Mentors Matter
Dr. John Hunter - Father of Modern Surgery
Dr. John Hunter (1728 - 1793) was a British surgeon known as “The Father of Modern Sur-gery”. He had distinguished influence upon other well-known medical pioneers such as Ed-ward Jenner (pioneer of smallpox vaccine) who was taught by Hunter and Joseph Lister (pi-oneer of surgical antisepsis) who was greatly influenced by Hunter’s theories in his writ-ings. And then, Dr. John Hunter in 1776 was the appointed Royal Surgeon to King George the III of Britain.
His breadth of expertise was impressive. He was an anatomy teacher (dissectionist) at his brother’s school of anatomy as a 21-year-old, became an assistant surgeon at St. George’s Hospital (1756), then an Army surgeon (1760 - 1763), learned dentistry and “tooth trans-plants” in London (1763-1768) and became a private full surgeon in London in 1768 where he became a leading authority in venereal disease (which was a “surgical disease” involving cautery!!). He became the first to surgical perform artificial insemination (1790). He was also a leading researcher of the lymphatic system including lacteals which are lymphatic capillaries in the lining of the stomach to absorb fats (triglycerides). His anatomical dissec-tions as a younger man included many pregnant women who died of pre-eclampsia (10% of all pregnancies today that is treated fairly routinely) and these dissections lead to the discovery that fetal and maternal circulations are separate. His wartime experience made him an expert in gunshot wounds and wound care.
But two aspects of Dr. Hunter which I find particularly inviting are his reform of surgical education and advancement; and his theories of inflammation which were literally 200 years ahead of their time. In 1790 as Surgeon General to the Prime Minister, William Pitt, Dr. Hunter introduced a system of appointment and promotion of surgeons based upon their experience, skills, and meritorious outcomes instead of by “patronage” which was the typical way in which you were advanced according to who you knew. Dr. Hunter has a vo-racious appetite to learn as exemplified by his breadth of seemingly disparate topics. He himself had collected over 14,000 organ specimens that he had dissected from various ani-mals, with intact skeletons of over 3,000 different animals. He had also bought the corpse of the famous London “giant” Charles Byrne who was 7 foot 7 inches from a relative at his funeral!! All of these are housed at the Hunter Teaching Museum which he started during his own lifetime (1783)
But the most intriguing aspect to me was his theory of inflammation in the human body. It was Dr. Hunter writing in his treatise, “A Treatise on the Blood, Inflammation, and Gunshot Wounds” (1794) that the rumor, calor, and dolar of infection and putrification (pus) of a wound was not caused by inflammation but rather that inflammation was non-patho-genic and was simply the response to infection. This novel theory would not be fully real-ized until the discover of nitric oxide (1980) and the endothelium with Dr. Roger Bone’s novel definition of “sepsis syndrome” (1991) — and even today in 2023 with “fever pho-bia” “sepsis alerts” and “sepsis order sets” is not fully realized.