To cool or not to cool: evolution of the treatment of burns in the 18th century.

The 18th century represents a transitional period in evolution of surgery and burn treatment, a time just before major advances such as asepsis, burn excision and skin grafting, were to revolutionise surgical practice. The medical minds of this era first began to question the centuries of dogma and speculation that were at the heart of medicine. The evolution of the treatment of burns in this crucial time is reviewed from the perspective of two of the exceptional medical minds of that era John Hunter and James Earle. Many of their observations are still valid today and their influence would prove inspirational in ushering in modern era of burn management.