reason—because there it would be more dangerous, or
fatal. It would be scarcely less serious in many cases, even though
placed on organs _secondarily_ affected; and therefore it is more
usually determined _to the surface_ of the body; where, taking them
simply in the order of their greatest number, or frequency, we find the
first class of diseased appearances, and which strikingly impress the
real nature of _the law_. They are the most numerous, most obviously
dependent on general disturbance, and most conservative, as being least
fatal. Diseases of the skin are those to which we allude, and which, in
the characters I have mentioned, exceed all other diseases.

Again—the next surface is that involution of the skin which covers the
eye, and which lines the mouth, throat, and the whole of the interior
surface of the respiratory tubes and the digestive organs. Here again
we find the _next_ seat of greatest frequency, and the conservative
tendency, to coincide. We need only refer to the comparative frequency
of what are called colds, ordinary sore throat, and so forth; as
contrasted with those more serious diseases which occur in the
corresponding surfaces of the respiratory organs and alimentary canal.
In tracing diseases onwards in the order of their number, we never lose
sight of this conservative tendency. When _organs_ become involved
in disease, we find that, for once that the _substance_ of the organ
is so _affected_, the _membrane covering_ it is affected a hundred,
perhaps a thousand times. This is equally observable with respect to
the brain, heart, lungs, digestive organs, and some other parts; and it
is of great importance practically to know how readily affections are
transferred from the _lining_ of the alimentary canal and other parts
to the membrane _covering_ it, rather than to the intermediate texture
of the organ; again impressing, though now in a dangerous type truly,
the conservative _tendency_ of the law.

Finally, then, we arrive at diseases of Organs; and here we see this
conservative tendency still typed in the site first chosen, which is
almost always (where we can distinguish the two structures) not so
much in the _actual tissue_ of the organ as in that which connects it
together—what we term the _cellular tissue_.

This is remarkable in the lungs; where tubercular deposits are first
seated; not in the essential structures of the organs, but in those
by which they are joined together. All those various depositions also
which are called tumours, generally begin in, and are frequently
confined to, the _cellular tissue_; and even though there is, in
certain malignant forms of tumour, a disposition to locate themselves
in organs, there is a very curious tendency towards such, as may have
_already fulfilled_ their purposes in the animal economy.

We might multiply these illustrations to a tedious extent. We might
show, for example, in the eye, how curiously the greatest number of
diseases in that organ are placed in structures least dangerous to
the organ; and even when the organ is spoiled, so to speak, how much
more frequently this is in relation to its function as _an optical
instrument_, than to the structure which forms the link with the brain,
as _an organ of sensation_. I must, however, refer those who wish to
see more of the subject, to the work[33] in which it is more fully
discussed, under the term, “The Law of Inflammation,” which is a bad
phrase, as imperfectly expressing the law; but as the greatest evils it
exposes occur in cases of Inflammation, and as it shows the essential
nature of that process to be entirely distinct from the characters
which had been usually ascribed to it, every one of which may be absent
so that expression was somewhat hastily given to the generalization
which seemed best to express a great practical fact.

To return to the bearing of all this on Abernethy’s views, and in
relation to organs primarily or secondarily affected. In obedience to
the conservative law to which I have above alluded, defective function
in one organ is usually accompanied by increased action in some other;
and thus it happens that the symptoms are _almost always_ in one organ,
whilst the cause, or originally injurious influence, has acted on
another. The general reader will, of course, understand that we are not
speaking of direct mechanical injury to an organ. _Now_ all the most
recondite diseases of the kidney are already acknowledged by many to
be seated in a secondarily affected organ. Still the practice is, in
too many instances, a _strange mixture_ of that which is in accordance
with the true view, more or less marred by much _that is in opposition
to it_; because it often includes that which is certain more or less to
_disturb_ the organ which it should be the object to tranquillize or
relieve.

In the same manner, the lungs and heart are continually disordered,
and ultimately diseased, from causes which primarily act on the liver;
and I have seen such a case treated with cod-liver oil and bitter
ales, with a result which could not but be disastrous. The liver sends
an enormous quantity of blood to the heart and lungs, from which
it ought previously to have extracted a certain quantity of carbon
(bile). If this be not done, the heart and lungs are oppressed both
by the quantity and the quality of the blood sent to them. If nothing
happen in either of the various sites I have mentioned, the blood must
be got rid of; and it is so. In many cases, a vessel gives way; or
blood is poured out from a vessel; or blood is employed in building
up the structures of disease; but then the _symptoms_ are frequently
altogether in the chest, and not a sign of anything wrong in the liver.

I cannot go on with the multitudinous illustrations of these
principles. The law is to determine injurious influences to the
surface. Deposition in the cellular tissue of the lung is bad enough;
but it is better—that is, less certainly fatal—there, than in the
respiratory tubes: and that is the explanation.

But now comes the practical point. How is the primary organ to be
got at? because that is the way to carry out the removal of the
impediments to the sanative processes of nature, which, in many cases,
no _mere general_ treatment can accomplish. This is to be found by an
examination into the _whole_ (that is, the former _as well as_ the more
recent) history of the case, and adding the further test of a real and
careful observation of all the secretions.

By going back to the former life of the patient, we shall seldom fail
to discover the various influences to which he has been subjected, and
the organs to which they have been originally addressed. Having made up
our minds, from our previous knowledge of injurious influences, on what
organ they will most probably have acted, we now test this, not merely
by inquiry after symptoms—and it may be not by symptoms at all—but
by careful observation of the _actual work_ of the suspected organ.
In this way we almost certainly discover the real offender; in other
words, the organ primarily affected. This is of immense importance;
for we confidently affirm that _one single beneficial impression made
on it_ will do more in a short time—nay, in some rare instances,
_in a single day_—than years of routine treatment, that has been,
nevertheless, of good _general_ tendency.

In treating it—_i. e._ the primary organ—however, great
discrimination is necessary. If it be already organically affected,
that treatment which would be, under _other circumstances_, necessary,
becomes either objectionable, or requiring the utmost caution.
For although an organ _diseased in structure_ will, under some
circumstances, as Abernethy long ago observed, yield its characteristic
secretion, yet, unless we know the _extent_ of the disease, which is
just the thing we can almost never be certain about, excitement of
it is _never without danger_. We should therefore excite the primary
organ with more or less energy, with more or less caution, or _not at
all_, according to circumstances. If we determine on not exciting it,
we should then act on organs _with_ which it has ordinarily closest
_community_ of function, or on whose integrity we can most depend.
For choice, we prefer organs which, in a natural state, have nearest
identity of function, as having the readiest sympathy, it may be, with
each other. Yet so universal is the sympathy between all the organs,
that there is no one that will not, under certain circumstances, or
which may not be induced, perhaps, by judicious management, to take on
_compensating_ actions.

We must not here pursue this subject further. We have endeavoured to
sketch certain extensions of the views of Mr. Abernethy, and can only
refer the profession and the public, for the facts and arguments which
demonstrate and illustrate them, to those works in which they have
been enunciated[34]. They have now been subjected to severer trials,
and abundant criticisms. So far as we know, they have not been shaken;
but if there be any merit in them, if they shall have made any nearer
approach to a definite science, or sketched the proofs that Induction
alone can place us in a position to talk of science at all, _they are
still sequences which have been arrived at by a steady analysis of
Abernethy’s views_. It was he who taught us, in our pupil days, first
to think on such subjects; to him we owe the first glimpse we ever
had of the imperfect state of medical and surgical science; and if we
do not wholly owe to him the means by which we conceive it can alone
be rendered more perfect and satisfactory, he has at least in part
exemplified the application of them. If we have made some advances on
what he left us, and added to his beautiful and simple general views,
something more definite on some points, something more _analytical_ on
others,—still, inasmuch as they are clear deductions from the views he
has left us, and from such views alone, such advances remind us that
the study of his principles serves but to demonstrate their increasing
usefulness, and to augment the sum of our obligations.

SECTION.

Mr. Abernethy’s book “On the Constitutional Origin of Local Diseases”
had an extensive circulation, and excited a great deal of attention
from the public as well as the profession.

As a work which may be read as it were in two days, so as a person
read it with one or other subject, it produced a great variety of
impressions. It may be read simply as a narrative of a number of facts,
with the inferences immediately deducible from them. All this is plain
and intelligible at once to anybody, and of great practical value; but
the work contains numerous observations of a suggestive kind, which
require careful thought, and some previous knowledge, to enable a
person to estimate their value, or to trace their onward relations.
The impression made by the work on different minds varied, of course,
with the reader, his information, and, in some sort, with the spirit in
which it was studied. Some, who had, in their solitary rides, and in
the equally solitary responsibilities of country practice, been obliged
to think for themselves, recognized, in the orderly statement of
clearly enunciated views, facts and principles which they had already
seen exemplified in their own experience, and hailed with admiration
and pleasure a book which realized their own ideas, and supplied a
rational explanation of their truth and value.

Some, who had never thought much on the subject, and were very
ill-disposed to begin, regarded his ideas as exaggerated, and hastily
dismissed the subjects, with the conclusion that he was a clever man,
but too full of theory, and too much disposed to look to the stomach or
the digestive organs. Others, making very little distinction between
what they heard of the man, the book, or his practice, and probably
not having seen either, but deriving only a kind of dreamy notion of a
clever man with many peculiarities, would say that he was mad, or an
enthusiast. Still, a great many of the thinking portion of the public
and the profession held a different tone. The book was recognized as
an intelligible enunciation of definite views—rather a new thing in
medical science. The application of them became more and more general;
his pupils were everywhere disseminating them, more or less, in the
navy, in the army, in the provinces, and in America.

Still, it must not be imagined that his principles became diffused
with that rapidity which might have been inferred from his
numerous and attentive class. Constituted as medical education is,
but more especially as it was at that time—for it is _slowly_
improving—pupils were almost entirely absorbed in the conventional
requisitions for examination. There, they were not questioned as to
the laws of the animal economy, nor any _laws_ at all, nor even on any
real axioms in approximation to them; but simply as to plain anatomy,
the relative situation of parts, and such of the ordinary surgery of
the day as had received the approbation of the Examiners, who were,
for the time, the authorities in the profession. Therefore, out of a
large number, there were comparatively few whose attentions were not
too much absorbed by the prescribed curriculum of hospital routine to
study principles: a curriculum constructed as if the object were to see
how much could be learnt in a short time, without detriment to the very
moderate requisitions of the examination at the College of Surgeons.
But if comparatively few had time to study Abernethy’s lectures at the
time, a great many had treasured up his remarks. As the impressions we
receive in our childhood, before we are capable of thinking of their
value, are vividly rekindled by the experience of real life, so many
of the more suggestive lessons of Abernethy’s lectures, which passed
comparatively unheeded at the time, or were swamped in the “getting
up” of the requisitions for an examination at the College, recurred in
after days in all their force and truthfulness. Many, however, with
more time, and perhaps more zeal, endeavoured to thoroughly master his
views; and now and then he was gratified by evidence, that time had
only served to mature the conviction of the pupils—in dedications and
other complimentary recognitions, in the works of such of them as had
been induced to publish any portion of their own experience.

However various, too, the impressions made by his book, there are two
things certain; viz. that he was much talked of, and the book had an
extensive sale, went through several editions, and served to give the
_public_ some notion of those principles which he was so beautifully
unfolding to the younger portions of the profession in his lectures.
Besides, although there were not wanting those who spoke disparagingly
of him, still, as an old and very far-seeing colleague of our own
used to say, with perhaps too much truth, when canvassing the various
difficulties of a medical man’s progress in the metropolis, “A man
had better be spoken ill of, than not spoken of at all.” He was now
beginning to be very largely consulted. The Public had “got hold of
him,” as we once heard a fashionable physician phrase it, and he soon
obtained a large practice. A great many consulted him for very good
reasons, and probably many for little better reason than that he was
the fashion.

Abernethy had now an amount of practice to which neither he nor any
other man could do full justice. Finding it impossible to make people
understand his views in the time usually allotted for consultation, he
now referred his patients to his book, and especially page 72. This has
been made the subject of a great deal of quizzing, and of something
besides, not altogether quite so good-natured. For our parts, we
think it the most natural thing in the world to refer a patient to a
book, which may contain more in full the principles we desire them to
understand, than we can hope to find opportunity to explain at the time
of consultation. We think that if asking a few questions, and writing
a prescription (and we are here only thinking of a reasonably fair
average time visit), be worth a guinea, the explaining a principle,
or so placing a plan before a patient that his following it may be
assisted and secured, is worth fifty times as much; and it came
particularly well from Abernethy, one of whose lessons, and a most
excellent lesson too, was the remark, “That if a medical man thought
he had done his duty when he had written a prescription, and a patient
regarded his as fulfilled when he had swallowed it, they were both
deceived.”

As we are convinced that, _cæteris paribus_, success in medical
treatment is indefinitely promoted by both patient and surgeon _clearly
understanding_ each other as to _principles_, we think it would be of
great use if every medical man, who has any definite principles of
practice, were to explain them in short printed digests. Nay, we have
sometimes thought it would be useful to both parties, if, in addition
to the inquiries and advice given at consultation, a medical man should
have brief printed digests of the _general_ nature and relations of
most of the well-defined diseases. A careful perusal of one of these
would help the patients to comprehend the nature and objects of the
advice given, tend to the diffusion of useful knowledge, and in time
help them to understand whether their treatment were conducted on
scientific views, or merely a respectable sort of empiricism. What is
here intended might be printed on a sheet of note paper; and, whilst it
would be of great service to the patient, would form _no bad test of
the clearness and definite principles of the medical attendant_. There
is no doubt that Abernethy did good service by referring patients to
his book. It led some to think for themselves, and it also assisted,
_pro tanto_, in doing away with that absurd idea which supposes
something in medical practice inappreciable by the public.

At this time, whilst, with a considerable indifference to money, he
was making a large income, still he was obliged to work hard for it.
He had as yet no emolument from the Hospital; he was still only an
assistant surgeon. The tenacity of office, of which assistant surgeons
so commonly complain, they have themselves seldom failed to exercise
when they have become surgeons (Mr. Abernethy, however, excepted). The
long tenure of office by his senior (Sir James Earle) wearied him, and
was at times a source of not very agreeable discussions.

On one occasion, Sir James was reported to have given Abernethy to
understand that, on the occurrence of a certain event, on which he
would obtain an accession of property, he, Sir James, would certainly
resign the surgeoncy of the hospital. About the time that the event
occurred, he happened one day to call on Abernethy, and was reminded
of what he had been understood to have promised. Sir James, however,
having, we suppose, a different impression of the facts, denied ever
having given such a pledge. The affirmative and negative were more than
once exchanged, and not in the most courteous manner. When Sir James
was going to take his leave, Abernethy opened the door for him, and,
as he had always something quaint or humorous to close a conversation
with, he said, at parting, “Well, Sir James, it comes to this: you say
that you did not promise to resign the surgeoncy of the hospital; I, on
the contrary, affirm that you did: now all I have to add is, —— the
liar!”

In 1813, Abernethy accepted the surgeoncy of Christ’s Hospital, which
he held until 1828, a short time before he retired from practice.

In 1814, he was appointed Professor of Anatomy and Surgery to the
College of Surgeons—an appointment which could be, at this period, of
little service to him, whatever lustre it might reflect on the College,
where he gave lectures with a result which has not always followed
on that appointment: namely, of still adding to his reputation. He
was one of the few who addressed the elders of the profession without
impressing the conviction that he had been too much employed in
addressing pupils. He had given lectures two years in succession, when,
in 1816, circumstances occurred which will occupy us for some little
time. A new scene will be opening upon us; and this suggests the period
(1815-16) as convenient for taking a retrospect, and a sort of general
view of Abernethy’s position.

[Footnote 31: Clench’s History. Letter from Ch. Uslano, to Gonsalvo de
Solano, July, 1590.]

[Footnote 32: “Health and Disease.” See Treatise on Tumours.]

[Footnote 33: “Medicine and Surgery One Inductive Science.” London,
1838. Highley.]

[Footnote 34: “Medicine and Surgery One Inductive Science;” and “On
Tumours,” Art. “Treatment of Organs.”]

“Sperat infestis, metuit secundis,
Alteram sortem bene preparatum Pectus.”

HOR.

“Whoe’er enjoys th’ untroubled breast,
With Virtue’s tranquil wisdom blest,
With hope the gloomy hour can cheer,
And temper happiness with fear.”

When we look abroad amongst mankind—nay, even in the contracted
sphere of our own experience—it is interesting to observe the varied
current of human life in different cases. In some, from the cradle
to the grave, life has been beset with difficulties; it has been a
continued struggle; the breath seems to have been first drawn, and
finally yielded up, amidst the multifarious oppositions and agitations
of adversity. In other instances, life seems like an easy, smoothly
gliding stream, gently bearing Man on to what had appeared to be the
haven of his wishes; and the little voyage has been begun and completed
without the appearance of a ripple. All varieties are, no doubt, the
result of constantly operating laws. Of these, many are probably
inscrutable by us; many more, no doubt, escape our observation. The
unforeseen nature of many events confers the character of mystery on
any attempt at foresight; yet, when we take a careful retrospect of
a life, it is curious to observe how naturally the secondary causes
appear to have produced the results by which they were followed; but
which, beforehand, no one had thought of predicting.

Varied, however, as is the course of human life, few men have
arrived at eminence without difficulty. We do not mean that ephemeral
prominence of “position” which makes them marked in their day;
but that which leaves the impression of their minds on the age in
which they lived, or on the science or other pursuit which they had
chosen—original minds, who have enlarged the boundaries of our
knowledge. Such men usually have the ample gifts of nature with
which they are endowed, somewhat counterbalanced by the difficulty
experienced in the successful application of them.

Abernethy had not been altogether exempt from such difficulties. With
a sensitive organization, he had had to make his own way; he had
experienced the difficulties which attend the advocacy of opinions
and principles which were opposed to, or at all events different
from, those generally entertained. He had had to encounter that
misconstruction, misrepresentation, ridicule, even malice—save the
mark!—which are too frequently provoked by any attempts to tell people
that there is something more correct than the notions which they have
been accustomed to value. Still, when we compare Abernethy’s course
with that of _many_—we had almost said _most_—benefactors to science,
he might be said to have been a fortunate man. If a man has power, and
a “place to stand on”—and Abernethy had both—truth will tell at last.

A retired spot, a room in an obscure street, near St. Bartholomew’s,
had been by his unaided talents expanded into a theatre within the
walls of the hospital. This was becoming again crowded; and, although
it formed a satisfactory arena for the development and illustration of
his principles, the increasing audiences were significant of the coming
necessity of a still larger building; which was, in fact, a few years
afterwards, constructed. He had indeed arrived, as we imagine, at a
point which was comparatively smooth water, and which we are inclined
to regard as the zenith of his career.

In the opening of his beautiful lectures at the College, Abernethy,
in one of his warm and earnest endeavours to animate his audience to
regard benevolence, and the love of truth, as the impulses which could
alone urge on, and sustain, industry in cultivating the “Science” of
our profession, had observed that, “unfortunately, a man might attain
to a considerable share of public reputation without being a real
student of his profession.” There have been indeed too many examples
of that, as also of those who, after years of labour, have failed to
obtain a scanty living.

Abernethy had been a real and laborious student in science, and he
was now reaping an abundant and well-deserved fruition. Few surgeons
have arrived at a position so calculated to satisfy the most exacting
ambition. Although the full extent and bearing of his principles were
by no means universally understood, yet the general importance of them
was so, and in some measure appreciated. In a greater or less degree,
they were answering the tests afforded by the bedside in all parts of
the world.

Ample, therefore, as might be the harvest he was reaping in a large
practice, he was enjoying a still higher fruition in the kind of
estimation in which he was held. He had a high reputation with
the public; one still higher amongst men of science. His crowded
waiting-room was a satisfactory evidence of the one, and the manner in
which his name was received here, on the Continent, and in America, a
gratifying testimony of the other. He was regarded much more in the
light of a man of enlarged mind—a medical philosopher—than merely as
a distinguished surgeon.

From the very small beginnings left by Mr. Pott, he had raised the
school of St. Bartholomew’s to an eminence never before attained by
any school in this country. I think I may say that, in its _peculiar
character_, it was at that time (1816) unrivalled.

Sir Astley Cooper was in great force and in high repute at this time;
and, combining as he did the schools of _two_ large hospitals, had, I
believe, even a larger class. Both schools, no doubt, endeavoured to
combine what is not, perhaps, very intelligibly conveyed by the terms
practical and scientific; but the universal impression, assigned the
latter as the distinguishing excellence of Mr. Abernethy, whilst the
former was held to express more happily the characteristic of his
eminent contemporary.

Whatever school, however, a London student might have selected as
his Alma Mater, it was very common for those whose purse, time, or
plans permitted it, to attend one or more courses of Abernethy’s
lectures; and it was pleasing to recognize the graceful concession to
Mr. Abernethy’s peculiar excellence afforded by the attendance of some
of Sir Astley’s pupils, and his since distinguished relatives, at the
lectures of Abernethy.

As I have said, his practice was extensive, and of the most lucrative
kind; that is, it consisted largely of consultations at home. Still, he
had patients to visit, and, as he was very remarkable for punctuality
in all his appointments, was therefore not unfrequently obliged to
leave home before he had seen the whole of those who had applied to
him. The extent of his practice was the more remarkable, as there was
a very general impression, however exaggerated it might be, that his
manners were unkind and repulsive. His pupils were enthusiastically
fond of him; and it was difficult to know which was the dominant
feeling—their admiration of his talents, or their personal regard.

Some of the most distinguished men had been of their number; and it
would be gratifying to us to enumerate the very complimentary catalogue
of able men who have been indebted for much of their eminence and
success to the lessons of Abernethy; but as, in doing so, we might
possibly, in our ignorance, omit some names which ought to be recorded,
we forego this pleasure, lest we should unintentionally appear to
neglect any professional brother whom we ought to have remembered.

In 1812-13, the pupils had presented Mr. Abernethy with a piece of
plate, “as a testimony of their respect and gratitude.” The arrangement
of the matter was confided chiefly to the present Sir James Eyre, Mr.
Stowe of Buckingham, and Mr. George Bullen. In a very interesting
letter, with which I have been favoured by Mr. Stowe, amongst other
matters hereafter to be mentioned, it is stated that the plate was
delivered at Abernethy’s house on the 1st of April; and as he had no
more entirely escaped such things than other medical men, he at first
regarded it as a hoax. But when the contents were exposed, and he
discovered the truth, he became much affected.

The regard of the pupils was always the thing nearest his heart. On
meeting the class at the hospital, he essayed to express his feelings;
but finding that he should only break down, he adopted the same course
as he had employed on another memorable occasion, and _wrote_ his
acknowledgments, a copy of which was suspended against the wall of the
theatre.

It is due to our worthy and kind-hearted contemporary, Sir James Eyre,
to add that Mr. Stowe observes in his letter, that, of all others, Sir
James was the most zealous promoter of a movement so creditable to all
parties. Some years after this, another subscription was commenced by
the pupils for a portrait of Abernethy, which was painted by Sir Thomas
Lawrence, and engraved by Bromley. It was after this engraving that
Mr. Cook executed the portrait which forms the frontispiece of the
present volume. Sir Thomas, and the engraver after him, have been most
successful. He has caught one of Mr. Abernethy’s most characteristic
expressions. We see him as he often stood when addressing the
_anatomical_ class. We think it impossible to combine more of of him
in one view. We fancy we see his acute penetration, his thoughtful
expression, his archness and humour, and his benevolence, all most
happily delineated, whilst the general position and manner is eminently
faithful. In his surgical lectures, he was generally seated; and in
the lithograph, he is represented in the position which he almost
invariably assumed when he was enunciating the proposition which is
placed beneath the engraving. It is the work of a young artist who was
considered to evince great promise of future excellence; but who, we
regret to say, died last year—Mr. Leighton.

In 1815, he had been appointed surgeon to the hospital, after
twenty-eight years’ tenure of the assistant surgeoncy; a subject that
we merely mention now, as we shall be obliged to revert to it when we
consider the subject of the “Hospital System.”

At the time to which we allude, lecturing had become so easy as to
appear little more than amusement to him; yet there were (we speak of
about 1816) no signs of neglect or forgetfulness. His own interest in
the subject was sustained throughout; but as his unrivalled lecturing
will be more fully described, we must not anticipate. Few old pupils
visited London without contriving to get to the hospital at lecture
time. The drudgery of the early morning anatomical demonstration was
taken off his hands by a gentleman who performed his task with credit
to himself and with justice to his pupils.

Abernethy, at this time, in addition to a successful school, a large
and attached class, a solid and world-wide reputation, was receiving
numerous proofs that his principles were recognized; that, however
imperfectly adopted, they were gaining ground; and that if all his
suggestions were not universally admitted, they were becoming axiomatic
with some of the first surgeons, both in this and other countries.

We think it not improbable that it was somewhere about this period
that it was proposed to confer on him the honour of a Baronetcy. We
had long been familiar with the fact; but not regarding it as very
important, and having nothing in proof of it but the generally received
impression, we omitted any reference to it in the first edition
of these Memoirs. Finding, however, more interest attached to the
circumstance than we expected, we have communicated with the family on
the subject, and have ascertained that all the circumstances are fresh
in their recollection, although they cannot recall the exact period at
which they occurred.

His first announcement of the fact to his family was at table, by his
jocosely saying: “Lady Abernethy, will you allow me to assist you
to—?” &c. Having had his joke, he then formally announced to them
the fact, together with the reasons which had induced him to decline
the proffered honour—namely, that he did not consider his fortune
sufficient, after having made what he regarded as only a necessary
provision for his family.

It is probable that his motives were of a mixed character. We do not
believe that he attached much value to this kind of distinction, and
that, had he availed himself of the offer, it would have been rather
from a kind of deference to the recognition it afforded of the claims,
and thus indirectly promoting the cultivation of Science, than for
any other reason. It was not but that he held rank and station in the
respect which is justly due to them; but that he regarded titles as
no very certain tests of scientific distinction. Enthusiastic in his
admiration of intellectual, still more of moral excellence, he had
something scarcely less than coldness in regard to the value of mere
titles; whilst he beheld, with something like repulsion, the flattery
to which their possessors were so often exposed.

There are men who have so individualized themselves that they seem
to obscure their identity by any new title. John Hunter was scarcely
known by any less simple appellation. We hardly now say “_Mr._” Hunter
without feeling that we may be misunderstood. It begins to have a sound
like “Mr.” Milton or “Mr.” Shakspeare; Abernethy and John Abernethy are
fast becoming the only recognized designations of our philosophical
surgeon, for even the modest prefix of _Mr._ is fast going into disuse.
Be this as it may, it is certain he declined the honour; and to us it
is equally so that he felt at least indifferent to it; for although
the good sense and good feeling implied in the reasons alleged were
characteristic, yet, had they constituted the only motive, he might,
with his abundant opportunities, have removed that objection in a very
reasonable time, without difficulty.

It is perhaps significant of the measured interest with which
Mr. Abernethy regarded the acquisition of a Baronetcy, that the
family could not recollect the period at which it was offered. This
information, however, I obtained from Sir Benjamin Brodie, who has
kindly allowed me to record the fact in the following reply to my
inquiry on the subject.

“14, Saville Row,
“November 16, 1854.

“MY DEAR SIR,

“My answer to your inquiry may be given in a very few words. I
perfectly well remember the having been informed by the late Sir
John Becket that he had been commissioned by Lord Liverpool to
offer Mr. Abernethy, on the part of the Crown, the honor of being
created a Baronet, which, however, Mr. Abernethy declined.

“I am, dear SIR,
“Yours faithfully,
“B. C. BRODIE.

“G. MACILWAIN, Esq.”

He told me once of an interview he had with Lord Castlereagh, which
may, perhaps, be not out of place here. When Sir T. Lawrence was
painting the portrait, and Abernethy went to give him a sitting,
Abernethy was shown into a room where another visitor, a stranger to
him, was also waiting. The stranger, looking at a portrait of the Duke
of York, observed, “Very well painted, and very like.” “Very well
painted,” Abernethy replied. The other rejoined: “A good picture, and
an excellent likeness.” “A very good picture,” said Abernethy. “And
an excellent likeness,” again rejoined his companion. “Why, the fact
is,” said Abernethy, “Sir Thomas has lived so much amongst the great,
that he has learnt to flatter them most abominably.” On being shown in
to Sir Thomas, Sir Thomas said: “I find you have been talking to Lord
Castlereagh.”

He had not, we think, as yet sustained the loss of any member of his
family, nor hardly experienced any of those ordinary crosses from
which few men’s lives are free, and which, sooner or later, seldom
fail to strew our paths with enough to convince us that perfect peace
cannot be auspiciously sought in the conduct of human affairs. He
was soon, however, to receive an impression of a painful nature,
and from a quarter whence, whatever might have been his experience,
he certainly little expected it. Long accustomed to be listened to
by admiring and assenting audiences, whether in the theatre of the
hospital, or in those clusters of pupils which never failed to crowd
around him whenever he had anything to say; he was now to have some of
his opinions disputed, his mode of advocating them impugned, his views
of “Life,” made the subject of ridicule, and even his fair dealing
in argument called in question. All this, too, by no stranger; no
person known only to him as one of the public, but by one who had been
his pupil, whose talents he had helped to mature and develop, whose
progress and prospects in life he had fostered and improved, and to
whom, as was affirmed by the one, and attested by the other, he had
been a constant friend.

That this controversy was the source of much suffering to Abernethy, we
are compelled to believe; and it is altogether to us so disagreeable,
and difficult a subject, that we should have preferred confining
ourselves to a bare mention of it, and a reference to the works
wherein the details might be found; it is, however, too important an
episode in the life of Abernethy to be so passed over; it suggests
many interesting reflections; it exhibits Abernethy in a new phase,
illustrates, under very trying circumstances, the

“Virtus repulsæ nescia
Intaminatis fulget honoribus,”

and brings out in stronger relief than any other transaction of his
life the best and most distinctive traits of his character (benevolence
and Christian feeling), under temptations which have too frequently
disturbed the one, and destroyed the other.

“Opinionum commenta delet dies, naturæ judicia confirmat.”—CICERO.

“Time, which obliterates the fictions of opinion, confirms the
decisions of nature.”

Whoever has wandered to the south side of Lincoln’s Inn Fields,
will have found himself in one of the “solitudes of London”—one
of those places which, interspersed here and there amidst the busy
current that rushes along every street and ally, seem quite out
of the human life-tide, and furnish serene spots, a dead calm, in
the midst of tumult and agitation. Here a lawyer may con over a
“glorious uncertainty,” a surgeon a difficult case, a mathematician
the general doctrine of probability, or the Chevalier d’Industrie
the particular case of the _habitat_ of his next dinner; but, unless
you have some such need of abstraction from the world, these places
are heart-sinkingly dull. You see few people; perhaps there may be a
sallow-looking gentleman, in a black coat, with a handful of papers,
rushing into “chambers;” or a somewhat more rubicund one in blue,
walking seriously out: the very stones are remarkably round and
salient, as if from want, rather than from excess, of friction. The
atmosphere from the distance comes charged with the half-spent, booming
hum of population.

Immediately around you, all is comparatively silent.

If you are in a carriage, it seems every moment to come in contact with
fresh surfaces, and “beats a roll” of continued vibrations; or, if a
carriage happen to pass you, it seems to make more noise than half
a dozen vehicles anywhere else. You may observe a long façade, of
irregular elevations—upright parallelograms, called habitable houses;
but, for aught you see, half of them may have been deserted: the dull
sameness of the façade is broken only by half a dozen Ionic columns,
which, notwithstanding their number, seem very serious and very
solitary. You may, perhaps, imagine that they bear a somewhat equivocal
relation to the large house before which they stand. You may fancy them
to be architectural relics, inconveniently large for admission to some
depository within, or that they are intended as a sort of respectable
garniture to the very plain house which they partly serve to conceal
or embellish; or quiz them as you please, for architects cannot do
everything, nor at once convert a very ugly house into a very beautiful
temple.

But, stop there!—for temple it is—ay, perhaps, as human temples
always are, not altogether unprofaned; but not so desecrated, we trust,
but that it may yet contain the elements of its own purification. It
enshrines, reader, a gem of great value, which nothing extrinsic can
improve, which no mere art can embellish—a treasure gathered from the
ample fields of nature, and which can be enriched or adorned only from
the same exhaustless store. Though humble, indeed, the tenement, yet,
were it humbler still, though it were composed of reeds, and covered in
with straw, it would remain hallowed to science.

It holds the monument of the untiring labour of a great master—the
rich garnerings of a single mind—the record, alas! but of _some_ of
the obligations mankind owe to the faithful pioneer of a Science which,
however now partially merged in clouds and darkness, and obscured by
error, still exhibits through the gloom, enough to assert its lofty
original, and to foster hopes of better times.

The museum of John Hunter (for it is of that we write) is one of the
greatest labours ever achieved by a single individual. To estimate that
labour aright, to arrive at a correct notion of the man, the spectator
should disregard the number of preparations—the mass of mechanical
and manipulatory labour which is involved—the toil, in fact, of mere
collection; and, looking through that, contemplate the _thought_ which
it records; the general nature of the plan; the manner in which the
Argus-eyed Author has assembled together various processes in the
vegetable creation; how he has associated them with their nearest
relations in the animal kingdom; and how he has traced the chain from
link to link, from the more simple to the more compounded forms, so
as to throw light on the laws dispensed to Man. The spectator should
then think of the Hunterian portion of the museum as the exhausting
harvest of half a life, blessed with no greatly lengthened days; a
museum gathered not in peaceful seasons of leisure, nor amid the ease
of undiverted thought, but amidst the interrupting agitations of a
populous city—the persistent embarrassments of measured means—the
multiform distractions of an arduous profession—the still more serious
interruptions of occasional indisposition—and, finally, amidst
annoyances from quarters whence he had every right to expect support
and sympathy—annoyances which served no other purpose but to embitter
the tenure of life, and to hasten its termination.

Our space will not allow us to dwell more on this subject or the Museum
just now. But where is our excellent conservator—where is Mr. Clift,
the assistant, the friend, and young companion of John Hunter? He,
too, is gathered to his rest. He, on whose countenance benevolence
had impressed a life-long smile—he who used to tell us, as boys, so
much of all he knew, and to remind us, as men, how much we were in
danger of forgetting—is now no more. How kind and communicative he
was; how modest, and yet how full of information; how acceptably the
cheerfulness of social feelings mantled over the staid gravity of
science. How fond of any little pleasant story to vary the round of
conservative exposition; and then, if half a dozen of us were going
round with him the “_con_ticuere omnes,” when, with his characteristic
prefatory shrug, he was about to speak of Hunter. Then such a memory!
Why once, in a long delightful chat, we were talking over the Lectures
at the College, and he ran over the general objects of various courses,
during a succession of years, with an accuracy which, if judged of
by those which had fallen within our own recollection, might have
suggested that he had carried a syllabus of each in his pocket.

We had much to say of Mr. Clift; but, in these times of speed, there is
hardly time for anything; yet we think that many an old student, when
he has lingered over the stately pile reared by John Hunter, may have
paused and felt his eyes moistened by the memory of William Clift.

When Mr. Abernethy lectured at the College, there was no permanent
professor, as is now the case; no Professor Owen, of whom we shall have
to speak more in the sequel. Both the professorship of anatomy and
surgery, and also that of comparative anatomy, were only held for a
comparatively short time.

It is not very easy to state the principle on which the professors were
selected. The privilege of addressing the seniors of the profession has
never, any more than any other appointment in the profession, been the
subject of public competition; nor, unless the Council have had less
penetration than we are disposed to give them credit for, has “special
fitness” been a very dominant principle. Considering the respectability
and position of the gentlemen who have been selected, the Lectures at
the College of Surgeons, under the arrangements we are recording, were
certainly much less productive, as regards any improvement in science,
than might have been reasonably expected.

The vice of “system” could not be always, however, corrected by the
merits of the individual. One result, which too commonly arose out of
it, was, that gentlemen were called on to address their seniors and
contemporaries for the first time, who had never before addressed any
but pupils. It would not, therefore, have been very wonderful, if,
amongst the other difficulties of lecturing, that most inconvenient one
of all should have sometimes occurred, of having nothing to say.

Mr. Abernethy was appointed in 1814, and had the rare success of
conferring a lustre on the appointment, and the perhaps still more
difficult task of sustaining, before his seniors and contemporaries,
that unrivalled reputation as a lecturer which he had previously
acquired. As Mr. Abernethy had been all his life teaching a more
scientific surgery, which he believed to be founded on principles
legitimately deducible from facts developed by Hunter; so every
circumstance of time, place, and inclination, disposed him to bring
Mr. Hunter’s views and opinions under the review of the audience at the
College, composed of his seniors, his contemporaries, and of pupils
from the different schools. He was, we believe, equally desirous of
disseminating them amongst the one class, and of having them considered
by the others. At this time, no lectures of Mr. Hunter had been
published; and Mr. Abernethy thought that, _to understand_ Hunter’s
opinions of the _actions_ of living bodies, it was expedient that
people should have some notion of what Mr. Hunter considered to be the
general nature of—”Life.”

We hold this point to be very important; for all experience shows that
speculation on the abstract nature of things is to the last degree
unprofitable. Nothing is so clear in all sciences as that the proper
study of mankind is the Laws by which they are governed. Yet we cannot,
in any science, proceed without something to give an intelligible
expression to our ideas; which _something_ is essentially hypothetical.

If, for example, we speak of light, we can hardly express our ideas
without first supposing of light that it is some subtle substance sent
off from luminous bodies, or that it consists in undulations; as we
adopt the corpuscular or undulatory theory. It would be easy to form a
third, somewhat different from either, and which would yet pretend to
no more than to give a still more intelligible expression to phenomena.

Now this is, as it appears to us, just what Mr. Abernethy did. He did
not speculate on the nature of life for any other reason than to give
a more intelligible expression to Mr. Hunter’s other views. At that
time there was nothing _published_, showing that Mr. Hunter’s ideas
of life were what Mr. Abernethy represented them to be; they might
have been remembered by men of his own age, but this was not very
good for controversy; and as that was made a point of attack[35], it
is well that the since collected “Life and Lectures of John Hunter,”
by Mr. Palmer, have given us a written authority for the accuracy of
Abernethy’s representations.

In theorizing on the cause of the phenomena of living bodies, men have,
at different times, arrived at various opinions; but although not so
understood, it seems to us that they all merge into two—the one which
supposes Life to be the result of organization, or the arrangement
of matter; the other, that the organization given, Life is something
superadded to it; just as electricity or magnetism to the bodies with
which these forces may be connected. The latter was the opinion which
Mr. Abernethy advocated as that held by Mr. Hunter, and which he
honestly entertained as most intelligibly and rationally, in his view,
explaining the phenomena.

That such were really the views held by Mr. Hunter, a few passages
from the work, as published by Mr. Palmer, will show. “Animal and
vegetable substances,” says Mr. Hunter, “differ from common matter
in having a power superadded totally different from any other known
property of matter; out of which various new properties arise[36].”
So much for a general view. Next, a reference to particular powers:
“Actions in animal bodies have been so much considered under a chemical
and mechanical philosophy, that physiologists have entirely lost
sight of Life;” again showing how correctly Abernethy had interpreted
Hunter’s notion of the necessary “Key,” as Abernethy phrased it, to
his views; Hunter says: “For unless we consider Life as the immediate
cause of attraction occurring in animals and vegetables, we can _have
no just conception_ of animal and vegetable matter[37].” Mr. Hunter,
in relation to the idea of life being the result of organization,
shows how faithful an exposition Abernethy had given of his views. “It
appears,” says he, “that the Living Principle cannot arise from the
peculiar modification of matter, because the same modification exists
where this principle is no more.”—Vol. i, p. 221. And in the same
page: “Life, then, appears to be something superadded to this peculiar
modification of matter.”

Then as to one of the illustrations employed by Abernethy, Hunter,
after saying that he is aware that it is difficult to conceive
this superaddition, adds: “But to show that matter may take on new
properties without being altered itself as to the species of matter,
it may not be improper to illustrate this. Perhaps magnetism affords
the best illustration. A bar of iron, without magnetism, may be
considered as animal matter without life. With magnetism, it acquires
new properties of attraction and repulsion,” &c.

Mr. Abernethy, as we have said, advocated similar views; and, we
repeat, founded his reason for so doing on what he conceived to be
the necessity of explaining Mr. Hunter’s ideas of life, _before he
could render_ his (Hunter’s) _explanation_ of the various phenomena
intelligible. In all of this, he certainly was expressing Mr. Hunter’s
own views, with that talent for ornamenting and illustrating everything
he discussed, for which he was so remarkable.

Abernethy multiplied the illustrations by showing the various analogies
which seemed to him to be presented in the velocity, the chemical, and
other powers of Life and Electricity; and, with especial reference
to the extraordinary discoveries of Sir Humphrey Davy, added such
illustrations, as more recent achievements in chemical science had
placed within his grasp; and thence concluding it as evident that some
subtile, mobile, invisible substance seemed to pervade all nature,
so it was not unreasonable to suppose that some similar substance or
power pervaded animal bodies. He guarded himself, however, both in his
first and again in his second Course of Lectures, from being supposed
to identify Life with electricity, in a long paragraph especially
devoted to that object. In his second Course, in 1815, he proceeded to
enumerate John Hunter’s various labours and contributions to science,
as shown by the Museum; imparting great interest to every subject, and
in so popular a form, that we wonder now, when (as we rejoice to see)
there are some small beginnings of a popularization of physiology, that
there is not a cheap reprint of these Lectures.

Keeping, then, his object in view, we cannot see how, as a faithful
interpreter of John Hunter, Abernethy could have done less; and if
any theory of life at all is to be adopted, as _necessary to give an
intelligible impression_ to phenomena, one can hardly quarrel with
that which takes the phenomena of life on one hand, and those of death
on the other, as the means of expressing our ideas. When we see a man
dead, whom we had contemplated alive, it certainly seems that something
has left him; and whether we say “something superadded,”—the “breath”
or “Life,” or by whatever term we call it,—we appear really to express
in as simple a form as possible the facts before us. It seems to us
that, after all, John Hunter did little more; for the illustration
or similitude by which we endeavour to render an idea clear, has in
strictness nothing _necessarily_ to do with the idea itself; any more
than an analogy, however real the likeness, or a parallelism, however
close, represents identity.

We should have thought it, therefore, of all things in the world the
least likely that a representation of any theory of Hunter’s should
have disturbed the harmony which ought to exist between men engaged
in scientific inquiries. It shows, however, the value of confining
ourselves as strictly as possible to phenomena, and the conclusions
deducible from them. Nothing could possibly be more philosophical than
the terms in which Mr. Abernethy undertook to advocate Mr. Hunter’s
views of life. His definitions of hypothesis, the conditions on which
he founded its legitimate character, the modesty with which he applies
it, and the clearness with which he states how easily our best-grounded
suppositions may be subverted by new facts, are very lucid and
beautiful, and give a tone to the lectures (as we should have thought)
the very last calculated to have led to the consequences which followed.

[Footnote 35: “For this Hunterian Theory of Life, which its _real_
author so stoutly maintains, &c. is nowhere to be found in the
published writings of Mr. Hunter.”—_See Lawrence’s Two Lectures
(Notes)._]

[Footnote 36: Vol. i, p. 214. Note.]

[Footnote 37: Vol. i, p. 217.]

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