William HUNTER1718–1783

has it been said that “he made his name immor- tal by the labour of his own hands outside the sphere of surgery.” The care of the collection, which contained over 13,000 specimens, caused some anxiety to Hunter’s family, but in young Clift his assistant they found a faithful and devoted guardian. For 7 years he kept watch, pre- venting deterioration in the soft specimens, and making copious extracts from the manuscripts.

On June 13, 1799, the government bought the col- lection for £15,000 and transferred it to the care of the Corporation of Surgeons. A charter was granted to the Corporation on March 22, 1800, whereby they were constituted the Royal College of Surgeons in London and were empowered to examine candidates for the Membership. The sur- geons gave up Surgeons’ Hall and moved to a house in Lincoln’s Inn Fields. In 1806 Parliament granted £15,000 to the College to build a museum and 3 years later another grant of £12,500. The surgeons themselves spent over £21,000 of their own money. By a charter of 1843 the title of the College was changed to the Royal College of Surgeons of England and the Fellowship of the College was instituted.

John Hunter has exercised a profound influence on British surgery. This was achieved not by social gifts or personal attraction, but entirely by his scientific mind. When he started dissecting, 3 years only had passed since surgeons had ceased to be associated formally with the “art and mystery of barbers.” But through his immense labors in comparative anatomy, physiology, and pathology, he raised the status of surgery to that of a scientific profession. In his quest for truth by observation and experiment he displayed a pene- trating vision, extending far beyond the horizon of his own time. His country experimental station long anticipated “Down House,” which is now the experimental farm of the Royal College of Surgeons. Most of his teaching is inevitably bound in the corpus of surgical doctrine and has lost its identity. Like Lister, he was interested in the phenomena of inflammation and coagulation of the blood, but he was denied the use of a micro- scope and he little dreamt of a world of micro- organisms. But his keen intellect noted and stressed mysterious variation in the reaction of tissues to injury according to whether the skin was broken or unbroken. If the skin was intact the healing process proceeded smoothly; whereas with a broken skin suppuration was the rule and repair was disturbed and delayed. And he pon- dered why. His great museum is the proud her-

itage of the Royal College of Surgeons of England and it is fitting that on the anniversary of his birth- day an oration in praise of him should be deliv- ered by a distinguished disciple.

References

Palmer JF (ed) (1835) The Works of John Hunter, FRS, with Notes, 4 vols, with a Life by Drewry Ottley.

London, Longmans

Paget S (1897) John Hunter. London, T. Fisher Unwin Butler FH (1910) John Hunter. Encyclopaedia

Britannica, 11

edn. New York

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Who’s Who in Orthopedics

William HUNTER

1718–1783

William Hunter, John Hunter’s older brother, was born in rural Scotland. He was well educated in Glasgow, Edinburgh, and London. In 1846, he began giving a series of lectures on surgery. He was an excellent speaker and became a very suc- cessful teacher. He was an avid student of anatomy and became the first great teacher of anatomy in England. Hunter developed an insti- tution for teaching and studying anatomy on Great Windmill Street in London. He gradually shifted the emphasis of his practice from surgery to obstetrics. His most important work was the book, The Anatomy of the Gravid Uterus, Exhibited in Figures.

The article on the anatomy and pathology of

the articular cartilage was published early in

Hunter’s career. His description of the cartilage was far in advance of his time. The article also reveals the wealth of anatomic material available to the author. The “subjects,” including the bodies of children, were procured largely through the services of “resurrectionists,” that is grave robbers. The common disease of the joints in Hunter’s time was tuberculosis. The acuity of his observations deserves our admiration.

antibiotics and little equipment, and the operating room was heated by a wood fire.

Nevertheless, in the two-storey wooden-frame hospital, he invented and developed the remark- able methods and equipment by which he became known. By 1951, he was using his devices to treat complex and infected fractures and to lengthen bones. His theory that bone would grow if gradually distracted and his external fixator, of circular steel haloes connected by rods and bone-fixating wires, produced dramatic results not seen before in orthopedics. His work was the beginning of a new medical paradigm, the con- servation and exploitation of the unlimited natural plasticity of bone.

Although Dr. Ilizarov’s results were astonish- ing, his theory was contrary to orthodox views on bone regeneration. His reputation remained con- fined to Siberia until 1967, when he successfully treated the Russian Olympic highjumper, Valery Brumel who, after a motorcycle accident, had chronically infected nonunited fractures of both legs, even after 14 operations by the best surgeons in Moscow. After treatment by Ilizarov, Brumel, completely healed, went on to jump again in competition.

Dr Ilizarov’s years in a small wooden hospital with no research laboratory were over. It became known that he could straighten and lengthen a shattered or deformed leg and the Russian elite in need of orthopedic care journeyed to Kurgan. His medical reputation soared into national prominence and by 1984 he presided over a new 1,000-bed Scientific Center for Reconstructive Orthopedics and Traumatology, with over 350 surgeons, 1,500 nurses, 60 doctorate researchers, and 24 operating rooms.

By 1986, North American orthopedic surgeons had learned the Ilizarov techniques from Europeans who had worked directly with him, and were performing Ilizarov limb-saving opera- tions. The use of his methods is widespread: the North American Association for the Study and Application of the Methods of Ilizarov (ASAMI) now includes over 200 surgeons.

Dr Ilizarov was one of the Soviet Union’s most decorated civilians, receiving the Order of Hero of Socialist Labor, the Order of Lenin three times, appointments to the National Academy of Sciences and the Soviet Parliament, as well as the highest civilian honors of Italy, Yugoslavia and Jordan. His work is now widely known through- out the world and will have an enduring impact on the relief of suffering patients. He was truly a 156

Who’s Who in Orthopedics

Gavriil Abramovich ILIZAROV

1921–1992

Gavriil Ilizarov made a remarkable life odyssey from an isolated village in the Caucasus moun- tains to become a world figure in orthopedics and one of the most decorated medical scientists in the Soviet Union. He was born in a small Jewish community and was unable to attend school until he was 11 years old because his family had no money for shoes.

He graduated from Simferopol Medical School, which had been moved during the war to the Soviet Near East, and in 1944 was sent to the Siberian town of Dolgovka as the only physician for an area the size of a small European nation.

In 1949 he was promoted to become a staff physi- cian at the hospital in Kurgan, Western Siberia, where he was faced with the daunting task of treating many patients with war wounds that had progressed to limb-threatening unhealed frac- tures, infections, and other complications.

Working conditions were primitive: there were no