‘Knife Man’ was the father of scientific surgery

One of a medical students’ first encounters is with a deceased person, a cadaver.

Because a thorough knowledge of human anatomy is fundamental for the practice of medicine, anatomy instruction and dissection of cadavers begins day one.

Medical schools, in recent decades, have been adequately supplied with bodies, partly because some folks want to make a contribution to medical science. The fact that the schools bear the costs of disposal (burial or cremation) may also be an incentive.

In 18th-century England, cadavers were difficult to obtain. Anatomists in London were limited by law to fewer than a dozen bodies a year – usually those of executed criminals. As a result, there were often pitched battles under the gallows between families and the anatomists for the body of a newly deceased. With no refrigeration, and embalming not yet developed – formaldehyde came into use in 1893 – there was strong demand for fresh bodies. Anatomists of that time earned respectable incomes by enrolling students for lecture classes and corpse dissection.

The solution to the shortage of bodies was further criminal behavior, then sometimes known as Resurrectionists. They kept a sharp eye out for funeral processions and awaited fresh burials. Working at night, for hard coin, they swiftly disinterred the dead and delivered them to an anatomist’s darkened rear door. However, bodies deteriorate at warm temperatures and quickly become “unsuitable.” Consequently, anatomists lectured and did their dissections in the winter months.

Medical practice was mired in antiquity with theories of disease and treatments dating a millennium or more to ancient Greece. If illness didn’t kill one, treatment well might. Obsession with the four “humors” of the body – phlegm, blood, black bile and yellow bile – prevailed. One man, John Hunter (1728-93), the 10th child of a Scottish family, challenged his medical contemporaries and laid the foundations for modern surgery. He dissected 2,000 bodies during a 12-year period. His lectures about human anatomy and his dissection rooms attracted more students than anyone else’s. By understanding normal anatomy, one can progress to the abnormal and begin to consider actual disease processes. Understanding disease becomes a step to rational treatments.

Hunter documented placental circulation and the fact that it was independent of maternal circulation. He also examined fetuses and animal embryos: Accepted teaching was that every being was completely formed in the earliest embryonic stage and simply grew in size. Instead, the reality was an orderly, progressive development of limbs, organs and nervous system. Examining various species, he discovered commonalities of development, the early science of embryology. Increasingly, his dissections included plants, insects, animals, even several whales, and his massive collection of specimens formed the discipline of comparative anatomy.

Rejecting much of the status quo, Hunter’s insights and discoveries are milestones of surgery. He recommended surgery only in the absolute necessity for it, and only if the surgeon would have it performed on himself in similar circumstances. The Royal College of Surgeons honored Hunter as “Founder of Scientific Surgery.” Read all about it in: The Knife Man by Wendy Moore.

www.alanfraserhouston.com. Dr. Fraser Houston is a retired emergency room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.