The case books of John Hunter FRS

About this book

Surgery in the 18thC, practised without aseptic procedures or anaesthetics, incurred a high mortality rate due to physiological shock and post-operative infection. John Hunter, being the first to apply the results of scientific research to the teaching of anatomy and operative surgery, was instrumental in raising the professional and social status of the surgeon. He played an important role in the establishment of organised, comprehensive surgical training to replace the apprenticeship system. Hunter deplored the tendency of some surgical contemporaries to embark on unnecessary invasive surgery for financial gain rather than for the well-being of the patient, and advocated a more conservative approach to surgery. He was acutely aware of the need to improve operative technique and to control the pain experienced by the patient. Unlike the teaching of his contemporaries, Hunter stressed the relationship between structure and function and demonstrated physiological principles, believing that the future of surgery lay, at least partly, in assisting the body's own powers to accommodate to trauma, physical disease or environmental change. Hunter based his lectures on the Principles of Surgery. Pupils who attended his private anatomy school benefited from his extensive teaching museum of human and comparative anatomy and physiology and morbid anatomy, which included many specimens of undiagnosed disease that Hunter preserved for future generations of medical students. Hunter's greatest achievement in operative surgery was his innovative management of popliteal aneurysm, the result of meticulous research into the growth of antlers in deer and the structure of arteries in dogs. Hunter's extant case records reflect the wide range of cases treated by a successful surgeon with a large private practice and a hospital appointment.