How the French surgeons may have been influenced by Abernethy on this subject, I do not know. When I was first in Paris, in 1824, they were divided; but I recollect Baron Larrey showing me a case which he regarded as a clear example of this fracture in course of firm consolidation, and he was well aware of the opinion of Abernethy.
The bearing which Abernethy's acuteness of observation of the influence of the state of the digestive organs on so-called specific poisons in producing or maintaining diseases resembling them, opposed as it was to the most powerful conventionalism, is a proof of his clear judgment; and, if we mistake not, will one day prove to have been the first ripple of a most important law in the animal economy, which will shed a light as new on specific affections as his other principles have on diseases in general.
His treatment of that severe malady, "lumbar abscess," is, in our view, a most acceptable addition to humane and successful surgery; and as regards one of its distinctive characters, he has, as we have shown, received the encomiums of the most distinguished of his contemporaries, including Sir Astley Cooper.
The manner in which he applied that law which prevails in voluntary muscles to the replacement of dislocations—namely, that muscles under the influence of the will cannot ordinarily act long and unremittingly—was an amendment as humane as scientific; and, whilst it has removed from surgery a farrier-like roughness in the treatment of dislocations, as repulsive as unnecessary, it has adjusted the application of more sustained force, when it becomes necessary, on principles at once humane, safe, and effectual. In short, whatever part of surgery we consider, we should have something to say of Abernethy—either something new in itself, or improved in application. We find him equally patient and discriminative, wherever there is danger; thus there is the same force and originality on the occasional consequences on the simple operation of bleeding in the arm, and the more serious proceeding of perforating the cranium. He is every where acute, penetrating, discriminative, humane, and practical; so that it is difficult which most to admire, his enlarged views in relation to important general principles, or the pervading science and humanity with which he invests their minutest details.
Hunter's method of investigation was highly inductive; and, whenever he adhered to it, the structure he has left is stable, and fit for further superadditions. Whenever he proceeded on any preconceived notions, or on an induction manifestly imperfect, his conclusions have, as we think, been proved unsound. His definition of disease, as distinct from accidental injury, is one instance which we formerly noticed in our own works; and some of his conclusions in regard to poisons—as mercury, for example—will not hold; but all that Abernethy made use of, either in developing his own views or maturing their practical applications, were sound and most careful deductions from obvious and incontrovertible facts. Abernethy took equal care to deduce nothing from them, or from anything of his own observations, but the most strictly logical inferences—conclusions which were, in truth, little more than the expression of the facts, and therefore irrefragable. He showed that, however dissimilar in kind, nervous disturbance was the essential element of disease; and that the removal of that disturbance was the essential element of cure. That no mode should be neglected, therefore, which was capable of exerting an influence on the nervous system; but that, whether he looked at the subject as mere matter of fact, or as assisted by the phenomena of health or disease generally, or merely to that which was most within our power, no more potential disturbers of the nervous system were to be found, than disordered conditions of the digestive organs; and that the tranquillizing of these must always be a leading object in our endeavours to achieve the still greater one of tranquillizing nervous disorder.
The absurd idea that he looked chiefly to the stomach—that he thought of nothing but blue pills or alterative doses of mercury—need scarcely detain us. His works show, and his lectures still more, that there was no organ in the body which had not been the object of his special attention; in almost all cases, in advance of his time; and not exceeded in practical value by any thing now done. We know of nothing more valuable or clear now than his paper on the skin; nothing so advanced or important as his observations on the lungs and skin, and the relations of these important organs; and it is unnecessary to repeat what has been already said about the digestive organs. His medical treatment was always very simple, and, if its more salient object was to correct disorders of the liver, it was because he knew that the important relations of that organ not only rendered it very frequently the cause of many disorders, but that there could be nothing materially wrong in the animal economy, by which it must not be more or less affected. He carried the same clearness and definiteness of purpose into his prescriptions, as that which characterized all his investigations; and, indisposed to employ any means except on some principle, used but few remedies; although he by no means wished to deter others from having recourse to a more extended pharmacopæia. We regret, indeed, the impossibility of doing full justice to Abernethy in any thing less than a running commentary on the publication of his works; but we have said enough, we trust, to show how largely the profession and mankind are indebted to him.
Now, in these days of testimonials, what memorials have we of Abernethy? It is true there is no monument at Westminster Abbey, and only a bust at St. Bartholomew's. His portrait, to be sure, given by his pupils, hangs at St. Bartholomew's, exalted where it can hardly be distinctly seen, to be replaced by those of Mr. Vincent[83], and Mr. Lawrence in his Professor's gown! But he has still a
"Monumentum ære perennius,"
in the claim he has established to the rarely so truly earned honour of "nihil quod non tetigit, et nihil quod tetigit, quod non ornavit;" in the grateful hearts of many a pupil who had no other obligation to him than his beautiful lessons; and in an improved medical Surgery, which, though it may have in London rather retrograded than otherwise since his time, is felt more or less in its moral as well as its medical bearings, and in a diminution of suffering and an improved practice throughout the civilized world.