John Abercrombie

Few doctors can look back on a career as a successful surgeon, a successful physician and a place in history gained by first describing a common clinical condition. After admission to the Incorporation, John Abercrombie established a surgical practice in Edinburgh so successful that he attracted many apprentices. He deployed these to provide free medical care to the poor of the City, and from his philanthropy was to emerge the Edinburgh Medical Missionary Society. Subsequently qualifying as a physician he achieved prominence by publishing meticulous case books and text books which were successful throughout the world. His was the first clinical description of perforated duodenal ulcer to be confirmed by a post mortem examination and the specimen from that historic autopsy remains on display to this day in the College Museum.

Born in Aberdeen in 1780, son of the Rev. George Abercrombie, John Abercrombie went to Aberdeen Grammar School and then Marischal College where he graduated MA at the age of 15. Thereafter he studied medicine in Edinburgh, graduating MD in 1803. After postgraduate study at St. George’s Hospital, London, he returned to Edinburgh and was admitted a Fellow of the College. He started in practice at 8 Nicolson Street, next to the Edinburgh Riding School which in 1832 was to become the site of the Playfair Building of the present Royal College of Surgeons of Edinburgh. His practice was successful and in 1805 he was appointed Surgeon to the Royal Public Dispensary in Richmond Street, a few yards from his practice. This dispensary had been founded by Dr. Andrew Duncan Sr. to provide medical aid to the poor. The success of his practice meant that he had attracted a large number of surgical apprentices, still at that time the commonest pathway to a surgical career. This allowed Abercrombie to assign his senior apprentices to the care of the poor in different areas of the town.

His meticulous case books were to form the basis for two important books published in 1828; the first on Diseases of the brain and spinal cord and the second on Diseases of the stomach, intestine, liver and other viscera of the abdomen. In this latter book he gave the first description of the clinical features of duodenal ulcer and most importantly of perforated duodenal ulcer. In the days before endoscopy, radiology or even abdominal surgery, it was difficult for physicians to correlate clinical features with pathology. Abercrombie’s interest in the post mortem made such correlations possible. He gave the first ever description of the clinical features of perforated duodenal ulcer confirmed by the post mortem. The specimen showing the perforated ulcer was placed in the College Museum where it is on display to this day.

Both of these books were to become standard texts. They were published in the United States where they achieved wide acclaim, were translated into French and German, and each ran to several editions.

The death of James Gregory in 1821 created a vacancy for the Chair of Practice of Physic at Edinburgh University. Abercrombie’s application was unsuccessful and this led him to concentrate on consultation work, which did not require a hospital appointment. To this end he became a Fellow of The Royal College of Physicians in 1824. Thereafter his publications turned increasingly to philosophical and religious topics. His philanthropy continued with support for the Edinburgh Association for Sending Medical Aid to Foreign Countries, which later developed into the Edinburgh Medical Missionary Society.

His consultation practice brought patients from all parts of the British Isles and from abroad. He became medical adviser to and subsequently a close friend of Sir Walter Scott. His abilities were recognised by his appointment as the first physician to the King in Scotland, King George IV. The University of Oxford gave him the prestigious award of an honorary MD. The prestige of this award can be judged by the fact that the only other recipient in the previous 50 years was Dr. Edward Jenner of vaccination fame. His Alma Mater honoured him by electing him Lord Rector of Marischal College which a few years later in 1860 was to amalgamate with Kings College to form the University of Aberdeen. He was elected a member of The Royal Academy of Medicine of France and Vice President of The Royal Society of Edinburgh.

After his death in 1844 his family presented his library to the College taking the stock from 150 to over 1000 books, while his extensive papers were donated to the Library of The Royal College of Physicians of Edinburgh.