Here the surgeon stated the treatment, which had, in addition to attention to the general health, involved some local administrations, of which, in general, Abernethy approved, but, as it would seem, not in this case. His difference of opinion he thus stated, in the presence of the patient:
"Well, I say that there is a sufficient disorder of your digestive organs to maintain the annoyances of which you complain; and I should confine my attention to endeavour to put that disorder right. Mr. —— seems to think that, in adding to this treatment the plan he proposes, he will shorten the case. Well, that may be so; he has paid, I know, a good deal of attention to this subject; and if I had one of my own family ill with this complaint, I should feel perfectly satisfied, if they were under his care. At the same time, I say what I think; and if you do not find the general plan successful, then the means he proposes might with propriety be added."
No harm resulted from this difference of opinion; but much benefit. The patient was not pleased with Abernethy; but he thought him very skilful and very honest.
One day, a surgeon went to him under the following circumstances. A patient who had recently recovered from a lameness, which, as alleged, had its cause in the foot, on a relapse went to another surgeon. This gentleman had, as it ultimately appeared, hastily decided that the lady had a complaint in the hip; she was therefore consigned to bed, and treated for disease of that part. After about three months, feeling no better, she desired to see the surgeon under whose care she had formerly been.
The surgeon was now very much annoyed; for he found that he had been by many persons charged with having mistaken the case, which he had never even seen on the second attack, and which now presented a phase in which disease of the hip, to a hasty examiner, might easily be suggested. He was not much better satisfied, when, after a careful examination of the case, he felt convinced that there was no disease in the hip, although the symptoms were more severe than ever. He declined undertaking the case without a previous consultation with the surgeon who had decided it to be a disease of the hip; but the patient being immoveable in her opposition to this request, and offering any other surgeon, or more, if required, her wishes were acceded to, and Mr. Abernethy requested to visit the case. On going to the patient, the surgeon explained to Mr. Abernethy the points at issue, but without telling him to which view his own opinion inclined, or the positive dictum of his senior brother, a very eminent surgeon. "I shall, therefore," said he to Abernethy, "feel particularly obliged to you, sir, if you will examine the case for yourself."
When they were introduced to the lady, Abernethy said: "Well, now, I should be very well satisfied with Mr. ——'s report of your case; but he says I must examine the limb for myself: so here goes."—A somewhat repulsive beginning to a delicate lady, perhaps; but nothing could be more cautiously gentle than his examination. In conducting it, he had avoided one test which usually does give a little pain. The other surgeon, deeming the decision to be very important, reminded him of this test (raising the limb and striking the heel gently), which he then proceeded to do with equal gentleness. "That will do," said he. "Now, sir, shall we go into another room?" "No, sir," replied the surgeon. "If you please, Mr. Abernethy, I should prefer your at once telling the patient what is your opinion on the case."
He then declared his opinion; but, fearing he might injure one or other party, with the following exordium: "Now, madam, we are all liable to mistakes: there is no man living who does not make more or less; and I am sure I make mistakes; therefore I may do so in my opinion of your case. But for the life of me I cannot perceive that you have any disease in your hip." He then gave a short, but most lucid view of what he conceived to be the cause of her pain, and illustrated it by referring to something which happened to himself in one of his own severe rheumatic attacks. The result proved that he was quite right as to his view of the case; the lady, by exercise and other means (which, had the hip been diseased, would have only exasperated her complaint), had a good recovery.
One very great charm in Abernethy in consultation was, that there was no difficulty in getting him to speak out. Some men are so afraid of being wrong, that they never give you the whole of their opinion in a case involving any difficulty. It is so obscure, and followed up by so guarded a prognosis, that it sometimes amounts to no opinion at all.
Even with surgeons who were very unobjectionable, Abernethy in his best manner contrasted very favourably. We recollect being very much struck with this when, very young, we had to meet Mr. Cline and Mr. Abernethy, within a few days of each other, in the same case. Mr. Cline was very kind to the patient, elaborately civil; nor was there anything which could be fairly regarded as objectionable; but his manner was too artificial; the contrast in Abernethy was very agreeable. The case was serious, and (as we thought) hopeless. Abernethy, the moment he saw it, had his sympathies painfully awakened. Having asked a few questions, he, in the very kindest manner, said, "Well, I will tell you what I would do, were I in your situation." He then proceeded to direct how she should regulate her living, how avoid mischievous experiments, and went into a rather lengthy series of directions, in the most unaffected manner, without leaving the room, or having any private consultation whatever. The lady, who was a distinguished person, and a very accomplished woman, was exceedingly pleased with him.
His manner, as we shall by and by admit, was occasionally rough, and sometimes rather prematurely truthful. One day, he was called, in consultation, by a physician, to give an opinion on a case of a pulsating tumour, which was pretty clearly an aneurism. On proceeding to examine the tumour, he found a plaister on it. "What is this?" said Abernethy. "Oh! that is a plaister?" "Pooh!" said Abernethy, taking it off and throwing it aside. "That was all very well," said the physician; "but that 'pooh' took several guineas out of my pocket."