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The sitter is possibly Anne Threlfall of Edmonton, wife of the eccentric surgeon John Abernethy (1764–1831), whom he married in 1800. The daughter of a retired merchant, Anne met Abernethy while staying with friends in Putney and the couple were married at All Saints church Edmonton after the bride had been given two weeks to consider the proposal. Abernethy, considered by his peers and patients to be a man of unconventional habits, gave a medical lecture on the day of his wedding. He was a surgeon at St. Bartholomew's Hospital and later Professor of Anatomy and Surgery at the College of Surgeons, as well as running a successful medical practice in central London. Anne was considered to be a ‘lady who to personal beauty added those social and moral excellences which combine to form a superior woman.’ In this portrait the sitter wears simple, elegant clothing typical of female neoclassical fashion.

This unusual and striking portrait is one of Smart’s largest, finished works on paper, comparable with the double portrait of Miss Harriet and Miss Elizabeth Binney in the Victoria and Albert Museum (dated 1806). Unlike his preparatory drawings, Smart’s aim here was to provide a cabinet drawing – a large, elegant portrait that was to be admired from a space in a cabinet or on the wall.

The entire surface of the paper is filled with detail and coloured, the work signed and dated as was his practice on ivory miniatures. As it was not possible, at this date, to obtain an ivory of this size, the drawing here is a compromise between the intimacy of a portrait miniature and a more public portrait form.