"Non ego1 paucis,
Offendar maculis, quas aut incuria fudit,
Aut humana parum cavit natura."
Horace.
"I will not be offended by a few blemishes2, the result of inattention, or against which human frailty3 has not sufficiently4 guarded."
Mankind have long established, by universal consent, the great importance of "Manner." It has been so ably and so variously discussed by different writers, that it is next to impossible to say any thing new on the subject, or what has not been even better said on the subject already. Still it is equally true that it is a thing very much less cultivated than its influence demands; so that really easy, good manners continue to be a very rare and enviable possession. But if manner be thus influential5 in the ordinary intercourse6 of life, it is still more important in ministering to disease. People, when they are ill, have, for the wisest purposes, their susceptibilities more vivid; and it is happy for them when those in health have their sympathies—as is natural, we think, that they should be—quickened in proportion. No doubt it is a great subtraction7 from whatever benefit the most skilful8 can confer, if it be administered in a dry, cold, unfeeling, or otherwise repulsive9 manner. There is too a very sound physiological10 as well as moral reason for kindness. It is difficult to overrate the value of that calm which is sometimes diffused11 over267 the whole system by the impression that there is an unaffected sympathy in our sufferings. We have of course, in our time, observed abundant varieties of manner in our professional brethren; and we have often listened with interest to conversations in society, in which the manners of various medical men have been the subject of discussion, from which good listeners might, we think, have often taken valuable lessons.
We are convinced that the disguise, worn by some, of an artificial manner, leaves, on many occasions, no one more deceived than the wearer. Many patients have their perceptions remarkably13 quickened by indisposition, and will penetrate15 the thin veil of any form of affectation much more readily than people imagine. In common language, good feeling and kind manner are said to spring from the heart. If a man feels kindly16, he will rarely express himself otherwise, except under some momentary17 impulse of impatience18 or indisposition.
There is no doubt that the secret of a kind and conciliatory manner consists in the regulation of the feelings, and in carrying into the most ordinary affairs of life that principle which we acknowledge as indispensable in serious matters—of doing to others as we would they should do to us.
We are not speaking of a polished manner; that is another affair. A man's manner to a patient may be unpolished, or as homely19 as you please; but if he really feels a sympathy for his patient, it will, with the exception to be stated, never be coarse or unkind.
Some men are absurdly pompous20; others, hard and cold; some put on a drawling, maudlin21 tone, which the most superficial observer detects as being affected12. An honest sympathy is more acceptable than even a polished manner; though doubtless that is a very desirable grace to a learned profession.
In general, our own experience—and we know something of indisposition in our own person—has induced us to judge favourably22 of the manner of medical men.
There are, no doubt, exceptions, and sometimes in men in whom you would least expect it. We have known men "eye" a patient, as if looking at some minute object; some, jocosely268 familiar. One man has an absurd gravity; another thinks he must be all smiles. We have known, too, the adoption23 of a tone characterized by a sort of religious solemnity. These, when assumed, are generally detected, and of course always vulgar. Some even say really rude and unfeeling things, before any thing has happened to provoke them. We attended a gentleman who had a great deal of dry humour, and who was very amusing on such matters. One morning, he said, "I saw Dr. —— on one occasion, and the first thing he said to me I thought he might as well have omitted. 'I see, sir,' said he, 'that you have taken the shine out of your constitution.'"
Abernethy's manner was at times—always, in serious cases, and, so far as we ever observed, to hospital patients—invariably, as unaffectedly, kind as could be desired. It is too true that, on many occasions of minor24 import, that impulsiveness25 of character which we have seen in the boy, was still uncontrolled in the man, and led him to say things which, however we may palliate, we shall not attempt to excuse.
It is true his roughness was very superficial; it was the easiest thing in the world to develop the real kindness of heart which constantly lay beneath it; and it is very instructive to observe how a very little yielding to an infirmity may occasionally obscure one of the most benevolent28 hearts that ever beat in a human breast, with the repulsive exterior29 of ungentle manners. Still, patients could not be expected to know this; and therefore too many went away dissatisfied, if not disgusted.
The slightest reaction was, in general, sufficient to bring him to his self-possession. A lady, whom he had seen on former occasions, was one day exceedingly hurt by his manner, and burst into tears. He immediately became as kind and patient as possible, and the lady came away just as pleased as she had been at first offended.
Reaction of a different kind would answer equally well. One day, a gentleman consulted him on a painful affection of his shoulder, which had been of a very excruciating character. Before he had time to enter on his case, Abernethy said, "Well, I know nothing about it." The gentleman sharply retorted: "I do269 not know how you should; but if you will have patience till I tell you, perhaps you then may." Abernethy at once said, "Sit down;" and heard him out, with the greatest kindness and patience.
I am indebted to Thomas Chevasse, Esq. of Sutton Coldfield, Warwick, for the following letter to a patient in Surrey, who had complained that he did not receive any sympathy from him.
"Dear Sir,
"I am sorry to have said any thing that has offended you. I may have felt annoyed that I could not suggest any plan of treatment more directly curative of your malady30, and expressed myself pettishly31 when you did not seem to understand my meaning; for I am a fellow-sufferer, and had tried what are considered to be appropriate remedies, unavailingly. I assure you that I did not mean to hurt your feelings, and that I earnestly hope the state of your health will gradually improve, and that your local maladies will decline in proportion.
"I am, dear Sir,???????
"Your obedient servant,??
"John Abernethy.
"Bedford Row, October 25."
A surgeon was requested to visit a patient in one of the suburbs of the metropolis32. When he arrived there, he had to mount two or three dilapidated steps, and to read a number which had been so nearly worn away, that he was enabled to determine whether it was the number he sought only by the more legible condition of its two neighbours. Having applied33 a very loose, dilapidated knocker, an old woman came to the door.
"Does Captain —— live here?"
"Yes, sir."
"Is he at home?"
"Yes, sir. Please, sir, may I be so bold—are you the doctor, sir?"
"Yes."
"Oh! then, sir, please to walk up."
The surgeon went up a small, narrow staircase, into a moderate-size,270 dirty, ill-furnished room, the walls of which were coloured something between yellow and red, with a black border. An old man, in a very shabby and variegated34 deshabille, rose from his chair, and, with a grace worthy35 of a court, welcomed the stranger. His manner was extremely gentlemanly, his language well chosen, the statement of his complaint particularly simple and clear. The surgeon, who, like most of us, sees strange things, was puzzled to make out his new patient; but concluded he was one of the many who, having been born to better things, had been reduced by some misfortune to narrow circumstances. Everything seemed to suggest that construction, and to warrant no other. Accordingly, having prescribed, the surgeon was about to take his leave, when the old gentleman said:
"Sir, I thank you very much for your attention;" at the same time offering his hand with a fee.
This the surgeon declined, simply saying:
"No, I thank you, sir. I hope you will soon be better. Good morning."
"Stay, sir," said the old gentleman; "I shall insist on this, if you please;" in a tone which at once made the surgeon feel that it would be painful and improper36 to refuse. He accordingly took it. The old gentleman then said, "I am very much obliged to you, sir; for had you not taken your fee, I could not again have the advantage of your advice. I sent for you because I had understood that you were a pupil of Mr. Abernethy's, for whom I could not send again, because he would not take his fee; and I was so hurt, that I am afraid I was almost rude to him. I suppose, judging from the appearance of things here that I could not afford it, he refused his fee; on which I begged him not to be deceived by appearances, but to take it. However, he kept retreating and declining it, until, forgetting myself a little, and feeling somewhat vexed38, I said, 'By G—, sir, I insist on your taking it!' when he replied, 'By G—, sir, I will not!' and, hastily leaving the room, closed the door after him."
This gentleman has been dead some years. He lived to a very advanced age—nearly, if not quite, ninety—and had many271 instructive points of character. He was really in very good circumstances; but he lived in a very humble39 manner, to enable him to assist very efficiently40 some poor relations. To do this, he saved all that he could; and although he insisted on the surgeon taking a fee when he visited him, he said that he should not hesitate to accept his kindness when he called on the surgeon. The intercourse continued many years; but with rather a curious result.
After a time, growing infirmities converted what had been a visit—perhaps once or twice a year—into occasional attendances, when the rule he had prescribed to himself, of paying visits at home, became characterized by very numerous exceptions; and, at last, by so many, that the rule and the exception changed places. The surgeon, however, went on, thinking that the patient could not do other without disturbing existing arrangements. When, however, the old gentleman died, about four hundred guineas were found in his boxes, wrapped up, and in various sums, strongly suggestive of their having been (under the influence of a propensity41 too common in advancing life) savings42, from the somewhat unnecessary forbearance of his medical attendant. We know one other very similar occurrence.
Sometimes Mr. Abernethy would meet with a patient who would afford a useful lesson. A lady, the wife of a very distinguished43 musician, consulted him, and, finding him uncourteous, said, "I had heard of your rudeness before I came, sir; but I did not expect this." When Abernethy gave her the prescription44, she said, "What am I to do with this?"
"Anything you like. Put it in the fire, if you please."
The lady took him at his word—laid his fee on the table, and threw the prescription into the fire, and hastily left the room. Abernethy followed her into the hall, pressing her to take back her fee, or to let him give her another prescription; but the lady was inexorable, and left the house.
The foregoing is well-authenticated. Mr. Stowe knows the lady well, who is still living. But many of these stories, to our own knowledge, were greatly exaggerated. Abernethy would sometimes offend, not so much by the manner as by the matter; by saying what were very salutary, but very unpleasant truths,272 and of which the patient perhaps felt only the sting. We know a gentleman, an old fox-hunter, who abused Abernethy roundly; but all he could say against him was: "Why, sir, almost the moment I entered the room, he said: 'I perceive you drink a good deal,'" which was very true. "Now," added the patient, very na?vely, "suppose I did, what the devil was that to him!"
Another gentleman, of considerable literary reputation, but who, as regarded drinking, was not intemperate46, had a most unfortunate appearance on his nose, exactly like that which frequently accompanies dram-drinking. This gentleman used to be exceedingly irate47 against Abernethy, although all I could gather from him amounted to nothing more than this, that when he said his stomach was out of order, Abernethy observed, "Ay, I see that by your nose," or some equivalent expression.
However rough Abernethy could occasionally be, there was, on grave occasions, no feature of his character more striking than his humanity. Dr. Barnett74 had a case where Abernethy was about to perform a severe operation. The Doctor, at that time a young man, was anxious to have every thing duly prepared, and had been very careful. When Abernethy arrived, he went into the room into which the patient was to be brought, and, looking on the instruments, &c. on the table, said: "Ay, yes, that is all right;" then, pausing for a moment, he said: "No, there is one thing you have forgotten;" and then, throwing a napkin over the instruments, added: "It is bad enough for the poor patient to have to undergo an operation, without being obliged to see those terrible instruments."
Few people get off so badly in the world as poor gentlemen. There are multifarious provisions in this kingdom for all sorts of claimants; but a poor gentleman slips down between those which273 are not applicable to his case, and those which are too repulsive to be practicable. His sensibilities remain—nay, perhaps are sharpened—and thus, whilst they tend to exasperate48 his wants, they increase the difficulty of supplying them. There is here afforded a grateful opportunity for the indulgence of what we believe, amidst some exceptions, to be the ruling spirit of medical men: a sensitive philanthropy, which no men in the world are more liberal in disbursing49. Abernethy had his full share of this excellence50. There are multitudes of instances exemplifying it. We are indebted for the following to Mr. Brown, of the respected firm of Longman and Co. Abernethy was just stepping into his carriage to go and see the Duke of ——, to whom he had been sent for in a hurry, when a gentleman stopped him to say that he should be very glad if he could, at his leisure, pay Mr. —— another visit at Somers Town. Abernethy had seen this poor gentleman before, and advised a course which it appeared that the patient had not resolution to follow. "Why," said Abernethy, "I can't go now, I am going in haste to see the Duke of ——." Then pausing a moment before he stepped into the carriage, he looked up to the coachman and said, quietly, "Somers Town." This is very characteristic. The fidgetty irritability51 of his first impression at interference, and the beneficence of his second thought.
Dr. Thomas Rees knew a gentleman who was a man of ability, who had been a long time ill, and who got a scanty52 living by his writings. Dr. Rees called on Abernethy, one morning, and told him that the gentleman wished to have his opinion; but that he had heard such accounts of him, he was half afraid to see him. "And if he were not," said Dr. Rees, "he is not able to pay you. He is a great sufferer, and he gets his living by working his brains." "Ah!" said Abernethy; "where does he live, do you say?" "At ——," mentioning a place full two miles distant. Abernethy immediately rang the bell, ordered his carriage, visited the gentleman, and was most kind to him.
One day, a pupil wished to consult him, and found him, about ten minutes before lecture, in the museum, looking over his preparations for lecture—rather a dangerous time, we should have274 said, for consultation53. "I am afraid, sir," said the pupil, "that I have a polypus in my nose, and I want you to look at it." No answer; but when he had sorted his preparations, he said: "Eh! what?" The pupil repeated his request. "Then stand upon your head; don't you see that all the light here comes from a skylight? How am I to look up your nose? Where do you live?" "Bartholomew Close." "What time do you get up?" "At eight." "That can't be then." "Why, sir?" "You cannot be at Bedford Row at nine." "Yes, sir, I will." "To-morrow morning, then." The pupil was punctual. Mr. Abernethy made a most careful examination of his nose, entered into the causes and nature of polypi, assured him that there was nothing of the sort, and exacted from him a promise that he would never look into his nose again. The gentleman, in his letter to me, adds: "This I have never done, and I am happy to say that there has never been any thing the matter."
The following we have from a source of unquestionable authority:
Abernethy was attending a poor man, whose case required assistance at a given time of the day. One morning, when he was to see this patient, the Duke of York called to say that the Prince of Wales wished him to visit him immediately. "That I cannot do," said Mr. Abernethy, "as I have an appointment at twelve o'clock"—the time he promised to visit the poor man. "But," said the Duke, "you will not refuse the Prince; if so, I must proceed to ——." "Ah!" said Abernethy, "he will suit the Prince better than I should." He was, however, again sent for, a few hours later, when he of course visited the Prince.
Very many instances of his liberality were constantly occurring. The following is a specimen54:
The widow of an officer of limited income brought her child some distance from the country to consult Abernethy. After a few weeks' attendance, the lady having asked Abernethy when she might return home, was told that she must remain some weeks longer, or he could not answer for the well-doing of the275 case. In the meantime, having learned how the widow was situated55, he continued to take the fees, folding them up in a paper. When he finally took his leave, he returned home, enclosed the fees which he had received, with the addition of a cheque for ￡50, with a kind note, saying, that as he understood her income was limited, he had returned the fees, with an addition, which would enable her to give the child, who could not walk, a daily ride in the fresh air, which was important to her recovery.
He was, indeed, as it appeared to us, most liberal in the mode of conducting his practice. When asked by a patient when he desired to see them again, it was at the longest period compatible with a reasonable observation of the case; and we doubt whether he ever took a fee where he had even a doubt as to the circumstances of the patient justifying56 his so doing. It would be easy to multiply examples of this; but it would be a constructive57 injustice58 to others to appear to bring things out in high relief, or as special excellences59, which (notwithstanding some exceptions) from our hearts we believe to be a prevailing60 characteristic of the profession.
Abernethy had been, nearly all his life, without being improvident61, habitually62 careless of money; and, although he provided his family with a comfortable competency, which very properly left their position unaltered by his death, yet we doubt if ever any man, with the opportunity of making so much, availed himself of that opportunity so little.
Many instances occurred of his carelessness in these matters.
He used to put his not very slowly accumulating fees anywhere; sometimes by the side of his portfolio64; sometimes on a shelf in his bookcase, between something else which might be there. When he retired65 from Bedford Row, they found a considerable heap of fees which he had placed in the bookcase and forgotten—an anecdote66 which shows that he must have been making some way in practice as early as his marriage, exemplifies this sort of carelessness, and suggests its impropriety. He was in the habit, even then, of leaving his fees on his table in his276 private room. He thought, on more than one occasion, that some had been removed: he, however, said nothing; but, having taken means to assure himself of the fact, he marked some fees and allowed matters to go on as usual. Again missing fees, he waited till the whole party, which consisted of pupils residing in the house, were settled at breakfast. "Gentlemen," he said, "I must beg you to give me your purses." This was of course immediately done. In one of the purses he found the marked fees. This individual has been dead many years. He turned out, as may be supposed, badly.
It had become the fashion in Abernethy's latter days to speak lightly of him as an operator; and we have very little desire to rest any portion of his reputation on this branch of our duty. Nevertheless, when we first knew Abernethy, if we had had to be the subject of an operation, we knew no man to whom we should have submitted with the same confidence. He was considerate and humane68; he did as he would be done by; and we have seen him perform those operations which are usually regarded as the most difficult, as well as we have seen them ever performed by any body; and without any of that display or effect too often observed, which is equally misplaced and disgusting.
His benevolent disposition14 led him to feel a great deal in regard to operations. Like Cheselden and Hunter, he regarded them, as in a scientific sense they truly are, the reproach of the profession; since, with the exception of such as become necessary from accidents, they are almost all of them consequent on the imperfection of Medicine or Surgery as a science.
Highly impulsive26, Abernethy could not at all times prevent the expression of his feelings, when perhaps his humanity was most earnestly engaged in his suppression of them. It was usually an additional trial to him when a patient bore pain with fortitude69.
One day, he was performing rather a severe operation on a woman. He had, before commencing, said a few words of encouragement, as was usual with him, and the patient was bearing the operation with great fortitude. After suffering some277 seconds, she very earnestly, but firmly, said, "I hope, sir, it will not be long." "No, indeed," earnestly replied Abernethy; "that would indeed be horrible."
In fact, he held operations as occupying altogether so low a place in our duties, and as having so little to do with the science of our profession, that there was very little in most of them to set against that repulsion which both his science and his humanity suggested.
As he advanced in life, his dislike to operations increased. He was apt to be fidgetty and impatient. If things went smoothly70, it was all very well; but if any untoward71 occurrence took place, he suffered a great deal, and it became unpleasant to assist him; but he was never unkind to the patient. It is, however, not always easy to estimate correctly the amount of operative dexterity72. Hardly any man will perform a dozen operations in the same manner. We have seen a very bungling73 operator occasionally perform an operation extremely well; whilst the very worst operation we ever saw was performed by a man whose fame rested almost entirely74 on his dexterity; and what made it the more startling, was that it was nothing more than taking up the femoral artery75. But whether it were that he was not well, or had been careless in the site of his first incision76, or in opening the sheath of the vessels77 before he passed his ligature, or all of these causes in conjunction, we could not tell, because we were not quite near enough; but we never witnessed a more clumsy affair.
The conditions calculated to ensure good operating, are few and simple; there are moral as well as medical conditions; and no familiarity ever enables a surgeon, on any occasion, safely to dispense78 with any of them. When they are all observed, operating usually becomes steady and uniform; when any of them are dispensed79 with or wanting, there is always risk of error and confusion.
We are afraid that we should be hardly excused in a work of this kind, were we to lay down the canons to which we allude80. We cannot, therefore, enter any further into the subject.
Previously81 to offering a few remarks on the causes of Abernethy's278 occasional irritability, we must not omit to mention a hoax82 that was played on him. He had been in particularly good, boy-like spirits, and had proposed going to the theatre; where he had enjoyed himself very much. On reaching home, there was a message desiring his attendance at Harrow. This was a very unwelcome finale. The hoax had been clumsily managed, but it did not strike anybody at the moment; so it was decided83 that Mr. Abernethy must go; and he took Mr. Skey with him. When they got to Harrow, they drove to the house of the surgeon, and, knocking him up, the surgeon came to the window in his night-cap, when the following dialogue began. The name of the patient we shall suppose to be Wilson.
"Does Mr. Wilson live here?"
"Who are you?"
"I say, then, is Mr. Wilson living here?"
"I say what do you want? Who the d——l are you?"
"I say that I want to find a Mr. Wilson; and my name is Abernethy."
"Immediately," says Mr. Skey, "off flew the night-cap."
"I beg your pardon, Mr. Abernethy; what can I do for you," &c.
"Is there a Mr. Wilson living here; and has he broken his leg?"
"Oh, yes, sir, he is living here; but he is very well, and has not met with anything of the kind."
Abernethy laughed heartily84, and ordered the post-boy to drive him home again.
There would be no difficulty in multiplying anecdotes85 given to Abernethy; but there are some objections to such a course. In the first place, there are many told of him which never happened; others, which may probably have happened, you find it impossible to authenticate45; and, lastly, there is a third class, which, if they happened to Abernethy, certainly happened to others before Abernethy was born. In fact, when a man once gets a reputation of doing or saying odd things, every story in which the chief person is unknown or unremembered is given to the279 man whose reputation in this way is most remarkable86. We need not say how impossible it is, in a Memoir87 of this kind, to introduce, with propriety67, matters thus apocryphal88.
We have no doubt that, with a most benevolent disposition, Abernethy's manner, particularly as he advanced in years, evinced great irritability; and we believe that it was the result of two or three different causes, which, in their combined influence, got a mastery which the utmost resolution was not at all times able to control. It had formed the subject of numerous conversations between Abernethy and some of his most intimate friends, and we believe had arisen, and been unconsciously fostered by the following causes: "In early life, he had been," as he told Dr. Thomas Rees, "particularly disgusted with the manner in which he had seen patients caressed89 and 'humbugged' by smooth and flattering modes of proceeding90, and that he had early resolved to 'avoid that at all events.'" He further observed: "I tried to learn my profession, and thinking I could teach it, I educated myself to do so; but as for private practice, of course I am obliged to do that too." We can easily understand how, in a sensitive mind, an anxiety to avoid an imputation91 of one kind might have led to an opposite extreme; and thus an occasional negligence92 of ordinary courtesy have taken the place of a disgusting assentation.
A temper naturally impulsive, would find in the perplexities which sometimes beset94 the practice of our profession, too many occasions on which the suggestions of ruffled95 temper, and of fear of improper assentation, would unfortunately coincide; and thus tend to intermix and confound the observance of a praiseworthy caution, with a yielding to an insidious96 habit. If to this were now added that increase of irritability which a disturbed and fidgetty state of physique never fails to furnish, and from which Abernethy greatly suffered, the habit would soon become dominant97; and thus an originally good motive98, left unguarded, be supplanted99 by an uncontrolled impulse. We believe this to have been the short explanation of Abernethy's manner; all we know of him seems to admit of this explanation. It was a habit, and required nothing but a check from his humanity or his good sense280 to correct it; but then this was just that which patients were not likely to know, and could have been still less expected to elicit100.
Again, most men so celebrated101 are sure to be more or less spoiled. They become themselves insensibly influenced by that assentation which, when detected, they sincerely despised. The moral seems to be, that the impulses of the most benevolent heart may be obscured or frustrated102 by an irritable103 temper; that habits the most faulty may rise from motives104 which, in their origin, were pure or praiseworthy; that it is the character of Vice37 to tempt27 us by small beginnings; that, knowing her own deformity, she seldom fails to recommend herself as the representative, and too often to assume the garb105, of Virtue106; that the most just and benevolent are not safe, unless habitual63 self-government preside over the dictates107 of the intellect and the heart, and that the impulse to which assent93 is yielded to-day, may exert the influence of a command to-morrow; that, in fact, we must be masters or slaves.
"Rege animum qui nisi paret
Imperat."
The views which we have thus ventured on submitting, are verbatim those which appeared in the former editions of these Memoirs108, and, consequently, were written long before we were favoured with the following letter. It was written to his daughter Anne, before her marriage with the late Dr. Warburton, dated Littlehampton, August 13, and is remarkably corroborative109 of some of the preceding remarks.
"My dear Anne,
"Lack of employment is, as I believe, the cause of your receiving this note in reply to the one I received from you by your mother. Certain I am that I never thought of writing an answer till just now, when it occurred to me that it would be polite to do so, which very phrase had nearly prevented the intention. Why have all the legitimate110 children of John Bull an aversion to politeness? 'Tis because it so commonly covereth a multitude of sins; because, with honest simplicity,281 they have often caught hold of the garb and found that it concealed111 deformity and malice112. I frankly113 acknowledge that I may have carried my detestation too far, because it does not necessarily follow that our best friends should not wear becoming and fashionable apparel. I like to see them en deshabille, however. 'Tis the man, and not the dress, I am concerned about. I tell you, sincerely, that I take your note to be one of many evidences of your having both a good head and heart. Other young ladies would have spoken to mamma. Enough of this unprofitable chat.
"Yours ever,????
"John Abernethy.
"Little Hampton, 13th August."
When the editors of the medical periodicals first began to publish the lectures given at the different hospitals, there was considerable discussion as to the propriety of so doing. The press, of course, defended its own views in a spirit which, though not always unwelcome to readers, is frequently "wormwood" to the parties to whom the press may be opposed.
We are not lawyers, and therefore have no claim to an opinion, we suppose, on the "right;" but, as regards the general effect of this custom as now practised, we are afraid (however advantageous114 it may be to the trade to obtain gratuitously115 these bulky contributions to their columns) that doubts may not be unreasonably116 entertained whether it is of advantage to science, to the character of our periodical literature, or the profession.
The publicity117 which it gives to a man's name, induces men to contribute matter which it would often have been, perhaps, more advantageous to them to have suppressed; and the proprietors118, so long as a periodical "pays," are not likely to quarrel with that which they get for nothing but the expense of publication.
Mr. Abernethy was very much opposed to the publication of his lectures; but, though not insensible by any means to the occasionally caustic119 remarks of the press, he does not seem to have been much annoyed by them.
282
The following is an extract from a letter, in which he expresses himself as opposed to the conduct of those who publish lectures without the permission of the authors. We suppress that part, because it involves his opinion of the conduct of individuals. As regards his personal feelings, he says:
"Though I have been so long in replying to your letter, I have felt very grateful for the kindness which induced you to take up the cudgels in my behalf. At the same time, I must say that, had I been at your elbow, I should have hinted to you that the object was not worth the trouble you have been so good as to bestow120 upon it. No one can expect to escape slander121 and misrepresentation; and these are so commonly bestowed122 upon all, that they have little or no influence on the minds of persons of character and judgment123.
"With many thanks and best wishes,
"I remain, my dear sir,??
"Yours very sincerely,?
"John Abernethy."
SECTION.
When Mr. Abernethy was appointed surgeon to St. Bartholomew's Hospital, in 1815, he had already been twenty-eight years assistant surgeon, and was therefore fifty years of age before he had an opportunity of taking an active share in the practical administration of the Hospital. This is one of the many effects of a System of which we shall presently give a sketch124. He was thus invested with the additional duties of Surgeon of the Hospital, and Professor to the College of Surgeons, at a time of life when most people, who have commenced young and laboured hard with their intellects, as distinguished from their hands, begin to feel their work. This was the case with Abernethy. We do not think that his original physical organization was to be complained of; he had been active and energetic, he was of moderate stature125 and well-proportioned; a magnificently poised126 brain, judging phrenologically; and, in short (under favourable127 circumstances),283 he appeared to have had the elements of long life; but we think that his organization—and especially the presiding power, the nervous system—was ill-adapted either for the air, the anxieties, or the habits of a crowded city; or the somewhat pestilential atmosphere of a dissecting-room.
We saw him, therefore, ageing at fifty very sensibly, and rather more than is in general observable at that period. He complained, in 1817, of the fatigue128 of the College lectures, coming, as they did, on the completion of a season of the "mill-round" of hospital tuition and practice. So that, when we mentioned the period of his lectures at the College as on so many accounts the zenith of his career, there was the serious drawback arising from a certain diminution129 of strength which had never been, at best, equal to the physical fatigue of his multiform avocations130. All this arose partly out of a System, which, although, like all evils, not allowed to proceed without being charged with elements of remotely prospective131 correction, has been the parent of much mischief132. This is what we have called the "Hospital System," some of the more important features of which we will now present to our readers.
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1
ego
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| n.自我，自己，自尊 | |
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blemishes
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| n.（身体的）瘢点( blemish的名词复数 )；伤疤；瑕疵；污点 | |
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frailty
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| n.脆弱；意志薄弱 | |
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sufficiently
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| adv.足够地，充分地 | |
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influential
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| adj.有影响的，有权势的 | |
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intercourse
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| n.性交；交流，交往，交际 | |
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subtraction
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| n.减法，减去 | |
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skilful
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| (=skillful)adj.灵巧的，熟练的 | |
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repulsive
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| adj.排斥的，使人反感的 | |
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physiological
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| adj.生理学的，生理学上的 | |
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diffused
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| 散布的，普及的，扩散的 | |
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affected
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| adj.不自然的，假装的 | |
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remarkably
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| ad.不同寻常地，相当地 | |
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disposition
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| n.性情，性格；意向，倾向；排列，部署 | |
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penetrate
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| v.透(渗)入；刺入，刺穿；洞察，了解 | |
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kindly
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| adj.和蔼的，温和的，爽快的；adv.温和地，亲切地 | |
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momentary
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| adj.片刻的，瞬息的；短暂的 | |
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18
impatience
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| n.不耐烦，急躁 | |
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19
homely
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| adj.家常的，简朴的；不漂亮的 | |
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pompous
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| adj.傲慢的，自大的；夸大的；豪华的 | |
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maudlin
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| adj.感情脆弱的，爱哭的 | |
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favourably
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| adv. 善意地，赞成地 =favorably | |
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adoption
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| n.采用，采纳，通过；收养 | |
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minor
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| adj.较小(少)的，较次要的；n.辅修学科；vi.辅修 | |
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impulsiveness
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| n.冲动 | |
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impulsive
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| adj.冲动的，刺激的；有推动力的 | |
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tempt
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| vt.引诱，勾引，吸引，引起…的兴趣 | |
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benevolent
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| adj.仁慈的，乐善好施的 | |
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exterior
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| adj.外部的，外在的；表面的 | |
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malady
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| n.病，疾病(通常做比喻) | |
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31
pettishly
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32
metropolis
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| n.首府；大城市 | |
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applied
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| adj.应用的；v.应用，适用 | |
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variegated
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| adj.斑驳的，杂色的 | |
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worthy
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| adj.(of)值得的，配得上的；有价值的 | |
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improper
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| adj.不适当的，不合适的，不正确的，不合礼仪的 | |
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vice
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| n.坏事；恶习；[pl.]台钳，老虎钳；adj.副的 | |
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38
vexed
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| adj.争论不休的；（指问题等）棘手的；争论不休的问题；烦恼的v.使烦恼( vex的过去式和过去分词 )；使苦恼；使生气；详细讨论 | |
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39
humble
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| adj.谦卑的，恭顺的；地位低下的；v.降低，贬低 | |
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efficiently
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| adv.高效率地，有能力地 | |
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propensity
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| n.倾向；习性 | |
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42
savings
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| n.存款，储蓄 | |
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43
distinguished
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| adj.卓越的，杰出的，著名的 | |
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prescription
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| n.处方，开药；指示，规定 | |
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45
authenticate
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| vt.证明…为真，鉴定 | |
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46
intemperate
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| adj.无节制的，放纵的 | |
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irate
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| adj.发怒的，生气 | |
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exasperate
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| v.激怒，使（疾病）加剧，使恶化 | |
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49
disbursing
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| v.支出，付出( disburse的现在分词 ) | |
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50
excellence
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| n.优秀，杰出，(pl.)优点，美德 | |
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51
irritability
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| n.易怒 | |
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52
scanty
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| adj.缺乏的，仅有的，节省的，狭小的，不够的 | |
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53
consultation
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| n.咨询；商量；商议；会议 | |
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54
specimen
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| n.样本，标本 | |
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situated
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| adj.坐落在...的，处于某种境地的 | |
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justifying
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| 证明…有理( justify的现在分词 )； 为…辩护； 对…作出解释； 为…辩解（或辩护） | |
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constructive
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| adj.建设的，建设性的 | |
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58
injustice
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| n.非正义，不公正，不公平，侵犯（别人的）权利 | |
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excellences
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| n.卓越( excellence的名词复数 )；（只用于所修饰的名词后）杰出的；卓越的；出类拔萃的 | |
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prevailing
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| adj.盛行的；占优势的；主要的 | |
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improvident
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| adj.不顾将来的，不节俭的，无远见的 | |
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habitually
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| ad.习惯地，通常地 | |
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habitual
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| adj.习惯性的；通常的，惯常的 | |
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portfolio
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| n.公事包；文件夹；大臣及部长职位 | |
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retired
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| adj.隐退的，退休的，退役的 | |
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anecdote
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| n.轶事，趣闻，短故事 | |
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propriety
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| n.正当行为；正当；适当 | |
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68
humane
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| adj.人道的，富有同情心的 | |
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69
fortitude
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| n.坚忍不拔；刚毅 | |
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70
smoothly
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| adv.平滑地，顺利地，流利地，流畅地 | |
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71
untoward
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| adj.不利的，不幸的，困难重重的 | |
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72
dexterity
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| n.(手的)灵巧，灵活 | |
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73
bungling
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| adj.笨拙的，粗劣的v.搞糟，完不成( bungle的现在分词 )；笨手笨脚地做；失败；完不成 | |
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entirely
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| ad.全部地，完整地；完全地，彻底地 | |
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artery
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| n.干线，要道；动脉 | |
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incision
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| n．切口，切开 | |
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vessels
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| n.血管( vessel的名词复数 )；船；容器；（具有特殊品质或接受特殊品质的）人 | |
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dispense
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| vt.分配，分发；配(药)，发(药)；实施 | |
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dispensed
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| v.分配( dispense的过去式和过去分词 )；施与；配（药） | |
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allude
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| v.提及，暗指 | |
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previously
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| adv.以前，先前（地） | |
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82
hoax
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| v.欺骗，哄骗，愚弄；n.愚弄人，恶作剧 | |
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decided
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| adj.决定了的，坚决的；明显的，明确的 | |
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heartily
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| adv.衷心地，诚恳地，十分，很 | |
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anecdotes
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| n.掌故，趣闻，轶事( anecdote的名词复数 ) | |
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remarkable
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| adj.显著的，异常的，非凡的，值得注意的 | |
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memoir
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| n.[pl.]回忆录，自传；记事录 | |
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apocryphal
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| adj.假冒的，虚假的 | |
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caressed
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| 爱抚或抚摸…( caress的过去式和过去分词 ) | |
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proceeding
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| n.行动，进行，(pl.)会议录，学报 | |
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imputation
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| n.归罪，责难 | |
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negligence
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| n.疏忽，玩忽，粗心大意 | |
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assent
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| v.批准，认可；n.批准，认可 | |
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beset
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| v.镶嵌；困扰，包围 | |
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ruffled
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| adj. 有褶饰边的, 起皱的 动词ruffle的过去式和过去分词 | |
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insidious
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| adj.阴险的，隐匿的，暗中为害的，（疾病）不知不觉之间加剧 | |
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dominant
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| adj.支配的，统治的；占优势的；显性的；n.主因，要素，主要的人(或物)；显性基因 | |
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motive
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| n.动机，目的；adv.发动的，运动的 | |
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supplanted
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| 把…排挤掉，取代( supplant的过去式和过去分词 ) | |
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elicit
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| v.引出,抽出,引起 | |
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celebrated
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| adj.有名的，声誉卓著的 | |
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frustrated
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| adj.挫败的，失意的，泄气的v.使不成功( frustrate的过去式和过去分词 )；挫败；使受挫折；令人沮丧 | |
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irritable
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| adj.急躁的；过敏的；易怒的 | |
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motives
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| n.动机，目的( motive的名词复数 ) | |
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garb
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| n.服装，装束 | |
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virtue
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| n.德行，美德；贞操；优点；功效，效力 | |
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dictates
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| n.命令，规定，要求( dictate的名词复数 )v.大声讲或读( dictate的第三人称单数 )；口授；支配；摆布 | |
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108
memoirs
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| n.回忆录；回忆录传( mem,自oir的名词复数) | |
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corroborative
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| adj.确证（性）的，确凿的 | |
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legitimate
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| adj.合法的，合理的，合乎逻辑的；v.使合法 | |
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concealed
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| a.隐藏的，隐蔽的 | |
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malice
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| n.恶意，怨恨，蓄意；[律]预谋 | |
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frankly
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| adv.坦白地，直率地；坦率地说 | |
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advantageous
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| adj.有利的；有帮助的 | |
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gratuitously
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| 平白 | |
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unreasonably
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| adv. 不合理地 | |
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publicity
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| n.众所周知，闻名；宣传，广告 | |
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proprietors
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| n.所有人，业主( proprietor的名词复数 ) | |
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caustic
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| adj.刻薄的，腐蚀性的 | |
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bestow
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| v.把…赠与，把…授予；花费 | |
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slander
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| n./v.诽谤，污蔑 | |
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bestowed
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| 赠给，授予( bestow的过去式和过去分词 ) | |
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judgment
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| n.审判；判断力，识别力，看法，意见 | |
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sketch
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| n.草图；梗概；素描；v.素描；概述 | |
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stature
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| n.（高度）水平，（高度）境界，身高，身材 | |
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poised
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| a.摆好姿势不动的 | |
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favourable
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| adj.赞成的，称赞的，有利的，良好的，顺利的 | |
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128
fatigue
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| n.疲劳，劳累 | |
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129
diminution
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| n.减少；变小 | |
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130
avocations
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| n.业余爱好，嗜好( avocation的名词复数 )；职业 | |
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131
prospective
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| adj.预期的，未来的，前瞻性的 | |
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132
mischief
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| n.损害，伤害，危害；恶作剧，捣蛋，胡闹 | |
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