A book that does what it says on the tin! The Extraordinary Surgeon concerned is Astley Cooper, a legendary late 18th- and early 19th-century medic, whom Druin Burch brings spectacularly to life. Burch is a surgeon (and an evocative writer), so can write confidently about the medical aspects of his tale and explain clearly the surgical processes carried out by Cooper and his colleagues without turning them into stomach-turning gothic interludes. He also weaves in stories from his own surgical experience which throw light on Cooper’s; in less disciplined hands, this could have descended into self-indulg­ence.

These factors combine to give the reader a rich flavour of the period in which Cooper lived, aided by the fact that he lived a very full life. His connections ran from the lowest (he was the star client of the body-snatching fraternity) to the highest (he operated on George IV for a sebaceous cyst); and his affiliations ran from extremism in his youth, when he was a radical democrat, to somewhat sycophantic royalism in later years.

He was, at least initially, a strong supporter of the French Revolution (though his ardour was cooled by observing the Terror first-hand), and associated with some of the most politically charged circles in London, until the need for career advancement led him to back off. Professionally, his career spanned the period from when surgery was only just ceasing to be a sideline for barbers to the early years of The Royal College of Surgeons.

Astley Cooper is an energetic presence, but Burch does not make the biographer’s common mistake of trying to force you to like his subject. I suspect even Burch is not sure that he likes him.

On the one hand, Cooper is a dedicated medical man who ministers to the poor free of charge, a dandy who is fond of terrible puns and dreadful practical jokes, someone given to frequent outbursts of snorting laughter.

On the other, he is a slightly slippery egotist who, when push comes to shove, abandons principles for advancement. He is a nepotist who does not hesitate to carry out unnecessary experiments on live animals, and an avid client of body snatchers.

He was not above sending them to retrieve the corpse of a patient on whom he’d successfully operated years before so he could preserve the evidence of his handiwork. He seems to have dispatched one to a relative serving in the Peninsular War so he could collect corpse teeth to set as dentures.

Whatever his less savoury side, though, Cooper comes out more or less on the side of the angels. He was fighting his way to the top of a profession that had barely established itself, living in a city of huge appetites and excesses, where different standards of morality and decency prevailed and where the threat of sudden and unpleasant death was always close at hand. This was particularly true for surgeons, as these were times before the germ theory of disease, and the need for rigorous cleanliness was not understood.

A student could die from a cut infected while dissecting a not-so-fresh corpse, and – as this was long before antibiotics – what would today be a minor infection could be a death sentence. There were no anæsthetics either, and surgical procedures had to be carried out at lightning speed on a conscious, screaming patient strapped to a table.

It was not unknown for the surgeon to lunge at the patient in order to do the procedure by surprise.

The street would have been full of people with appalling visible afflictions which could be instantly treated today (at least in the developed world), but with the few doctors being hugely ignorant by today’s standards, hideous disease was rampant.

This book abounds with grotesque hernias, bulging aneurisms, cancerous, rotting genitals, gangrene, amputation and all manner of horrors that were everyday 18th-century occurrences.

In the end, Cooper was dedicated to trying to introduce systematic, rigorous evidence-based knowledge to the practice of medicine, and wean it away from ignorance and folklore. In that he was an immensely influential founder of modern, scientific medicine. Whatever his failings, we have much to thank him for.

Druin Burch’s biography does justice to a complex and not altogether pleasant man who lived in very different times. He does it with a wit and intelligence often sorely lacking in biographies of characters whose times are similarly distant from our own.