John and William Hunter worked together for over a decade, and during
that time, made gargantuan discoveries regarding the human frame. Their
description of the lymphatic system would perhaps only be surpassed by
the revelation that the blood vessels between the placenta and the uterine
wall did not share blood, as had been assumed, after careful dissection by
John Hunter on pregnant women deceased late in term. After years of
dissections on mid- and full-term London women, William published in
1774 The Anatomy of the Human Gravid Uterus Exhibited in Figures,
displayed in massive “elephant”-folio in one of the greatest works of
anatomy ever conceived. The dissections were all the work of John Hunter,
the words were William’s, and the magnificent, if not sobering, artwork
was by Jan van Rymsdyk.
After several years of training with Cheselden and Pott, and after
serving as a surgical pupil at St. George’s Hospital during the summer of
1754, Hunter began to treat his first patients. The coarse country boy was
transforming into an objective scientist, and from the beginning, he
maintained fastidious notes with observations and outcomes.
Historian Wendy Moore describes an early patient, a young man (a
chimney sweep) who had contracted gonorrhea that had resulted in a
urethral stricture—a blockage in the urethra—that resulted in painful
urination:
Establishing the patient’s medical history, Hunter brought to
bear all his natural scientific curiosity—embarking on the
experimental approach to surgery that would characterize his
whole life—on the sweep lying in pain and frustration ...
Initially, Hunter attempted the classic approach to unblocking
a stricture, presumably learned from Pott, which entailed
attempting to push a “bougie”—a cylindrical bung made of
wax or sometimes lead into the urethra to force a way through.
When this failed, he characteristically decided to experiment
and, importantly, record his results. Hunter conjectured that he
might shift the blockage by burning a way through, using a
caustic salve on the end of a bougie ... [Hunter first used
mercuric oxide, which caused much inflammation and pain,
then attempted] with remarkable forbearance on the part of
the sweep, Hunter fastened a piece of “lunar caustic”—silver