men, had followed in the same wake of investigation; therefore there was an opportunity of that test which comparison alone affords. Abernethy was, in fact, regarded at this time more in the light of a rising man. than merely a promising surgeon. He now moved from St. Mary Axe (as I am informed), and took a house in St. Mildred's Court, in the Poultry.

Sir Charles Blicke had moved to Billiter Square. I find by the rate-books, which Mr. R. L. Jones was so good as to inspect for me, that this was in April, 1793. He could hardly fail at this time to have had a very acceptable portion of practice, although we apprehend it was not as yet extensive. His reputation was, however, fast increasing, which the attention paid to his opinion at the hospital at this time must have materially accelerated.

Certainly not later than 1795, there were very few cases of doubt or difficulty in which, independently of that participation in the consultation at the hospital common to all the medical officers, there was not especial value and influence attached to his opinion; and I have heard a pupil of that day assert, that in cases of real doubt and difficulty, there was nothing more beautiful in itself, nor more characteristic of Abernethy, than the masterly way in which he would analyze a case, bring the practical points before his colleagues, and at the same time suggest the course he preferred. As from his other occupations it would often happen that some consultation might be pending while he was engaged at the theatre or in the museum, it would often happen that a consultation would terminate for the time by some one observing, "Well, we will see what Mr. Abernethy says on the subject."

In 1796 he became a Fellow of the Royal Society, his old preceptor, Sir William Blizard, being one of those who signed the proposal for his election. He only contributed one paper after this to the "Philosophical Transactions." After his death the Duke of Sussex pronounced a very well-deserved eulogium, of which a copy will be found in a subsequent chapter. He had not been idle, however, but in 1797 published the third part of the "Physiological Essays," and which we will, in the next place, consider.

IN estimating the practical penetration and clear judgment of Abernethy, it was almost necessary to see him placed by the side of other men.

His mind was so quick at perceiving the difficulties which lay around any subject, that it appeared to radiate on the most difficult a luminosity that made it comparatively easy, by at least putting that which, to ordinary minds, might have been a confused puzzle, into the shape of an easy, definite, and intelligible prop

osition.

It was immaterial whether the difficulties were such as could be overcome, or whether they were in part insurmountable; both were clearly placed before you; and while the work of the quickest mind was facilitated, the slowest had the great assistance of seeing clearly what it had to do.

All this was done by Abernethy in a manner so lit

tle suggestive of effort, that, like his lecturing, it was so apparently easy, that one wondered how it happened that nobody could ever do it so well.

But when we saw him placed in juxtaposition with other men, these peculiarities, which, from the easy manner in which they were exhibited, we had perhaps estimated but lightly, were thrown into high relief, and by contrast showed the superiority of his powers.

The second series of Essays he had dedicated to his old master, Sir Charles Blicke. The third, the subject of our present consideration, he inscribed to his early instructor in anatomy, Sir W. Blizard. The dedication is straightforward and grateful.

The first paper of the series is interesting in two points of view. First, it was an important improvement in the management of a difficult form of a very serious class of accident, "Injuries of the Head;" and, secondly, it derives a peculiar interest from the parallelism it suggests between Abernethy and one of the most distinguished surgeons of France, the celebrated Pierre Joseph Dessault-a parallelism honorable to both, yet remarkably instructive as to the superior discriminative powers of Abernethy. Dessault's pupil, Bichat, himself one of the most accomplished anatomists of his time, has left an eloquent eulogium on Dessault, which, although somewhat florid, is by no means above his merits. He says he was the father of Surgical Anatomy in France; and certainly few men evinced more sagacity in that immediate application of a fact to practical purposes, which constitutes art, than Dessault.

Bichat, in his glowing analysis of Dessault's character, among other things in relation to his study of the profession, observes of him that, "Un esprit profond

et réfléchi, ardent à entreprendre, opiniâtre à continuer, le disposa de bonne heure à surmonter des dégoûts qui précédent, et les difficultés qui accompagnent son étude. A cet âge où l'âme encore fermée à la réflexion semble ne s'ouvrir qu'au plaisir, apprendre fut son premier besoin-savoir sa première jouissance-devancer les autres sa première passion."*

A quick and clear perception, for the most part untrammeled by preconceived opinions, led Dessault to a vivid appreciation of the immediate results of surgical proceedings; and as these were definite, successful, doubtful, or abortive, he either persevered with a characteristic tenacity of purpose, or at once and forever abandoned them. He was remarkably happy in his selection and appreciation of the mechanical parts of surgery, and his quick perception disclosed to him several useful points in practice which depend on the more important truths of medical surgery.

Now almost all this, as applied to the active portion of Abernethy's life, is equally true of both. But Dessault was by no means so deep or so original a thinker as Abernethy. Like Abernethy, he was clear and penetrative, but he did not see nearly so far, nor were his views nearly as comprehensive. Dessault was quick at detecting an error in practice, and in sensibly rejecting it. Abernethy would unfold it, examine it, and by his talents convert the very defect into usefulness. Dessault had by no means, in the same degree, that power of reflection, that suggestive faculty which, in endeavoring to interpret the meaning of phenomena, can point out the true question which it is desired to ask of nature, as well as the mode of inquiry.

All this and much more was strikingly developed in Abernethy. The paper before us involves a subject which had engaged the attention both of Abernethy and Dessault. They had met with the same difficulty; and the practical solution of it which each obtained, though somewhat different, was extremely characteristic. We will try to make this intelligible. In severe injuries in which the cranium is broken, it frequently happens that a portion of bone is so displaced that it presses on the brain. The consequence of this, in many cases, is a train of symptoms sufficiently alarming in themselves, but the actual cause of which many circumstances sometimes concur to complicate or obscure.

The same forces which produced the accident not unfrequently involve a violent shock to the whole body -sometimes fracture or other injury of other parts. Sometimes the patient is deeply intoxicated. Then, again, patients are presented to the surgeon in different cases at extremely different periods after the reception of the injury, so that the case is very different as you see it first at one or other phase of it.

These, and many other circumstances, give rise to various modifications of the symptoms, and, under some complications, constitute a class of cases which yield to none in importance or difficulty. There is something in the idea of a piece of bone pressing on the brain, which instinctively suggests the expediency of raising it to the natural level. This is, in fact, the object of what is called "trepanning," or, as we generally term it, "trephining."

This consists in nothing less than perforating the cranium, and then, by means of an instrument adapt