18th century medic was first to link a job to health problems

Sir Percivall Pott

Sir Percivall Pott - Credit: Edward Hedges, London, 1785

Today it is obvious. Some jobs are bad for your health and some chemicals cause cancer.

Some jobs involve chemicals which can produce dermatitis. In the past miners and asbestos workers could develop serious chest problems and cancer.  

But these ideas were not obvious in 1775 until an important paper by one of my medical heroes, Sir Percivall Pott.  

He noticed that several of the unfortunate boys who were sent up chimneys developed a cancer of the scrotum, which we now think was a skin cancer.

He correctly linked it to soot. It was the first time any illness was linked to an occupation and the first time it was suggested that anything in the environment could cause cancer.

It as not until 1933 that Pott’s Chimney Sweeps’ Carcinoma was found to be caused by a chemical in coal tar.  

But in his paper he was not content to stick to his medical observations.

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He did not hold back on what today would be called human rights and child abuse.

He wrote that these boys, often as young as four were 'most often treated with great brutality, and almost starved with cold and hunger; they are trust up narrow and sometimes hot chimneys where they are bruised, burned and almost suffocated'.

His passionate arguments led to the Chimney Sweeper’s Act 1788 but this was not a great step forward.

The new law ensured that no boy could be apprenticed until he was eight. The master sweep had to get approval from the boy’s parents and provide 'suitable' clothing and living conditions.

Most importantly, they must attend church on Sundays.

Did they really believe the line in the Bible, 'suffer little children... to come unto me' meant push them up a chimney?

Parliament may have diluted the Act but the public outcry created by Pott’s work continued.

In 1803, a pressure group was formed with the snappy title of the “Society for superseding the necessity of climbing boys by encouraging a new method of sweeping chimneys and for improving the condition of children and others employed by chimney sweepers”.

But any attempt to stop boys being sent up chimneys was opposed by insurance companies and homeowners.

Boys dying from this horrible disease was a small price to pay to protect everyone from chimney fires.

Any further improvement was blocked until 1875 when there was both a decline in chimney sweep boys and a decline in cancer of the scrotum, proving Pott right.  

Luckily, there is no evidence that Bert, the chimney sweep in Mary Poppins used chimney sweep boys.

There is a scene when Mary Poppins and her charges go up a chimney but then she had the advantage of using magic.

The only human rights abuse in the 1964 film was Dick van Dyke’s attempt at a Cockney accent.  

Not content with founding the whole field of occupational health and the idea of carcinogens he was also a pioneer in orthopaedics.

In 1765, before his ground-breaking work on chimney sweep boys he broke his lower leg with an open wound when he fell off his horse.

He asked his servant to buy a door from a nearby building site which he lay on to be taken home.

The usual treatment for such a serious fracture was amputation but this often led to fatal infections.

He persuaded the surgeons to put his leg in a splint instead and eventually recovered completely.

Today, we still talk about a 'Pott’s fracture', but this is far less serious than the one Pott actually suffered.

He also believed in patient education, an unusual belief in the days when doctors tried to keep some mystique over their work.

He published numerous papers for the public. Today, he might have been a media doc on TV, radio and online.

So when we hear about important safety measures at work or nasty chemicals causing cancer we should remember an 18th century surgeon who gave the world these ideas.