thumb|Percivall Pott, engraved from an original picture by [[Nathaniel Dance-Holland, National Library of Medicine, Images from the History of Medicine.]]

Percivall Pott (6 January 1714, in London – 22 December 1788) was an English surgeon, one of the founders of orthopaedics, and the first scientist to demonstrate that cancer may be caused by an environmental carcinogen, namely chimney sweeps' carcinoma. Many diseases are his namesake including Pott's fracture, Pott's disease of the spine, and Pott's puffy tumour. It is believed that Pott's standard of living contributed to the rise of the surgeon within social standings.

Early life and education

Percivall Pott was born the son of Percivall Pott senior in London. His father died when he was a child, but Joseph Wilcocks, Bishop of Rochester, who was a relative of his mother, paid for his education. He served his apprenticeship with Edward Nourse, assistant surgeon to St Bartholomew's Hospital, and in 1736 was admitted to the Barbers' Company and licensed to practice.

Career

He became assistant surgeon to St Bartholomew's in 1744 and full surgeon from 1749 till 1787.

As the first surgeon of his day in England, excelling even his pupil, John Hunter, on the practical side, Pott introduced various important innovations in procedure, doing much to abolish the extensive use of escharotics and the cautery that was prevalent when he began his career.

In 1756, Pott sustained a broken leg after a fall from his horse. It is often assumed that his injury was the same one that later came to be known as Pott's fracture, but in reality, Pott's broken leg was a much more serious compound fracture of the tibia. As he lay in the muck, he sent a servant to buy a door from a nearby construction site, then had himself placed on the door and taken home. Surgeons cleaned the wound and discussed amputation, an operation which at the time had a very high rate of failure, as it often led to sepsis and death, but Pott prevailed on them to splint the leg, and he ultimately recovered completely.

Percivall Pott's dedication to his patients and standard of care garnered Pott high praise and fame. He is generally regarded as one of the two greatest surgeons of the 18th century along with his student John Hunter.

thumb|Percivall's son, Joseph Holden Pott, Archdeacon of London, 1843 mezzotint by John Porter

Although little more is known about Percivall Pott's private life, Pott is regularly described as having excellent character, and an archetypical English surgeon. It is believed that Pott's standard of living (he was rich enough to give Polly a dowry of £5000) was a contributor to the rise of the surgeon within social standings.

thumb|Diagram from the chirurgical works of Percivall Pott

Discovery and identification credit

Scrotal cancer, although largely thought to have been identified by Percivall Pott, had been thought to have been described nearly 40 years before Pott's "Chirurgical Observations" as a "canker of privities" per documentation in the burial records of the Parish of St. Botolph without Aldgate from 1589 to 1599. These descriptions are ambiguous and it is unclear which anatomical parts are considered "privities". As such, most historians generally agree, that Bassius first correctly described scrotal cancer in 1731.

Surgery

As a surgeon, Pott was well respected and often assisted fellow surgeons. Pott was viewed as a mentor and even allowed other physicians and surgeons to live with him while under his guidance. Pott rose to fame for these connections between occupational hazards and cancer malignancy even though the connection was not fully understood at the time. Pott's "Chirurgical Observations" provided a framework to shape the modern understanding of Occupational cancers.

Legacy

Percivall Pott's work influenced a wave of research and change in public policies. After his initial publication, more clinical cases began to emerge rapidly over the following years. This triggered a series of "Chimney Sweepers' Acts" which aimed to protect chimney sweepers. These facilitated the formation of societies like the "Society for Superseding the Necessity of Climbing Boys, by Encouraging a New Method of Sweeping Chimneys and for Improving the Condition of Children and Others Employed by Chimney Sweepers" in 1803 which included the likes of Dukes, Earls, and Royal Patrons.

Latter animal studies (1933) painting coal tar onto skin would demonstrate the role of the first proven chemical carcinogen benzo(a)pyrene, which occurs in high concentrations in smoke and chimney soot, with the process that Pott first identified. Pott's early investigations thus contributed to the science of epidemiology and the Chimney Sweepers Act 1788.

See also

  • Cancer cluster
  • History of medicine
  • History of surgery
  • Pott disease

Notes

References

  • Dobson, J., 'Percivall Pott' in Annals of the Royal College of Surgeons of England, vol. 50 (1972), pp. 54–65
  • History of Surgeons – Percivall Pott. surgeons.org.uk England
  • Article on Percivall Pott in Who Named It
  • Sir Percivall Pott. Surgical Tutor UK.