John Hunter

John Hunter Military

After gaining some basic, but nevertheless formal, training in some aspects of medicine, John Hunter was commissioned in the Seven Years' War (1756-1763) between Britain and France. In this pre-Listerian era, it was difficult, if not impossible, for an aspiring medical student or civilian to gain surgical experience as it pre-dated the discovery of antiseptic. This was one of the main reasons that John Hunter served as an army surgeon; this opportunity meant that he could develop his skills and training, gaining experience along the way.

Hunter was able to demonstrate his extensive knowledge of human anatomy in this role. Hunter was commissioned as an army surgeon in Portugal and Belle Isle in France and lived here for three years, putting his skills to good use. Here Hunter acquired "surgical skills on gunshot wounds and inflammation".¹

The experiences he encountered not only allowed him to improve his practical skills but also allowed him to enhance his theoretical knowledge of medicine. For example, when John Hunter arrived in Portugal, the general protocol for treating gunshot wounds was extremely primitive and outdated.

Gunshot wounds were treated at the time with bloodletting, unnecessary amputations, or extremely invasive and often deadly procedures to remove the bullets.

During this era, surgery was a very risky procedure because there was no way to prevent bacterial infection, and anaesthesia had not yet been properly developed.

The moment John Hunter arrived, he cleverly identified that there was an issue with this form of treatment and began using his scientific methodology.

John Hunter Discovery

John Hunter observed five French soldiers who had been wounded by gunshots during the war but had not been treated. Despite having sustained gunshot wounds, John Hunter found that the patients were able to heal.

In this observation, John Hunter made a discovery. Allowing gunshot wounds to heal naturally ultimately resulted in higher survival rates. Hunter, however, still urged that gunshot wounds be properly cleaned to prevent infection from spreading.

In light of this discovery, John Hunter proposed that surgery should only be performed in rare cases of low-risk gunshot injuries. He concluded that:

• Gunshot bullets were only to be removed if the wound was superficial and the bullet was easy to remove.
• Operations were only to be done if the procedure was crucial in restoring a functional anatomical process.

The discovery was extremely progressive and demonstrated Hunter's focus on scientific methods in his research for the profession of medicine.

Hunter died in 1793 from a heart attack. However, his research was published posthumously in 1794, with the paper Treatise of Blood, Inflammation and Gunshot Wounds.

Fig. 3 - Photograph of Joseph Lister, the man who developed antiseptic treatments

Despite being unaware that infections cause inflammation, Hunter made insightful observations in his research about how inflammation is related to smallpox, venereal diseases, and tuberculosis. The observations made by Hunter influenced the later pioneer of antiseptic treatment, Joseph Lister.

Contributions of John Hunter

John Hunter's contributions to medical procedures and practice continued after he left the army in 1763.

Dentistry

In his post-military career, John Hunter spent around five years in dentistry. During this time, he made revolutionary contributions. Based on the knowledge he acquired during the five years, Hunter published The Natural History of Human Teeth in 1777.

The book described how teeth develop from birth, discussed tooth structure, and proposed a method for treating tooth misalignments. This was the first time that scientific classifications like cuspids, bicuspids, molars, and incisors were used.

Teaching

Hunter built up a large surgical practice and trained hundreds of other surgeons with his scientific approach to surgery. It is not surprising that so many of the young surgeons he taught went on to become great medical teachers in nineteenth-century Britain and America. Edward Jenner, who discovered the smallpox vaccine, trained with him and became a close friend.

Hunter started his own private lectures on the practice and principles of surgery in the 1770s, which he began after returning to London in 1763 following his time spent as an army surgeon. Hunter's anatomy school and private surgical practice were founded in London in 1764.

Venereal Disease

The study of venereal diseases was also advanced by John Hunter. At the time, both gonorrhoea and syphilis were believed to be caused by the same pathogen. Hunter disagreed, arguing they were separate pathogens. To disprove this theory, John Hunter infected himself with gonorrhoea.

Due to unknowingly infecting himself with both gonorrhoea and syphilis when he thought it was just gonorrhoea, his results were skewed as he concluded that gonorrhoea developed into syphilis. Even though he came to an incorrect conclusion, his initial hypothesis was correct.

Fig. 4 - Portrait of Edward Jenner, the man who developed the medical process of vaccination

Hunter's book On Venereal Disease (1786) was translated into several languages and was widely studied.

The work had a significant influence on Edward Jenner. John Hunter was said to have pushed his peer Jenner to conduct experimental research and use his findings to develop effective treatments. By building on Hunter's experiments with inoculation, Jenner eventually developed vaccination.

Osteoporosis

Hunter's observations of the human jaw, along with his experiments on animals, led him to a surprising conclusion. Hunter discovered that new bone formed when the old bone was resorbed. It is for this reason that Hunter is credited with making advances in bone studies, orthopaedics, and the treatment of osteoporosis.

Importance of John Hunter

Hunter is considered one of the greatest surgeons of all time. John Hunter's advancements during his time were revolutionary, especially his advocacy of scientific research and experimentation as a means to develop treatments.

• Later revolutionary thinkers like Edward Jenner focused deeply upon building on Jenner's experimentation, which led to the creation of vaccination. Vaccination is considered to be one of the most significant advances in modern medicine.
• While serving as an army surgeon, John Hunter articulated some extremely important ideas that saved countless lives by avoiding dangerous and unnecessary procedures.
• John Hunter conducted around 2,000 dissections during his lifetime, which contributed to the understanding of the human body and how to treat it effectively. The significance of Hunter's contributions cannot be understated, as they were in an era before antiseptics and vaccinations.
• Hunter's dissections, discoveries and treatments aided not only the growth of British hospitals but also their enhancement. His history, education, and drive to develop surgery meant that the role of a surgeon became more informed and restricted to scientists instead of tradesmen.
• Public Health in Industrial Britain was far from safe. However, John Hunter encouraged other doctors to study the anatomy of both humans and animals to understand how the body works, drastically improving public health and healthcare.
• Hunter advocated for the lessening of unnecessary and unsafe surgical procedures. This aided in the growth of British hospitals as it allowed them to practice safely and efficiently.