The Case of the Doctor Whose Brain Was Stronger Than His Heart

Albert B. Lowenfels, MD

Disclosures

December 07, 2012

Hunter's Contributions to Medicine and Surgery

In addition to being an outstanding clinician and surgeon, Hunter is remembered today for his scientific approach to surgery, based on careful observations and on his detailed knowledge of anatomy. He made numerous contributions to a field that at the time was still based on antiquated Galenic principles.

He did what we would now regard as rather simple experiments: for example, noting that human body temperature dropped during sleep, which eventually led to work on circadian rhythms. He also discovered that new bone formation results in absorption of old bone, which is relevant to current osteoporosis research.

Hunter's interests were broad. His early war experience made him an authority on gunshot wounds and other traumatic injuries. However, he was also interested in pregnancy, human growth, and the development of the lymphatic system. Today, we also remember Hunter for the eponymous Hunter canal, which contains the femoral vessels and the saphenous nerve in the middle of the thigh.

Transplantation was another area that greatly interested Hunter. He successfully grafted a rooster's spur to the animal's forehead, and followed this with successful reimplantation of a human tooth into the gum of a patient who had sustained a facial injury. Charlatans soon picked up on this report, leading to a short-lived and disastrous vogue for dental transplantation from one individual to another. The procedure was never successful and carried the risk for infection from the donor to the recipient.

To augment his study of human and animal pathophysiology, Hunter collected thousands of unique specimens, which he displayed in a well-organized museum. Finding and then housing his ever-enlarging collection consumed much of Hunter's income. Perhaps the most unusual object in the collection was the skeleton of Patrick O'Brien, known as the "Irish Giant." Knowing that O'Brien was ill, Hunter tried unsuccessfully to persuade him to donate his remains to the museum. Hunter eventually obtained the corpse by bribing the undertaker. Shortly after Hunter's death, the British government purchased this unique collection, which is now maintained by the Royal College of Surgeons.

Hunter's Students

Hunter was a dedicated and inspiring teacher who usually had a few students living with him. Some of his students became highly regarded physicians themselves.

Edward Jenner

Edward Jenner, the mild-mannered English physician who discovered and popularized a method for prevention of smallpox, was certainly Hunter's outstanding student. Hunter encouraged Jenner's research interest and in 1775, shortly before Jenner began to investigate the relationship between cowpox and smallpox, Hunter wrote to him saying, "I think your solution is just, but why think? Why not try the experiment?"

Surprisingly, it was Jenner who first made the now well-documented link between coronary artery disease and the symptoms of angina.[2] Upon performing an autopsy on a patient who died during an anginal attack, Jenner found blockage of the coronary arteries, and he concluded that diseased coronary arteries were the cause of the symptoms. Jenner also thought that Hunter, his revered teacher, probably suffered from this serious, then untreatable condition.

Philip Syng Physick

Dr. Philip Syng Physick, an American physician who was friendly with Benjamin Franklin, was another of Hunter's students. After the completion of his surgical training in London, Physick returned to Philadelphia in 1792 to become Professor of Surgery at the recently founded University of Pennsylvania School of Medicine. Physick has been referred to as the father of American surgery.

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