John Abernethy

John Abernethy was the son of a merchant. He went to school in Wolverhampton, but in 1778 left school to go to London. In 1779, only 15 years of age, he was apprenticed to Sir Charles Blicke (1745-1815), a surgeon who was associated with St. Bartholomew's Hospital and had a large practice. Since no lectures in anatomy were held at the St. Bartholomew's at the time, he attended lectures by Dr Maclaurn and Sir William Blizard (1743-1835) at the London Hospital. He soon became their assistant, while also attending the lecture of the famous Sir John Percivall Pott (1714-1788) at St. Bartholomew's, and by John Hunter (1728-1793).

When Pott retired he was succeeded by Blicke. In July 1787 Abernethy took over his post as assistant surgeon, and became teacher of anatomy, physiology, pathology, and surgery. Much of his importance as a teacher lies in his recognition of the importance of comparative anatomy in the study of anatomy and physiology.

Because of lack of suitable rooms he had to give his lectures outside the hospital, in his own rooms. Because of the large number of students who flocked to his lectures, an auditorium was built for Abernethy at the hospital in 1790 and 1791. He thus became the founder of St. Bartholomew's Hospital Medical School. He is also credited the establishment of the excellent museum of pathological anatomy at the hospital.

The early 1790's was a busy period for Abernethy, as he did anatomical works and conducted physiological experiments besides his work at the hospital. In 1793, the year of John Hunter's death, his first article was printed in the Philosophical Transactions of the Royal Society of London. Abernethy was a devoted pupil and disciple of John Hunter whom he succeeded at St. Bartholomew's Hospital.

In 1813 Abernethy became surgeon at Christ's Hospital, a position he held until 1828, shortly before he abandoned his practice. In 1814 he was appointed professor of anatomy and surgery at the Royal College of Surgeon, and, in 1815, after 28 years as assistant surgeon, he became Surgeon to St. Bartholomew's Hospital.

Abernethy was now at the peak of his career, running an extensive practice and still an exceptionally popular lecturer. His lectures in anatomy, physiology, surgery, and pathology were considered unequalled. They were, in fact, so popular that they were taken down by fast writers and published in the Lancet in 1826 and 1827 - whereby the publisher was sued by Abernethy. Complying with student's wishes, he published Lectures on anatomy, surgery and pathology... in 1828 and Lectures on the theory and practice of surgery in 1830. Although he was a generous man he deliberately assumed a brusque manner with his patients, assuming it would inspire their confidence.

Abernethy was a skilled surgeon. Continuing Hunter's work on ligation, he became the first to tie successfully the external iliac artery for aneurism, and in 1798 he ligated the common carotid. Like great colleagues as William Cheselden (1688-1752) and John Hunter, however, he only operated when absolutely necessary. Over the years his reluctance to take up instruments increased, and in 1827 he laid down his post as surgen at the St. Bartholomew's, and in 1829 retird from his chair at the Royal Colle of Surgeons. He then moved to Enfield, where he owned a house, and died there on April 20, 1831, at the age of 67, after a protracted period of illness.

His publishing covered a wide field. One of his books concerned the anatomy of the whale.

A selection of quotations:

«One day, for example, a lady took her daughter, evidently most tightly laced, a practice which we believe mothers now are aware of is mischievous, but scarcely to the extent known to medical men. She complained of Abernethy’s rudeness to her, as well she might; still he gave her, in a few words, a useful lesson. «Why, Madam,» said he, «do you know there are upward of thirty yards of bowels squeezed underneath that girdle of your daughter’s? Go home and cut it; let nature have fair play, and you will have no need of my advice.»
Quoted by George Macilwain in Memoirs of John Abernethy, chapter 33.

«Private patient’s, if they do not like me, can go elsewhere; but the poor devils in the hospital I am bound to take care of.»
Quoted by George Macilwain in Memoirs of John Abernethy, chapter 5.

«There is no short cut, nor «royal road,» to the attainment of medical knowledge. The path which we have to pursue is long, difficult, and unsafe. In our progress, we must frequently take up our abode with death and corruption; we must adopt loathsome diseases for our familar associates, or we shall never be thoroughly acquainted with their nature and dispositions; we must risk, nay even injure, our own health in order to be able to preserve or restore that of other.»
Hunterian oration, 1819.

«Pray, Mr. Abernethy, what is a cure for gout?» was the question of an indolent and luxurious citizen. «Live upon a sixpence a day - and earn it,» was the cogent reply.
Quoted by Thomas J. Pettegrew in Medical Portrait Gallery, Volume II.

«The hospital is the only proper College in which to rear a true disciple of Aesculapius.
Quoted by Thomas J. Pettegrew in Biographical Memoirs.

«Mr. Abernethy,» sais a patient, «I have something the matter, Sir, with this arm. There, oh! (making a particular motion with the limb), that, Sir, gives me great pain.» «Well what a fool you must be to do it then,» said Abernethy.
Quoted by George Macilwain in Memoirs of John Abernethy, chapter 33.

«Abernethy, leaving his house, kicked his foot against a paving stone where the road was under repair. He shouted to a workman (who was Irish) to take it out of the way. «And where shall I take it?» asked the Irishman. «Take it to H-ll for all I care.» «May be,» said the Irishman, «if I Take it to Heaven it will be more out of your Honor’s way.»
Quoted by Howard Marsh in
St. Barholomew’s Hospital Journal, 1904, 2: 89.

To the daughter of a widowed patient: « I have witnessed your devotion and kindness to your mother. I am in need of a wife, and I think you are the very person that would suit me. My time is essentially occupied, and I have therefore no leirsure for courting.. Reflect upon this matter until Monday.»*.
Quoted by Samuel D. Gross in Autobiography.
*She did, and subsequently became Mrs. Abernethy

«Various advantages result even from the publication of opinions; for though we are very liable to error in forming them, yet their promulgation, by exciting investigation, and pointing out the deficiencies of our information, cannet be otherwise than useful in the promotion of science.»
Surgical and Physiological Works, Volume I, Preface.

We thank Ian Elis for information submitted.

• Account of two instances of uncommon formation in the viscera of the human body. 1793.
• Surgical and physiological essays. 1793.
• Some particulars in the anatomy of the whale. 1796.
• Surgical observations, containing a classification of tumours with cases to illustrate the history of each species, an account of diseases which strikingly resemble the venereal disease, and various cases illustrative of different surgical subjects. Volume I, 1804 (2 volumes).
• Surgical observations, part the second: containing, an account of the disorders of the health in general, and of the digestive organs in particular, which accompany local disease, and obstruct their cure: - observations on diseases of the urethra, particularly of that part which is surrounded by the prostate gland, and, observations relative to the treatment of one species of the naevi materni.
  Volume II. 245 pages. London, Hurst, Rees, and Orme, 1806. New and expanded edition, London, 1811.
• Surgical Observations on the Constitutional Origin and Treatment of Local Diseases.
  London, Longman, 1809.
• Surgical observations.
  2 volumes. London, Longman, Hurst, Rees, and Orme, 1809-1810.
  Contains two publications:
  Surgical Observations on the Constitutional Origin and
  Treatment of Local Diseases, and On Aneurysms and Surgical Observations on Diseases Resembling Syphilis.
  Appeared in numerous editions up to 1831.
  In volume 1, pp. 234-292 is recorded the first successful ligation of the external iliac artery for aneurysm. An operation carried out by Abernethy in 1796.
• An enquiry into the probability and rationality of Mr. Hunter’s theory of life; being the subject of the first two anatomical lectures delivered before the Royal College os Surgeons.
  136 pp. Longman, Longman, Hurst and others, 1814-1815.
  With a second title page: ”Introductory lectures exhibiting some of Mr. Hunter’s opinions,” etc.
• Lectures on anatomy, surgery and pathology, including observations on the nature and treatment of local diseases: delivered at St. Bartholomew's Hospital.
  2 volumes, London 1828. Boston, Benjamin Perkins & Co., 1828. 402 pages.
• Lectures on the theory and practice of surgery.
  London, 1830. New York, C. S. Francis, 1830. 402 pages.
• Surgical and physiological works.
  4 volumes, London, Longman, Rees, Orme, Brown & Green, 1830.
  Volume 1: On the constitutional origin and treatment of local diseases, aneurysms, diseases resembling syphilis, and diseases of the urethra.
  Volume 2: On injuries of the head, tumors, lumbar abscesses, and miscellaneous subjects.
  Volume 3: Lectures on surgery.
  Volume 4: Physiological lectures.
• Abernethy’s family physician, or, ready prescriber in cases of illness or accident, where medical attendance is not desired or cannot be procured. Containing the causes, symptoms and treatment of diseases, the proper remedies in burns, contusion, poisoning, and all varieties of physical casualties. Forming a complete guide to the retention and recovery of health.
  [2nd American edition] revised and enlarged by H. Bostwick. 132 pages. New York, Stringer & Townsend, 1849.
• The new family physician, and guide to health and long life.
  215 pages. London, Joseph Smith,, [n. d.]