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Percival Pott and the chimney sweeps' cancer It is two hundred years ago this year that Percival Pott published his book of " Chirurgical Observations ", which included a chapter entitled " A Short Treatise of the Chimney Sweeper's Cancer ". The chapter contained only 725 words but the observations recorded in it provided the first clear description of an environmental cause of cancer, implied a way to prevent the disease and led indirectly to the synthesis of the first known pure carcinogen and the isolation of the first carcinogenic chemical to be obtained from a natural product. No wonder, therefore , that Pott's observation has come to be regarded as the foundation stone on which the modern knowledge of cancer prevention has been built. Pott's description of the peculiar conditions which gave rise to scrotal cancer is so precise and so terse that it can be quoted verbatim. ". . every body " he wrote, " is acquainted with the disorders to which painters, plummers, glaziers, and the workers in white lead are liable; but there is a disease as peculiar to a certain set of people which has not at, least to my knowledge, been publickly noticed; I mean the chimney-sweepers' cancer... The fate of these people seems singularly hard; 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 chimnies, where they are bruised, burned, and almost suffocated; and when they get to puberty, become peculiarly liable to a noisome, painful and fatal disease. " Of this last circumstance there is not the least doubt though perhaps it may not have been sufficiently attended to, to make it generally known. Other people have cancers of the same part; and so have others besides lead-workers, the Poictou colic, and the consequent paralysis ; but it is nevertheless a disease to which they are peculiarly liable; and so are chimney-sweepers to the cancer of the scrotum and testicles. " The disease, in these people ", he added " seems to derive its origin from a lodgment of soot in the rugae of the scrotum. " The comparison with lead colic is less exact than it might have been, but it is greatly to Pott's credit that he recognized the occupational hazard, despite the fact that the disease also occurred under other conditions …

Part III: 7th Walter Hubert lecture. Pott and the prospects for prevention