Farther remarks on the useless state of the lower limbs, in consequence of a curvature of the spine: Being a supplement to a former treatise on that subject

Percivall Pott was born in London on January 6, 1714, and died in that city on December 22, 1788. He was apprenticed to a Barber surgeon named Edward Nourse in 1729 when he was 17 years old. He completed his training with Nourse In 1736 and passed the examination offered by the Barbers and Surgeons in the same year. In 1739, 10 years after he had begun his apprenticeship, he was admitted to "the Livery of the Company of Barbers and Surgeons." In 1745 the Surgeons separated themselves from the Barbers and declared Surgery to be a separate discipline. Pott was in the vanguard of this movement. He advanced through the positions of Surgeon to St. Bartholomew's Hospital, the Court of Assistants of the Company of Surgeons, Member of the Court of Examiners, Master, and Fellow of the Royal Society. In 1775 Pott published a lengthy text entitled "The Chirurgical Works of Percivall Pott, FRS." In it he covered diverse topics such as head injury, hydrocele, fistula in ano, cataracts, "ruptures," and "mortification of the toes and feet." He also included a long chapter on fractures and dislocations and in it he described in detail the fracture dislocation of the ankle which has, since then, been known as "Pott's fracture." He had himself sustained this injury but he made no mention of that fact in his book. He also wrote two monographs on spinal deformity associated with carious destruction of vertebrae associated with spastic lower limb paralysis, and that condition has subsequently been known as "Pott's disease." In these papers he distinguished the diseased states of the vertebral bodies from deformity caused by trauma and he described the paravertebral abscesses which track down over the psoas muscle to present in the groin. Port also observed that the spastic paralysis associated with this condition improved when patients spontaneously developed drainage from the spine, thereby decompressing the spinal cord. This observation prompted him to recommend surgical drainage and he advised that this should be "large and of a sufficient depth" (pg. 33). The true cause of Pott's disease was not known to the surgeons and physicians of the 18(th) century. They could only describe the gross and macroscopic appearance of the vertebrae and record the clinical course of the condition without knowing what produced It. Nevertheless, the term "Pott's disease" is instantly recognized by 21(st) century physicians more than 225 years after Pott wrote about it.