This biographical sketch of John Hilton corresponds to the historic text, The Classic: On Rest and Pain: Lecture XIV, available at DOI 10.1007/s11999-009-0928-1

Brand, Richard A.

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Richard A. Brand

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John Hilton, 1805–1878

SYMPOSIUM: PAPERS PRESENTED AT THE ANNUAL CLOSED MEETING
OF THE INTERNATIONAL HIP SOCIETY
John Hilton, 1805–1878
Richard A. Brand MD
Published online: 12 June 2009
 The Association of Bone and Joint Surgeons1 2009
Abstract This biographical sketch of John Hilton corre-
sponds to the historic text, The Classic: On Rest and Pain:
Lecture XIV, available at DOI 10.1007/s11999-009-0928-1.
John Hilton was born in Castle Hedingham, Essex, in the
southeast part of England September 22, 1805 [4].
(Atkins in his biographical notes of Hilton in a reprinted
edition of ‘‘On Rest and Pain’’ from 1950 noted various
sources incorrectly stated his birth year as 1804 or 1807
[4].) He entered medical school at Guy’s Hospital in 1824
at the age of 19. At the quite young age of 23, he was
appointed Demonstrator in Anatomy in 1828. Hilton was
by some considered the greatest anatomist of his time,
and was nicknamed ‘‘Anatomical John’’ [2]. At the age of
34 he was appointed Fellow of the Royal Society based
largely on his anatomical work, and in particular that
related to the laryngeal nerves. A few years later Hilton
was elected one of the Charter Fellows of the Royal
College of Surgeons (attesting to his surgical expertise,
although he retained a focus on anatomy). In 1844 he
received the title of assistant surgeon at Guy’s Hospital
and in 1849 full surgeon [1]. (Atkins notes Hilton may
have been prevented from earlier appointment as a full
surgeon by his predecessor, Aston Key, who was ‘‘a testy,
impetuous and difficult colleague…’’ [4]). Hilton, lacking
a cultured upbringing, was ‘‘brusque in manner, and
looking more like a successful business man than a sur-
geon’’ [4]. His manner, however, did not prevent his
attainment of the highest of appointments: Hilton was
appointed anatomist to the Royal College of Surgeons in
1959, became president of that august body in 1867, and
in 1871 shortly after resigning his post at Guy’s was
appointed ‘‘Surgeon-Extraordinary’’ to Queen Victoria.
Working in the pre-anesthetic, pre-Listerian age of sur-
gery, he was a cautious surgeon, perhaps owing to his
nature and also to the suggestion that he was not con-
sidered a brilliant technician despite his expertise in
anatomic dissections. Yet, he was ‘‘a very skilful observer
and shrewd clinically, he could interest students in the
most mundane topics and always managed to find some
point overlooked by others so that he was highly regarded
as a consultant’’ [1].
Hilton was married twice, but ‘‘…cannot have been
much of a family man despite his two marriages. A man
who had written so much without mentioning his wife or
his family, without ever having referred to the incidents of
home life in illustration of some point in a lecture, cannot
have had them much on his mind. We never hear or read of
an endearing expression coming from him’’ [4]. Even his
will did not mention his surviving children by name. Hilton
was evidently devoted to his profession. He died in 1878 of
a carcinoma of the stomach after a prolonged period of
suffering.
Between 1860 and 1862 while Professor of Anatomy to
the Royal College, he delivered a series of lectures which
became the basis for his classic, ‘‘On Rest and Pain’’
(originally published as, ‘‘On The Influence of Mechanical
and Physiological Rest In The Treatment of Accidents and
Surgical Diseases, And The Diagnostic Value of Pain’’
[3]). We reproduce here a portion of Lecture XIV, on ‘‘hip-
joint disease.’’ He describes ‘‘sympathetic pain’’ in which
‘‘one of the earliest symptoms is remote from the actual
seat of mischief.’’ In particular he recognized the impor-
tance of knee symptoms in hip disease as a result of the
R. A. Brand (&)
Clinical Orthopaedics and Related Research, 1600 Spruce Street,
Philadelphia, PA 19103, USA
e-mail: dick.brand@clinorthop.org
123
Clin Orthop Relat Res (2009) 467:2208–2209
DOI 10.1007/s11999-009-0927-2
innervation supplying both joints. He is perhaps best
known for Hilton’s Law, stated in an earlier lecture (VII),
that ‘‘The same trunks of nerves, whose branches supply
the groups of muscles moving a joint, furnish also a dis-
tribution of nerves to the skin over the insertions of the
same muscles; and – what at this moment more especially
merits our attention – the interior of the joint receives its
nerves from the same source.’’ (Italics are Hilton’s.) We
hope readers will enjoy reading the remarks of so careful a
clinician.
References
1. John Hilton. Available at: http://www.whonamedit.com/doctor.
cfm/2559.html. Accessed May 1, 2009.
2. John Hilton (surgeon). Available at: http://en.wikipedia.org/wiki/
John_Hilton_(surgeon). Accessed May 1, 2009.
3. Hilton J. On The Influence of Mechanical and Physiological Rest
in the Treatment of Accidents and Surgical diseases, and the
Diagnostic Value of Pain. London, England: Bell and Daldy; 1863.
4. Hilton J. Rest and Pain. 6th ed. Walls EW, Philipp EE, Atkins
HJB, eds. Philadelphia, PA: J. B. Lippincott Co; 1950.
Volume 467, Number 9, September 2009 John Hilton: 1804–1878 2209
123


Available at: http://en.wikipedia.org/wiki/ John_Hilton_(surgeon). Accessed

Available at: http://www.whonamedit.com/doctor.

On The Inﬂuence of Mechanical and

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John Hilton, 1805–1878

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