History of Civilization in England, Vol. 3 of 3

904

‘There is no such thing, strictly speaking, as a predisposing cause. What is commonly understood by a predisposing cause is an increased susceptibility to form disposition to action. When I say I am predisposed for such and such actions, it is only that I am very susceptible of such and such impressions.’ Hunter's Works, vol. i. p. 303. See also p. 301: ‘The most simple idea I can form of an animal being capable of disease is, that every animal is endued with a power of action, and a susceptibility of impression, which impression forms a disposition, which disposition may produce action, which action becomes the immediate sign of the disease; all of which will be according to the nature of the impression and of the part impressed.’

905

Hunter died in 1793. In 1835, Mr. Palmer writes: ‘Those who have traced the progress of modern surgery to its true source, will not fail to have discerned, in the principles which Hunter established, the germs of almost all the improvements which have been since introduced.’ Hunter's Works, vol. i. p. vii. Eighteen years later, Mr. Paget says of Hunter's views respecting the healing of injuries: ‘In these sentences, Mr. Hunter has embodied the principle on which is founded the whole practice of subcutaneous surgery; a principle of which, indeed, it seems hardly possible to exaggerate the importance.’ Paget's Lectures on Surgical Pathology, London, 1853, vol. i. p. 170. At pp. 197, 198: ‘After what I have said respecting the process of immediate union, it may appear that Mr. Hunter was more nearly right than his successors.’

906

‘Inflammation of the veins, originally studied by Hunter, has of late years attracted the attention of many distinguished Continental and British pathologists.’ Erichsen's Surgery, London, 1857, p. 475. ‘No subject more amply illustrates the essential services which the science and art of medicine have derived from pathological anatomy than that of phlebitis. By this study many a dark point in the phenomena of disease has been either thoroughly elucidated, or, at all events, rendered more comprehensible. We need only refer to the so-termed malignant intermittents, consequent upon wounds and surgical operations, – to certain typhoid conditions, puerperal diseases, and the like, John Hunter, the elder Meckel, and Peter Frank, were the first to commence the investigation.’ Hasse's Anatomical Description of the Diseases of the Organs of Circulation and Respiration, London, 1846, p. 10. ‘Hunter was the first to open the way, and since that period the scalpel has shown that many previously unintelligible malignant conditions are attributable to phlebitis.’ Jones and Sieveking's Pathological Anatomy, London, 1854, p. 362. On the application of this discovery to the theory of inflammation of the spleen, see Rokitansky's Pathological Anatomy, vol. ii. p. 173, London, 1849; compare vol. iv. p. 335.

907

Sir Benjamin Brodie says: ‘It is true that the essential parts of John Hunter's doctrines as to inflammation and its consequences are now so incorporated with what is taught in the schools, that to be acquainted with them you need not seek them in his works; but I recommend you, nevertheless, to make these your especial study, for the sake of the other valuable information which they contain, and the important views in physiology and pathology which, in almost every page, are offered to your contemplation.’ Brodie's Lectures on Pathology and Surgery, London, 1846, p. 25. ‘John Hunter, whose treatise on Inflammation is a mine in which all succeeding writers have dug.’ Watson's Principles and Practice of Physic, London, 1857, vol. i. p. 146. ‘The appeal to philosophical principles in Hunter's works was, indeed, the cause of their being a closed volume to his less enlightened contemporaries; but, though the principles implied or expressed, subjected them to the scorn and neglect of those less imbued with the spirit of philosophy, the results of those principles, verified as they were by facts, have gradually and insensibly forced themselves on the conviction of the profession; and though adopted silently, and without acknowledgment, as if the authors themselves had forgotten or were ignorant from whence they were derived, they now form the very groundwork of all books, treatises, and lectures on professional subjects.’ Green's Vital Dynamics, London, 1840, p. 81. Finally, I will quote the very recent testimony of Mr. Simon, who, in his masterly, and singularly beautiful, essay on Inflammation, has not only brought together nearly every thing which is known on that interesting subject, but has shown himself to be possessed of powers of generalization rare in the medical profession, or, indeed, in any other profession. ‘Without undue partiality, an Englishman may be glad to say that the special study of Inflammation dates from the labours of John Hunter. An indefatigable observer of nature, untrammelled by educational forms, and thoroughly a sceptic in his method of study, this large-minded surgeon of ours went to work at inflammation with a full estimate of the physiological vastness of his subject. He saw that, in order to understand inflammation, he must regard it, not as one solitary fact of disease, but in connexion with kindred phenomena – some of them truly morbid in their nature, but many of them within the limits of health. He saw that, for any one who would explain inflammation, all inequalities of blood supply, all periodicities of growth, all actions of sympathy, were part of the problem to be solved.’ … ‘He cannot be understood without more reflection than average readers will give; and only they who are content to struggle through a veil of obscure language, up to the very reality of his intent, can learn with how great a master they are communing.’ … ‘Doubtless, he was a great discoverer. But it is for the spirit of his labours, even more than for the establishment of new doctrine, that English surgery is for ever indebted to him. Of facts in pathology, he may, perhaps, be no permanent teacher; but to the student of medicine he must always be a noble pattern. Emphatically, it may be said of him, that he was the physiological surgeon. Others, before him (Galen, for instance, eminently), had been at once physiologists and practitioners; but science, in their case, had come little into contact with practice. Never had physiology been so incorporated with surgery, never been so applied to the investigation of disease and the suggestion of treatment, as it was by this master-workman of ours. And to him, so far as such obligations can be personal, we assuredly owe it that, for the last half-century, the foundations of English surgery have, at least professedly, been changing from a basis of empiricism to a basis of science.’ Simon on Inflammation, in A System of Surgery, edited by T. Holmes, London, 1860, vol. i. pp. 134–136.

908

Mr. Bowman, in his Principles of Surgery (Encyclopædia of the Medical Sciences, London, 4to, 1847) says (p. 831): ‘Before the time of Hunter, the operation was performed by cutting into the sac of the aneurism, and tying the vessel above and below. So formidable was this proceeding in its consequences, that amputation of the limb was frequently preferred, as a less dangerous and fatal measure. The genius of Hunter led him to tie the femoral artery, in a case of popliteal aneurism, leaving the tumour untouched. The safety and efficacy of this mode of operating have now been fully established, and the principle has been extended to all operations for the cure of this formidable disease.’ See also p. 873; Paget's Surgical Pathology, vol. i. pp. 36, 37; and Erichsen's Surgery, pp. 141, 142, 508, 509.

909

‘The majority of Hunter's contemporaries considered his pursuits to have little connexion with practice, charged him with attending to physiology more than surgery, and looked on him as little better than an innovator and an enthusiast.’ Ottley's Life of Hunter, p. 126. In a work, which was written by a surgeon only the year after Hunter died, the reader is told, in regard to his remarkable inquiries respecting animal heat, that ‘his experiments, if they be true, carry with them no manner of information: – if they be true, no effect for the benefit of man can possibly be derived from them.’ Foot's Life of Hunter, London, 1794, p. 116. At p. 225, the same practitioner reproaches the great philosopher with propounding ‘purely a piece of theory, without any practical purpose whatever.’ Foot, indeed, wrote under the influence of personal feelings, but he rightly judged that these were the sort of charges which would be most likely to prejudice the English public against Hunter. It never occurred to Foot, any more than it would occur to his readers, that the quest of truth, as truth, is a magnificent object, even if its practical benefit is imperceptible. One other testimony is worth quoting. Sir Astley Cooper writes of Cline: ‘His high opinion of Mr. Hunter shows his judgment; for almost all others of Mr. Hunter's contemporaries, although they praise him now, abused him while he lived.’ The Life of Sir Astley Cooper, by Bransby Blake Cooper, London, 1843, vol. ii. p. 337.

910

‘Those who far precede others, must necessarily remain alone; and their actions often appear unaccountable, nay, even extravagant, to their distant followers, who know not the causes that give rise to them, nor the effects which they are designed to produce. In such a situation stood Mr. Hunter, with relation to his contemporaries. It was a comfortless precedence, for it deprived him of sympathy and social co-operation.’ Abernathy's Hunterian Oration, p. 49.

911

‘These he continued for several years; but so far were his talents, and his enlightened views, from exciting the attention they merited, that his hearers never amounted to twenty,’ Ottley's Life of Hunter, p. 28.

912

‘The members were of opinion,’ writes the Moderator, ‘The that it was likely, in the circumstances, that a national fast would be appointed on royal authority. For this reason, they delayed making an appointment for this locality, and directed me, in the meantime, respectfully to request that you would be pleased to say – if you feel yourself at liberty to do so – whether the appointment of a national fast by the Queen is in contemplation. The Presbytery hope to be excused for the liberty they use in preferring this request.’

913

‘The weal or woe of mankind depends upon the observance or neglect of those laws.’

914

‘Lord Palmerston would, therefore, suggest that the best course which the people of this country can pursue to deserve that the further progress of the cholera should be stayed, will be to employ the interval that will elapse between the present time and the beginning of next spring in planning and executing measures by which those portions of their towns and cities which are inhabited by the poorest classes, and which, from the nature of things, must most need purification and improvement, may be freed from those causes and sources of contagion which, if allowed to remain, will infallibly breed pestilence, and be fruitful in death, in spite of all the prayers and fastings of a united, but inactive nation.’