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The Extraordinary Life And Times Of John Hunter, Father Of Modern Surgery

482pp Bantam

By Rob Hendry
Contact the author by e-mail at roberth@mddus.com

What has happened to medicine over the last two and a half centuries? John Hunter, born near East Kilbride in 1728, followed his brother William to London and over the course of a remarkable career led a breakout from the intellectual confines of medieval pre-scientific medical thinking. Things had changed little since the days of Galen, yet successful careers could be built in the metropolis around the pedalling of theories and practices which clearly didn't work by any objective standard. However if you had never know better they were state of the art. Hunter appeared on the scene with his enquiring mind and no shortage of self confidence. Moore suggests he may also have been dyslexic and spent little time at school. As the Enlightenment was dawning he sought rational explanations for what he observed and introduced the notion of experimentation into medical practice to test his theories.

Having spent years in his brother's anatomy school he devised new surgical approaches to treating such problems as popliteal anuerysms, a common occupational hazard for eighteenth century coachmen apparently due to their high leather riding boots which rubbed against the backs of their knees.

If he was courageous, his patients must have been even braver despite their desperation. Life at the time was frequently brutal and often short. Suffering was part of life as, of course it remains for much of the world's population today. The graphic descriptions of the long suffering men who allowed Hunter to try different techniques for treating urethral strictures make the reader glad we live in an era where anaesthetics exist.

Hunter is hailed as the father of modern surgery - a man who has given much good to mankind. But could he do it today? The profession was almost completely unregulated in those days, and the professional bodies such as there were largely concerned themselves with protecting the rights and privileges of their members. As a procurer of bodies for the thriving anatomy school he helped his brother to run, Hunter ran the risk of criminal prosecution. Even late in his life he went to extraordinary efforts and expense to add to his collection of interesting human and animal body parts.

It is a trite observation to make that nowadays Hunter would have been struck off or imprisoned early in his career, assuming someone with his lack of formal educational achievement could ever have become a doctor in the first place. However beneath this suggestion lies a troubling grain of truth. In a society which demands that medicine is highly regulated by the public and which measures its doctors against 'standard practice', mavericks and free thinkers are weeded out. This certainly means safer doctors for patients, but pretty impotent ones if you happen to be suffering from motor neurone disease, a spinal injury, autism or muscular dystrophy to name but a few of the myriad of conditions that remain as untreatable as they did when they were unnamed 'distempers' in the eighteenth century.

Moore's description of the dash and élan shown by Hunter and his followers, such as Edward Jenner, at the dawn of scientific medicine is invigorating. The discovery of knowledge was exploding in all directions. New continents were being explored by the likes of Cook, new animals and plants were being brought back to Britain and the principles of chemistry and geology were being described. Today's cautious, lumbering, highly institutionalised approach to medical research seems rather dull by comparison. Employing thousands of faceless workers it consumes huge amounts of resource, promises much but delivers disappointingly little. Most advances are refinements of existing treatments rather quantum shifts in thinking.

The conditions that gave rise to a man like Hunter in eighteenth century Europe, may no longer exist here, but it is very possible they do in other parts of the world. It seems likely that the next lurch forward in medicine will not happen in the ivory towers of the West, but in China, South America or perhaps sub-Saharan Africa. I only hope they are more generous in sharing their discoveries with us than we have been with them.

This fascinating account of Hunters is not a great work of literature. Some tighter editing would have helped by reducing the number of times stories and comments are repeated, but this detracts little from an excellent story which ought to make us all think about where our profession is going. If you haven't read this book get your hands on a copy.

Other online articles by Rob Hendry can be found at:
hoolet edition 45 - Goodbye...
hoolet edition 45 - The Knife Man
hoolet edition 43 - Strength Through Joy
hoolet edition 32 - The Drugs War

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.