Percivall Pott

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.

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.

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.

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.

[3] He would distribute pamphlets, noting his observations and thoughts on topics ranging from "head injuries, hydrocele, fistula, rupture, and fracture", in the hospital environment.

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.

Pott quickly recognised the association between carcinoma and chimney sweeps and published his findings in a piece titled "Chirurgical Observations relative to…the cancer of the scrotum.

[4] Despite the surgical trends of his time, Pott did not agree with severe treatments and heroic medicine but rather preferred gentler forms.

"[9] In addition to surgery, Pott's focused on public health as well drawing his attention to the challenges of chimney sweeps in his community.

He wrote, "in their early infancy, they are most frequently treated with great brutality, and almost starved with cold and hunger; they are thrust up narrow, and sometimes hot chimneys, where they are bruised, burned and almost suffocated; and when they get to puberty, become peculiarly liable to a most noisome, painful, and fatal disease.

He famously argued this point based on a trend seen where gardeners who used soot to kill slugs had developed skin carcinoma on their hands.

In 1878, George Lawson suggested that the cancer was caused by the friction generated by the chimney sweeper's overalls against the scrotum while sifting through soot.

[11][9] There was pressure for action as early as 1788, yet it was not until 1875 that Pott's work finally began to influence change: in this year a decline in scrotal cancer incidence and mortality was noted.

[5] 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.