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.
[31] Clench's History. Letter from Ch. Uslano, to Gonsalvo de Solano, July, 1590.
[32] "Health and Disease." See Treatise on Tumours.
[33] "Medicine and Surgery One Inductive Science." London, 1838. Highley.
[34] "Medicine and Surgery One Inductive Science;" and "On Tumours," Art. "Treatment of Organs."