Came across a fascinating news article on the BBC website a couple of days ago explaining how modern doctors have confirmed a diagnosis made more than two centuries ago by one of medicine's most influential surgeons.
The surgeon was John Hunter and in 1786 he diagnosed a patient with a ‘tumour as hard as bone’. Samples from the patient, along with Hunter’s case notes, are preserved at the Hunterian Museum in London, in the Royal College of Surgeons. They were recently analysed by a cancer team from the Royal Marsden Hospital.
As well as confirming the diagnosis, the team believes that Hunter's centuries-old samples may give clues as to how cancer has been changing over time.
Hunter, for those who might not know, became surgeon to King George III in 1776 and is one of the men credited with moving the medical discipline from butchery to a science.
In this particular instance his notes described a man who arrived at St George's Hospital, in 1786, with a hard swelling on his lower thigh which appeared to be a thickening of the bone and which was increasing at a very rapid rate. After closer examination Hunter found it consisted of a substance that surrounded the lower part of the thigh bone and was ‘of the tumour kind, which seemed to originate from the bone itself.’
Hunter’s response was to amputate the leg. The patient appeared to recover but after four weeks ‘he began to lose flesh and sink gradually, his breathing becoming more and more difficult.’ The patient eventually passed away seven weeks after the operation. When Hunter performed his autopsy he discovered that several bony tumours had spread to the patient’s lungs, the lining of the heart and on the ribs.
Skip forward through history and the samples came to the attention of one Dr Christina Messiou who, upon reading them, realized that her own diagnosis confirmed the one made by Hunter two hundred years earlier and much of what today’s medical profession knows about the disease’s behaviour.
According to Dr Messiou ‘the large volume of new bone formation and the appearance of the primary tumour were really characteristic of osteosarcoma.’ Intrigued, she approached her colleagues at the Royal Marsden Hospital and asked them for a second opinion.
Using modern day scanning technology they were able to confirm Hunter’s diagnosis. Dr Messiou told the BBC that Hunter’s diagnosis was extremely impressive and that, astonishingly, ‘his management of the patient followed similar principles to what we would have done in the modern day.’
In fact, so impressed were Dr Messiou and her colleagues that they plan to compare more of Hunter’s samples with contemporary tumours to see if there are any differences. Essentially, the investigation has turned into a study of cancer’s evolution over the past two hundred years. Dr Messious now intends to see if it's possible to link lifestyle risk factors between historical and current cancers.
Now, if you're still with me, the reason I latched onto all this was that the character of John Hunter played an important part in the second Hawkwood novel, Resurrectionist.
Colonel Titus Hyde - the villain of the piece - was a student of Hunter and scenes in the novel take place in what was John Hunter’s real-life house, then located in Castle Street – now Charing Cross Road – London. In the novel's historical note I explain how I took advantage of the fact that Hunter also owned the house directly behind his Castle Street address and which opened onto Leicester Square. He had the gap between the houses bridged with an operating room specially constructed to aid his anatomy lectures. Above it, he built a museum in which were displayed thousands of his ‘preparations’.
Following Hunter’s death the museum was tended by his former assistant William Clift until the contents were later purchased by the Royal College of Surgeons which went on to found the Hunterian which in turn enabled Dr Messious to gain access to the exhibits and Hunter’s notes.
Sadly, neither Hunter’s house nor the school building or operating room have been preserved though it is possible to visit the Hunterian - located in Lincoln's Inn Fields - in which the contents of Hunter's collection are exhibited to splendid effect.
If you’d like more information click on the photo, right, and the link will take you to the Hunterian’s website.
As an adjunct, while Hunter’s operating room has long been demolished it is still possible to visit a similar location – The Old Operating Theatre Museum and Herb Garrett - which formed part of the old St Thomas' Hospital and which is located in Southwark, on the same street as the Shard, a short walk from London Bridge Underground Station.
If you click on the image of the theatre, below, the link will take you to that Museum’s website.
Both it and the Hunterian are well worth a visit and Wendy Moore's biography of Hunter - The Knife Man - is a terrific read.