Case.—I was called to a man with a fractured thigh, and employed the usual means, but without success, for no union of the fractured parts was formed in the usual time; and at about the end of four weeks the man died with some other complaint. Upon examination of the parts I found that the upper end of the bone rode considerably over the under, and, consequently, there was a great cavity in the soft parts, the parietes of which were thickened by the adhesive inflammation, though not so much as if the parts had been better disposed for the adhesive inflammation. There was no extravasated blood, nor matter, nor coagulable lymph, to be found, except a few threads, which probably were the remains of some extravasated blood. Here the parts had lost two chances of being united, the one by the extravasated blood, the other by the coagulable lymph thrown out by the adhesive inflammation; and nature had here begun a third, which was that of forming granulations of new animal matter on the ends of the bones, and the surface of the surrounding cavity; and adhesions, you see, have taken place between the bones and soft parts, by which the bones would have been united by bony case: hence we find that granulation may take place without suppuration. This mode of union by granulation is much more extensive, I believe, than has been imagined; this third bond of union taking place when the parts have missed the first and second, as just mentioned. In the exposure of cavities of abscesses we have granulations going on hand in hand, and following suppuration. As the suppurative inflammation follows injuries with exposure, it seems that this inflammation is in general necessary to granulation in these cases. Granulation is an accretion of new animal matter, the old vessels being extended, and new ones formed, the vessels passing from one edge of the surface toward the other. Granulations are always of the same nature with the part on which they are formed: if that is diseased, as with any specific disease, so are they also. The granulating surface is convex, and covered with prominent points; the colour is of a deep florid red, but, when unhealthy, is of a livid colour, which, perhaps, may be produced by the circulation through them being exceedingly slow; this change of colour may also be an effect of difference of position.
JOHN HUNTER
(Copied from Thomas J. Pettigrew’s “Medical Portrait Gallery,” London, 1838. The original portrait was painted by Sir Joshua Reynolds; the engraving was done by G. H. Adcock.)
Hunter’s biographer in the “New International Encyclopaedia” speaks of him as a man of great industry, the boldest and best operating surgeon of his day as well as the greatest anatomist known and a marvelous zoölogist.
Some idea of the intensity of Hunter’s devotion to the cause of science may be obtained from a perusal of the following incident, which is related in A. M. W. Stirling’s “Coke of Norfolk and His Friends”:[[17]]
Epping Place may be said to have been the centre of his [Coke’s] operations; and there was in these days a celebrated Irish giant O’Brien or O’Bryne who came to live there solely for the sake of joining Mr. Coke’s hounds whenever he allowed himself any recreation. O’Brien was eight feet high in 1780 and apparently went on growing, for in 1782 he measured two inches more and after his death in 1783 he was found to measure eight feet four inches, yet no other member of his family was unusually tall. He was crazy about hunting and became so attached to Jones, Mr. Coke’s huntsman, that he paid the latter a visit at Holkam and was there solemnly introduced by Jones to Mr. Coke and his guests. O’Brien’s end was curious. With extreme simplicity he invested all his property in a single banknote of seven hundred pounds which, needless to say, he lost; and grief at his loss combined with excessive drinking brought about his death. John Hunter, the celebrated surgeon, was extremely anxious to secure his skeleton; and learning that the giant was dying he set his men to watch the house in order to be sure of getting the body. O’Brien hearing of this, and having a horror of being dissected, left orders that his corpse should be watched night and day until a lead coffin could be made, in which it was to be conveyed to the Downs and sunk in twenty fathoms of water. O’Brien died, and his body started for the Nee, escorted by a walking wake of thirty Irishmen who drank deeply en route. Howison, Hunter’s man, who watched closely, informed the surgeon when he might catch the bodyguard off duty at the public house, and Hunter went thither to bribe them. He offered fifty guineas to one of the men to allow the body to be kidnapped, and the man consented on his own account, but said that he must first consult with his companions, who, perceiving Hunter’s eagerness, raised their price, first to one hundred pounds and finally to five hundred before they would agree. Hunter borrowed the money to pay them, and the coffin consequently went on its way filled with stones, while the body of the dead giant journeyed back to London in a spring cart, until John Hunter’s own carriage met it, after dark, and drove it to his house in Earl’s Court. There, for fear of detection, he did not dare to dissect it; but, separating the flesh from the bones by boiling and cutting, he quickly skeletonized it. Hence in the Museum of the Royal College of Surgeons may be seen, to-day, the skeleton—brown from boiling—of the giant whose greatest joy when living was a gallop with Mr. Coke’s hounds and the friendship of Mr. Coke’s huntsman.
At the time of Hunter’s death, his museum contained 10,563 specimens and preparations illustrative of human and comparative anatomy, physiology, pathology and natural history. He died, however, in comparative poverty, and his collection was purchased, two years after his death, by the Government for £15,000 and was presented to the Royal College of Surgeons.
John Hunter, says Pettigrew, had some very good ideas regarding the educational training of the pupils who placed themselves under his guidance. One of these is revealed in his practice of receiving certain pupils into his house. In this way several of England’s most distinguished physicians came to be, for varying periods of time, inmates of his home, and among this number—to mention only a single instance—was Dr. Jenner, the inventor of vaccination. One or more physicians from the United States—if I am rightly informed—also enjoyed this privilege. Valuable as this practice must have been to those who were thus given the opportunity of frequent informal intercourse with a most inspiring master, it certainly could not have been an easy matter, even in those more primitive days, to fit these pupils into the régime of the teacher’s home life; and, under the conditions of modern life, the arrangement would certainly prove impracticable.
Benjamin Collins Brodie was born at Milford, near Salisbury, England, on June 9, 1783. In 1803, when he was twenty years of age, he became Sir Everard Home’s pupil at St. George’s Hospital, London. Two years later he began to assist Mr. Wilson in teaching anatomy, and during the following four years he filled the position of Demonstrator of Anatomy. In 1808, a year and a half before he began private practice, he was appointed assistant to Sir Everard Home at St. George’s Hospital, and retained the position up to the time (1822) when he was appointed full surgeon at that institution. About six months after Mr. Brodie received his appointment as Assistant Surgeon, he began lecturing on surgery and continued giving instruction on this subject up to 1830. In addition, he gave clinical lectures regularly to large classes, and this most important part of his work, which he began in 1813, was kept up by him through a long period of years. In 1819 he was appointed Professor of Anatomy and Surgery to the Royal College of Surgeons, a position which he held until 1823. In that year, upon the death of Sir Everard Home, he was appointed one of the Serjeant-Surgeons to the King. Two years later a baronetcy was conferred upon him, an honor which gave him the right to be addressed as Sir Benjamin Brodie.