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THE INFLUENCE OF THE HUNTERS ON MEDICAL EDUCATION Hunterian Oration delivered at the Royal College of Surgeons of England on 14th February 1957 by Sir Ernest Finch, M.D., D.Sc., M.S., F.R.C.S. Late Honorary Surgeon, Royal Infirmary, Sheffield, and late Professor of Surgery, University of Sheffield I MUST FIRST of all thank you, Mr. President, for the honour you have conferred upon me and my School by asking me to deliver this the eighty-ninth Hunterian Oration in memory of John Hunter (Fig. 1) on this the two hundred and twenty-ninth anniversary of his birth. When his F.z 1. John Hunter. Born 1728. Died 1793. Froti thestatiuehbY H. Weekes, RA. at tie College. museum was first opened to the public in the year 1813, twenty years after his death, his executor3, who were Sir Everard Home his brother-in- law, and Matthew Baillie his nephew, Being desirous of showing a lasting mark of respect to the memory of John Hunter endowed an annual oration to be delivered in the Theatre of the College on his birthday, the 14th of February; such oration to be expressive of the merits of Comparative Anatomy, Physiology, and Surgery, not only of John Htinter but also of such persons as should lx from time to time deceased, whose labours have contributed to the improvement or extension of surgical science." In 229 years much has happened, ideas and ideals have changed, and the thoughts and labours of many like those of William and John Hunter have been directed towards ascertaining and putting into practice the best methods for the education and training of their successors and have thereby contributed both directly and indirectly to " the improvement or extension of surgical science." 205 SIR E. FINCH I would at once stress the difference between training and education. Training implies what might be designated as a drill, the acquirement of skill and precision, and the desire to achieve; but education implies Fig. 2. William Hunter. Posthiim7?oiis por-trait by Reynolds at Gla.sgow. many additional disciplines and demands growth unlimited and perpetual. William Hunter (Fig. 2) and his brother John were both great teachers. practitioners, and workers in research projects to extend the boundaries of knowledge. In later years William wrote " To acquire knowledge and to communicate it to others has been the pleasure, the business, and the ambition of my life." In 1793 when John wrote to the Governiors of St. George's Hospital in order to stimulate his colleagues to undertake more teaching to the pupils, he said that he had been anxious to gain an appointment on the staff because " My motive in the first place was to serve the hospital and in the second to diffuse the knowledge of the art, that all might be partakers of it this indeed is the highest office in which a surgeon can be employed." They, by their example, have influenced, perhaps more than is usually realised, many who have been interested in the development, reform. and even the present day trends in medical education. My purpose is to attempt to estimate the extent and ultimate effect of that influence, not only in our own country but also in others, on those who teach. practise, and by their research pursue projects on the fringe of knowledge. The immediate influence of John Hunter on those who had actually been his pupils was such that, when the London Medical and Phvsical 206 THE INFLUENCE OF THE HUNTERS ONl MEDICAL EDUCATION Society had its first full meeting on 11th February 1819 after being inaugurated on 3rd February, it was proposed from the Chair, which was occupied by one of his pupils Sir William Blizard (Fig. 3), and agreed. that the Society in the future should be known as The Hunterian Society (Fig. 4). William Clift was present, and as Miss Jessie Dobson, the Anatomy Curator of the College, has related in his biography. it is due to him, who was its first conservator, that this College owes the preserva- tion and arrangement of the original Hunterian Museum. During the meeting Clift took part in a discussion on tape worms, and later on that occasion was made an Honorary Member of the Society. The biographical details of William and John Hunter have been related by many previous orators, they are the subject of many books which are well known, so any reference I may make will be somewhat cursory. The family home was at Long Calderwood, in the parish of East Kilbride in Lanarkshire about seven miles from Glasgow; an appeal is being made at the present time for financial assistance to preserve the house. There was a family of ten children, three of them died in infancy probably from tuberculosis of the lung, and four in the prime of life probably from the same cause, but William and John lived till they were sixty-five and Dorothea lived to old age and was the mother of Matthew Baillie who succeeded with William Cruikshank, on William Hunter's death in 1783, to the joint use of his museum for thirty years, and to the freehold of the premises of the Windmill Street School Baillie continued _h. Fig. 3. Sir William Blizard. to lecture there till 1799 and then retired. He became a physician to St. George's Hospital in 1789 and in 1793, the year of John Hunter's death, published the first book in English on morbid anatomy illustrated with beautiful copper plates, many of which were made from drawings by 207 SIR E. FINCH William Clift. William Hunter's museum was taken to Glasgow in 1807. John being the youngest of the family was probably a somewhat spoilt child. He had little education, one biographer states he could neither read nor write with confidence when he was seventeen years of age and HUNTERIAN SOCIETY Fig. 4. Hunterian Society prograninie. could have passed no modern examination. He consequently had no love of books nor would he apply himself to any employment for very long. In his own words, later in his life, he remarked: When I was a boy I wanted to know all about the clouds and the grasses, and whv the leaves changed colour in the autumn, I watched the ants, the bees, the tadpoles. and caddis worms; I pestered people with questions about which nobody knew or cared anything." This statement has been interpreted by some as evidence of his natural proclivity for research, but this is to regard such an inclination from a very narrow point of view. A persistent and repeated desire for new knowledge is natural in all. It is a main occupation of childhood as all parents know, and can be very trying to them to be always answering Why'? and How ? This inclination of the child wears off as its attention is directed by factual education; in the adult the desire to know becomes dimmed until it is re-awakened by an education, of a different type, which is directed to preserve and increase it. The eldest son to grow up was James who was educated in law with the object of becoming a Writer to the Signet. William at the age of thirteen obtained a bursary at the University of Glasgow, and became a student in Arts intending to enter the Ministry. After leaving the University he applied unsuccessfully for the post of schoolmaster at East Kilbride, but having in the meantime become acquainted with William Cullen (Fig. 5), who was in medical 208 THE INFLUENCE OF THE HUNTERS ON MEDICAL EDUCATION practice at Hamilton, he decided to follow medicine as his vocation and resided in Cullen's house for three years as his apprentice. When he was twenty-two, on Cullen's advice, he went for a year to Edinburgh (1739-40) and attended the anatomy classes of Professor Alexander Monro (primus). .~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ c. f. Fig. 5. William Cullen. By Clchirante, in Hunteria,i Museum, Glasgow. Cullen also advised him to spend a year or two in London and then return to Hamilton where they would practise as partners. Fortunately, for both of them and for medicine, the arrangement did not materialise and in later years while William was becoming the best-known surgeon man-midwife and anatomist in London, William Cullen became Lecturer in Chemistry and later Professor of Medicine (1751) at the University of Glasgow. In 1757 he was appointed as Professor of Chemistry at Edin- burgh University and later occupied successively the Chair of " The Institutes of Medicine" (Physiology), and of Medicine. He played a prominent part in the development of the medical school in each uni- versity; he is also credited with being the first in 1757 to give lectures in the vernacular at Edinburgh instead of in Latin. Cullen gave William Hunter an introduction to two Scots living in London, namely William Smellie (1687-1763) who, after practising in Lanark for nineteen years, migrated to London to practise as an apothecary and man-midwife, and James Douglas, a surgeon anatomist who was well established as a teacher of human and comparative anatomy. Douglas had already published a book (1707) The Comparative Description of Muscles in a Man and a Quadruped. William Cheselden in the preface of his book The Anatomy of the Human Body (1713) refers to James Douglas as " that most accurate and indefatigable anatomist"; his eponymous fame will always be the pouch of Douglas (1730). He is not to be confused with his brother John who in 1719 advertised a course of lectures on anatomy, chirurgical operations and bandaging, and also introduced an 209 19 SIR E.

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