CHAPTER IV.

ABERNETHY'S HOSPITAL PRACTICE, AND GENERAL PROFESSIONAL MAXIMS.

IF Cornaro, who has always been with me a great favourite, may be thought to have occupied somewhat more attention than was due to my friend Abernethy, it is certain that he would have been the first to excuse it. Still, it is high time to return to him in the field, where I left him, of his greatest utility-St. Bartholomew's Hospital. No one could have been more successful in the application of the means suitable to his curative intentions, particularly the local means of cure. His superiority, in this respect, to some other surgeons of the Hospital, at the period to which my recollection of him chiefly refers, was most conspicuous. He was then only assistant surgeon; but, whenever there occured an opportunity for him to exhibit the effect of his rules of practice, the face of things might be perceived immediately to brighten. He was particularly skilful in knowing when to stimulate diseased surfaces, and when to soothe them; an art of no small importance among a class of patients, always numerous in large Hospitals-for there, wounds and sores, in weak and irritable subjects, are sure to abound. But it cannot be doubted, that his local applications derived a considerable share of their efficacy from his invariable attention to the

general health. "Gentlemen," he used to say, "if you wish to make good work, you must take care to have good materials; these the system alone is capable of supplying, and you must, therefore, be careful to keep that as right as you can; for, unless you do so, your external dressings, and the best contrivances of mechanical surgery, will avail you nothing. Let me then give you one plain rule-endeavour to correct whatever is obviously wrong in the system; and there is generally something going on wrong, in the digestive, or chylopoietic functions, in protracted surgical cases. Be sure, then, to attend to this. There are, likewise, many important diseases within the province of surgery, in the treatment of which, your chief dependence must be on strict attention to diet-for, unless you can strengthen the powers of the stomach, or supply it with such food as it is capable of digesting, there will be no recovery."

"A gentleman," he said, " who was thought to be dying 'of a local complaint, came to London to consult Sir Everard Home and myself. We were both inclined, upon consultation, to regard the case as nearly hopeless. I told the patient, however, my notions of the benefit to be obtained by exactly proportioning the quantity of food to the powers of the digestive organs, so as to leave no surplus of alimentary matter to ferment and corrupt in the different stages of its progress."

About seven or eight years afterwards, a gentleman was speaking of a famous trotting mare which he possessed, and added, "By the way, I bought her of a patient of yours, who told me that he had himself trotted her at a surprising

rate," which excited my astonishment, as I remembered his going up to London to consult you when no one expected that he would return alive. On my alluding to this, he exclaimed, "Ah! I deserved to recover, for very few would have weighed their food, and taken it by rule, as I did, for several years."

The above case is illustrative, in a striking degree, of the benefit which may be derived from a strictly and well-regulated diet; but neither Conaro in the sixteenth, nor Abernethy in the present century, dreamt of recommending any specific plan to which, as to a bed of Procrustes, all are to submit. Their object, it is scarcely necessary to repeat, was to make the fatal consequences of excess more apparent to our minds, whilst they set before us an animated picture of the blessings of temperance, and laid down certain rules for our guidance. In the application of these rules, regard must be had to the individual temperament, the sex, the time of life, the climate and season of the year, the condition and occupation of life, with other numberless varying circumstances, which may require to be taken into the account. To the valetudinarian, they sayyou must pay minute and exact attention to your diet, if you would regain your health. To the healthful, they recommend temperance generally, as the surest method of keeping disease off, or, should it assail them, of enabling them to contend with it successfully. They, in short, commend it as the main stay of that health which makes life desirable, and of those virtues which tend to make death easy. Now, as Abernethy is known to have been a great

invalid during the latter part of his life, a life protracted to no very advanced period, it may fairly be asked, how he profitted so little by his own maxims ?

The following anecdote, which has been recorded of him, must, I fear, be taken as his own honest confession upon this point. Some one, whom he met at a dinner party, joked with him about a little discrepancy perceptible between his dietetic principles and his own practice-upon which he stood erect, with one arm extended at right angles, as much as to say, "Don't you see what I am ? a mere directing post!" Thus, not scrupling to make himself debtor to Joe Miller, when it suited his purpose. He was far from being a wine-bibber, or a gourmand, in an offensive sense; but he was, in very kindness of heart, much given to hospitality, and, in the relaxation of a convivial scene, he may be well excused for having sought occasionally to escape from those cares and anxieties incident to his profession-and from which, not even that invaluable medicine, but treacherous hobby, a blue pill, could not protect his somewhat too sensitive frame.

His pupils, of that day, will not have forgotten the anxiety which he was known to have felt, upon one occasion in particular, when, after performing skilfully an operation, for which he was justly celebrated, on a lady of some consequence, he found that the case did not go on as he had reason to expect, but, on the contrary, that her irritability of body and mind so interfered with the repose, without which recovery from severe operations is scarcely attainable, and which in this case no narcotic could

procure, that she gradually sank and died-a misfortune which affected him very grievously. He tried all he could to walk it off, and talk it off, but to little purpose, insomuch, that this may be set down as one of the accidents which looked towards his own grave; or, as is commonly said, planted a nail in his coffin.

The world sometimes speak of medical men as if they saw little else but fees glittering about the beds of their patients; whereas, it is but too certain that, in their anxiety to save the lives of others, they often gather for themselves the nails alluded to. The most extraordinary exemption from afflicting occurrences, during the course of a long life, passed in the active duties of his profession, is that recorded of one of the Monros, the father, I believe, of a long line of Professors of Anatomy, of that name, at Edinburgh. The author of a memoir, which appeared at his death, tells us, that, throughout his whole career, he had scarcely met with a single untoward event; the current of his fair fame, as an author, a lecturer, and a surgeon, having equally and altogether preserved a uniformly unruffled surface. This was indeed a bliss beyond that of the "fortunatos nimium," of the Roman poet; even far beyond that of the still more celebrated Doctor Baillie. That eminent physician told a friend that he should not have survived the shock of the Princess Charlotte's death, and of her infant offspring, if he had not thrown himself instantly back into the vortex of his professional engagements; by so doing he did, it is true, survive the shock, but how many were the grey hairs