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Late Career

Percivall Potts married Sara Cruttendon in 1740 and lived together in Lincoln's Inn Fields in London. They would go on to have five sons and four daughters.

Although little more is known about Percivall Pott's private life, Pott is regularly described as having excellent character and an archetypical English surgeron. It is believed that Pott's standard of living was a contributor to the rise of the surgeon within social standings.

Amid the patient wards, Pott also honed his writing skills and believed in patient education. He would distribute pamphlets, noting his observations and thoughts on topics ranging from "head injuries, hydrocele, fistula, rupture, and fracture", in the hospital environment. These pamphlets were in high demand and would sell for more than one shilling and six pence. Between 1760s and the 1770s over fourteen of Pott's pamphlets were in circulation.

Percivall Pott's dedication to his patients and upholding his own standard of care garnered Pott high praise and fame. He is generally regarded as one of the two greatest surgeons of the 18th century along with his student, John Hunter. In 1786, he was honored as the first Honorary Fellow of the Royal College of Surgeons of Edinburgh. Shortly after, he retired in 1787 and was named a governor of St. Bartholomew's Hispital.

Percivall Pott and Chimney Sweepers' Carcinoma

Percivall Pott has influenced medicine and modern understanding of diseases. Many diseases today are his namesake including: Pott’s Fracture, Pott’s disease of the spine, and Pott’s puffy tumor. One disease which does Pott quickly recognized the association between carcinoma and chimney sweeps and published his findings in a piece titled “Chirurgical Observations relative to…the cancer of the scrotum” He wrote that the disease was, " peculiar to a certain sort of people [ and ] which has not at least to my knowledge, been publicly noticed – I mean the chimney-sweepers ’ cancer. The disease, in these people, seems to derive its origin from a lodgment of soot in the rugae of the scrotum." 

Discovery and Identification Credit

Scrotal cancer, although largely thought to have been identified by Percival Pott had been thought to have been described nearly 40 years before Pott’s “Chirurgical Observations” as a “canker of privities” per documentation in the burial records of the Parish of St. Botolph without Aldgate from 1589 to 1599.These descriptions are ambiguous and it is unclear which anatomical parts considered “privities.” As such, most historians generally agree that Bassius first correctly described scrotal cancer in 1731. Some historians argue that what Bassius considered scrotal cancer was in fact perineal abscesses to the scrotum as opposed to carcinoma. The minority of historians who agree with this fact, attribute the discovery of scrotal cancer to Treyling in 1740.

Surgery

As a surgeon, Pott was well respected and often assisted fellow surgeons as well. Pott was viewed as a mentor and even allowed other physicians and surgeons to live with him while under his guidance. Despite the surgical trends of his time, Pott did not agree with severe treatments and heroic medicine but rather preferred gentler forms. Percivall Pott’s son-in-law, James Earle described Pott’s surgery as being “divested of great part of its horrors, became, comparatively, a pleasing study."

Soot and Occupational Cancer

In addition to surgery, Pott’s focused on public health as well drawing his attention to the challenges of chimney-sweeps in his community. He wrote, "in their early infancy, they are most frequently treated with great brutality, and almost starved with cold and hunger; they are thrust up narrow, and sometimes hot chimneys, where they are bruised, burned and almost suffocated; and when they get to puberty, become peculiarly liable to a most noisome, painful, and fatal disease." Pott’s approach was unique amongst his contemporaries in that he did not simply note an association but approached Chimney Sweeps’ carcinoma from a causal perspective. His work helped later identify soot as the disease-causing agent. Pott did not figure this out on his own but rather pointed research in the right direction. During Pott’s time, there were many discussions pertaining to the cause of scrotal cancer. James Earle believed that the cancer was caused as a result of the soot entering and residing in the rugae of the scrotum. He famously argued this point based on a trend seen where gardeners who used soot to kill slugs had developed skin carcinoma on their hands. In 1878, George Lawson suggested that the cancer was caused by the friction generated by chimney sweeper’s overalls against the scrotum while sifting though soot. This idea was explored by Passey in 1992 who demonstrated that it was the ethereal extract of soot which was capable of inducing sarcoma.Furthermore, Pott also identified the most at-risk occupation, and that prepubescent boys were most vulnerable to the carcinoma. Pott rose to fame for these connections between occupational hazards and cancer malignancy even though the connection was not fully understood at the time. Pott’s “Chirurgical Observations” provided a framework to shape the modern understanding of Occupational Cancers.

Influence

Percivall Pott’s work influenced a wave of researcher and change in public policies. After his initial publication, more clinical cases began to emerge rapidly. and by triggering a series of “Chimney Sweepers' Acts” which aimed to protect chimney sweepers. These facilitated the formation of societies like 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 in 1803 which included the likes of Dukes, Earls, and Royal Patrons.

Despite outcry and public demands to change chimney sweeping practices, such as suggesting that young chimney sweeping boys be replaced with mechanical devices, insurance companies and homeowners argued that Chimney Sweeper’s carcinoma was a small price to pay for the protection of mthe masspopulation against smoke and chimney fires. Despite the call for action as early as 1788, Pott’s work finally began to influence change in 1975 when a decline in scrotal cancer incidence and mortality was noted.