Pott, Percivall (DNB00)

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POTT, PERCIVALL (1714–1788), surgeon, only son of Percivall Pott, a native of London, whose profession was that of a scrivener, was born on 6 Jan. 1713–14, in that part of Threadneedle Street which is now covered by the Bank of England. The house was probably pulled down between 1766 and 1788, when the east and west wings were added to the bank buildings. His father was his mother's second husband. Her first husband, named Houblon, a son of Sir James Houblon [see under Houblon, Sir John], was a young officer who was killed in action soon after his marriage. Pott's father died in 1717, leaving his widow with very inadequate means of support. After Pott's own death in 1788 a small box was found among his papers containing a few pieces of money, amounting to less than five pounds, which was the whole sum he received from the wreck of his father's fortune. The mother, with her son and daughter, however, were assisted by a distant relative, Dr. Wilcox, bishop of Rochester; Percivall was sent at the age of seven to a private school at ‘Darne’ (apparently Darenth) in Kent. He showed a liking for surgery, and on 1 Aug. 1729 he was bound for seven years an apprentice to Edward Nourse [q. v.] His mother paid 210l. as premium. Nourse, at this time an assistant-surgeon at St. Bartholomew's Hospital, gave, contrary to the practice of most of his colleagues, private lectures in anatomy at London House in Aldersgate Street, and it became Pott's duty to prepare the subjects for these demonstrations. Pott seems to have gained some professional reputation even at this early period in his career. According to his biographer, Earle, during the later years of his apprenticeship, being ‘confident in the fair prospects of industry, he hired a house of considerable rent in Fenchurch Street, and took with him his mother and her daughter by her first husband.’ A court minute-book, now in the possession of the Barbers' Company, records that on ‘7 Sept. 1736 Percivall Pott was admitted into the freedom of the Company by service, upon the testimony of his master, and was sworn.’ Later in the same day he ‘received the diploma testifying his skill and impowering him to practice.’ He was registered in the books of the Barber-Surgeons' Company as living in Fenchurch Street, but he had removed to Bow Lane before 1 May 1739, when he ‘tooke the livery [of the Barber-Surgeons' Company], and paid the usual fine of 10l. for so doing.’ He acted as steward of the livery dinner of the company in 1741 and as steward of the mayor's feast in 1744. In 1745 the United Company of Barber-Surgeons was dissolved, and thereupon Pott naturally allied himself with the surgeons.

Pott took an active part in the affairs of the Corporation of Surgeons from its very commencement. On 5 July 1753 the court of assistants of the newly formed company elected Pott and Hunter the first masters of, or lecturers on, anatomy. He became a member of the court of assistants on 23 Dec. 1756 in place of Legard Sparham, deceased, and he was elected a member of the court of examiners on 6 Aug. 1761, to fill the place rendered vacant by the resignation of William Singleton. On 7 July 1763 he became under or second warden of the company; on 5 July 1764 he was promoted to be upper or first warden, and on 4 July 1765 he succeeded Robert Young as master or governor of the Corporation of Surgeons.

Pott became assistant-surgeon to St. Bartholomew's Hospital on 14 March 1744, ‘in room of Joseph Webb, appointed surgeon and guide to Kingsland Hospital,’ and on 30 Nov. 1749 he was made full surgeon to the charity ‘in place of James Phillips.’ Pott introduced many improvements into the art of surgery during his long tenure of this office, rendering its practice more humane and less painful both to patient and surgeon. Earle tells us that, for some years after Pott became surgeon to St. Bartholomew's Hospital, escharotic dressings were continually employed, and that the actual cautery was in such frequent use that, at the times when the surgeons visited the hospital, it was regularly heated and prepared as part of the necessary apparatus. It was only by Pott's constant endeavours that these abominable methods were discarded.

In 1756 an accident befell him which rendered his name of world-wide fame. ‘As he was riding in Kent Street, Southwark, he was thrown from his horse, and suffered a compound fracture of the leg, the bone being forced through the integuments. Conscious of the dangers attendant on fractures of this nature, and thoroughly aware how much they may be increased by rough treatment or improper position, he would not suffer himself to be moved until he had made the necessary dispositions. He sent to Westminster, then the nearest place, for two chairmen to bring their poles, and patiently lay on the cold pavement, it being the middle of January, till they arrived. In this situation he purchased a door, to which he made them nail their poles. When all was ready he caused himself to be laid on it, and was carried through Southwark, over London Bridge, to Watling Street, near St. Paul's, where he had lived for some time. … At a consultation of surgeons the case was thought so desperate as to require immediate amputation. Mr. Pott, convinced that no one could be a proper judge in his own case, submitted to their opinion, and the proper instruments were actually got ready, when Mr. Nourse (his former master and then colleague at St. Bartholomew's Hospital), who had been prevented from coming sooner, fortunately entered the room. After examining the limb he conceived there was a possibility of preserving it; an attempt to save it was acquiesced in, and succeeded.’

The term ‘Pott's fracture’ is still commonly applied to that particular variety of broken ankle which he sustained on this occasion. During the leisure consequent on the necessary confinement Pott first turned to authorship, and planned and partly executed his ‘Treatise on Ruptures.’ He thus began to write at the age of 43, by a curious coincidence the exact age at which his illustrious pupil, John Hunter, published his first book. But from that time onwards he issued a long series of books, and his writings revolutionised the practice of surgery in this country. In 1764 he was elected a fellow of the Royal Society.

While he lived in Watling Street he instituted a course of lectures for the pupils attending his practice at St. Bartholomew's Hospital. This course was at first private, but from 1765, the year in which he succeeded Nourse as senior surgeon, it was delivered publicly to all the students at St. Bartholomew's Hospital. These lectures, at first given with hesitation and reserve, afterwards became the most celebrated in London, and served to disseminate his views and methods of treatment throughout Europe.

He purchased a house near Lincoln's Inn Fields in 1769, and lived in it until he moved in 1777 to Prince's Street, Hanover Square, when the retirement of Sir Cæsar Hawkins materially increased his already extensive practice. He was living in this house when, in conjunction with W. C. Cruikshank in 1783, he treated Dr. Johnson for the sarcocele which troubled the doctor's declining years. In 1786 the Royal College of Surgeons of Edinburgh elected Pott an honorary fellow of their corporation, with the gratifying intimation that ‘he was the first gentleman of the faculty they had thought proper to bestow the honour on,’ and on 9 Sept. in the following year he was elected an honorary member of the Royal College of Surgeons in Ireland.

He resigned the office of surgeon to St. Bartholomew's Hospital on 12 July 1787, after having served it, as he used to say, man and boy for half a century, and in recognition of his work there he was elected a governor.

Pott died of pneumonia, at his house in Hanover Square, on 22 Dec. 1788. He was buried on 7 Jan. 1789 in the chancel of St. Mary's, Aldermary, in Queen Victoria Street. A tablet to his memory is on the wall of the south aisle. John Hunter was elected on 12 Feb. 1789 to fill his place in the court of assistants of the Surgeons' Company.

Pott's affection for his mother prevented him from forming during her life any attachment which might separate him from her. In 1746, after he had been released from this filial engagement, he married Sarah, the daughter of Robert Cruttenden, by whom he had five sons and four daughters. His third and second surviving son, Joseph Holden Pott, archdeacon of St. Albans and London, is noticed separately.

‘The labours of the greatest part of his life,’ says Pott's son-in-law, Sir James Earle, ‘were without relaxation, an increasing family requiring his utmost exertion; of late years he had a villa at Neasden, and in the autumn he usually passed a month at Bath or at the seaside.’ His kindness of heart was proverbial, and he is said to have had at one time three needy surgeons living in his house until he could provide them with the means of earning an independent livelihood. His high character and blameless life helped to raise the surgeon's social standing in this country.

Wadd says of him that ‘he predominated early in life in a profession which has been said not to procure its members bread until they have no teeth to eat it, particularly as a consulting surgeon, a post generally occupied by veterans. He was the first surgeon of his day, and a scientific writer remarkable for the classic purity of his style, the scrupulous precision of his definitions, and the unerring closeness of his argument.’ Pott appears to have done for surgery what Glanville did for science: he introduced a wholesome scepticism. He always professed the utmost respect for the early writers on the art of surgery, and read their voluminous works with diligence; yet in his practice he relied entirely upon his own observations, and was guided by his common sense. In this way he broke through the trammels of authority, and may be regarded as the earliest surgeon of the modern type. Like Wiseman, too, he was of necessity a clinical rather than a scientific surgeon, for pathology as yet had no existence. The descriptions of his cases are so clear, and the facts are so well stated, that it is generally possible to recognise them, and to draw conclusions from them by the light of modern knowledge, while the cases narrated by many of his contemporaries and successors are incomprehensible from their manner of intermingling theories with facts. As a practical surgeon, Pott was as far in advance of his chief predecessor, Wiseman, as that surgeon had been in advance of Thomas Gale (1507–1587) [q. v.] and William Clowes the elder (1540–1604) [q. v.], the chief surgeons of Elizabeth's reign, or of Woodall under James I. In practical surgery he takes rank, too, before his pupil Hunter; but as a scientific surgeon the pupil was much greater than his master, although in power of expression and literary style Pott was Hunter's superior. ‘In practical surgery’ (according to Sir James Paget), ‘Pott generally appears more thoroughly instructed, a more “compleat surgeon;” but with the science and the exposition of principles Hunter alone deals worthily.’

Pott's works are: 1. ‘A Treatise on Ruptures,’ London, 8vo, 1756; 2nd edit. 1763; 3rd ed. 1769; 4th ed. 1775; one of the works upon which the reputation of Pott rests. Mr. C. B. Lockwood, to whom the writer of this notice referred the treatise, said that ‘it may still be read with advantage and instruction. The narrative bears the imprint of truthfulness and sincerity, and his views of the anatomy and pathology of hernia are luminous and correct. He quotes few authorities, but it is evident that, in advocating early operations for strangulated hernia, he was in advance of most of his contemporaries, while he carried operations upon non-strangulated herniæ as far as they could legitimately go without the aid of antiseptics.’ 2. ‘An Account of a particular kind of Rupture frequently attendant upon new-born Children,’ London, 8vo, 1757; 2nd edit. 1765; 3rd edit. 1775; this paper led to a short controversy with Dr. William Hunter, who claimed priority of discovery. One of the specimens illustrating the tract is still preserved, as Pott left it, in St. Bartholomew's Hospital museum; it is No. 2138. 3. ‘Observations on that Disorder of the Corner of the Eye commonly called Fistula Lachrymalis,’ 8vo, London, 1757; 2nd edit. 1758; 3rd edit. 1769; 5th edit. 1775. This tract, according to present ideas, is quite obsolete. 4. ‘Observations on the Nature and Consequences of Wounds and Contusions of the Head and Fractures of the Skull, Concussion of the Brain,’ &c., 8vo, London, 1760. This tract does not appear to be reprinted in the collected editions of Pott's works. 5. ‘Practical Remarks upon the Hydrocele,’ London, 8vo, 1762; 2nd edit. 1767. The cause of the affection is clearly defined, due credit is given to Professor Monro and to Samuel Sharp for their work upon the subject, and a rational line of treatment is laid down. A dissertation upon sarcocele, then a mysterious affection, concludes this pamphlet. 6. ‘Remarks on the Disease commonly called Fistula in Ano,’ London, 8vo, 1765; 2nd edit. 1765; 3rd edit. 1771; 4th edit. 1775. Pott advocates a return to the old and good practice of simple division, in preference to the more complicated methods of procedure adopted in England by Cheselden, and in France by Le Dran and De la Faye. In this treatise he points out the lessons which regular practitioners may learn from quacks. 7. ‘Observations on the Nature and Consequences of those Injuries to which the Head is liable from External Violence,’ 8vo, London, 1768; 2nd edit. 1771. This is one of the classical writings of English surgery. It abounds in interesting cases well recorded, and some of the conclusions are still regarded as axioms in practice. With the first edition of this work was published: 8. ‘Some few Remarks upon Fractures and Dislocations,’ London, 8vo, 1768; 2nd edit. 1773. This treatise was translated into Italian (Venice, 1784) and into French (Paris, 1788). This, on the whole, is the most important contribution by Pott to the surgical practice of the last century. Dr. Hamilton, the greatest American authority on the subject of fractures and dislocations, writing in 1884, says that ‘the work is distinguished for the originality and boldness of its sentiments, and was destined soon to revolutionise, especially throughout Great Britain, the old notions as to the treatment of fractures, and to establish in their stead, at least for a time, what has been called, not inappropriately, “the physiological doctrine.” The peculiarity of this doctrine consisted in its assumption that the resistance of those muscles which tend to produce shortening can generally be overcome by posture without the aid of extension; and that for this purpose—for example, in the case of a broken femur—it was only necessary to flex the leg upon the thigh, and the thigh upon the body, laying the limb quietly on its outside upon the bed.’ In a modified form this doctrine was accepted by the majority of the great surgeons who succeeded Pott in Great Britain, and, owing to Dupuytren's influence, it was extensively adopted in France. It never gained much ground in America, and of late years it has been considered to be incorrect, and, except in a few cases, the treatment of fractures by flexion has been replaced by the method of extension. 9. ‘An Account of a Method of obtaining a Perfect or Radical Cure of Hydrocele,’ 8vo, London, 1771; 3rd edit. 1775. This tract is an expansion of, and forms a conclusion to, No. 5. 10. ‘Chirurgical Observations,’ 8vo, London, 1775; translated into German, Berlin, 12mo, 1776. The observations are: (i) ‘Remarks on the Cataract,’ an attempt to maintain the operation of “Couching” in opposition to that of the extraction of the opaque lens. (ii) ‘A Short Treatise of the Chimney Sweeper's Cancer,’ which was reprinted in 1810, with additional notes by Sir James Earle, F.R.S. Although this work only consists of five octavo pages, it is still quoted for the accuracy of its clinical details, and it has led to the production of much good work in the fields of pathology and surgery. (iii) ‘Observations and Cases relative to Ruptures.’ A monograph of great interest, in which the best cases are put last. (iv) ‘Observations on the Mortification of the Toes and Feet.’ We owe to this short, clear, and modest tract that treatment of gangrene by opium which has maintained its ground uninterruptedly until the present day. (v) ‘Some few Remarks upon the Polypus of the Nose.’ Pott himself suffered from nasal polypi. 11. ‘Remarks on that kind of Palsy of the Lower Limbs which is frequently found to accompany a Curvature of the Spine,’ 8vo, London, 1779. Translated into Dutch, Leyden, 8vo, 1779, and twice into French, first at Brussels in 1779, and afterwards at Paris in 1783. The influence and importance of this tract may be estimated by the fact that the particular form of spinal disease here described is now almost universally known as ‘Pott's disease.’ Although one of the best known of Pott's works, it is one of the least satisfactory according to modern ideas. The clinical description is admirable, but the treatment adopted was unnecessarily severe, and was not founded upon rational principles. One of the specimens illustrating this paper is in the museum of St. Bartholomew's Hospital, No. 1097. 12. ‘Farther Remarks upon the Useless State of the Lower Limbs in consequence of a Curvature of the Spine,’ London, thin 8vo, 1782. 13. ‘Remarks on the Necessity and Propriety of the Operation of Amputation in certain Cases and under certain Circumstances.’ A controversial pamphlet of ephemeral interest. 14. Papers in the ‘Philosophical Transactions’ for 1741 and 1764.

Among extant manuscript notes of Pott's lectures in existence, taken and transcribed by the students who attended them, are: 1. A quarto volume of manuscript notes in the library of the Royal College of Surgeons of England, dated 2 Oct. 1777, and containing 112 pages of writing. 2. A manuscript in the library of St. Bartholomew's Hospital containing the notes of thirty-two of Pott's lectures on surgery in 331 pages, dated 1781, and written by Thomas Oldroyd. The library of the Royal Medical and Chirurgical Society contains two manuscripts of Pott's surgical lectures. 3. A quarto volume containing notes of forty-two lectures in 217 pages, dated 1789. 4. An undated manuscript of Pott's lectures on surgery, with his method of performing each operation.

The chief collected editions of Pott's works are: (1) in one vol. 4to, London, 1775; (2) in French in 2 vols. 8vo, Paris, 1777; (3) in 2 vols. 8vo, Dublin, 1778; (4) new edit. 3 vols. 8vo, 1779; reprinted (?) as (5) new edit. 3 vols. 8vo, London, 1783; (6) new edit. edited by Sir James Earle in 3 vols. 8vo, London, 1790; (7) in 3 vols. 8vo, London, 1808; (8) in 2 vols. 8vo, Philadelphia, 1819.

The chief portrait of Pott is in the Great Hall at St. Bartholomew's Hospital; it is a life-size three-quarter length in oils, seated in an armchair, painted by Sir Joshua Reynolds, P.R.A., with the inscription ‘Percivall Pott, surgeon to St. Bartholomew's Hospital. A.D. 1784, æt. 71. The gift of James, Marquis of Salisbury, and Heneage, Earl of Aylesford. A.D. 1790.’ There is an octavo engraving by Heath of this portrait in the Squibb collection of medical portraits at present in the possession of the Royal Medical and Chirurgical Society of London. Another engraving is by Townley. There is also in the library of the medical school a bust presented by his son, Archdeacon Joseph Holden Pott [q. v.] The Royal College of Surgeons of England possesses two life-size portraits, half-length, in oils. The one in the secretary's office is painted by Sir Nathaniel Dance Holland, bart., R.A.; the other in the council room is by George Romney. There is a bust by Peter Hollins, A.R.A., on the staircase of the Royal College of Surgeons. The Squibb collection of medical portraits also contains a stipple engraving by R. M. of Dance Holland's painting, and an unsigned line engraving of Percivall Pott, apparently from a miniature. The present Archdeacon Alfred Pott possesses an oval portrait in oils, unsigned, and a miniature in a large locket, with a monogram P.P., and light hair behind. Both represent Pott as quite a young man.

[A short account of the Life of Percivall Pott, prefixed to Sir James Earle's edition of his works, London, 1790. The best thanks of the writer of the present notice are due to Mr. Sidney Young, F.S.A., master of the Barbers' Company; to Mr. W. H. Cross, the clerk of St. Bartholomew's Hospital; and to Mrs. South, who severally gave details of Pott's connection with the Barber-Surgeons, with St. Bartholomew's Hospital, and with the Corporation of Surgeons; as well as to the Ven. Alfred Pott, B.D., archdeacon of Berkshire, the great-great-grandson of Pott, who afforded such additional information about him as is traditional in the family.]

D’A. P.