"quanto quisque sibi plura negaverit
ab dis plura feret."
we believe that there is no greater fallacy than that which supposes that private advantage can be promoted at the expense of the public good. we are very well disposed to believe that selfish people are the very worst caterers for the real interests of the idol they worship. the more we consider the hospital system, the more reason shall we find to distrust it; and we by no means exclude that very point wherein it is supposed to be most successful—namely, in securing the pecuniary advantage of those whose interests it is supposed to serve.
of the apprentices, we shall say little more than to express our belief that many of them have lived to obtain the conviction that they would have done much better had they not been fed by hopes that were never realized. all apprentices cannot, of course, be surgeons. again, if, in the course of a century, a solitary instance or two should occur of the success of an unapprenticed candidate, they not unnaturally feel it as an injustice in thus being deprived of that, the especial eligibility to which was a plea for the exaction of a large apprentice fee. but to the surgeons themselves, it seems to us that the system is far from realizing the benefits that its manifold evils are supposed to secure. the adage that "curses, like chickens, come home to roost," is far from inapplicable. after all, many of the hospital surgeons are little known; and the public inference with regard to men invested with such splendid opportunities of distinguishing themselves, is not very flattering. mr. abernethy, so far297 from benefiting from the "system," appears to us to have suffered from it in every way.
his talents, both natural and acquired, would have given him every thing to hope and nothing to fear from the severest competition; whilst the positive effects of the system were such as to deprive him of what was justly his due, and to embitter a retirement which in the barest justice should have been graced by every thing that could add to his peace, his honour, or his happiness, from the institution whose character he had exalted and maintained, and whose school he had founded.
but let us look at the facts. the system which pronounces that there shall be three surgeons to attend to some 500 or 600 patients (for the purposes of science—the next thing to an impossibility), kept abernethy twenty-eight years an assistant surgeon. during this time he was filling the hospital with students, to the amount of sums varying from ￡2,000 to ￡3,000 a year, of which, in the said twenty-eight years, he never received one farthing.
he saw, from time to time, many men, of whose capacities we know he had the highest opinion, shut out from the hospital by the mere circumstance of their not having been apprentices; and two of these were the late professor macartney, of dublin, and the present distinguished professor of comparative anatomy, professor owen. and here we must pause to record one of our numerous obligations to the perceptivity and justice of abernethy. we have formerly observed that, at the very commencement of life, he had been accustomed to inculcate the importance of studying comparative anatomy and physiology, in order to obtain clear views of the functions of man; but all arrangements made with this view, from the time of mr. hunter onwards, though varying in degree, were still inefficient. it was next to an impossibility to combine an availing pursuit of a science which involves an inquiry into the structure and functions of the whole animal kingdom, with the daily exigencies of an anxious profession.
when mr. owen had completed his education, his thoughts were directed to a surgeoncy in the navy, as combining a professional appointment with the possibility of pursuing, with298 increased opportunities of observation, his favorite study. fortunately for science, he went to abernethy, who requested him to pause. he said, "you know the hospital will not have any but apprentices. macartney left on that account. stay," said he, "and allow me to think the matter over." this resulted in his proposing to the council of the college of surgeons that there should be a permanent professor of comparative anatomy, and that the appointment should be given to mr. owen.
this is among the many proofs of abernethy's perception of character. mr. owen had dissected for lecture; and abernethy saw, or thought he saw, a peculiar aptitude for more general and enlarged anatomical investigation. the whole world now knows how nobly the professor has justified the hopes of his talented master. it would be out of place for us to attempt a compliment to a man so distinguished in a science, wherein the varied pursuits of a practical profession allow us to be mere amateurs; neither do we wish to forget other gentlemen who distinguish themselves in this branch of science; but we believe that most competent judges allow that the celebrated cuvier has not left any one more fitted to appreciate his excellence, or who has more contributed to extend that science of which the baron was so distinguished a leader, than professor owen.
there is one incident, however, in the professor's labours which, for our own purposes, we must relate; because we shall have to refer to it in our humble exhortation to the public and the profession to believe in the practicability of raising medicine and surgery into a definite science. the incident shows what may be done by that mode of investigation which is the still delayed desideratum in medicine and surgery—namely, the most comprehensive record of facts, and the study of their minutest relations. professor cuvier was the first to impress, in a special manner, that those beautiful relations in the structure of animals, so many of which are even popularly familiar, extended throughout the animal; so that if any one part, however apparently subordinate, were changed, so accurate were the adaptations in nature, that all parts underwent some corresponding modification; so that diversity of structure in parts, more or less affected the whole.
299
the beautiful result of all this is, that if these relations be once thoroughly mastered, then any one part necessarily suggests, in general terms, the nature of the animal to whom it belonged. few instances, however, so remarkable as the one we are about to mention, could have been anticipated.
a seafaring man brought a piece of bone, about three or four inches in length, as he said, from new zealand, and offered it for sale at one or two museums; amongst others, at the college of surgeons. we shall not here detain the reader by telling all that happened. these things are often brought with intent to deceive, and with false allegations. most of those to whom the bone was submitted, dismissed it as worthless, or manifested their incredulity. amongst other guesses, some rather eminent persons jocosely hinted that they had seen bones very like it at the london tavern; regarding it, in fact, as part of an old marrow-bone, to which it bore, on a superficial view, some resemblance. at length it was brought to professor owen, who, having looked at it carefully, thought it right to investigate it more narrowly; and after much consideration, he ventured to pronounce his opinion. this opinion, from almost anybody else, would have been perhaps only laughed at; for, in the first place, he said that the bone (big enough, as we have seen, to suggest that it had belonged to an ox) had belonged to a bird. but before people had had time to recover from their surprise or other sensation created by this announcement, they were greeted by another assertion, yet more startling—namely, that it had been a bird without wings.
now, we happen to know a good deal of this story; and that the incredulity and doubt with which the opinion was received were too great, for a time, even for the authority of professor owen to dispel. but mark the truthfulness of a real science; contemplate the exquisite beauty and accuracy of relation in nature! by and by, a whole skeleton was brought over to this country, when the opinion of the professor was converted into an established fact. nor was this all; there was this appropriate symbol to perpetuate the triumph: that which had appeared as the most startling feature of what had been scarcely better received300 than as a wild conjecture, was so accurate in fact, as to form the most appropriate name to the animal thus discovered76.
it would be unjust to others to attribute professor owen's appointment exclusively to abernethy: that, the state of things did not place within his single power; but his penetration was the first to suggest, and his weight most potential in securing, an appointment which various circumstances, besides the merits of the individual, bring up in high relief, as the best ever made by the london college of surgeons.
to return to the hospital system, as affecting abernethy. he continued to lecture, and the emoluments arising thence he of course enjoyed. until 1815, the whole of the hospital fees had been taken by the surgeons in chief. these fees, in twenty-eight years (allowing a reasonable deduction for those pupils who went to the school independently of the inducement offered by the most attractive lecturer ever known), must have amounted to an enormous sum. having founded the school, he became surgeon at about fifty years of age; and then retired at sixty-two. on retiring, unpleasant discussions arose, which, with others long antecedent, rendered his concluding associations with the hospital scarcely more agreeable than they had been at the college of surgeons.
the whole of abernethy's closing career gave him no reason to rejoice at the hospital system. the circumstances, though they convey a lesson in the history of the lives of men of genius, were, abstractedly, extremely unimportant. they show that abernethy, in his retiring hours, whilst his reputation had become european, and transatlantic77—whilst hundreds were benefiting their fellow creatures, more or less, according to their talents and301 opportunities, in every part of the world—seems to have been surrounded by men who, so far as we can see, were little disposed to grace his retirement either with much sympathy, or even with reasonably generous appreciation of all that he had done, either for science in general, or the hospital in particular.
instead of considering how they could best do honour to the waning powers of one who had not only raised the reputation of st. bartholomew's hospital to a point it had never before attained, who had founded a school there, constituting the largest single hospital class in london, and who was leaving the inheritance of a rich annual harvest to his successors,—the time was occupied in discussing whether he could resign the surgeoncy without resigning the lectureship; whether, on paying a hundred guineas, which there seemed no difficulty in receiving, he could become a governor whilst still an officer; and then, whether his being a lecturer without retaining the surgeoncy did not so constitute him. these, and similar questions scarcely more important, were the source of considerable annoyance.
in former editions, we were obliged to discuss some of these matters more at large than is now necessary; because, amongst the individuals associated in the transactions of the period, there was one to whom mr. abernethy had been of especial service; but in regard to whom he had been much misrepresented. further, this had taken place in our own hearing, in whose recollection all the facts were perfectly fresh, but who were, at that time,302 without the documents which are now in our possession. we accordingly sought to obtain whatever documents there were from the source most likely to test the correctness of our recollection; when a note was written which, as we now learn, quite unintentionally conveyed the idea, or at least was susceptible of the construction, that a disinclination to make any communication on the subject proceeded from a desire to withhold something unfavourable to mr. abernethy. this determined us on discussing the matter, so far as was necessary to rebut such interpretation. and it was fortunate we did so; for it very soon appeared, not only that such an impression had been produced, but that "gossip," with its usual aptitude for invention, had soon supplied the myth thus supposed to have been charitably withheld.
it was not very long after the publication of these memoirs, that we learned, in a conversation with a highly distinguished member of the profession, that he had been led to entertain the impression to which we have alluded. here we had, of course, an opportunity of correcting the error; but it obviously became a subject of very serious consideration, what must be done in dealing with this matter, and other matters arising out of it, in a subsequent edition. to treat the affair seriously, would have involved a reference to documents in our possession which, though highly honorable to mr. abernethy, would have been of no general interest, whilst they would have involved details disagreeable to several persons. we therefore, after much consideration, resolved on endeavouring to see whether it was not possible to quash a tedious and painful discussion, and at the same time to obtain, of course, all that was necessary to the memory of mr. abernethy.
the following letter, and the reply, will, we think, sufficiently develop the very difficult and disagreeable position in which we were placed; our sole object being, so far as it was possible, to avoid repeating or enlarging a discussion which we had learned would have given pain to certain parties. the concluding paragraph has been omitted, as being unnecessary to the point more immediately under discussion.
303
"3, the court yard, albany,??
"july 17th, 1856.
"sir,
"for reasons which may be gathered from this note, i think it proper to inform you that i am preparing another edition of the memoirs of abernethy. impressions have been conveyed to certain persons, that the reasons on which you grounded your disinclination to make any communication in relation to your differences with abernethy, were the desire you professed to withhold something which involved imputations unfavourable to him. further, a sort of body has been given to these vague impressions by inferences which the documentary and other evidence at my disposal enable me to disprove. in one quarter, the circumstances are so strongly suggestive as to the sources whence the erroneous impressions were derived, that it is impossible to leave that portion of the memoirs which treats of your differences with abernethy as it at present stands, without the risk of injustice. it is regarded as necessary that you should either recognize or ignore the inferences which (whether correctly or not i will not presume in this place to determine) have certainly been formed on your supposed authority. the justice of such a course is sufficiently obvious. i need scarcely say, it is immaterial to me what course is taken. if i am obliged to enter into the discussion of the subject, i shall take the opportunity of defending myself from the remarks that have been made upon me, and of showing what i did say, as well as what i might have said. these remarks are less excusable from it being known to me that a letter of mine to a third party was by my express permission read to you, in which was stated my willingness to alter or modify any passage which might have offended your feelings, provided only that such alteration involved no injustice to mr. abernethy. the (as i think) ill-advised rejection of the offer, coupled with the intimation, long after, which was given to mr. longman by a friend of yours, that certain papers would be forthcoming, provided only that certain passages relating to mr. stanley were suppressed,304 will involve a discussion in which i shall now be very unreserved; but which, i fear, will be scarcely less disagreeable to you than painful to myself. if you ignore the imputations to which i have referred, it seems to me that the whole discussion may be quashed by your simply writing me a note, in which you state as the reason for your not making any communication to me your dislike to revive the recollection of differences with one whose memory you will always regard with respect, gratitude, and affection, or whatever other terms your feelings may justify, or the claims of mr. abernethy require.
* * * * *
* * * * *
"i am, sir,????
"your obedient servant,??
"g. macilwain."
the following is mr. stanley's reply:
"brook street, july 18th.
"sir,
"upon the subject of your communication to me, i can only say, that i have no information to give; for i am not in possession of any document relating to it; and so many years have elapsed since the occurrences to which you refer, that i could not trust my memory for the accuracy of any statement, if i were disposed to make it. you will therefore perceive that there exists no foundation for the supposition that 'i desire to withhold something which involved imputations unfavourable to mr. abernethy,' or that any other feelings than those of the utmost respect for the memory of mr. abernethy have existed in my mind.
"i am, sir,????
"your obedient servant,??
"edward stanley.
"g. macilwain, esq."
we here conclude this subject.
305
a somewhat amusing illustration of one feature of the hospital system occurred about this time. sir astley cooper had, without the smallest intention to give offence, made some observation on the somewhat too free use of mercury at that period in the borough hospitals. his observations having been misunderstood or misrepresented, he took occasion to remove any idea of intentional offence, by addressing the class. among other things, he is reported to have said: "why, gentlemen, was it likely that i should say any thing unkind towards these gentlemen? is not mr. green my godson, mr. tyrrell my nephew, mr. travers my apprentice" (the three surgeons of st. thomas's hospital), "mr. key my nephew, mr. cooper my nephew?" (surgeons of guy's)78.
this was very na?ve, and is an illustration of the value of evidence in proof of facts having no necessary connection with those it was intended to establish.
it is difficult to conceive any one more disinterested than mr. abernethy had been in relation to the surgeoncy of the hospital, from the moment at which he was appointed to the hour of his resignation. although he had waited twenty-eight years as assistant, and not participated in one farthing of the large sums accruing from his reputation in hospital pupil fees—although, too, he had a large family,—yet, so far was he from wishing to indemnify himself for this long exclusion from office by a lengthened tenure of it, that he at once announced his opinion as to the expediency of earlier resignations of the surgeoncies, and his intention of acting on it when he should have attained his sixtieth year. his reasons were liberal and judicious. amongst others, he said that he had "often witnessed the evils resulting from men retaining the office of surgeons to hospitals when the infirmities of age prevented them from performing their duties in an efficient manner. that, at sixty, he thought they should resign in favour of the juniors," &c.; thus contemplating a tenure of only ten years. again, he who had founded a306 school from such small beginnings as could be accommodated in a private house in an obscure neighbourhood (bartholomew close), taken for that purpose—who had so increased it, that a theatre was built within the hospital—this again pulled down and rebuilt of enlarged dimensions to receive his increasing audiences—having, too, some time previously made over his museum to the hospital, in trust for the use of the school,—required that his only son (should he prove competent in the opinion of the medical officers) should in due time—do what? succeed him? no; but be admitted to a share in the lectures.
indeed, mr. abernethy's closing career at the hospital gave him no great reason to rejoice at the "hospital system." men, who could see nothing in leaving very much more important situations to an indefinite succession of apprentices, cavilled at a prospective lectureship for his only son; whilst his lectures were delivered over to gentlemen—one of whom had, from an early period, ridiculed, as he said, the opinions which he taught as—and which we now know to have been—john hunter's; and another, with whom there had been of late several not very pleasing associations.
this was necessarily a result of the "hospital system;" a system that gave a still more melancholy and fatal close to the labours of john hunter, whose death took place suddenly in the board-room of st. george's hospital, whilst resisting an interference with a privilege which his love of science rendered valuable to him, and which it was for the interests of science that he should enjoy; but, mournful as these results are, and many others that might be added, still, if we found that the system worked well for science, we might rest satisfied; but is it so? what advances have the hospital surgeons of london, under the apprentice system, made in the science of surgery? let those answer the question who are desirous of maintaining this system. for our own parts, the retrospect seems to show "the system" in a more striking manner than any thing we have yet stated. john hunter, that primus inter omnes, was no hospital apprentice; he migrated from st. bartholomew's, where the rule was too exclusive to give him a chance, to st. george's,307 where he obtained admittance; st. bartholomew's preserved "the system," and lost hunter.
abernethy was an apprentice, truly; but all those glorious labours which shed such a lustre on his profession, and such a benefit on mankind, were completed long before he became surgeon to st. bartholomew's hospital; and it is material to repeat that at that time the assistant surgeons, with the exceptions already stated, had nothing to do. in casting our eyes over the retrospect of years, one honoured name attracts our notice, in connection with a real advance in the knowledge of the functions of nerves. we allude to sir charles bell. but here again "the system" is unfortunate; for sir charles was never a hospital apprentice at all, and only succeeded to a post in a london hospital after an open canvass in an institution in which the narrow portal of the apprentice system is unrecognized.
we might have traced the effects of the apprentice system into the more covert sites of its operations, as exemplified in the abortive or mischievous legislation observed at different times in the college of surgeons of london; or have extended the catalogue we formerly exposed as taking place in the royal med. and chir. society up to the influence—proh pudor!—that it is allowed to exert in the councils of the royal society; but our so doing here would have led us into discussions which are irrelevant or unnecessary to our present objects. in the meantime, it is useful to remark that there are two sides to all questions. if, in our corporate bodies, we see the prurient appetencies of trade usurping the place of the lofty aspirations of science,—if we see this carried to the extent of men allowing themselves to receive money without rendering any intelligible account of its amount,—let us not forget that there is a public—aye, and a profession too—which calmly allows such things.
let us also reflect on those numerous instances, in human affairs, of things being only accomplished when there is a real necessity for them; and, again, whether that necessity for a higher and purer administration of corporate privileges and scientific distinctions may not alone reside in a higher and purer moral308 standard on the part of the public and the profession. those who, in a worldly sense, suffer from the system, have at least the consolation that they are not obliged to participate in the administration of that which they disapprove; and that the losses they so sustain are perhaps necessary tests of their having achieved proper motives. no better proof of the sincerity and earnestness of our love of science can be afforded us, than a patient and thoughtful cultivation of it, independently of patronage, position, or other auxiliaries, which too often mask from us the true objects of research, sully the purity of mind by mixtures of questionable motive, or mislead us from the temple of truth to the altar of a fugitive and fallacious ambition. there are indeed signs of a "delenda est carthago." as we have said, the point of the wedge is inserted, and a very little extension of public information will at no distant period drive it home.
in the meantime, medical science, instead of being in a position to receive every quackery as a means of demonstrating the superior beauty of truth, by placing it in contrast with error, is obliged to regard any absurdity, however gross, as one of the hydra-headed fallacies through which we are to evolve what is true, only by the circuitous plan of exhausting the resources of hypothesis and conjecture: whilst sweeping epidemics, which, wholesomely regarded, should be looked on reverently as besoms of destruction, are hailed by the observant as melancholy, but necessary, impulses, to drive us to the adoption of measures, to which our capital of common sense is not sufficient to induce us to listen.
neither are the old hospitals the only parts of a defective system. there is no hospital in london that, even yet, has any country establishment for convalescents; whilst of two of those more recently established, one is built over a church-yard; and the other, intended only for the relief of decarbonizing organs, is placed in the immediate neighbourhood of the most smoky metropolis in europe. both, therefore, instead of standing out as the most distinguished illustrations of the laws of sanitary and physiological science, being, on the contrary, emphatic examples of their violation.
309
we are unwilling to conclude this chapter without observing that, notwithstanding the coldness and discussions which threw somewhat of melancholy and shade over abernethy's retiring days, thus presenting an unwelcome contrast with the more palmy periods of his career—a contrast from which it might have been hoped his conscientious retirement might have spared him,—we yet see how appropriate a preparation it might have been for a transition from the exciting, and adulatory, atmosphere which surrounds a popular and scientific teacher, as compared with the calmness and peace of a life in the country. he was now no more to enter the hospital square, where we have so often seen him mobbed, as it were, by the crowding and expectant pupils; no more to be daily addressing audiences who never seemed to tire even with repetitions of that with which many were already familiar; nor any more to see, as occasional visitors, men grown grey in the successful practice of his early lessons, bringing their sons to the same school, and both listening with equal pleasure. there is no doubt that, contrasted with all this, retirement was a great, though now probably a welcome, change. eminent men unintentionally exert an influence which is not without its evils; and we shall see that of this he was fully aware. assentation is too much the order of the day. the multitude appear to agree. the few who differ, are apt to be cautious or reserved. if a man is too sensible to be fed with such garbage as direct flattery, there are always tricksters or tacticians, who have a thousand ways of paying homage without detection.
then, again, those who really admire a man, and are honest,—keep aloof, and shrink from an association with those whom they know, or believe, to be parasites. it thus happens that there are men to whom so few venture to be honest, that the world may present little better than a practical lie. it is a mercy then, when a man's sun is setting, that he be blessed with a little twilight of truth.
there are, in the moral and intellectual constitution, as well as in the physical endowments of man, beneficent powers of adaptation, which let us gently down to contrasts, which, too sudden, might be painful or destructive.
310
there is, however, this difference—the external senses have intrinsic powers of adaptation so ready, and perfect, as scarcely to be taken by surprise by any natural transition. the moral and intellectual powers do not appear to possess this electric activity; but require slower gradations of impression, which, by some law in the progress of human affairs, are (as the rule) mercifully supplied.
in his own lessons, whenever he met with any apparent imperfection, and wished to impress its real beauty of adaptation, abernethy was very fond of what he termed his argumentum ex absurdo. he would suppose various other arrangements, and point out in succession their unfitness for the purposes required. tried in the same manner, we can see nothing better than that which really happened.
if abernethy met with coldness where he expected warmth—and dispute and discussion where he might have calculated on grateful concession,—how well-fitted must have been that reverence and affection which longingly awaited his retirement at home. if the greatest worldly success, in that occupation in which he had always felt most pleasure, was still not without its dark lights—shadowing forth what the world really is,—what could he have had better to concentrate his views on those substantial sources of comfort, of which he had long believed and estimated the value, and on which he was contented to repose. it had always been a favourite expression of his, when in any doubt or difficulty: "well, i will consult my pillow, and we shall see." we believe that pillow seldom flattered.
