sketch of this paper appeared in ‘Surgical Observations,’ part ii. (1806); it was afterwards published in a more complete form in ‘Surgical Works,’ vol. i. (1811). In it he shows that on the one hand local irritation will produce disorders of the digestive organs, and that this takes place by a reflected operation through the nervous system (pp. 6–10). On the other hand, he insists upon the variety of diseases which may result from disorders of the digestive organs, such as ‘diminution of the functions of the brain, or delirium, partial nervous inactivity and insensibility, muscular weakness, tremors, palsy, convulsions . . .’ ‘Also local diseases in such a constitution will become peculiar in their nature and difficult of cure’ (p. 61). Although evincing great power of generalisation, these views were clearly extravagant and one-sided. ‘In his lectures and practice,’ says a witness of the highest authority (Sir James Paget), Abernethy ‘simplified still more, and seemed to hold only that all local diseases which are not the immediate consequence of accidental injury are the results of disorders of the digestive organs, and are all to be cured by attention to the diet, by small doses of mercury, and by purgatives.’ These views were not only imparted by Abernethy to the profession, but impressed upon his private patients, who were referred to ‘page seventy-two of my book, published by Messrs. Longman;’ while the medicinal treatment indicated above, which has become known all over the world as characteristic of English practice, suited admirably the well-fed and free-living Londoners who crowded his consulting-room. On the surgeons of his time the ‘system’ had a happy effect in leading them to study the general health of their patients, and it may be said to have introduced a new principle into surgical practice in England.
The secret of Abernethy's ascendency over the profession is not, however, to be found in his books, which, though clearly written, are flimsy in texture. They contain fewer valuable observations than those of many men who have made much less figure in the world, and are quite wanting in that best originality which is based upon thoroughness of investigation. ‘Indeed,’ says Sir James Paget, ‘for the observation of particular facts, and for the strict induction of general truths from them, his mind was altogether unsuited; for he was naturally indolent, and early success rendered industry unnecessary.’ So that to a student of the present day Abernethy's writings are disappointing, and his celebrity an enigma.
The solution of the mystery is to be found in his vigorous and attractive personality, and in a power of exposition to which contemporaries have borne striking testimony. Sir Benjamin Brodie writes: ‘Mr. Abernethy was an admirable teacher. He kept up our attention so that it never flagged; and that which he told us could not be forgotten. He did not tell us so much as other lecturers, but what he did he told us well. His lectures were full of original thought, of luminous and almost poetical illustrations, the tedious details of descriptive anatomy being occasionally relieved by appropriate and amusing anecdotes. . . . Like most of his pupils, I learned to look upon him as a being of a superior order’ (Brodie's Autobiography, p. 23). He seems, indeed, to have possessed enough of the arts of the advocate and the actor to secure unhesitating acceptance for whatever he chose to put forth. ‘He reserved all his enthusiasm,’ says Dr. Latham, ‘for his peculiar doctrine. He so reasoned it, so acted, so dramatised it, and then in his own droll way he so disparaged the more laborious searchers after truth, calling them contemptuously “the Doctors,” and so disported himself with ridicule of every system but his own, that we accepted his doctrine in all its fulness. We should have been ashamed to do otherwise. We voted ourselves by acclamation the profoundest of medical philosophers at the easy rate of one half-hour's instruction. . . . We never left his lecture-room without thinking him the prince of pathologists, and ourselves only just one degree below him.’
To this should be added that such admiration was not wasted on an unworthy character. Abernethy was a man of blameless life, highly honourable in all his dealings, generous to those in need of help, incapable of meanness or servility. His blunt independence and horror of ‘humbug’ were doubtless among the factors of that rudeness and even brutality of manner for which he was notorious, and of which many strange stories are told. This defect was fostered by a physical irritability probably connected with the latent heart-disease which ultimately closed his life. In the end it seems to have become a wilful and almost calculated eccentricity, in which he was confirmed by the experience that a masterly roughness commanded the confidence of his patients even better than an amiability, possibly suggestive of weakness, would have conciliated it.
The following is a condensed list of Abernethy's writings. All but one are in octavo, and all published in London: 1. ‘Surgical and Physiological Essays.’ Part i. On Lumbar Abscess, &c., 1793; Part ii. On Matter per-
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