The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery

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When Robert Louis Stevenson wrote his gothic horror story of Dr. Jekyll and Mr. Hyde, he based the house of the genial doctor-turned-fiend on the home of John Hunter. The choice was understandable, for Hunter was both widely acclaimed and greatly feared.
 
From humble origins, John Hunter rose to become the most famous anatomist and surgeon of the eighteenth century. In an age when operations were crude, extremely painful, and often fatal,...
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Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery

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Overview

When Robert Louis Stevenson wrote his gothic horror story of Dr. Jekyll and Mr. Hyde, he based the house of the genial doctor-turned-fiend on the home of John Hunter. The choice was understandable, for Hunter was both widely acclaimed and greatly feared.
 
From humble origins, John Hunter rose to become the most famous anatomist and surgeon of the eighteenth century. In an age when operations were crude, extremely painful, and often fatal, he rejected medieval traditions to forge a revolution in surgery founded on pioneering scientific experiments. Using the knowledge he gained from countless human dissections, Hunter worked to improve medical care for both the poorest and the best-known figures of the era—including Sir Joshua Reynolds and the young Lord Byron.
 
An insatiable student of all life-forms, Hunter was also an expert naturalist. He kept exotic creatures in his country menagerie and dissected the first animals brought back by Captain Cook from Australia. Ultimately his research led him to expound highly controversial views on the age of the earth, as well as equally heretical beliefs on the origins of life more than sixty years before Darwin published his famous theory.
 
Although a central figure of the Enlightenment, Hunter’s tireless quest for human corpses immersed him deep in the sinister world of body snatching. He paid exorbitant sums for stolen cadavers and even plotted successfully to steal the body of Charles Byrne, famous in his day as the “Irish giant.”
 
In The Knife Man, Wendy Moore unveils John Hunter’s murky and macabre world—a world characterized by public hangings, secret expeditions to dank churchyards, and gruesome human dissections in pungent attic rooms. This is a fascinating portrait of a remarkable pioneer and his determined struggle to haul surgery out of the realms of meaningless superstitious ritual and into the dawn of modern medicine.
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Editorial Reviews

From Barnes & Noble
John Hunter was a medical genius whose ghoulish practices horrified many of his contemporaries. Born a poor Scottish farm boy, he pursued his medical experimentation with obsessive fervor. At a time when bloodletting and a monarch's touch were considered cures, he dissected hundreds of human corpses; experimented with human transplants; and attracted an impressive roster of eminent patients, including Benjamin Franklin, Lord, Byron, Adam Smith, and Sir Joshua Reynolds. Yet his willingness to traffic in black market cadavers gave him a scandalous reputation that long survived him: Robert Louis Stevenson modeled the house of the demonic Mr. Hyde on the abode of this corpse collector.
Mary Roach
It isn't just what Hunter achieved that makes him so fascinating, but also what he risked. He confronted the status quo at every turn, making enemies who would ultimately try to damage his legacy. He infuriated physicians who sold useless potions to gonorrhea sufferers by showing that the ailment retreated on its own in a few years. He rejected the near-universal claim that masturbation caused impotence, stating, sensibly, that ''a practice so general'' could hardly be the cause of a relatively rare affliction. He angered colleagues by publishing papers on the dangers and limitations of surgery and preaching extreme moderation in its practice. He admitted his errors (''I think it is probable I killed him'') and undercharged his patients. Medicine needs more John Hunters, and biography needs more Wendy Moores.
— The New York Times
Publishers Weekly
Brilliant anatomist, foul-mouthed and well met, avid empiricist and grave robber, John Hunter cut an astonishing figure in Georgian England. Born in Scotland in 1728, he followed his brother, a renowned physician, to London and into the intellectually grasping, fiercely competitive world of professional medicine. With ample servings of 18th-century filth and gore, Moore offers a vivid look at this remarkable period in science history, when many of the most impressive advances were made by relentless iconoclasts like Hunter. In an age when ancient notions of bodily humors still smothered medical thinking, Hunter challenged orthodoxy whenever facts were absent-which was usually the case. A prodigious experimenter-to the point of obsession-he dissected thousands of corpses and countless animals (many of them living) in his effort to define the nature of the human body. Yet he was also an early adherent of medical minimalism, shunning bloodletting by default and advocating physical therapy over invasive surgeries. This is a deftly written and informative tale that will please readers of science history, period buffs and everyone in between. (Oct. 1) Copyright 2005 Reed Business Information.
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Product Details

  • ISBN-13: 9780767916523
  • Publisher: Crown Publishing Group
  • Publication date: 9/13/2005
  • Pages: 352
  • Product dimensions: 6.43 (w) x 9.51 (h) x 1.08 (d)

Meet the Author

Wendy Moore is a writer and a journalist. After working as a reporter for local newspapers she has specialized in health and medical topics for more than twenty years. As a freelance journalist her work has been published in a range of newspapers and magazines—including the Guardian, the Observer, and the British Medical Journal—and has won several awards. Having written extensively on medical history, she obtained the Diploma in the History of Medicine from the Society of Apothecaries (DHMSA) in 1999 and won the Maccabaean Prize for the best dissertation that year. This is her first book. Upon its publication in the United Kingdom, The Knife Man was named Consumer Book of the Year by the Medical Journalists’ Association. Moore lives in South London with her partner, Peter, also a journalist, and two children, Sam and Susannah.
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Read an Excerpt

The Knife Man


By Wendy Moore

Broadway

Copyright © 2005 Wendy Moore
All right reserved.

ISBN: 0-7679-1653-0


Chapter One

The Coach Driver's Knee

St. George's Hospital, Hyde Park Corner, London December 1785

The patient faced an agonizing choice. Above the cries and moans of fellow sufferers on the fetid ward, he listened as the surgeon outlined the dilemma. If the large swelling at the back of his knee was left to continue growing, it would soon burst, leading to certain and painful death. If, on the other hand, the leg was amputated above the knee, there was a slim chance he would survive the crude operation-provided he did not die of shock on the operating table, or bleed to death soon after, or succumb to infection on the filthy ward days later-but he would be permanently disabled.

For the forty-five-year-old hackney coach driver, both options were unthinkable. Since he had first noticed the swelling in the hollow behind his knee three years ago, the lump had grown steadily, until it was the size of an orange.(1) It throbbed continuously and was now so painful, he could barely walk. Extended on the hospital bed before him, his leg and foot were hideously swollen, while his skin had turned an unsightly mottled brown. Once the coachman had gained admittance to St. George's, having persuaded the governors he was a deserving recipient of their charity, the surgeon on duty hadlost no time in making a diagnosis. He had seen popliteal aneurysms at exactly the same spot on numerous occasions and knew the prognosis all too well.

It was a common-enough problem in the cabdriver's line of work. Aneurysms could happen to anyone, anywhere in the body, but they appeared to occur with particular frequency among coach drivers, and others in equestrian occupations in Georgian London, in the popliteal artery behind the knee. The condition, in which a section of artery that has been injured or otherwise weakened begins to bulge to form a blood-filled sac, may well have been triggered by the wearing of high leather riding boots, which rubbed the back of the knee. As the aneurysm swelled, it not only became extremely painful but made walking exceedingly difficult. Whatever the cause, the outcome was often an early death-if not from the condition itself, then from the treatment generally meted out. To lose his leg, even supposing the coach driver survived such a drastic procedure in an era long before anesthesia or antiseptics, would mean never being able to work again. But to carry on working, navigating his horse-drawn carriage over London's rutted and congested roads, would be equally impossible if the lump was left to grow. Either way, the cabbie feared destitution and the workhouse.

But there was a third choice, the surgeon at his bedside now confided on that early December day, for a coachman sufficiently willing or desperate. In his slow Scottish lilt, redolent of his humble farming origins, the surgeon laid out his scheme for a daring new operation. Surrounded by the poxed, maimed, and diseased bodies of London's poorest wretches, huddled in their beds on the drafty ward, the cabbie resolved to put his life in the hands of John Hunter.

Without a doubt, John Hunter's reputation was well known to the coach driver long before he limped through the portal of St. George's, for he was generally acknowledged as one of the best-skilled surgeons in London, if not Europe, and was a favorite among the well-heeled and the unshod alike. As well as working for no recompense patching up the poor in St. George's, he was in constant demand from the fee-paying patients who thronged each morning to his fashionable home in Leicester Square or called him out for consultations in the elegant drawing rooms of their West End villas. For all his blunt manners, coarse speech, and disdain for fashion-he currently sported an unkempt beard and tied his tawny-colored hair behind his head in preference to wearing the customary wig- Hunter was firmly established in Georgian high society. He visited court as surgeon extraordinary to George III, dined with the society artist Sir Joshua Reynolds, and debated science with his close friend, the well-connected naturalist Sir Joseph Banks.

Now aged fifty-seven, with seventeen years' service at St. George's under his belt, Hunter was renowned for his pioneering and controversial operations. Only two months before the coach driver's admission, he had skillfully cut away from the neck of a thirty-seven-year-old man a massive benign tumor weighing more than eight pounds and roughly the size of an extra head. The relieved patient had walked away with only a long, neat scar as souvenir of his ordeal. Hunter was popular with the medical students, too. The coachman had watched the eager pupils trooping devotedly after their teacher on his ward rounds, for more students clocked to Hunter's side than to all the other surgeons at St. George's put together. Aspiring young surgeons traveled not only from the far reaches of the British Isles but even from across the Atlantic to "walk the wards" at Hunter's side and hear their hero expound on his radical views in the private lectures he held at his home each winter.

But the cabbie would have heard darker stories, too, whispered on the wards, insinuated in newspapers, and muttered in coffeehouses and cockpits, for Hunter was as much feared and despised as admired in eighteenth-century London. Although his pupils idolized their master, and patients often had cause to thank the bluff but honest surgeon, Hunter's fiery temper and maverick views had earned him powerful enemies within the four walls of St. George's, and beyond. While aristocrats bowed to his medical advice, and denizens of the Royal Society-the engine room of eighteenth-century progress-hung on his every pronouncement, Hunter was isolated at St. George's. To his fellow surgeons, he was at best a laughingstock and at worst a reckless fool. And he had quarreled, too, with several of the city's other leading practitioners, not least his own elder brother.

To the students, the explanation for this was straightforward: Hunter was simply so far ahead of his contemporaries that he stood alone. But his rivals at St. George's had other opinions. They decried Hunter's novel approach and controversial methods, preferring to bleed, blister, and purge their patients to early graves-in strict accordance with classical teaching-than to question conventional modes of practice. They even encouraged Hunter's most vociferous enemy, a mediocre house surgeon named Jess Foot, who worked in a neighboring hospital, and whom Hunter had upset by criticizing a surgical appliance the young upstart had invented. In Foot's jaundiced view, Hunter was "a very inferior, dangerous, and irregular practical surgeon" who was embroiled in "continual war" at St. George's.

But there were stranger stories still about the rebellious surgeon. Hunter was known to keep rare and exotic wild beasts-including a lion, a jackal, a dingo, and two leopards-at his country home in the tranquil village of Earls Court, a few miles west of London. In this rural retreat, the surgeon performed countless experiments on animals both dead and alive. Innumerable research papers, presented to his friends in the Royal Society, detailed his bizarre trials, such as grafting a cockerel's testicle into the belly of a hen-an early step toward transplanting body parts in humans-as well as the freezing of fish and rabbits' ears in a forlorn attempt to invent a scheme for human immortality. At this prototype research center, Hunter dissected great carcasses, including whales washed up on the banks of the Thames, apes sent back from explorations into unmapped territories, and elephants donated by Queen Charlotte. It was here, too, that he experimented on living animals, tying down squealing pigs, sheep, and dogs for lengthy dissections in order to explore how healthy organs function and to test ways to improve surgery. Although by now they had become inured to the sight of rare beasts grazing the lawns, Hunter's curious neighbors still gaped on occasions when the surgeon set out from Earls Court driving a cart pulled by three Asian buffalo, headed for the West End. Arriving at his Leicester Square town house, a drawbridge could be swiftly lowered- and just as swiftly raised-to allow mysterious cargoes to trundle in and out.

The enterprising surgeon did not confine his zeal for research to the animal kingdom, however, for Hunter had built up his surgical expertise through an unrivaled knowledge of human anatomy. Since arriving in London almost four decades earlier, Hunter had dissected human bodies in unprecedented numbers. By his own admission, he had carved up "some thousands" during his lengthy career. It was through this relentless firsthand exploration of the human body, rather than by reading the works of the ancient Greeks and Romans or passively watching over the shoulders of other practitioners, that Hunter had become such a skilled operator. Although other surgeons of the day had become adept at certain procedures through trial and error, many operations performed in London's charity hospitals were still risky gambles, due to ignorance of anatomy and physiology. Whenever Hunter cut, probed, sliced, and sawed, he knew precisely what lay beneath. He possessed a better knowledge than any other surgeon in town of the exact whereabouts, functions, and habits of every organ, muscle, blood vessel, and tissue, healthy or diseased, that he was likely to encounter.

Yet while many of Hunter's patients, rich and poor, were grateful for their surgeon's intimate knowledge of the human body, few gave their approval to the sinister extremes to which he went to obtain his research material. Like most surgeons and anatomists of the time, Hunter had no lawful source for the majority of the bodies he daily dissected. Like others, he was forced to adopt underhanded means to pursue his work, turning to London's criminal elements to supply his needs. Hunter, however, went further than any other anatomist of the day in his connections with the Georgian underworld. Desperate to expand his collection of animal and human specimens in the remarkable museum he had just established at his Leicester Square house, Hunter was notorious for paying above the norm for any kind of anatomical curiosity-whether rare human deformities or the results of a pioneering, but ultimately fatal, operation.

So as the tortured coach driver stared anxiously from his hospital bed into Hunter's pale blue eyes, he knew that volunteering to go under the renowned surgeon's knife in the operating theater at St. George's could very well mean going under his knife a second time-dead on the dissection table, with his mutilated leg destined for the anatomist's museum. Nonetheless, clinging to the slim prospect of recovery held out to him, he gave John Hunter his consent for the new operation.

For Hunter, the coach driver represented the perfect human guinea pig. Until now, he had tried to save patients with popliteal aneurysms from either a premature death or a life-threatening amputation by performing an operation that he knew was highly risky and exceedingly painful. This procedure, which had been attempted by surgeons across Europe with various refinements for some centuries, meant cutting straight into the back of the knee, tying the damaged artery above and below the aneurysm, and scraping out the blood-filled sac. Based on his knowledge of anatomy and research, Hunter believed that once prevented from taking its usual path down the popliteal artery, the blood supply would find alternative routes- or "collateral circulation"-through the smaller blood vessels in the area. Almost without exception, the technique had failed. More often than not, the already-weakened blood vessel burst and the patient bled to death, making Hunter the butt of his colleagues' scorn.

Given such outcomes, Percivall Pott, a respected surgeon at St. Bartholomew's Hospital, as well as Hunter's former teacher, insisted that amputation was the only viable remedy for popliteal aneurysms-even though he admitted the procedure was "terrible to bear" and "horrid to see." The surrounding blood vessels in the leg were simply too few and too small, Pott argued, to foster collateral circulation once the main artery was tied. Conversely, William Bromfield, the recently retired senior surgeon at St. George's, who had once been Hunter's examiner for his surgeon's diploma, proclaimed that neither amputation nor "Hunter's operation" were of the slightest use in treating the condition. Mistakenly averring that a popliteal aneurysm indicated that a patient's entire arterial system was diseased, he insisted that there was simply no cure for the problem. It was an opinion that effectively dealt a death sentence to every poor coachman who ventured into Bromfield's care.

Never one to bow to authority or defer to his elders, Hunter was not prepared simply to abandon hope and consign his patients to a lingering, agonizing death. His aversion to drastic surgery except as a last resort, and his firm belief in nature's healing powers, made him equally unwilling to perform amputations. Refusing to be defeated, he resolved to apply his singular approach to the problem. Unlike the vast majority of surgeons operating in London homes and hospitals, who wielded their lancets and saws in imitation of long-dead past masters while rarely considering any need for improvement, Hunter believed all surgery should be governed by scientific principles, which were based on reasoning, observation, and experimentation.

Techniques for most operations had changed little since medieval times, while treatment regimes still owed their basic principles largely to the theories of the ancient Greeks. Although medical students usually learned some rudimentary anatomy, this was considered a useful but not vital adjunct to on-the-job experience. And when patients died on the operating table as a result of ignorance and blundering, as they frequently did, few, if any, lessons were learned from the outcome.

Hunter, however, had enjoyed a distinctly different preparation for the job, having spent a full twelve years studying anatomy in his brother William's dissecting rooms and only a brief spell walking the wards, before embarking on his surgical career. As a consequence, he considered anatomy the foundation stone for all surgery. He believed that only by minutely studying the human body, in order to understand the whereabouts and functions of every living part, could surgeons possibly hope to improve their skills. Furthermore, his experience on the hospital wards had taught him principally, in ghastly and bloody detail, how primitive his profession really was.

So Hunter had set out systematically to question every established practice, develop hypotheses to advance better methods, and test by means of rigorous observation, investigation, and experiment whether these methods worked. Often he tried out his theories on animals before attempting new procedures on humans, while the results of the handiwork he performed in the operating theater were always carefully observed during the patient's subsequent recovery, or, if the person died, in autopsy investigations. The lessons he learned were diligently applied to modify his methods, resulting in a continuous research loop, which would still stand up to scientific scrutiny more than two centuries later. Instilling the same approach in his pupils, Hunter summed up his doctrine in characteristically concise style when his favorite protégé, Edward Jenner-who would later develop the smallpox vaccine-asked him for help in solving a problem. "I think your solution is just," responded his mentor, "but why think, why not trie the Expt."

(Continues...)



Excerpted from The Knife Man by Wendy Moore Copyright © 2005 by Wendy Moore. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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First Chapter

The Knife Man


By Wendy Moore

Random House

Wendy Moore
All right reserved.

ISBN: 0767916522


Chapter One

1

The Coach Driver's Knee

'I have seen a man die almost immediately upon the loss of a testicle ...The loss of a limb above the knee, is more than man can bear...'
John Hunter

St George's Hospital, Hyde Park Corner, London, December 1785

The patient faced an agonizing choice. Above the cries and moans of fellow sufferers on the fetid ward, he listened as the surgeon outlined the dilemma. If the large swelling at the back of his knee was left to continue growing, it would eventually burst, leading to certain and painful death. If, on the other hand, the leg was amputated above the knee, there was a slim chance he would survive the crude operation — provided he did not die of shock on the operating table, or bleed to death soon after, or succumb to infection on the filthy ward days later — but he would be permanently disabled.

For the forty-five-year-old hackney coach driver either option was unthinkable. Since he had first noticed the swelling in the hollow behind his knee three years ago, the lump had grown steadily until it was now the size of an orange; it throbbed continuously and had become so painful he could barely walk. Extended on the hospital bed before him, the leg and foot were hideously swollen while the skin had turned an unsightly mottled brown. Once the coachman had gained admittance to St George's, having successfully persuaded the governors he was a deserving recipient of their charity, the surgeon on duty had lost no time in making a diagnosis. After examining the tell-tale lump, which was 'so large as to distend the two hamstrings laterally', he had no doubts about the verdict. The surgeon had seen popliteal aneurysms at exactly the same spot on numerous occasions and knew all too well the prognosis.

It was a common enough problem in the cab driver's line of work: popliteal aneurysms could happen to anyone — they could develop in arteries anywhere in the body either through injury or, more commonly, due to a medical condition as a result of which the artery walls lose their elasticity — but appeared to occur with unnatural frequency among coach drivers, postilions and others working in equestrian occupations in Georgian London. The problem may quite possibly have been exacerbated by the wearing of high leather riding boots which rubbed at the back of the knee. Whatever the cause, the weakened section of artery would begin to bulge and develop into a sac which eventually became filled with clotted blood. When these occurred behind the knee, in the popliteal artery, they were not only extremely painful but made walking exceedingly difficult. The outcome was often an early death, if not from the condition itself then from the treatment generally meted out. To lose his leg, even supposing the coach driver survived such a drastic procedure in an era long before anaesthesia or antiseptics, would inevitably mean never being able to work again. But to carry on working, navigating his horse-drawn carriage over London's rutted and congested roads, would be plainly impossible if the lump was left to grow. Either way, the cabbie faced destitution and the workhouse.

But there was a third choice, the surgeon at his bedside now confided on that early December day, for a coachman sufficiently willing or desperate. In his slow Scottish lilt, redolent of his humble Lowland farming origins, the surgeon laid out his scheme for a daring and novel operation. Surrounded by the poxed, maimed and diseased bodies of London's poorest, huddled in their beds on the draughty ward, the cabbie resolved to put his life in the hands of John Hunter.

Without a doubt, John Hunter's reputation would have been well known to the coach driver long before he limped through the portal of St George's, for he was generally acknowledged as one of the best-skilled surgeons in London, if not Europe, and was a favourite among the well-heeled and the unshod alike. As well as working for no recompense in St George's, patching up the poor most afternoons, he was in constant demand from the fee-paying patients who thronged each morning to his fashionable home in Leicester Square or called him out for consultations in the elegant drawing rooms of their West End mansions. For all his blunt manners, his coarse speech and his disdain for fashion — he currently sported an unkempt beard and tied his tawny-coloured hair back in preference to the customary wig — Hunter was firmly established in Georgian high society, visiting court as Surgeon Extraordinary to George III, dining with the society artist Sir Joshua Reynolds, and debating science with his close friend, the well-connected naturalist Sir Joseph Banks.

Now aged fifty-seven, with seventeen years' service on the staff of St George's under his belt, Hunter was approaching the peak of his career and success, and enjoyed fame and earning power in equal measures as reward. When the Scottish philosopher David Hume consulted a galaxy of doctors about his worsening health in 1776, it was Hunter — the only one of the medics physically to examine the patient — who diagnosed terminal cancer. It was Hunter who gave first-aid to Dr Nevil Maskelyne, the ambitious astronomer royal, when he collapsed vomiting in a coffee-house after eating tripe in 1782. And when the genial American diplomat Benjamin Franklin became crippled with pain from a bladder stone in the summer of 1785, it was Hunter he consulted.

Aside from tackling the routine surgeons' fare of stanching stab-wounds from duels, removing lumps and limbs, and tending sundry abscesses, boils, pimples and running sores, Hunter was renowned for his pioneering operations. Only two months before the coach driver's admission he had skilfully cut away from the neck of a thirty-seven-year-old man a massive benign tumour that weighed more than four kilograms and measured roughly the size of an extra head. The grateful patient had walked away with only a long, neat scar as a souvenir of his ordeal.

No doubt the coachman had also watched from his bed as Hunter's medical students trooped devotedly after their teacher on his regular rounds of the surgical wards, for more pupils flocked to Hunter's side than to all the other surgeons at St George's put together. Aspiring young surgeons travelled not only from the far reaches of the British Isles but even from across the Atlantic to 'walk the wards' at Hunter's side and to hear their hero expound his radical views in the private lectures he held at his home throughout the winter. Fired by his revolutionary ideas, they walked home to their lodgings through the dimly lit streets hotly debating the theories they had absorbed, and would quote their mentor, as one put it, with all the authority of Aristotle. One zealous student reported Hunter's lectures as 'so far superior to every thing I had conceived or heard before, that there seemed no comparison between the mind of the man who delivered them, and all the individuals whether ancient or modern who had ever gone before him'. Another devotee called him simply 'the dear man'.

But the cabbie would doubtless also have heard darker stories, whispered on the wards, insinuated in newspapers or muttered in taverns, coffee-houses and cockpits, for Hunter was not a popular man within the four walls of St George's. Although his pupils idolized their master, and patients were frequently thankful to the bluff but honest surgeon, Hunter's fiery temper and maverick views, coupled with his decidedly unorthodox methods, had earned him powerful enemies at the hospital and beyond. While aristocrats humbly bowed to his medical advice and denizens of the Royal Society — the engine room of eighteenth-century progress — hung on his every pronouncement, Hunter was isolated at St George's. To his fellow surgeons he was at best a laughing stock and at worst a reckless, ill-educated fool. Hunter had quarrelled too with several of the city's other leading practitioners, not least his own brother.

To the students, the explanation was straightforward: Hunter was simply so far ahead of his contemporaries that he stood alone. 'It was a comfortless precedence, for it deprived him of sympathy and social co-operation; and he felt that his labours and merits were not known, or fairly estimated,' said one. But rival surgeons had other views. Colleagues at St George's decried Hunter's novel approach and his controversial methods, preferring rather to bleed, blister and purge their patients to early graves, in strict accordance with classical teaching stretching back to Ancient Greece, than to question any established modes of practice. They certainly concurred with, if not actively encouraged, Hunter's most vociferous enemy, a mediocre house surgeon at the nearby Middlesex Hospital called Jessé Foot, whom Hunter had once stung by summarily dismissing a surgical appliance the young man had invented. In Foot's view, Hunter was 'a very inferior, dangerous, and irregular practical surgeon' who was, furthermore, embroiled in 'continual war' at St George's.

Aside from concerns at his unusual ways, the chief source of conflict at the hospital was Hunter's enduring campaign to create a medical school aimed at providing students with a rounded introduction to surgery along the lines of the model established earlier in 1785 at the London Hospital. But this idea had been peremptorily rejected by Hunter's contemporaries. Thwarted by his efforts to enhance medical education, Hunter had been staging lectures on surgery in his own home for more than a decade, and had even invited St George's pupils to his early courses for free.

But there were stranger stories still about the rebellious surgeon, which could hardly have escaped the coach driver's attention. Hunter, for instance, was well known to keep rare and exotic wild beasts — including a lion, a jackal, a dingo and two leopards — at his country home in the tranquil village of Earls Court, a few miles to the west of London. It was in this rural retreat that the surgeon performed countless experiments on animals both dead and alive. Innumerable research papers, presented to his friends in the Royal Society, detailed the bizarre experiments he had pioneered, such as grafting a cockerel's testicle into the belly of a hen — an early step towards transplanting body parts in humans — as well as the freezing of fish and rabbits' ears in a forlorn attempt to invent a scheme for human immortality. At this prototype research centre, Hunter dissected great carcasses, including whales washed up on the banks of the Thames, apes sent back from explorations into unmapped territories, and elephants donated by Queen Charlotte. Yet he was just as fascinated to study the tiniest of living forms, like the worms he discovered inside the whales' intestines and the bees he tended in observation hives in the conservatory. It was here too that he experimented on living animals, tying down squealing pigs, sheep and dogs for lengthy dissections designed to explore how healthy organs function and to test theories on ways to improve surgery for his numerous patients. Curious neighbours, by now inured to the sight of rare animals grazing his lawns, had nicknamed Hunter 'the cunning man', reputedly in reference to his reputation for knowledge rather than to anything more sinister. Yet the villagers must still have gaped on occasions when the surgeon himself drove a cart pulled by three Asian buffaloes from Earls Court through the crowded West End streets to his Leicester Square townhouse, where a drawbridge could be swiftly lowered — and just as swiftly raised — to allow mysterious cargoes to trundle in and out.

Naturally enough, the enterprising surgeon did not confine his zeal for research to the animal kingdom. Hunter had built up his surgical expertise through an unrivalled knowledge of human anatomy. Ever since arriving in London almost four decades earlier, Hunter had dissected human bodies in unprecedented numbers. Giving evidence as an expert witness at a recent murder trial, he had been asked, 'I presume you have dissected more than any man in Europe?' and agreed, 'I have dissected some thousands during these thirty-three years.' It was through this relentless first-hand exploration of the human body, rather than by reading the dry works of the Ancient Greeks and Romans or passively watching over the shoulders of other medical men, that Hunter had become such a skilled operator. Although other surgeons of the day had become adept at certain procedures through the long experience of trial and error, many operations performed in London's charity hospitals were still risky gambles through comparative ignorance of anatomy and physiology. Whenever Hunter, by contrast, lifted his knife to begin an operation he knew precisely what lay beneath; he possessed a better knowledge of the human interior than any other surgeon in town. When Hunter cut, probed, sliced and sawed, he knew better than anyone else the exact whereabouts, the precise functions and the particular habits of every organ, muscle, blood vessel and tissue, healthy or diseased, that he was likely to encounter.

Yet while many of Hunter's patients, rich and poor, had good reason to give thanks for the surgeon's intimate knowledge of the human body, precious few would have given their approval to the sinister extremes to which he went to obtain his research material. Like all surgeons and anatomists of the time, Hunter had no lawful source for the majority of the bodies he daily dissected and he, like others, was forced to turn to underhand means to pursue his work. Although more enlightened families might give their consent to an autopsy on a relative who died on the operating table in order to discover the cause of death, most of the London populace still recoiled with horror at the notion of cutting up the body of a loved one. In consequence, surgeons had little option but to find alternative sources for the bodies they needed to hone their skills.

The gallows provided one steady stream of corpses for keen anatomists, both within the law — the Company of Surgeons in London was legally entitled to the bodies of six hanged murderers each year for public dissection — and outside the law, as surgeons flocked to Tyburn Tree on hanging days to beg, buy or steal the corpses of executed villains. But since even the steady flow of petty felons condemned to the gallows could not keep pace with the growing demands of anatomists, other more devious methods had evolved. Like other London anatomists, Hunter had turned to unscrupulous undertakers, shifty gravediggers and, above all, the gangs of professional body-snatchers who scoured London's churchyards by night unearthing fresh bodies to deliver to dissecting rooms before dawn. Hunter, however, had gone further than any other anatomist of his day in his connections with the Georgian underworld.<

Continues...


Excerpted from The Knife Man by Wendy Moore Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Sort by: Showing all of 4 Customer Reviews
  • Posted December 5, 2011

    more from this reviewer

    Interesting read - even if you don't know much about the history of medicine

    This was an interesting book about a man who it seems is somewhat lost in history, but who contributed much to what we know as modern medicine. It does not try to explain his motives, but does illuminate his surprising contributions. And if you like things that are a bit macabre, this will have some passages for you.

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  • Anonymous

    Posted September 29, 2005

    A very engaging book!

    This is one of the best nonfiction books I have read in a long time. I found it well ordered and at the same time very interesting. Before I started reading this book I wasn't familiar with the history of surgery. I have learned a lot and enjoyed it thoroughly. I just couldn't put it down.

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  • Anonymous

    Posted June 8, 2009

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  • Anonymous

    Posted June 29, 2011

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