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The Knife Man: The Extraordinary Life and times of John Hunter, Father of Modern Surgeryby Wendy Moore
Synopses & Reviews
The Coach Driver's Knee
St. George’s Hospital, Hyde Park Corner, London December 1785
The patient faced an agonizing choice. Above the cries and moans of fellow sufferers on the fetid ward, he listened as the surgeon outlined the dilemma. If the large swelling at the back of his knee was left to continue growing, it would soon burst, leading to certain and painful death. If, on the other hand, the leg was amputated above the knee, there was a slim chance he would survive the crude operation-provided he did not die of shock on the operating table, or bleed to death soon after, or succumb to infection on the ﬁlthy ward days later-but he would be permanently disabled.
For the forty-ﬁve-year-old hackney coach driver, both options were unthinkable. Since he had ﬁrst noticed the swelling in the hollow behind his knee three years ago, the lump had grown steadily, until it was the size of an orange.(1) It throbbed continuously and was now so painful, he could barely walk. Extended on the hospital bed before him, his leg and foot were hideously swollen, while his skin had turned an unsightly mottled brown. Once the coachman had gained admittance to St. George's, having persuaded the governors he was a deserving recipient of their charity, the surgeon on duty had lost no time in making a diagnosis. He had seen popliteal aneurysms at exactly the same spot on numerous occasions and knew the prognosis all too well.
It was a common-enough problem in the cabdriver's line of work. Aneurysms could happen to anyone, anywhere in the body, but they appeared to occur with particular frequency among coach drivers, and others in equestrian occupations in Georgian London, in the popliteal artery behind the knee. The condition, in which a section of artery that has been injured or otherwise weakened begins to bulge to form a blood-ﬁlled sac, may well have been triggered by the wearing of high leather riding boots, which rubbed the back of the knee.(2) As the aneurysm swelled, it not only became extremely painful but made walking exceedingly difﬁcult. Whatever the cause, the outcome was often an early death-if not from the condition itself, then from the treatment generally meted out. To lose his leg, even supposing the coach driver survived such a drastic procedure in an era long before anesthesia or antiseptics, would mean never being able to work again. But to carry on working, navigating his horse-drawn carriage over London's rutted and congested roads, would be equally impossible if the lump was left to grow. Either way, the cabbie feared destitution and the workhouse.
But there was a third choice, the surgeon at his bedside now conﬁded on that early December day, for a coachman sufﬁciently willing or desperate. In his slow Scottish lilt, redolent of his humble farming origins, the surgeon laid out his scheme for a daring new operation. Surrounded by the poxed, maimed, and diseased bodies of London's poorest wretches, huddled in their beds on the drafty ward, the cabbie resolved to put his life in the hands of John Hunter.
Without a doubt, John Hunter's reputation was well known to the coach driver long before he limped through the portal of St. George’s, for he was generally acknowledged as one of the best
Presents the life of John Hunter, the eigtheenth century English surgeon who revolutionized surgical techniques and principles, developed innovative medical procedures, and made contributions to the fields of geology and evolution.
When Robert Louis Stevenson wrote his gothic horror story of Dr. Jekyll and Mr. Hyde, he based the house of the genial doctor-turned-fiend on the home of John Hunter. The choice was understandable, for Hunter was both widely acclaimed and greatly feared.
From humble origins, John Hunter rose to become the most famous anatomist and surgeon of the eighteenth century. In an age when operations were crude, extremely painful, and often fatal, he rejected medieval traditions to forge a revolution in surgery founded on pioneering scientific experiments. Using the knowledge he gained from countless human dissections, Hunter worked to improve medical care for both the poorest and the best-known figures of the era—including Sir Joshua Reynolds and the young Lord Byron.
An insatiable student of all life-forms, Hunter was also an expert naturalist. He kept exotic creatures in his country menagerie and dissected the first animals brought back by Captain Cook from Australia. Ultimately his research led him to expound highly controversial views on the age of the earth, as well as equally heretical beliefs on the origins of life more than sixty years before Darwin published his famous theory.
Although a central figure of the Enlightenment, Hunter’s tireless quest for human corpses immersed him deep in the sinister world of body snatching. He paid exorbitant sums for stolen cadavers and even plotted successfully to steal the body of Charles Byrne, famous in his day as the “Irish giant.”
In The Knife Man, Wendy Moore unveils John Hunter’s murky and macabre world—a world characterized by public hangings, secret expeditions to dank churchyards, and gruesome human dissections in pungent attic rooms. This is a fascinating portrait of a remarkable pioneer and his determined struggle to haul surgery out of the realms of meaningless superstitious ritual and into the dawn of modern medicine.
About the Author
Wendy Moore is a writer and a journalist. After working as a reporter for local newspapers she has specialized in health and medical topics for more than twenty years. As a freelance journalist her work has been published in a range of newspapers and magazines—including the Guardian, the Observer, and the British Medical Journal—and has won several awards. Having written extensively on medical history, she obtained the Diploma in the History of Medicine from the Society of Apothecaries (DHMSA) in 1999 and won the Maccabaean Prize for the best dissertation that year. This is her first book. Upon its publication in the United Kingdom, The Knife Man was named Consumer Book of the Year by the Medical Journalists’ Association. Moore lives in South London with her partner, Peter, also a journalist, and two children, Sam and Susannah.
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