John Hunter: ‘Founder of Scientific Surgery’

Hunter’s experiments provided many invaluable insights for modern medicine.

Primarily a student of observation as opposed to strict academia, John Hunter’s wide-ranging interests allowed him to explore several areas of medicine simultaneously. As a surgeon with an attraction to comparative anatomy, Hunter dedicated his skills and focus to “no less than a total understanding of life,” leading to his voracious, lifelong studies of anatomy, physiology and pathology in both humans and animals.

Always the innovator, Hunter applied his scientific conclusions to concepts of wound healing, transplantation, heart disease, orthopedics and pathology. As he conducted his research, Hunter compiled specimens and notes into one of his greatest contributions to medicine: the Hunterian Museum.

Though initially considered a difficult young man, Hunter eventually evolved into a skilled surgeon whose passion for research would pave the way for future leaders in his field.

A budding naturalist

Though his original birth date is unclear, John Hunter, in characteristically stubborn fashion, insisted on celebrating his birthday on February 14. The last of 10 children born to the Laird of Long Calderwood in 1728, Hunter spent the majority of his childhood exploring the natural wonders of his father’s estate in East Kilbride, Scotland. Throughout this time, he expressed his contempt for, and impatience with, school, preferring to examine the natural world, a penchant that would persist throughout his life.

John Hunter was a skilled surgeon whose passion for research paved the way for future leaders in his field. Source: Source: Royal College of Surgeons

As a young adult, Hunter went to London to join his older brother William, an anatomist and obstetrician with a growing lab and a respectable reputation. To everyone’s surprise, Hunter, who was unwieldy and irritated by academics, demonstrated a tremendous dexterity for dissection. Hunter immediately commenced working at William’s anatomy school before becoming a pupil at Chelsea Hospital in 1749.

An apprenticeship in surgery at St. Bartholomew’s Hospital followed, and from there, Hunter went on to work at St. George’s Hospital, where he would become house surgeon in 1768. Yet, Hunter’s appointment was short-lived; he desired to devote himself to anatomy.

In 1763, Hunter opened a surgical practice in London and bought a plot of land in Earl’s Court in London. He quickly populated this land with numerous animals of various species to extend his knowledge of comparative anatomy. Eventually, Hunter made this his home with his wife, Anne Home, a poet with whom he would have four children.

Renowned observations

Some of Hunter’s most remarkable discoveries dealt with the importance of pathology, especially in relation to surgery. His ideas regarding this connection originated during his service as an army staff surgeon in the Seven Years War.

In Hunter’s posthumous publication, “A Treatise on Blood, Inflammation and Gun-shot Wounds,” he noted the significance of inflammation and examined its causes as well as its subsequent effect on tissue damage in soldiers who sustained severe gunshot injuries. Hunter’s conclusions caused him to adhere to a conservative viewpoint: surgery and amputation should be a last resort. Though his ideas were disputed at the time, Hunter was ultimately proven correct.

Much of Hunter’s work focused on the pathology of infectious conditions, such as tuberculosis, suppuration in abscesses, bone lesions and osteomyelitis. He was one of the first physicians to concentrate on these infectious conditions in relation to surgery and consequently was one of the first to understand the importance of infection control in surgery.

In addition to these observations, Hunter amassed more than 2,000 pathological preparations of his own research that eventually found their way into the Hunterian museum. Among the accumulated data, numerous cases of cancer appeared, indicating Hunter’s early contributions to oncology. His collection included examples of tumors; early instances in which cancer of the breast and rectum had spread to regional lymph nodes; initial cases of pathological atheroma; and evidence of malignancies from carcinoma.

One of Hunter’s more famous specimens involved the body of a man with osteosarcoma of the thigh. Although he did not actually name the phenomenon, Hunter noted the emergence of similar tumors in the man’s lungs and theorized about their constitution and development. In this case, Hunter’s preliminary recognition of metastasis served as proof that his powers of observation precipitated later important discoveries.

However, Hunter’s experiments were not limited to pathology. One of his well-known scientific trials, which involved tying a thread around a stag’s carotid artery, successfully demonstrated the concept of collateral circulation. Initially, the stag’s tied-off antler became cold and stopped growing. Nevertheless, as Hunter hypothesized, its warmth returned in two weeks and resumed developing. After this triumphant experiment, Hunter translated his research to formulate procedures that could bypass vascular aneurysms.

Hunter’s museum preparations also illustrate his growing grasp of bone resorption. After conducting numerous experiments on animals, including transplanting human teeth into a cock’s comb, Hunter advocated tooth transplantation for dentists of his time. Although original attempts at tooth transplantation in humans met with failure due to graft rejection, Hunter gained insight into the need for “freshness of transplanted tissue” as well as “matching for size” of transplanted organs.

Even though more than two centuries have passed, these revolutionary experiments, as well as Hunter’s abundant preparations, can still be seen in London at the Hunterian Museum at the Royal College of Surgeons of England, which was purchased and preserved by parliament in 1799.

Recognition earned

Throughout his distinguished career, Hunter maintained a reputation for his stubborn pursuit of research. For instance, Hunter made countless requests for hedgehogs as research subjects to be sent from his friend and former pupil, Edward Jenner, despite their inability to survive at Earl’s Court. Also, his relentless yearning to study the body of Charles Byrne, the Irish giant, led him to engage in bribery and body-snatching.

Hunter’s studies proved to be more useful than unusual, and he earned a great deal of respect from the public and his peers. In 1767 at the age of 39, Hunter was elected to the Royal Society, and nine years later in 1776, King George III dubbed him Surgeon Extraordinary. In 1786, Hunter also received the esteemed Copley Medal from the Royal Society.

By this time, Hunter was recognized as the leading teacher of surgery of his time. His passion and expertise attracted many students who would eventually become famous in their own right, such as Thomas Chevalier and Edward Jenner.

Unfortunately, despite his early aversion to scholarship, Hunter’s fervor to institute better academic programs for his students led to his death at the age of 65. On Oct. 16, 1793, Hunter, a longtime sufferer of angina pectoris, died of a coronary occlusion during an argument with the board of St. George’s Hospital about his desire to train two students who were unapproved for the surgical profession.

Hunter’s accomplishments were far-reaching and his forays into various areas of science and medicine make it nearly impossible to classify him as having just one specialty. His epitaph at Westminster Abbey describes him as “a gifted interpreter of the Divine Power and wisdom at work in the laws of organic life” and “The Founder of Scientific Surgery.”

In 1914, the Royal College of Surgeons of England recognized Hunter’s many accomplishments by establishing the Hunterian Oration in his honor, thus commemorating his revolutionary mind for future generations of scientists and physicians. – by Melissa Foster

For more information:

• Ann R Coll Surg Engl. 2005;87:1-18.
• BMJ. 1978;1:391-392.
• BMJ. 1949;1:379-383.
• Br Heart J. 1986;56:109-114.
• John Hunter. The Royal College of Surgeons of England website. www.rcseng.ac.uk/museums/history/johnhunter.html. Published 2008. Accessed Dec. 23, 2008.