This biography of the English surgeon Percivall Pott (1713–88), one of the most famous practising operators and anatomy lecturers of his time, by Lynda Payne of the University of Missouri, is a useful and interesting contribution to the history of surgery, still a rather neglected branch of the historiography of medicine. If he is remembered today, it is generally because of Pott's disease (arthritic tuberculosis of the intervertebral joints) named after him and especially because of his work identifying soot as the cause of scrotal cancer among chimney sweeps. Payne's book puts Pott back into his eighteenth-century London context, outlining his career in writing and teaching about surgery at St Barts, which led to him being regarded by some as the city's leading surgeon by the end of his life. It is valuable as a social study of a man in a rising profession in a dynamic imperial military and trading state with a growing demand for surgeons for the army, navy and East India Company.

An introductory chapter provides a short description of the life of Pott and his family, and is followed by Chapter 1, on what his life shows us about the financial and social position of surgeons in the mid-eighteenth century. In Chapter 2, Payne writes well about the role of emotion in the surgery of the period. Pott seems to have stressed the role of manly composure for surgeons, but also to have been interested in trying to reduce the pain of operations and emphasizing the role of feeling to his pupils, prefiguring in some ways the emotional world of sensibility of nineteenth-century surgery. Chapter 3 is on Pott's work on victims of accidents and violence, offering a fascinating insight into the perils of working in pre-industrial London. Despite himself having come close to losing a leg to an operation after a fall from a horse in middle age, he was a defender of the more extensive use of amputation in the wake of Jean-Louis Petit's improved tourniquet technique, against the scepticism of observers such as the Prussian military surgeon Johann Ulrich von Bilguer. Chapter 4 looks at his thinking on the chronic conditions common in London at the time. The book then finishes with a consideration of Pott's legacy.

One of Payne's central subjects is what Pott's career can tell us about a key moment in surgery's development as a profession from the world of barber-surgeons to that of the surgeon-as-gentleman, famously reflected in the split of the Company of Surgeons (from 1800 the Royal College of Surgeons) from the barbers in 1745 in the midst of Pott's working life. As the son of a grocer, Pott completed his apprenticeship with the last barber-surgeon to be elected surgeon at St Barts, going on to become prosperous and well connected, with celebrity patients such as Samuel Johnson, David Garrick and Thomas Gainsborough. Payne provides much rich detail about Pott's career and what it meant in terms of social status, but the discussion of Pott's thinking on the manners and social standing of surgeons would perhaps have benefited from a consideration of the parallel debate about physicians’ status and etiquette, for instance in John Gregory's 1770 Observations on the Duties and Offices of a Physician, and the historiography on that topic.

As Payne observes, Pott himself was often very critical of the techniques of a previous generation of surgeons, depicting his newer ideas as better at reducing pain and scarring. Likewise, James Earle, Pott's son-in-law, pupil and biographer, implied that Pott's work marked the dawn of humane surgery, ending a world of butchery and cruelty. However, this might be seen in a wider context in which ‘modern’ humane surgery always seems to have begun a generation before the observer. Those that Michael Brown has called the ‘Romantic surgeons’ of the early nineteenth century saw the Hunters and especially themselves as the first to make surgery a real science and a model of compassion, and in the wake of the development of antisepsis and anaesthesia, later nineteenth-century surgeons were again sure that they were the beginning of real modern surgery. A discussion of this shifting historiographical horizon and what it means for ideas of ‘modern’ surgery would have been a helpful addition to this book.

While this is a thorough and enjoyable account of the life of Pott that illuminates important aspects of the medical life of Georgian London, there are also other intriguing avenues that remain unexplored. For instance, the London focus of the biography is natural for a book about a man so associated with the city, but more could be said about the relationship between surgery in the capital and that in the rival Scottish school that was entering its own Golden Age in his lifetime. The Scottish background of the Hunter clan, with which he clashed, makes this point even more worth considering. More broadly, the book might have been improved by expanding from its strengths in British social history to consider where Pott fits into a wider European context and especially into the longue durée history of surgery and its claims to scientific rigour and clinical effectiveness. Nevertheless, this is a strong book that anyone interested in eighteenth-century surgery should read.