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Biographical entry Hilton, John (1805 - 1878)

M.R.C.S., May 22nd, 1827; F.R.C.S., Dec. 11th, 1843, one of the original 300 Fellows; F.R.S., 1839.

  • Image of Hilton, John
Born
22 September 1805
Sible Hedingham, Essex, UK
Died
14 September 1878
London, UK
Occupation
Anatomist and General surgeon

Details

Born at Sible Hedingham, a small village on the River Colne in the heart of Essex, on Sept. 22nd, 1805, the first son of John and Hannah Hilton. His parents were in humble circumstances when he was born, but his father afterwards made money in the straw-plaiting industry, became the owner of some brickfields, and built the house in Swan Street which is still called Hilton House. In addition to John, the Hilton family consisted of a brother, Charles, who inherited his father's property, and two sisters, one of whom, Anne, married Charles Fagge on Dec. 27th, 1836.

Hilton was educated at Chelmsford and afterwards at Boulogne, and became a student at Guy's Hospital about 1824. Guy's separated from St. Thomas's during his student career, and he was appointed Demonstrator of Anatomy under Bransby Cooper (q.v.), his fellow-demonstrator being Edward Cock (q.v.), in 1828. The two demonstrators worked together in friendly rivalry, and when Sir Astley Cooper proposed that they should investigate the origin and distribution of the superior laryngeal nerve, Cock undertook the comparative and Hilton the human anatomy side of the question. The results were largely instrumental in causing his election as F.R.S. in 1839.

From 1828 Hilton devoted himself so assiduously to the dissecting-room as to acquire the sobriquet 'Anatomical John'. When he was not dissecting or teaching he was making post-mortem examinations, and after sixteen years of this work he had gained an unrivalled knowledge of the anatomy of the human body and had become a first-rate teacher and lecturer. About 1838 he was engaged in making those dissections which, modelled in wax by Joseph Towne, still remain as gems in the Museum of Guy's Hospital. For this purpose Hilton spent an hour or two every morning in making a most careful dissection of some very small part of the body - usually not more than an inch or two. He then left, and Towne copied the dissection in wax. Towne worked alone in a locked room, and the secrets of his art died with him. Hilton was elected Lecturer on Anatomy in 1845 and resigned in 1853. As a lecturer and teacher he was admirable, for he had the power of interesting students by putting the trite and oft-told facts of anatomy in a totally new light, the result of his own observation and experience. He combined, too, elementary physiology with anatomy, for the two subjects had not then been separated. He was, however, a confirmed teleologist and tried to prove that anatomical distribution was due to design rather than to development. He had neither the education nor the inclination to appreciate anatomy in its scientific aspects.

Hilton was elected Assistant Surgeon to Guy's Hospital in 1844, Thomas Callaway and Edward Cock being his colleagues, whilst John Morgan, Aston Key, and Bransby Cooper were full Surgeons. He thus had the distinction of being the first surgeon at one of the large London hospitals who was appointed without having served an apprenticeship either to the hospital or to one of its Surgeons. In 1847 James Paget was elected to a similar position at St. Bartholomew's Hospital without either of these qualifications, and the rule previously looked upon as inviolate soon became more honoured in the breach than in the observance. Hilton's period of probation in the out-patient room was of short duration. Aston Key (q.v.) died of cholera after an illness of twenty hours in 1849, and Hilton as the Senior Assistant Surgeon was promoted to fill his place. The ordeal was trying, for he had been an anatomist all his life and had never had charge of beds, but he came well through it. He did not acquire the brilliancy or expertness of the older surgeons, but the very exactness of his anatomical knowledge made him a careful operator. His caution is still remembered by that method of opening deeply-seated abscesses with a probe and dressing forceps after making an incision through the skin, which is known as 'Hilton's method'. He shone especially in clinical lectures, where he brought out the importance of every detail in a case, and so linked them together as to form a continuous chain which interested even the idlest student. He attracted to himself the best type of men, and to be a dresser to Hilton was considered a blue ribbon at the hospital. Yet he was no easy master to serve, for he was rough in speech and was prone to indulge in personalities designed to hurt the amour propre of those to whom they were addressed.

At the Royal College of Surgeons Hilton was chosen a life-member of the Council in 1854. He lectured as Hunterian Professor of Human Anatomy and Surgery from 1859-1862, but it was not until 1865 that he became a Member of the Court of Examiners, a post he held for ten years. He served as Vice-President during the years 1865 and 1866, and was elected President in 1867, the year in which he delivered the Hunterian Oration. He resigned the Lectureship on Surgery at Guy's Hospital in 1870, though he continued to practise at 10 New Broad Street, E.C. In 1871 he was appointed Surgeon Extraordinary to Queen Victoria, and in the same year he was President of the Pathological Society. He married twice, and his children survived him. He died at Clapham of cancer of the stomach on Sept. 14th, 1878.

Hilton's claim to remembrance rests upon his essay "On the Influence of Mechanical and Physiological Rest in the Treatment of Accidents and Surgical Disease and the Diagnostic Value of Pain". The essay was delivered as his course of Arris and Gale Lectures at the Royal College of Surgeons in the years 1860, 1861, and 1862, with the title "Pain and Therapeutic Influences of Mechanical and Physiological Rest in the Treatment of Surgical Diseases and Accidents". It was published as an octavo volume in 1863; the second edition, with the shortened title On Rest and Pain, edited by W. H. A. Jacobson (q.v.), appeared in 1877; the third in 1880; the fourth in 1887; and the fifth in 1892. All the issues except the first are duodecimos; the third, fourth, and fifth contain no material changes. Rest and Pain is interesting historically as showing the state of surgery in a large general hospital when its practice was based entirely upon anatomy and was devoid of the assistance it now derives from histology, bacteriology, and anaesthetics. It bears perhaps the same relation to modern surgery as Chambers's Vestiges of Creation bears to modern geology and biology. There is much morbid anatomy, and great common sense mingled with very crude speculation. It remains a fascinating work, written by one who, though a master of one side of his subject, was unable to see the whole, partly because he was insufficiently acquainted with advances of his contemporaries, and partly because the means for developing the scientific aspects of surgery were not in existence. The particular points upon which Hilton laid stress in his lectures were the blocking of the foramen of Magendie in some cases of internal hydrocephalus; the cautious opening of deep abscesses; the pain referred to the knee by patients with hip disease and its anatomical explanation; the cause of triple displacement in chronic tuberculous disease of the knee; and the importance of the early diagnosis and treatment of hip disease. All this and many other things which are now the commonplaces of surgery, Hilton set out in Rest and Pain, in which the naïve description of his cases and their treatment is by no means the least attractive feature.

It was said that no one looking at Hilton would have taken him for a great surgeon: he appeared much more like a prosperous City man. Short, rather stout, and plodding in his walk; dapper in a plain frock-coat with a faultless shirt front, a black stock or bow-tie, a fancy waistcoat festooned with a long gold chain which was hung from the neck; always in boots irreproachably blackened at a time when Warren's and Day & Martn's blackings were at the height of their vogue - such was the picture of Hilton as he sat on the bed of a patient in one of his wards examining an inflamed ulcer with a probe to determine the position of any exposed nerve.

A life-size half-length oval portrait of Hilton by Henry Barraud (1811-1874) hangs in the Conservator's room at the College. It was presented by Mrs. Hilton in 1879. There is a photograph in the New Sydenham Society's "Portraits by President" portfolio; and a medallion given by Mrs. Oldham to C. H. A. Golding-Bird, F.R.C.S., in 1894 hangs in the Librarian's room at the College.

Sources used to compile this entry: [There is a good personal account of John Hilton in Wilks and Bettany's Biographical Account of Guy's Hospital, London, 1892, 347. Dict. Nat. Biog., sub nomine et auct. ibi cit. MacCormac's Address of Welcome, 1900. Brit. Jour. Surg., 1919-20, vii, 435, with a reproduction of Barraud's portrait. Hallett's Catalogues of Portraits and Busts in the Royal College of Surgeons of England, London, 1892.].

The Royal College of Surgeons of England