Sir Percivall Pott (1714-1788)

Percivall Pott was born in Threadneedle Street, London in 1714. His father died when he was only 3 years old and as a result the family were poorly provided for. However, the Bishop of Rochester who was related to his mother by a previous marriage, paid for his education. At the age of 15, Pott was apprenticed to Edward Nourse, a surgeon at St Bartholomew's Hospital. This cost the sum of 200 pounds. One of Pott's duties was to dissect preparations for anatomy demonstration. He performed this duty at Nourse's house in Aldersgate Street in east London and this where he probably developed his great surgical skill. At the age of 22, he was admitted to the Company of Barber Surgeons and moved into practice in Fenchurch Street where he lived with his mother and stepsister. In 1739 he applied for the post of assistant surgeon at St Bartholomew's Hospital but was rejected. When his former master was made surgeon at that hospital in 1745, Pott became assistant surgeon and was promoted to full surgeon in 1749 where he remained for the next 38 years. He was very successful and his patients included Samuel Johnson, David Garrick and Thomas Gainsborough.

The most significant event in Pott's life was in 1756 when he was riding to see a patient in Southwark. He fell from his horse and sustained a compound fracture of his tibia. The surgeon who attended him advised amputation and Pott agreed. However, before the operation was performed, Nourse turned up at his home he suggested reduction of the fracture. The fracture eventually healed by primary intention. During his convalescence Pott wrote A treatise on Ruptures which established his reputation. In it he refuted many of the old theories concerning the causes of hernias and methods of treatment He was one of the first doctors to recognise and industrial disease when he described the association between work as a chimney sweep and scrotal carcinoma.

Pott's name is eponymous associated with several conditions.

Pott's disease of the spine - This is due to tuberculosis. He noted that the disease almost always affected the vertebral bodies and not the articular processes. He notes that destruction of the vertebrae produced a curvature of the spine and a 'useless state of the limbs'.

Pott's fracture of the ankle - This is a fracture dislocation of the ankle.

Pott's puffy tumour - This arises from and extradural abscess normally as a result of frontal sinusitis or middle ear disease and occasionally compound fractures. Pott described the condition in 1760 in Injuries of the Head from External Violence. In it he described 43 cases of head injury acquired in various ways and in it outlines the clinical features of 'puffy, circumscribed, indolent tumour of the scalp' associated with the intracranial abscess. He also described the lucid interval that precedes the coma associated with an extradural haematoma.

Recent papers

Dobson J. Percivall Pott. Ann R Coll Surg Eng 1972; 50: 54-65.

Tattersall R, Tattersall R. Pott's puffy tumour. Lancet 2002; 359: 1060-1063.