John Hunter (surgeon)


John Hunter was a Scottish surgeon, one of the most distinguished scientists and surgeons of his day. He was an early advocate of careful observation and scientific method in medicine. He was a teacher of, and collaborator with, Edward Jenner, pioneer of the smallpox vaccine. 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. His wife, Anne Hunter, was a poet, some of whose poems were set to music by Joseph Haydn.
He learned anatomy by assisting his elder brother William with dissections in William's anatomy school in Central London, starting in 1748, and quickly became an expert in anatomy. He spent some years as an Army surgeon, worked with the dentist James Spence conducting tooth transplants, and in 1764 set up his own anatomy school in London. He built up a collection of living animals whose skeletons and other organs he prepared as anatomical specimens, eventually amassing nearly 14,000 preparations demonstrating the anatomy of humans and other vertebrates, including 3,000+ animals.
Hunter became a Fellow of the Royal Society in 1767.
The Hunterian Society of London was named in his honour, and the Hunterian Museum at the Royal College of Surgeons preserves his name and his collection of anatomical specimens. It still contains the illegally procured body of Charles Byrne, despite ongoing protests.

Early life

Hunter was born at Long Calderwood, the youngest of ten children. The exact date of his birth is uncertain; Robert Chamber's "Book of Days" gives an alternative birth date of 14 July, and Hunter is recorded as always celebrating his birthday on this date rather than 13 July as shown in the parish register of the town of his birth. Family papers cite his birthday as being variously on 7 and 9 February. Three of Hunter's siblings died of illness before he was born. An elder brother was William Hunter, the anatomist. As a youth, John showed little talent, and helped his brother-in-law as a cabinet-maker.

Education and training

When nearly 21 he visited William in London, where his brother had become an admired teacher of anatomy. John started as his assistant in dissections, and was soon running the practical classes on his own. 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. John is alleged to have been connected to these deaths, since at the time he was acting as William's assistant. 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. 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.
Hunter heavily researched blood while bloodletting patients with various diseases. This helped him develop his theory that inflammation was a bodily response to disease, and was not itself pathological.
Hunter studied under William Cheselden at Chelsea Hospital and Percival Pott at St. Bartholomew's Hospital. Hunter also studied with Marie Marguerite Bihéron, a famous anatomist and wax modeler teaching in London; some of the illustrations in his text were likely hers. After qualifying, he became assistant surgeon at St George's Hospital and surgeon.

Army surgeon

Hunter was commissioned as an Army surgeon in 1760 and was staff surgeon on expedition to the French island of Belle Île in 1761, then served in 1762 with the British Army. Contrary to prevailing medical opinion at the time, Hunter was against the practice of 'dilation' of gunshot wounds. This practice involved the surgeon deliberately expanding a wound with the aim of making the gunpowder easier to remove. 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.

Post-Army career

Hunter left the Army in 1763, and spent at least five years working in partnership with James Spence, a well-known London dentist. Although not the first person to conduct tooth transplants 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. These principles are still used in the transplanation of internal organs. 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.
Hunter set up his own anatomy school in London in 1764 and started in private surgical practice.

Earl's Court house

In 1765, Hunter bought a house near the Earl's Court district in London. The house had large grounds which were used to house a collection of animals including 'zebra, Asiatic buffaloes and mountain goats', as well as jackals. In the house itself, Hunter boiled down the skeletons of some of these animals as part of research on animal anatomy. 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.

Self-experimentation

Hunter was elected as Fellow of the Royal Society in 1767. At this time he was considered the leading authority on venereal diseases, and believed that gonorrhea and syphilis were caused by a single pathogen. Living in an age when physicians frequently experimented on themselves, he was the subject of an often-repeated legend claiming that he had inoculated himself with gonorrhea, using a needle that was unknowingly contaminated with syphilis. When he contracted both syphilis and gonorrhea, he claimed it proved his erroneous theory that they were the same underlying venereal disease. The experiment, reported in Hunter's A Treatise on the Venereal Diseases, does not indicate self-experimentation; this experiment was most likely performed on a third party. Hunter championed treatment of gonorrhea and syphilis with mercury and cauterization. Because of Hunter's reputation, knowledge concerning the true nature of gonorrhea 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.

Late career

In 1768, Hunter was appointed as surgeon to St George's Hospital. Later, he became a member of the Company of Surgeons. In 1776, he was appointed surgeon to King George III.
In 1783, Hunter moved to a large house in Leicester Square. The space allowed him to arrange his collection of nearly 14,000 preparations of over 500 species of plants and animals into a teaching museum. The same year, he acquired the skeleton of the 2.31 m Irish giant Charles Byrne against Byrne's clear deathbed wishes—he had asked to be buried at sea. Hunter bribed a member of the funeral party and filled the coffin with rocks at an overnight stop, then subsequently published a scientific description of the anatomy and skeleton. "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." The skeleton, today, with much of Hunter's surviving collection, is in the Hunterian Museum at the Royal College of Surgeons in London.
In 1786, he was appointed deputy surgeon to the British Army and in March 1790, he was made surgeon general by the then Prime Minister, William Pitt. 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.
Hunter's death in 1793 was due to a heart attack brought on by an argument at St George's Hospital concerning the admission of students. He was originally buried at St Martin-in-the-Fields, but in 1859 was reburied in the north aisle of the nave in Westminster Abbey, reflecting his importance to the country.
Hunter's character has been discussed by biographers:
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'.

Family

In 1771, he married Anne Home, daughter of Robert Boyne Home and sister of Sir Everard Home. They had four children, two of whom died before the age of five. One of his infant children is buried in the churchyard in Kirkheaton, Northumberland, and the gravestone is Grade II listed. Their fourth child, Agnes, married General Sir James Campbell of Inverneill.

Legacy

In 1799, the government purchased Hunter's collection of papers and specimens, which it presented to the Company of Surgeons.

Contributions to medicine

Hunter helped to improve understanding of human teeth, bone growth and remodeling, inflammation, gunshot wounds, venereal diseases, digestion, the functioning of the lacteals, child development, the separateness of maternal and foetal blood supplies, and the role of the lymphatic system. He carried out the first recorded artificial insemination in 1790 on a linen draper's wife.

Literary references

, a key figure in Romantic thought, science, and medicine, saw in Hunter's work the seeds of Romantic medicine, namely as regards his principle of life, which he felt had come from the mind of genius.
Hunter was the basis for the character Jack Tearguts in William Blake's unfinished satirical novel, An Island in the Moon, and a principal character in Hilary Mantel's 1998 novel, The Giant, O'Brien. Hunter is mentioned by Dr Moreau in Chapter XIV of H.G. Wells's The Island of Doctor Moreau and appears in the play Mr Foote's Other Leg as a friend of the actor Samuel Foote. In Imogen Robertson's 2009 novel, Instruments of Darkness, anatomist Gabriel Crowther advises an acquaintance to seek refuge at his friend Hunter's home for the young Earl of Sussex's party from deadly pursuers released during the Gordon Riots; leopards in Hunter's menagerie killed the would-be assassins, and he envisaged their bodies' dissection.
His Leicester Square house is said to have been the inspiration for the home of Dr Jekyll of Robert Louis Stevenson's 1886 novel The Strange Case of Dr Jekyll and Mr Hyde. Hunter's house had two entrances, one through which the living area for his family was accessible, and another, leading to a separate street, which provided access to his museum and dissecting rooms. This pattern echoes that of the house in the story, in which the respectable Dr Jekyll used one entrance to the house and Mr Hyde the other, less prominent, one.

Memorials

A bust of John Hunter stands on a pedestal outside the main entrance to St George's Hospital in Tooting, South London, along with a lion and unicorn taken from the original Hyde Park Corner building, Lanesborough House. Another stands in the south-west corner of Lincoln's Inn Fields. A further bust once stood in Leicester Square near where his home and anatomy school were situated, but was removed around 2010, and has not yet been re-instated.
The John Hunter Clinic of the Chelsea and Westminster Hospital in London is named after him, as are the John Hunter Hospital in Newcastle, Australia and the Hunterian Neurosurgical Laboratory of the Johns Hopkins Hospital.
His birthplace in Long Calderwood, Scotland, has been preserved as Hunter House Museum.