British Journal of Industrial Medicine, 1975, 32, 244-250
Notes and miscellanea
Percivall Pott and cancer scroti M. D. KIPLING and H. A. WALDRON Employment Medical Advisory Service, Department of Employment, and the Department of Social Medicine, The Medical School, Birmingham
The name of Percivall Pott (Fig. 1) is perpetuated through three eponymous diseases, Pott's fracture, Pott's disease of the spine, and Pott's puffy tumour. His other important clinical observation, however, does not bear his name. Pott gave notice of a disease (Pott, 1775) which was 'peculiar to a certain sort of people (and) which has not at least to my knowledge, been publickly noticed-I mean the chimney-sweepers' cancer.' The disease was not exclusive to the sweeps any more than the colic of Poitou was the sole prerogative of lead-workers, but it was a disease, said Pott, to which they had a special liability. Scrotal cancer had been described almost 40 years before Pott wrote and there is a much older reference to 'Canker of privities' in burial records of the Parish of St Botolph without Aldgate from 1589 to 1599 (Forbes, 1971). It is not clear from these records which anatomical site is meant and most authorities ascribe priority in the description of scrotal cancer to Bassius in 1731. There are grounds for thinking, however, FI that the condition which Bassius described was perineal abscess with the formation of sinuses to the FIG. 1. Percivall Pott. An engraving published in 1790 scrotum rather than carcinoma, in which case, the from a portrait by Sir Joshua Reynolds. first description of the malignant lesion of the scrotum should be attributed to Treyling in 1740 young surgeons to live in his own house. Pott also (Kipling, Usherwood, and Varley, 1970). Pott has become famous for his observation be- used his influence to see to it that some of the severe cause of the causal link which he established between forms of treatment, such as the use of escharotic occupation and malignancy, although in his own dressings and the actual cautery, common when he day, the significance of this association was not began his professional life, were discarded. Thus fully understood. Not that he was under-rated by his James Earle, his son-in-law, wrote 'surgery being contemporaries: his standing among his colleagues divested of great part of its horrors, became, comwas high, as much for his concern for the suffering paratively, a pleasing study' (Earle, 1790a). Pott's description of scrotal cancer is probably the of others as for his surgical skills. His kindness of heart was proverbial, and he frequently assisted most succinct to be found in a surgical work; it is struggling members of the profession, often having certainly the best. 244
Notes and miscellanea 245
'It is a disease which always makes its first attack on, and its first appearance in, the inferior part of the scrotum; where it produces a superficial, painful, ragged, ill-looking sore, with hard and rising edges: the trade call it the soot-wart . .. In no great length of time, it pervades the skin, dartos, and membranes of the scrotum, and seizes the testicle, which it enlarges, hardens, and renders truly and thoroughly distempered; from whence it makes its way up the spermatic process into the abdomen, most frequently indurating and spoiling the inguinal glands: when arrived within the abdomen, it affects some of the viscera, and then very soon becomes painfully destructive.' Pott's description of the disease produced in its wake a succession of accounts from other authors. After the publication of his tract, clinical reports appeared with some regularity, increasing in number
Notes and miscellanea
Percivall Pott and cancer scroti M. D. KIPLING and H. A. WALDRON Employment Medical Advisory Service, Department of Employment, and the Department of Social Medicine, The Medical School, Birmingham
The name of Percivall Pott (Fig. 1) is perpetuated through three eponymous diseases, Pott's fracture, Pott's disease of the spine, and Pott's puffy tumour. His other important clinical observation, however, does not bear his name. Pott gave notice of a disease (Pott, 1775) which was 'peculiar to a certain sort of people (and) which has not at least to my knowledge, been publickly noticed-I mean the chimney-sweepers' cancer.' The disease was not exclusive to the sweeps any more than the colic of Poitou was the sole prerogative of lead-workers, but it was a disease, said Pott, to which they had a special liability. Scrotal cancer had been described almost 40 years before Pott wrote and there is a much older reference to 'Canker of privities' in burial records of the Parish of St Botolph without Aldgate from 1589 to 1599 (Forbes, 1971). It is not clear from these records which anatomical site is meant and most authorities ascribe priority in the description of scrotal cancer to Bassius in 1731. There are grounds for thinking, however, FI that the condition which Bassius described was perineal abscess with the formation of sinuses to the FIG. 1. Percivall Pott. An engraving published in 1790 scrotum rather than carcinoma, in which case, the from a portrait by Sir Joshua Reynolds. first description of the malignant lesion of the scrotum should be attributed to Treyling in 1740 young surgeons to live in his own house. Pott also (Kipling, Usherwood, and Varley, 1970). Pott has become famous for his observation be- used his influence to see to it that some of the severe cause of the causal link which he established between forms of treatment, such as the use of escharotic occupation and malignancy, although in his own dressings and the actual cautery, common when he day, the significance of this association was not began his professional life, were discarded. Thus fully understood. Not that he was under-rated by his James Earle, his son-in-law, wrote 'surgery being contemporaries: his standing among his colleagues divested of great part of its horrors, became, comwas high, as much for his concern for the suffering paratively, a pleasing study' (Earle, 1790a). Pott's description of scrotal cancer is probably the of others as for his surgical skills. His kindness of heart was proverbial, and he frequently assisted most succinct to be found in a surgical work; it is struggling members of the profession, often having certainly the best. 244
Notes and miscellanea 245
'It is a disease which always makes its first attack on, and its first appearance in, the inferior part of the scrotum; where it produces a superficial, painful, ragged, ill-looking sore, with hard and rising edges: the trade call it the soot-wart . .. In no great length of time, it pervades the skin, dartos, and membranes of the scrotum, and seizes the testicle, which it enlarges, hardens, and renders truly and thoroughly distempered; from whence it makes its way up the spermatic process into the abdomen, most frequently indurating and spoiling the inguinal glands: when arrived within the abdomen, it affects some of the viscera, and then very soon becomes painfully destructive.' Pott's description of the disease produced in its wake a succession of accounts from other authors. After the publication of his tract, clinical reports appeared with some regularity, increasing in number
