Get me a Retrospectascope...Stat!: John Hunter

Hunterian Museum

‘No theory can ever be proved true - we can only show that a theory is false’ - Karl Popper

I've been meaning to do something specific on John Hunter (13 February 1728 – 16 October 1793) for some time and though there have been a couple of posts that touch on him, I've not written anything explicit. Indeed my course in the spring used his collection of curios at the Royal College of Surgeons as a point of departure for many themes coming out of ‘exhibiting the body’. Therefore the excellent talk presented by Professor Stephen Challacombe at the RSM provided the material for this post.

The simple question that he wanted to explore focused on the relevancy of John Hunter’s approach to science and research. What was so special or different about his methods?


But just as I formed the question, ‘so what were his approaches?’, the professor provided a brief overview of Hunter. To read more about him, you can find really good briefs over at the Science Museum  or RCS.  He was a true polymath, a seemingly tireless worker and his range of interests were boggling; surgeon, anthropologist, physiologist, geologist, dentist. You only need look at the list of his medical tomes to get an idea of his expertise. And it wasn't just humans that interested him, he also wrote about animals, insects and birds, producing books on bees, pheasants, dogs. This combination of complete observation of organic life, the realisation that life forms changed over time and that man was closely related to primates, the professor suggested, Hunter anticipated Darwin’s theories on evolution.

Background

Though he was living in an era of burgeoning exploration, scientific research and experimentation (Royal Society was founded in 1660), it has to be remembered that medicine and anatomical knowledge was still very basic. The classical names of Hippocrates and Galen continued to be highly regarded and despite advances by Versalius, Harvey etc, bloodletting for most ailments was standard. Incidentally, it was interesting to note that even by early 1800s the medical realities were such that chills were seen as dangerous and precursors to something more serious.

Approaches

Skulls (2013) © Marine Crosta

Against this background of undeveloped medicine, his approaches to biological science and research appear startlingly modern; he was a meticulous note taker and he relied on observation and deduction. He would formulate a hypothesis, carry out experimentation then apply what he had learnt to an appropriate medical situation. This is now what is known as ‘translational clinical research’.

His massive collection of specimens demonstrates the importance of the study of the normal so that if something goes wrong, he would know the proper function of the malfunctioning part. In his many lectures, he stressed the relationship between structure and function in all living creatures which can only be taught by a vast experience of comparative anatomy. He was also fascinated with the way that the body adapted to and compensated for damage through injury, disease and environment.

He thought that disease could not be rationally treated without knowing the full workings of the body. In his preparations which you can see at the Huntarian Museum, you can see the care he took in traced every vessel, cavity, and fibre in his exploration of human body.

Case Studies

• In his investigations in to what age teeth start to calcify, we can see that he experimented on various jaw bones and made direct observations. We learn from his drawings and preparations that the calcification of teeth begins at 6 months old. He also compared human teeth with rodents and there is an amazing skull of a rodent, whose incisors grew right round.

• In his dental explorations, he documented his work on doubting the vascularity of teeth:

"First I never saw them injected in any preparation, nor could I ever succeed in any attempt to inject them, either in young or old subjects; and therefore believe there must have been some fallacy in the cases where they have been said to have been injected. Secondly, we are not able to trace any vessels going from the pulp into the substance of the newly formed teeth; and whatever part of a tooth is formed, it is always completely formed, which is not the case with the other bones. But what is a more convincing proof, is reasoning from the analogy, between them arid other bones, where an animal has been fed with madder. The parts of the teeth already formed, do not become tinged with the dye, while those that are forming while the animal is being fed with the madder, are dyed red; and this colour remains permanent." Link

• He was also one of the first to master the detail of urology, one of his case studies was ‘The Professor’s Testicle (1752) which Wendy Moore  enjoys relating in her book. He demonstrated the labyrinth of minute tubes within testicles by recording them in mercury. 

• After some experiments in transplanting chicken parts, he tried it on human teeth - he wasn't the first but he made it popular. He took healthy teeth bought from poor people to put into the mouths of the rich. In this way he discovered that venereal disease could be transmitted.

• His wartime practice led to the realisation that less surgery was better than the prevailing messy and brutal operations. He compared the treatment of British soldiers with French prisoners of war; one set had the surgery, whilst the French were treated ‘conservatively’, with wounds merely dressed. When the French fared better, he became aware of the notion of infection.

• He was also one of the first to carry out a randomised placebo controlled trials. Gonorrhoea was a major problem and many ‘cures’ were offered. Using bread tablets as placebo and mercury pills, he proved that no treatment was as good as the mercury. This didn't make him popular with avaricious colleagues. 

Ethics

Hunter becomes more problematic when we start looking at ethics (or lack thereof) through modern eyes. As the Professor pointed out, he certainly wasn't a signatory to the Helsinki agreement. There were many vivisection, animal experiments which must have caused great suffering to a multitude of creatures, large and small, although he did state that he didn't do endless repeats of the same experiment once he had established his theories.   The tooth transplantation could be an ethical case study all by itself; the purchase of healthy teeth, transference of disease, and even his peers denounced it as immoral and unsuccessful. 

There was also the lack of consent, for instance in his VD experiments and his methods of obtaining cadavers was highly questionable. His view on body snatching was that the ends justified the means and that the medical value of cadavers had to take precedence over the needs of relatives.

Conclusions

Professor Challacombe spent some time talking about modern scientific methods and really the only difference I could see between Hunter and the modern way, is that he had less literature to read. He suggested that Hunter wasn't a great reader anyway and preferred to get on with looking, practical research, testing and applying new techniques and documenting everything. A question from the audience wondered if he would have got as much done if he had been born in a different time and had to be answerable to ethics committees, wading through previous research - the answer was, no, probably not. 

His passion for research, extremely wide reach and influence, combined with inspirational teaching made him unique among his contemporaries - though it is his meticulous notes and massive physical collection that have ensured his popularity and vision continues today. To paraphrase Einstein, 'politics is for the present, research for eternity'. William Clift his first curator stated that he was not fully appreciated in his time - perhaps because he was so scathing in criticism of his medical contemporaries. In any case, the more I read and hear about him, the fascinated I become. 

The museum's ability to continue to inspire the arts and science continues. As I was looking at twitter for mentions,  I came across @MarineEdith and her astonishingly haunting and evocative oil painting 'Skulls' - the perfect piece to illustrate Hunter's repetition and comparison of the normal. Anyone for another trip to the Hunterian Museum?

The title is nonsense but I loved the word retrospectascope, thank you Professor Challacombe.