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The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery

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It is hard to understand that the genius John Hunter, one of the star figures of the Enlightenment, should not be one of those scientists whom everyone has heard of. If the name does not ring a bell, it is strongly recommended that you pick up _The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery_ (Broadway Books) by Wendy Moore. Not just a genius in surgical technique and innovator of scientific experiment to guide surgical choices, he was a brilliant anatomist of other species as well, he was an attentive teacher, and he set up a museum that demonstrated the now accepted views of the origins of life and the age of the Earth. He was constantly attentive to animal behavior and physiology and his curiosity never stopped. A mainstay to his friends, he was also willful and irascible, and made enemies easily, one of the reasons he got limited credit during his lifetime for his new ways of thinking. Moore's book is an exhilarating view of a foolhardy, energetic, innovative, and brilliant man.

John Hunter was born in 1728 in Scotland. He left school at thirteen, and left Oxford after just two months. He instead followed his older brother William to London to help in William's anatomy school in Covent Garden. He would dissect thousands of bodies, and was well acquainted with the "resurrection men", the grave robbers who provided fresh, or maybe not so fresh, specimens. Hunter's reliance on observation and experiment put him squarely against the medical establishment, which had insisted on relying on Aristotle, Hippocrates, and Galen, "preferring to bleed, blister, and purge their patients to early graves." He alienated his fellow surgeons by insisting that surgery was always the last step that should be taken, and should be avoided unless absolutely necessary. His innovations in surgery include teaching (from his days as a naval surgeon) that musket balls entering the body were best left where they were, if possible; digging them out did more damage than the bullet itself. He knew the value of using a placebo when testing a medicine's powers. He made the first experimentation (on dogs) to show what the lymphatic system did. Not only was he not above dealing with the resurrection men, but he tricked the friends of Charles Byrne ("The Irish Giant") into burying a huge casket of rocks, while the giant's body went to the anatomical table. He married well, a woman poet who kept salons; they lived in different worlds, and he designed a house that would accommodate society at the front and resurrection men at the back. (Robert Louis Stevenson is said to have based Jekyll and Hyde on the idea of this structure.) He was always eager to get to his research rooms instead of socializing, but an observer said of the course-talking Scot that he was not polished or refined, "but from originality of thought and earnestness of mind he was extremely agreeable in conversation." He loved keeping strange animals, and loved dissecting them when they died. He drove a cart pulled by three zebus, curly-horned Asian buffaloes, and alarmed his neighbors by using it as regular transportation. He may have been the inspiration for Doctor Dolittle. Wendy Moore has done a spectacular job of bringing him and his times to us. _The Knife Man_ has many gruesome patches that are hard to take, from descriptions of surgery without anesthesia, to experiments on hapless dogs, to the business of the cadaver trade. Its portrait of an extraordinary thinker, however, is vivid, compelling, and enormous fun.

The Knife Man is an absolutely compelling read and is a superb blend of history, science, and philosophy. John Hunter was kind of like the Richard Feinman of the medical establishment of the 18th century. He pursued his own research, never buckled to peer pressure, and had absolute faith in his beliefs. At the same time, he was methodical, open-minded, and humble enough to realize that man bowed to Nature, not vice versa as many of his contemporaries would have wished.

We have John Hunter to thank for bringing medicine, quite literally, out of the dark ages and into the scientific age. Prior to Hunter's arrival, doctors believed that most ill derived from imbalances in "humors." By bloodletting, drinking your own urine, etc, etc, one could have a hope of regaining health. Frankly, as Hunter quickly learned, this was complete and utter hogwash and he systematically set out to prove that many of that age's theories were plainly wrong.

Hunter succeeded in not only altering the understanding of medicine and anatomy in his time but also in inculcating a true scientific approach in his teaching role that reaches to today. He literally taught over a thousand doctors, including those who would go on to found the University of Pennsylvania's hospital in the capital of the American colony in Philadelphia. These doctors spread around the world in a wave and ultimately brought down the ridiculous knowledge base founded by Galen thousands of years before and replaced it with a rigorous, scientific one.

You don't need to be a doctor to understand this book but it helps to have a little medical knowledge, anyone who has taken biology at high school level will be fine. Hunter lived during an exciting time period too, overlapping with Napoleon's run on the continent, William Pitt the Younger as PM of Great Britain, Benjamin Franklin as plenipotentiary in France, and the independence of the American colonies. Hunter crossed paths with many people who shaped history.

This is one of the best books I've read this year.

As a retired surgeon I found this biography of anatomist-surgeon John Hunter fascinating. It has a readable style that both informs and entertains as we are led through the dark medical universe of 18th century London, where the average life expectancy was 35 years due to the abysmal public health conditions of the day and a medical system based on blood-letting and other mythologies, and learn of the achievements of this towering figure in the advance of medicine and surgery who is not well known or recognized beyond establishment circles today.

In our modern world of miraculous medical achievements we too often take for granted the scientific approach initially promulgated by John Hunter. Living in London in the mid-1700s this Scottish-born, brilliant yet eccentric surgeon, who was both an ardent naturalist and an innovator of medical practice, was a voice in the wilderness of his day. His common sense approach has been responsible for our emergence from a world of superstition and quackery into today's era of rational science that has increased longevity and relief from so many debilitating maladies.

A man of intense curiosity and self-confidence, Hunter bucked the medical establishment in demanding that objective criteria be the basis of determining the efficacy of medical intervention. Over several decades of intense study and research on human and animal bodies, made possible by the controversial practice of obtaining "material" for his dissection laboratory of fresh corpses from the grave yards of London, he catalogued the gross and minute anatomic principles of the living body and opened the door to a logical understanding of the normal and the pathological features of health and disease. Along the way his work convinced him that the biblical account of history was wrong, and being unafraid to challenge the popular wisdom of his era he did not hesitate to publish his subversive opinions about evolution that preceded Darwin by more than half a century.

As his reputation grew Hunter attracted hundreds of students and disciples to his laboratory, out of whom came many of the most notable medical leaders of the next generation, both in Europe and in America. One of his favorites was Edward Jenner, the discoverer of vaccination, which ultimately eliminated the scourge of smallpox from the face of the earth. Jenner acknowledged his master when he put forth his basic principles for the practice of medicine. These he summarized thusly: first is the priority to look after the patient; next the importance of a continuous quest for knowledge, that is, to read; third is the value of research, not to merely assume, but to "do the experiment"; and finally the responsibility to teach those that follow.

In his successful effort to convince the world of the efficacy of vaccination against smallpox Jenner followed the Hunterian formula of exposition. It begins with the statement of a thesis, then a review of existing knowledge on the subject (in current parlance, a review of the literature), a presentation of an hypothesis, a description of the experiment with "materials and methods", a disclosure of the results with a discussion, and finally a conclusion. This is the scientific method introduced by John Hunter that is used today that has produced the advances in medicine that have so benefitted mankind.

This book deserves wide circulation. It is not only profoundly informative but also produces repeated literary pleasures with each turn of the page for both the expert and lay person alike. We are indebted to Wendy Moore for this fascinating review of the life and achievements of John Hunter.

Wendy Moore's magnificent book, "The Knife Man," is a thoroughly researched account of the life and times of John Hunter, one of the most controversial and fascinating figures of the eighteenth century. Born in 1728 in Scotland, Hunter was the tenth child of humble farming parents. He was an indifferent student who preferred learning through observation and experimentation rather than by reading dusty texts. During his teenage years, John's father and six of his siblings died. This was not surprising during an era when "burials far exceeded baptisms." Matters were not helped by the use of such toxic "remedies" as bloodletting, purging, and blistering to cure the sick. Doctors never washed their hands or sterilized their instruments; if the disease didn't kill the patient, the physician's intervention would probably do the trick.

In 1748, Hunter traveled to London to assist in the anatomy school founded by his brother, William. This revolutionary institution enabled medical students, for the first time in England, to obtain daily hands-on practice in human dissection. This was a financially successful venture for William and it marked the beginning of John Hunter's brilliant career. Until his death in 1793, John worked tirelessly (sleeping, on average, four hours a night) not only as an anatomist, but also as a popular lecturer, surgeon, naturalist, and scientific thinker, whose theories about the origins of life, resuscitation techniques, and surgical practice were nothing short of visionary. One of his main preoccupations was the collection, dissection, and preservation of animals and insects of many different species, which led to the establishment of his own museum of medicine, comparative anatomy, and natural history.

Because of his unorthodox ideas, many of which contradicted accepted religious beliefs and standard medical practice, Hunter garnered his share of enemies along with his many admirers. He was a vivisectionist who experimented on live animals, and although he was never prosecuted for grave robbing, he was certainly guilty of endorsing and exploiting this practice. His colleagues in St. George's Hospital in London also resented Hunter's high-handedness, frank speech, and disregard for convention; they were undoubtedly also jealous of his huge popularity and devoted following among medical students.

In lesser hands, "The Knife Man" could have been a dry account of an individual whose name few people even recognize, but Wendy Moore's accessible and lively prose brings Hunter and his contemporaries to brilliant life. The author captures a time when medicine was, in many ways, still in its infancy, but it was also an era when innovative ideas were beginning to dissipate the cobwebs of the past. Moore's fluid prose reads like thrilling fiction. She takes us along to the graveyard where Resurrection Men, night after night, ruthlessly dig up fresh corpses for dissection. She seats us in the lecture hall as John Hunter enthralls his rapt students with his exhortation to "ask the reason of things" and take nothing for granted. Moore makes us understand Hunter's vision--to teach his acolytes "to subject every common superstition and unproven therapy to scrutiny, to question every step they took."

Among Hunter's estimated one thousand students were future doctors who would become influential figures in nineteenth century teaching hospitals, spreading Hunter's doctrines throughout Europe and the United States. Among his pupils were Edward Jenner, who developed the vaccine against smallpox, and James Parkinson, for whom Parkinson's disease is named. Hunter also served as surgeon extraordinary to King George III, was elected to the Royal Society of Medicine, and treated such luminaries as David Hume, Adam Smith, a young Lord Byron, and Thomas Gainsborough. No more fitting tribute can be given John Hunter than these words of his assistant, William Clift: "He seemed to me to have lived before his time and to have died before he was sufficiently understood." "The Knife Man" is an unforgettable journey that will enthrall anyone who is interested in the history of medicine and the origins of modern surgical practice.

This is a well written and enlightening biography of the great 18th century British physician-scientist John Hunter. Moore has done a real service by bringing Hunter before the reading public. Known largely to historians of medicine as an important figure in the history of surgery, Moore shows Hunter to be definitely that and much more. Hunter is also a remarkable personal story. An expatriate Scot and son of impoverished parents, largely uninterested in formal education as a youth, Hunter became the outstanding anatomist of his time under the tutelage of his older brother William and by virtue of his great natural talents. Similarly, he had relatively little in the way of formal medical education, though given the primitive state of medical theory and practice in his time, this was arguably an advantage. By the end of his life, he was perhaps the preeminent surgeon in Britain, enjoyed an international reputation as a scientist, and inspired a large number of students to pursue his brand of empirical, more scientifically oriented practice and research. Though Hunter's story is in some respects a lurid one, with the reliance on grave robbers for cadavers and the vicious professional rivalries characterizing some of his career, Moore does very well to show the essential nature of these events without letting them overpower the narrative. The most interesting aspect of the book is actually not Hunter's medical accomplishments, though these were very important, but Moore's description of his other achievements. Moore shows Hunter to be a profoundly important teacher who influenced a whole generation of British and American surgeons and physicians including important individuals like Jenner. Hunter's achievements as a biologist, particularly his work in anatomy, comparative anatomy, and what would become physiology, were substantial. Moore makes the good point that Hunter's achievements may have been unappreciated in part because credit for some of his achievements were attributed to his older brother and after John Hunter's death, appear to have been appropriated by his shameless brother-in-law. Hunter appears also to have been at the center of the British Enlightenment. His friendships included a number of notable British intellectuals like the great naturalist Joseph Banks and he was on good terms with individuals like Gibbon and Adam Smith.
Written in a clear and lively style, this book does an excellent job of describing Hunter's life and major achievements. It also gives a good sense of contemporary medical practice and scientific life. The drawback of this book is that Moore doesn't give much sense of where Hunter fits into contemporary medical, scientific, and intellectual life. Hunter appears to be a major figure of the British Enlightenment, but he is never described as such by Moore. How did Hunter's work compare with developments in the rest of Europe, for example, Paris, where the end of the 18th century would see a revolution in medical education, some of whose features were anticipated by Hunter? How does Hunter, with his skepticism, his continual questioning of authority, and his dedication to experiment, fit into the broad currents of the Enlightenment and specifically within the British Enlightenment? There is an outstanding secondary literature on many of these topics, but Moore does not seem to have used it in her work on Hunter.

Morbidly fascinating, this book is great, just hands-down great. Not only presents a fully realized portrait of fascinating man, but recaptures an entire era (Georgian England). What happens after the death of the subject (to his books and papers, to his museum of anatomical curiosities) reads like a short story by Borges or Kafka. Will be thinking about this one for days, maybe years.

(This review is from the softcover version of the same book)
I teach anatomy and the history of medicine at a U.S. medical school and had this book on my to-do list for a long time. Now that I've read it, I'm kicking myself for not getting it sooner.

First, John Hunter should be a household name 3 times over for the amazing experimental work that he conducted in the late 1700's. I have been familiar with him for several years and had lapsed into thinking I had him categorized until I read this remarkably brief biography and realized that I had barely scratched the surface. In addition to revolutionizing surgery, medical examination, experimental biology, comparative anatomy, and medical education, John Hunter steered the history of science down a path of skeptical inquiry that it was sadly lacking.

Secondly, Wendy Moore presents Hunter in his true complexity. We can cheer the ill-mannered maverick of medicine as he mercilessly replaces ignorance with hard-won experience; but we have a harder time reconciling our hero with the grave-robbing criminal that was an equally-valid aspect of John Hunter.

This biography is concise (which must have been very difficult for the author to accomplish) and written in a conversational tone. It neither sides with or against Hunter (although it does take some well-warranted stabs at his petty detractors) and situates him in the context of the people and places that surrounded him, which makes his accomplishments even more amazing. This book will be a compulsive read to any curious person, and EVERY medical and science student would benefit from reading this excellent biography. HIGHLY recommended!

John Hunter was one of the champions who introduced scientific methods to medicine over the opposition of those who valued ideology over evidence. He fought this battle only about 225 years ago when doctors often prescribed bloodletting. John Hunter paid attention to evidence that it was sometimes best to leave gunshot wounds untreated rather than apply the remedies physicians often applied at that time. This book is fascinating and is written very well. I was shocked to learn how primitive medicine was only 225 years ago. Our recent progress under the scientific approach has been astounding. John Hunter's personal story was also a very dramatic rise from poverty to recognition as his nation's leading surgeon and physician.

Fantastic, intriguing, fun to read. Brings a deep respect to our progenitors and how they ever survived those "unapprised " years. It is a great tribute to the great man John Hunter.

The stories seem to be endless, and they're pertinent to today. Dr. John Hunter had a brilliant mind--recognized as such during his lifetime, and modern medicine owes him a debt of gratitude for his pioneering work in medicine and surgery in eighteenth century England. Interwoven throughout the book are numerous "ah-ha" moments of history, including medicine, surgery, natural history, embalming, grave robbing, and the fanaticism with collecting that leads to the establishment of a museum. While I'm fascinated by the subject matter in general, I was also intrigued that a single individual could credit accomplishment in so many areas. This is a "must read" on so many fronts. I happened on the book as displayed on the end cap of a chain store while travelling, and after skimming just a few pages, I decided that I had to have a copy and in hardback. It's a book that is worth keeping for future reference. The bibliography and endnotes are extensive. As a historian, I'm used to scholarly reading, and while the author has risen to that level, the style and presentation are accessible to readers at many levels of interest. I'd have liked a section of selected period illustrations (Hogarth, Cruckishank, and Rowlandson come to mind)if nothing more than to place Hunter and his subject graphically in Georgian London; however, the sole illustration is an engraved formal portrait of our subject.