A Treatise (Second Edition, 1823) by Founder of Scientific Surgery John Hunter

By Sophie Quick

A Treatise on the Blood, Inflammation, and Gun-Shot Wounds (Second Edition, 1823), by Dr. John Hunter (1728-1793), “was considered the most important study of inflammation and has been widely quoted since,” [1] as the Treatise is considered a foundational source by modern doctors and medical researchers. This book, detailing a wide range of topics within the context of battlefield medicine, contains a treasure trove of information that forever changed the study of blood, and wounds and their aftermath.

Hunter had no formal education but was hired by his brother William to be a dissection assistant in 1748 when they moved to London [2]. During this time of practical learning, and after gaining quite a bit of experience, John Hunter proved himself to be very gifted with the study of human anatomy and surgery and ended up teaching classes and running his own dissections and autopsies for other incumbent physicians and surgeons [3]. Then, between 1749 and 1754, he studied at Chelsea Hospital in London under several highly acclaimed, celebrated surgeons, before returning to his brother’s practice to do much the same as he did before, only in a more highly studied, professional manner [4]. Before long, he was hired on as a senior surgeon with the Royal Navy and spent several years from 1760 to 1763 attached to war efforts, carrying out duties as both a surgeon and a researcher [5]. This time produced the studied book, at the behest of King Charles III: A Treatise on the Blood, Inflammation, and Gun-Shot Wounds. After his return to civilian life, he opened his own surgical and dental practices in London. Hunter was eventually named Fellow of the Royal Society in 1767 due to his command of science [6]. He published a few more papers, but otherwise lived a quiet life researching and performing surgeries in London [7].

As a slightly off-topic point of interest, he was also the main inspiration for Robert Louis Stevenson’s The Strange Case of Dr. Jekyll and Mr. Hyde due to his reclusive tendencies, somewhat mad genius, and maniacal research habits [8]. Three years before his death in 1793, King George III funded Hunter’s research and published several of his research papers, including a reworked version of A Treatise [9]. This skyrocketed his prestige, even after his death in 1793. Although his research was already groundbreaking and was circulated widely, the publication ensured his research went global and would be remembered for a long time [10].

Dr. John Hunter, therefore, became known as the father of scientific surgery. He had several students, from both Great Britain and the United States; one of them, Dr. Philip Syng Physick (not a pen name, shockingly enough), happens to be the author of the second edition of A Treatise, and is therefore the additional author of the copy found in the Ruth Lilly Medical Library. Reprinted in 1823, the second edition of A Treatise is an annotated version of the original, in which Dr. Physick adds comments pertaining to advancements in technology and new developments in medical practice, as well as critiques of the contents of the original publication. It also reformats the work into a more “readable and palatable” [11] version of the original without taking away from style, format, organization, content, and detail. Dr. Philip Syng Physick, a former student of Hunter, and a celebrated leader of American surgery at the University of Connecticut himself, is perhaps one of the very few qualified people to do such a thing to Dr. John Hunter’s work and fully maintain its original integrity.

This book, evidently having been studied thoroughly by surgeons and doctors worldwide, became, as stated above, a highly quoted and referenced text on inflammation and other effects of wounds, violent or otherwise. His work is particularly prized because it “is based mainly on his wide clinical experience, including that as a military surgeon” [12]. The medical community trusted him and his work not just because it was funded and published by King George III, but because he gained it all through hard observation and practice on the battlefield. As an established surgeon, his research became even more widely known, and attracted several hopeful students, many of which Hunter ended up taking on. Specifically, his research revolutionized the study of and care for gunshot wounds, which were obviously becoming more and more frequent as weaponry modernized, and England’s colonization efforts were ramping up in scale, frequency, and duration. Getting helpful, modern information from a trusted surgeon who dealt with the situations firsthand, meant that his research and subsequent book became the reference for treatment for wounds that ended up acquiring inflammation, gunshot wounds in particular.

The fact that Dr. Physick republished his work, decades later, with minimal changes to its base information, suggests that Dr. Hunter’s work was foundationally correct and that no major changes needed to be made even though medical technology and knowledge had developed much in the years since the Treatise’s original publication. The Treatise set standards with accurate and highly detailed research – standards that still, in part, remain today. Hunter is considered the Founder of Scientific Surgery by the National Institutes of Health (it’s true! Put “founder of scientific surgery” into your search bar and see who pops up!), and “Many of his pupils became famous in their own right and two of them founded the USA's first medical school;” [13] one of those pupils was Physick. The level of surgical skill we possess in today’s modern medical field was in part due to Hunter and his teachings, carried out by pupils like Physick, and built on by those who came after.

That being said, the Ruth Lilly Medical Library is quite fortunate to have this book, written by both teacher and student, in its stores.

(This post was written for the course HIST H364/H546 The History of Medicine and Public Health. Instructor: Elizabeth Nelson, School of Liberal Arts, Indiana University, Indianapolis).

References:

[1] J.L. Turk, “Inflammation: John Hunter’s ‘A Treatise on the Blood, Inflammation, and Gun-Shot Wounds,’” International Journal of Experimental Pathology 70, no. 6 (Dec. 7 1994): 385.
[2] Kelly Kap and Glenn Talboy, “John Hunter: the Father of Scientific Surgery,” American College of Surgeons, Bulletin of the Surgical History Group, Papers from the 2017 Poster Competition, American College of Surgeons Clinical Congress, 2017, p. 34, https://www.facs.org/media/xuqgdukk/2017_shg_posterpapers_fullinteractive.pdf
[3] Kap and Talboy, “John Hunter”, 35
[4] Ibid., 36
[5] Ibid.
[6] Ibid.
[7] Ibid.
[8] Ibid.
[9] John Hunter, A Treatise on the Blood, Inflammation, and Gun-Shot Wounds, (No. 24 Eighth Street, 1823), 2nd edition, pg. XXI
[10] Ibid.
[11] Ibid.
[12] Turk, “Inflammation”
[13] C.H. Evans, “John Hunter and the Origins of Modern Orthopaedic Research,” Journal of Orthopaedic Research 25, no.4 (Apr. 25 2007): 556-560.

Image Credits:

Kelly Kap and Glenn Talboy, “John Hunter: the Father of Scientific Surgery,” American College of Surgeons, Bulletin of the Surgical History Group: Papers from the 2017 Poster Competition, American College of Surgeons Clinical Congress, 2017, p. 35. https://www.facs.org/media/xuqgdukk/2017_shg_posterpapers_fullinteractive.pdf