John Hunter

John Hunter

JohnHunter

Figure 1 By Thomas Rowlandson – Fiona Haslam: From Hogarth to Rowlandson. Medicine in Art in Eighteenth Century Britain, Liverpool 1996, p. 281, Public Domain, https://commons.wikimedia.org/w/index.php?curid=12026353

1728-1753

Contents

General

John Hunter was a Scottish (2,3) pioneer in surgery (1,5) in 18th century Britain. (1,2)

Youth

He was born (1,2) into a large family (3,6) at Long Calderwood, Lanarkshire, (4,6) near Glasgow (3) Scotland (6) on 13th (2,4) [OR] 7th, 9th or 14th (7) February 1728. (2,4) The parish register of the town says 13th, but the exact date of his birth is uncertain. (7) He was the youngest of ten children. (6,7) Three of Hunter’s siblings (one of whom had also been named John) died of illness before he was born. (7) His father died in 1741, and Hunter left school. (6) As a youth, John showed little talent. (7) He received his early education at the grammar school in East Kilbride, but petted by his mother, he disliked school and hated books. (8) He preferred to lead an out-of-door life, looking after nests, insects and animals, whilst his brothers got the same education as country gentlemen. (8) After the death of his father in 1741, when he was 13 years of age, he dropped out of school, and the likelihood of future success was slim. (8) He worked on the family farm (6) and helped his brother-in-law (7) as a cabinet-maker. (6,7) He showed ‘neatness of hands and quickness of perception in anything that regarded mechanism’. (8)

In London 1748-60

William’s Anatomy School

John’s (2,3) 30 year old (3,6) elder (3,5) brother (2,3) William was a famous (7,8) anatomist (6,7) [OR] a successful obstetrician (3,4) and physician. (3,5)At the age of 20, in 1748 (5,6) John wrote to his William to ask whether he might come to join him in London. (8) William agreed to the request. (8)He visited (7) William in London. (2,3) [OR] he went to London to work at William’s anatomy school in Central London. (2,5) He arrived in time to assist in preparations for the autumn course of his lectures. (8) John had an extraordinary talent for such work, and his first preparation, that of a human arm, was excellent. (8) William ensured that (3) under his direction (5) John (3,7) received training despite his lack of formal education. (3) John (2,3) had to assist in the preparation of dissections for the course of anatomy (4) His skill in preparing specimens for his brother’s anatomy lectures was so impressive that he became William’s assistant. (6) [OR] John started as his assistant in dissections (1748), and was soon running the practical classes on his own. (7) For 11 winters (4) he studied anatomy (2,3) in his brother’s dissecting rooms. (4) He was probably present at the dissection of more than two thousand human bodies during the 12 years he spent working with his brother. (3) He showed great aptitude for anatomical work, (3,5) particularly dissection. (5) He secured a supply of corpses (3) to be prepared as specimens. (5) He gathered them from post mortem examinations, from his brother’s dissecting rooms, and from ‘resurrectionists’, body-snatchers who dug up freshly buried corpses from graveyards and sold them secretly to surgeons. (6) Hunter heavily researched blood while bloodletting patients with various diseases. (7) This helped him develop his theory that inflammation was a bodily response to disease, and was not itself pathological. (7) William found his brother’s aptitudes promising and arranged that he should attend surgical classes at St. George’s and (8) under William Cheselden at Chelsea Hospital and Percival Pott at St. Bartholomew’s Hospital. (7,8) Hunter also studied with Marie Marguerite Bihéron, a famous anatomist and wax modeller teaching in London; some of the illustrations in his text were likely hers. (7)

Deaths of Pregnant Women

It has recently been alleged that Hunter’s brother William, and his brother’s former tutor William Smellie, were responsible for the deaths of many women whose corpses were used for their studies on pregnancy. (7) John is alleged to have been connected to these deaths, since at the time he was acting as William’s assistant. (7) However, persons who have studied life in Georgian London agree that the number of gravid women who died in London during the years of Hunter’s and Smellie’s work was not particularly high for that locality and time; the prevalence of pre-eclampsia — a common condition affecting 10% of all pregnancies, and one which is easily treated today, but for which no treatment was known in Hunter’s time — would more than suffice to explain a mortality rate that seems suspiciously high to 21st-century readers. (7) In The Anatomy of the Gravid Uterus Exhibited in Figures, published in 1774, Hunter provides case histories for at least four of the subjects illustrated. (7)

Chelsea Hospital

In the summers of 1749 and 1750 (4) William also arranged for him (5,6) to learn surgery from (4,5) the eminent surgeon (5) William Cheselden (4,5) (1688-1752) (5) at Chelsea (4,6) and St. Bartholomew’s (6) Hospital (4,6) and Percivall Pott (1714-88). (5) The younger Hunter became a master of anatomy in 1753. (6)

Surgeon’s Hall, 1753

In 1753 he was elected a master of anatomy at Surgeon’s Hall, responsible for reading lectures. (4,8) He quickly became an expert in anatomy. (2) From 1754 to 1756 John was house surgeon [OR] a surgical pupil (3) at St. George’s Hospital (3,8) where he received most of his practical training. (8) During the summer of 1754 he was busy studying the routes by which the branches of the olfactory nerve leave the skull, traced the course of the nasopalatine nerve, and the rambling nerve known as the nasal branch of the ophthalmic division of the fifth. (8) A specimen he dissected to show these nerves exists in the Museum in excellent condition. (8)

Oxford

John was said to be of some embarrassment to his brother because of his inability to express himself and his lack of formal education. (8) In the summer of (8) 1755, William therefore persuaded him to enter (6,8) as a student at St. Mary’s Hall, (8) Oxford, (6,8) to acquire a formal education (6) taking lessons in elocution and classical languages. (8) Academics held no interest for the young man: (6) the instruction was of little value and John could not stand the requirements in classic languages. (8) He therefore returned to London at the beginning of the autumn term to continue his duties in the dissecting room. (8) He never completed a course of studies in any university, and, as was common for surgeons during the 18th century, and never attempted to become a doctor of medicine. (4) He wrote of this time: “Jessie Foot accuses me of not understanding the dead languages, but I could teach him things about a dead body which he never knew in any language dead or living”. (8) He returned to London within two months to resume his dissection work with William and his own original experimentation. (6)

St George’s Hospital

After qualifying at Chelsea, (7) he was elected surgeon (4) [OR] became assistant surgeon (house surgeon) at St George’s Hospital in 1756 [OR] 1758. (4)

Army Service 1760-63

However, as a result of his concentrated work effort, his health began to suffer, and (8) in 1760 (3,4) [OR] in the spring of 1761 he had some lung trouble which made it necessary for him to seek change of climate. (8) This problem was attributed to the putrid air of the dissecting rooms. (8) Suffering from ill health, Hunter (6,8) signed up as a (2,3) commissioned (4,7) army (2,3) staff (6,7) surgeon (2,3) As England was then engaged in the Seven Years’ War, he was ordered to join the expeditionary forces that set sail on March 29th, (8) 1761 (7,8) from Portsmouth with the intention of capturing Belle-Île-en-Mer (Belleisle) (8) [OR] Belle Île (7) a small island off the French coast near the mouth of the Loire. (8) He was staff surgeon on this expedition. (7) He gained much experience in managing (3,8) gunshot (5,8) wounds (3,5) when he and his colleagues were kept busy treating casualties for months after the island had surrendered. (8) As well as developing new ideas on the treatment of common ailments – such as wounds and venereal disease – Hunter spent time collecting specimens of lizards and other animals. (5) Contrary to prevailing medical opinion at the time, Hunter was against the practice of ‘dilation’ of gunshot wounds. (7) This practice involved the surgeon deliberately expanding a wound with the aim of making the gunpowder easier to remove. (7) Although sound in theory, in the unsanitary conditions of the time it increased the chance of infection, and Hunter’s practice was not to perform dilation ‘except when preparatory to something else’ such as the removal of bone fragments. (7) He then served in 1762 with the British Army (?) (7) spent two (3) [OR] three years in France and Portugal (5) during the Seven Years’ War. (6,8) One of the last episodes of the War was an attempt on the part of France and Spain to invade Portugal. (8) During this time Hunter’s first paper, The State of the Testis in the Foetus and on the Hernia Congenita, was published in William Hunter’s Medical Commentaries (1762, pp. (8) 75-89) with illustrations by the medical artist Jan van Rymsdyck. (8) It is in this paper that he names the ‘gubernaculum testis’ “because it connects the testis with the scrotum, and directs its course in its descent.” (8) His observations on heaps of granite on the Alentejo plateau provoked speculations about inconsistencies between geology and scripture, but he was advised by friends not to publish it. (8) Hunter’s fossils turned Richard Owen’s thoughts to palæontology in the 1830s, and he led men to take an interest in animals, huge and weird, that once moved about the earth and then passed into the twilight and silence of the past. (8)

London 1763-1768

The Peace of Paris was signed (8) in 1763, (3,4) ending the war, (6) and Hunter left the Army. (7)

Dentistry

He returned to London, (3,4) a staff surgeon and deputy purveyor on half pay in the early summer. (8) He did not rejoin his brother’s establishment in Covent Garden (8) but set up in (6,8) private practice (4,6) in Golden Square, (8) where he continued until his death1. (4) [OR] Hampered by a lack of formal apprenticeship, he found it difficult to establish a practice and so (3) he spent at least five years (7) worked in dentistry (2,3) in partnership with the well-known London (7) dentist James Spence (6,7) conducting tooth transplants. (2,7) Although not the first person to transplant teeth between living people, he did advance the state of knowledge in this area by realising that the chances of a successful tooth transplant would be improved if the donor tooth was as fresh as possible and was matched for size with the recipient. (7) These principles are still used in the transplantation of internal organs. (7) Although donated teeth never properly bonded with the recipients’ gums, one of Hunter’s patients stated that he had three which lasted for six years, a remarkable period at the time. (7) He continued his research at the same time. (6) In 1771 he wrote “The Natural History of the Human Teeth” (4) a basic building block of modern dentistry. (6)

Anatomy School and Private Practice 1764-7

Hunter set up his own anatomy school in London in 1764 (2,7) and started in private surgical practice. (7) While most of his contemporaries taught only human anatomy, Hunter’s lectures stressed the relationship between structure and function in all kinds of living creatures. (5) In 1765, (7,8) Hunter bought (6,8) a lease of (8) two acres (6) [OR] on three plots (8) of land at Earl’s Court, (6,7) [OR] near the Earl’s Court district (7) in London. (6,7) He built a house, (7,8) with large grounds which (7) he filled with an overflowing and (6) diverse collection of animals. (6,7) [OR] a small menagerie, (8) and made observations and experiments. (6,8) The animals included ‘zebra, Asiatic buffaloes and mountain goats’, as well as jackals. (7) A newspaper article reported that many animals there were ‘supposed to be hostile to each other but … in this new paradise, the greatest friendship prevails’, and this image may have been the inspiration for the Doctor Dolittle literary character. (7) In the house itself, Hunter boiled down the skeletons of some of these animals as part of research on animal anatomy. (7) Hunter’s practice (3,5) and reputation grew rapidly. (6) His scientific work was rewarded (2,5) on February 5th (8) 1767 when he was elected a Fellow of the Royal Society. (2,5)

Lecturing

Determined to make surgical training more accessible, (6) Hunter (3,6) trained students. (3) In the early 1770s (4) he began his own private lectures (4,6) on the principles and practice of surgery. (4,6) The lectures took place in his own home. (6) Hunter had a great influence on the development of scientific, experimentally based surgery through students who trained under him and later became famous, (6) notably Edward Jenner, (1749-1823) (3,6) pioneer of the smallpox vaccine, with whom he also collaborated (2) and Philip Syng Physick, (6,8) the ‘Father of American surgery.’ (6)

Surgeon at St George’s 1768

In 1768 (4,5) [OR] 1767 (6) he was elected (5) [OR] appointed (6,7) Surgeon (5,6) with teaching duties (4) at St George’s Hospital. (4,5) Later (7) in that year he was also finally admitted to the Company of Surgeons. (3,7)

Marriage

In 1771 (6,7) he married Anne Hunter (née Home), (2,6) daughter of Robert Boyne Home and sister of Sir Everard Home. (7) She was a minor; (6) [OR] was aged 29. (8) She became a poet, and some of her poems were set to music by Joseph Haydn. (2) They had four children, two of whom died before the age of five. (7) One of his infant children is buried in the churchyard in Kirkheaton, Northumberland, and the gravestone is Grade II listed. (7) Their fourth child, Agnes, married General Sir James Campbell of Inverneill. (7) While she was tall, blonde, sensitive and skilled in the harpsichord, painting and poetry, he was dishevelled, poorly read and preoccupied with the dissecting room and hospital ward. (8) However, she managed to maintain one of the liveliest salons in London, with regular conversaziones and soirées attended by the most sophisticated clientele. (8) Mrs. Hunter had a brother, Robert Home, an artist, who painted a portrait of Hunter which eventually came into the position of the Royal Society. (8) Hunter’s life was now ordered to a regular pattern. (8) He arose very early, especially in the summer, to have the best daylight for making fine dissections, and to arrange the day’s work for his assistants and pupils. (8)

Company of Surgeons

His ambition to gain a senior surgical post in a hospital, however, made it essential to have credentials other than an abundance of experience. (8) So, at the advanced age of forty, Hunter entered as a candidate for the diploma of the Company of Surgeons and was successful at his first attempt on July 7, 1768. (8) He became a member of Company of Surgeons. (7)

Royal Surgeon 1776

When he became surgeon (3,4) extraordinary (4,6) to King George III in 1776 (3,4) he had access to the king’s menagerie, and performed many experiments on animals. (3) In 1783 he moved to a large house in Leicester Square, which enabled him to take resident pupils. (5)

Bodysnatching

He developed his skills by using bodies that were legitimately obtained from executions, and also illegally from grave-robbing. (1) He is alleged to have paid for the stolen body of Charles Byrne, and proceeded to study and exhibit it against the deceased’s explicit wishes. (2) This made him unpopular with members of the public. (1)

Experimental methods

He was an early advocate of careful observation and scientific method in medicine. (2) He carried out many important studies and experiments in comparative aspects of biology, anatomy, physiology, and pathology. (4) Hunter believed that surgeons should understand how the body adapted to and compensated for damage due to injury, disease or environmental changes. (5) He encouraged students such as Edward Jenner and Astley Cooper to carry out experimental research and to apply the knowledge gained to the treatment of patients. (5) He made detailed studies of the structure and function of the lymph vessels and carried out early experiments on tissue transplantation, including grafting a human tooth into a cock’s comb. (6) He published important studies of venereal disease (4,6) and animal hibernation, developed surgical techniques to repair the Achilles tendon and to ligate arteries in cases of aneurysm instead of amputating, and improved embalming techniques – most notably for a gentleman whose wife’s body had to remain above ground in order for him to inherit her wealth. (6)

Venereal Disease

John had encountered venereal disease while serving in the army. (5) He wrote several books, including one on venereal disease which was the first text to discuss venereal disease in a non-judgmental manner. (3) At this time he was considered the leading authority on venereal diseases. (7) He believed, wrongly, that gonorrhoea and syphilis were caused by a single pathogen (7) and wanted to demonstrate this. (3,7) He lived in an age when physicians frequently experimented on themselves (7) and while writing the book (3) he was rumoured to have inoculated himself (3,4) [OR] he did in 1767 inoculate himself (6) [OR] he inoculated a subject (4,7) with pus from a person (4) with gonorrhoea as an experiment. (3,4) He used a needle that was unknowingly contaminated with syphilis. (7) Hunter’s health was permanently affected because he contracted syphilis. (6) [OR] The subject developed symptoms of both diseases. (4,7) He claimed this proved his theory that they were the same underlying venereal disease. (7) In 1786 he wrote his ‘Treatise on the Venereal (4,7) Disease’ (4) [OR] Diseases. (7) In the book the experiment is reported (part 6 section 2, 1786) but there is no mention of self-experimentation. (7) Hunter championed treatment of gonorrhoea and syphilis with mercury and cauterization. (7) Because of Hunter’s reputation, knowledge concerning the true nature of gonorrhoea and syphilis was set back, and his theory was not proved to be wrong until 51 years later through research by French physician Philippe Ricord. (7)

Museum 1783

After a falling-out with his brother, (6) Hunter moved to (6,7) a large house (7) in Leicester Square in 1783. (6,7) In his new house he built an educational complex with lecture and conversation rooms. (6) In 1783 (3,5) he set up his own (1,2) teaching (7) museum, (1,2) in the Leicester Square House. (5,6) He was unique in seeking to provide an experimental basis to surgical practice, and his museum is a lasting record of his pioneering work. (5) He devoted all his resources to it. (5) He built up a collection of living animals whose skeletons and other organs he prepared as anatomical specimens. (2) The museum housed his extensive collection of specimens and served as an invaluable teaching aid for his students, demonstrating the structure and functions of both diseased and healthy body parts in a wide range of species. (6) It included nearly 14,000 preparations (2,5) of more than 500 different species of plants and animals, (5,7) demonstrating the anatomy of humans and other vertebrates. (2) It housed five thousand wet preparations, (3) three thousand (2,3) stuffed or dried animals, 1200 fossils, nearly a thousand osteology specimens and almost a thousand diseased organs. (3) In 1783, John Hunter bribed an undertaker 500 pounds to obtain the corpse of an Irish giant

Charles Byrne

In 1783, (7) he acquired the skeleton of the (6,7) 2.31 m (7’7”) (7) [OR] eight-foot-tall (6) Irish giant Charles Byrne (6,7) (who had made his name as a circus attraction in London. (8)) against Byrne’s clear deathbed wishes. (7) Byrne had planned a burial at sea (6,7) so as to remain out of Hunter’s museum. (6) Hunter bribed a member of the funeral party (possibly for £500) (7,8) and filled the coffin with rocks at an overnight stop, then subsequently published a scientific description of the anatomy and skeleton. (7) ‘He is now, after having being stolen on the way to his funeral,’ says Muinzer, ‘on display permanently as a sort of freak exhibit in the memorial museum to the person who screwed him over, effectively’. (7) The skeleton, today, with much of Hunter’s surviving collection, is (7) a prized specimen (6) in the Hunterian Museum at the Royal College of Surgeons in London. (7)

Well-paid by the doctor, the resurrectionists thwarted Byrne’s last wishes. (6) As his reputation grew, he was supplied with rare specimens such as kangaroos brought back by Sir Joseph Banks from James Cook’s voyage of 1768-71. (5) He founded it to display his work to the public in the belief that fear of his work was due to ignorance. (1) This allowed members of the public to confront their moral objections to his work. (1) When the king’s elephant died Hunter performed the first dissection of an elephant. (3) In 1786 he wrote ‘Observations on Certain Parts of the Animal Oeconomy’. (4)

1783 to death in 1793

By the 1780s Hunter enjoyed widespread recognition as the leading teacher of surgery of his time. (5) In 1786, he was appointed deputy surgeon to the British Army. (7) In March 1790, he was made surgeon general by the then Prime Minister, William Pitt. (7) While in this post, he instituted a reform of the system for appointment and promotion of army surgeons based on experience and merit, rather than the patronage-based system that had been in place. (7) Hunter helped to found the Royal Veterinary College in 1791. (8) His character has been discussed by biographers:

His nature was kindly and generous, though outwardly rude and repelling. [In 1783], for some private or personal reason, he picked a quarrel with the brother who had formed him and made a man of him, basing the dissension upon a quibble about priority unworthy of so great an investigator. Yet three years later, he lived to mourn this brother’s death in tears’. (7)

He was described by one of his assistants late in his life as a man ‘warm and impatient, readily provoked, and when irritated, not easily soothed’. (7) He had not got on well with his senior colleagues at Belleisle. (8) The acclaim which he enjoyed did little to mellow (5) his blunt-speaking and argumentative nature. (5,7) His temper was to be his downfall, [OR] he was increasingly troubled by angina pectoris. (6) Edward Jenner noted that he was suffering from angina. (8) Hunter’s attacks were frequently precipitated by emotional upsets and he predicted correctly that one of these would cause his death. (8) He died on 16th October 1793 (2,3) in London, (4) following (8) [OR] during an argument at (5,7) a meeting of the board of (6,8) governors at (8) St George’s Hospital (5,6) over the acceptance of students for training. (5,7) He said nothing, left the room and turned to one of the physicians of the hospital, groaned (8) collapsed and died after suffering (5,6) a fit (5) [OR] a heart (7) attack. (6,7) He was originally buried at St Martin-in-the-Fields, (7) but his remains were reinterred at Westminster Abbey in 1859, (6,7) with an inscription memorializing him as the ‘Founder of Scientific Surgery’, (6) reflecting his importance to the country. (7)

Posthumous

His important treatise on gunshot wounds, (6,8) “A Treatise on the Blood, Inflammation and Gun-Shot Wounds” (8) was published after his death in 1794. (6,8) The Hunterian Society of London was named in his honour. (2) His financial position had been parlous: the family home at Long Calderwood was left to his son John, but the Earl’s Court estate and part of the contents of the house in Leicester Square were to be sold to repay debts amounting to more than £19,000. (8) His collection was eventually bought (2,3) by Parliament on behalf of (4) the nation (3,4) Hunter’s vast collection of anatomical and pathological specimens was bought by for the in 1799. (4) Hunter’s collection of papers (7) and museum of specimens (6,7) were purchased by the British government in 1799. (6,7) They were presented to (4,7) the Company of Surgeons (7) [OR] the Royal College of Surgeons. (4) They were severely damaged in the London blitz of 1941. (6) The collection is now kept as the Hunterian Museum (2) at the Royal College of Surgeons. (2,3) It still contains the illegally procured body of Charles Byrne, despite ongoing protests. (2,6)

Estimate

John Hunter is today remembered as a founder of `scientific surgery’. (5) His contributions to anatomy and surgery were vast. (6) Although a man with little formal education, he rose to become one of the most eminent and influential surgeons of his time. (6) He was the founder of pathological anatomy in England, and early advocate of investigation and experimentation. (4) His saying “Don’t think, try the experiment” has inspired generations of modern surgeons. (8) Hunter not only made specific contributions of great importance in surgery but also attained for surgery the dignity of a scientific profession, basing its practice on a vast body of general biological principles. (4) Hunter helped to improve understanding of human teeth, bone growth and remodelling, inflammation, gunshot wounds, venereal diseases, digestion, the functioning of the lacteals2, child development, the separateness of maternal and foetal blood supplies, and the role of the lymphatic system. (7)

FRESCI

F Anglo-Scot; War service

R Empirical Verification; Evolution.

E Leg up by brother; Private Practice; Royal patronage; In debt at death

S No University education; venereal disease; Museum; FRS.

C Illegal body snatching;

I Bad tempered; self inoculation?

HUNTER

H Hunterian Museum

U University not finished

N Natural History of Human Teeth

T Tall Irishman illegally exhibited

E Elephant dissected

R Royal Surgeon

GLUTIBILE

To be learned only on the night before the exam!

Hunter helped to improve understanding of human teeth, bone growth and remodelling, inflammation, gunshot wounds, venereal diseases, digestion, the functioning of the lacteals3, child development, the separateness of maternal and foetal blood supplies, and the role of the lymphatic system.’ (7)

G Guns and Gonorrhoea

L Lacteals

U Umbilical Cord

T Teeth

I Infant development

B Bone growth

I Inflammation

L Lymphatic System

E Evolution?

Biibliography

  1. https://www.bbc.com/teach/class-clips-video/biology-ks34-brian-cox-on-18th-century-surgeon-john-hunter-and-public-engagement-in-science/z6gmhbk
  2. Wikipedia summary
  3. https://www.bbc.com/teach/class-clips-video/biology-ks34-brian-cox-on-18th-century-surgeon-john-hunter-and-public-engagement-in-science/z6gmhbk
  4. https://www.britannica.com/biography/John-Hunter-British-surgeon
  5. https://www.britannica.com/biography/John-Hunter-British-surgeon
  6. http://www.madehow.com/inventorbios/88/John-Hunter.html
  7. https://en.wikipedia.org/wiki/John_Hunter_(surgeon)
  8. https://www.britannica.com/biography/John-Hunter-British-surgeon

1 Moves to Earls Court, Leicester Square?

2 the lymphatic vessels of the small intestine which absorb digested fats

3 the lymphatic vessels of the small intestine which absorb digested fats

 

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