RESEARCH IN MEDICINE 513 



that as ligation of veins and aitevies in simple wounds was possible, it 

 was possible also at amputation, and at the first opportunity he demon- 

 strated the correctness of his views. So by doing away with boiling oil 

 and the heated iron he ranks among the greatest of humanitarians and, 

 by establishing rational procedures for the treatment of wounds and 

 for the ligation of vessels, as one of the greatest of surgeons. 



Here it is well to depart from the chronological order and discuss 

 John Hunter and his work and thus bring the advance in surgery to 

 the year 1800. Between Pare and Hunter surgery was influenced by 

 Haller and Harvey, but both these must be treated in detail in a con- 

 sideration of other lines of activity. Suffice it to point out here that 

 Harvey's work on the circulation of the blood and Malpighi's discovery 

 of capillary circulation advanced surgery enormously by clearing up 

 for the surgeon the mysteries of the blood-vascular system. The dread 

 of hemorrhage had previously deterred surgeons from all operations 

 except those of dire necessity or those in which the operation was in a 

 gangrenous tissue. AVith this mystery of hemorrhage solved, the sur- 

 geon boldly ventured into new territory and rapidly extended the possi- 

 bilities of his art. 



John Hunter, pathologist, physiologist and surgeon, was active in 

 the latter part of the eighteenth century. He worked in anatomy, com- 

 parative anatomy, physiology and surgery; essentially a laboratory 

 investigator, " content " it is said " with four hours of sleep, scanty 

 rations and little play." (Mumford.) Many were his contributions 

 to anatomy, but his work on coagulation of the blood, inflammation and 

 the repair of wounds, and, above all, the demonstration, that after 

 ligation of vessels there occurs the establishment of a collateral circula- 

 tion by anastomosis, were of the utmost importance to surgery. This 

 latter, the basis of his famous operation for aneurism, was the result of 

 a study of the growth of deer's antlers, in the course of which he tied 

 one of the carotid arteries. To his surprise the cold antler of the 

 ligated side, after two weeks, became warm. Dissection demonstrated 

 that the ligature had not slipped, and on the basis of this observation he 

 established those principles concerning the ligation of vessels in con- 

 tinuity so important in modern surgery. He also presented the first 

 satisfactory explanation of inflammatory and thrombotic diseases of 

 veins and contributed to the knowledge of gunshot wounds and of 

 many other phases of medical science; but his great influence was the 

 impetus which he gave to proper scientific research in medicine as well 

 as surgery, in pathology as well as physiology. 



To Hunter, the nineteenth century English school of surgery owes 

 its fame, and in his honor the Royal College of Surgeons established the 

 annual Hunterian Oration. After Hunter, and largely due to his 

 infiuence, surgery advanced surely, though slowly, Init without momen- 



VOL. LXXX. — 34. 



