Anatomical Dissection in Enlightenment England and Beyond

Autopsy, Pathology and Display

Piers Mitchell

• Publisher: Routledge
• Year: 2016
• Print ISBN: 9781409418863
• eBook ISBN: 9781317181446
• Topic: Medicine
• Subtopic: World History

Excavations of medical school and workhouse cemeteries undertaken in Britain in the last decade have unearthed fascinating new evidence for the way that bodies were dissected or autopsied in the eighteenth and nineteenth centuries. This book brings together the latest discoveries by these biological anthropologists, alongside experts in the early history of pathology museums in British medical schools and the Royal College of Surgeons of England, and medical historians studying the social context of dissection and autopsy in the Georgian and Victorian periods. Together they reveal a previously unknown view of the practice of anatomical dissection and the role of museums in this period, in parallel with the attitudes of the general population to the study of human anatomy in the Enlightenment.

Chapter 1
There’s More to Dissection than Burke and Hare: Unknowns in the Teaching of Anatomy and Pathology from the Enlightenment to the Early Twentieth Century in England

Piers D. Mitchell

Introduction

Most people in Britain with even a vague interest in history will have heard of Burke and Hare. These two characters from Edinburgh became infamous in 1828 for murdering 16 people in order to sell their corpses for dissection by the doctors teaching anatomy in the city. This story clearly caught the imagination of the general public, having spawned a successful film released in 2010 and a good number of books.1 However, very few people appear to have been murdered just to sell their corpses for dissection, and in fact the alternative sources of cadavers for the teaching of anatomy would be just as controversial were they still used today.2

What is well known

Since the 1500s convicted murderers in Britain could be punished by having their dead bodies dissected by anatomists after they were hanged.3 This ‘opening of the body’, as it was known, shares some parallels with the medieval practice of hanging, drawing and quartering of traitors. The addition of dissection to the death penalty gave a further level of degradation to the punishment. By the 1700s, when demand for corpses for anatomical teaching outstripped the number of murderers, resurrectionists dug up large numbers of bodies on the night after their burial so that they could be sold and dissected by anatomists while still relatively fresh.4

In 1832 the law in Britain was changed in order to remove the market for the resurrected corpses of those recently buried. The 1832 Anatomy Act enabled the bodies of the poor who died in workhouses and charitable hospitals, but were unclaimed by friends or relatives, to be used for teaching anatomy to medical students.5 In a short space of time this Greatly increased the numbers of cadavers available for dissection and the market for bodies exhumed from cemeteries disappeared. However, the practice of dissecting the poor after their death, regardless of their wishes during life, would still be highly controversial today. Ruth Richardson and others have explored the process by which anatomists obtained the cadavers they required from the time of the Enlightenment to the late 1800s in some detail.6

The manner in which anatomists used these corpses has also been studied. In the medieval period most anatomical knowledge came from classical Greek medical manuscripts by Galen and the dissection of animals such as pigs or the occasional criminal.7 By the 1500s printed publications originating in Europe such as Andreas Vesalius’s De humani corporis fabrica libri septem8 stimulated research on the human body, and the changes that took place in renaissance Europe have been extensively studied by Andrew Cunningham and others.9 By the 1600s anatomists in Britain were becoming more active in the field, with Oxford being a centre of anatomical learning. In the 1700s London was at the forefront of British research in anatomy and pathology, with the leader of his age being John Hunter, who ran one of the many private anatomy schools of the time and amassed a huge collection of anatomical specimens, known at the time as ‘preparations’.10 In the 1800s the medical schools took over from the private anatomy schools as the providers of anatomical education and research11 and remain so until the present day.

Preparations thought to be of particular interest by anatomists were often preserved for later use in teaching or as part of a museum. Students’ fees paid the bills, so teaching was clearly an important consideration for any anatomist. A museum gave status to an anatomist or teaching institution since a large museum was perceived to indicate Great expertise. Many of the first cases of diseases described in western medical literature were preserved in these medical museums, as often the publisher was also the museum curator. This allows an interesting comparison of the original paper with the original specimen today. Simon Chaplin, Sam Alberti, Jonathan Reinarz and others have explored the role of the medical museum in the past.12

Specimens were preserved for teaching, research and display. In the 1600s anatomical structures of interest were generally dried and displayed in cabinets. Inspired by Egyptian mummies, attempts were made in the Netherlands to preserve the soft tissues better using oils and resins, known as ‘balsaming’. By the 1660s anatomists in Leiden were also injecting wax into blood vessels and other hollow structures to maintain their shape and size once dried. In time, coloured dyes were added to the wax in order to aid the visual differentiation of neighbouring structures.13 Mercury was injected to show up fine structures such as blood vessels and lymphatics for teaching purposes on fresh preparations, but was not used to preserve them. By the 1770s John Hunter was employing spirits to preserve soft-tissue specimens in London, although it did remove the original colours. This was used to advantage by John Sheldon (1752–1808) who deliberately made some preparations transparent using turpentine in order to highlight his mercury injections into the blood vessels.14 Manuals explaining how to preserve and display preparations were published in Britain from the 1700s.15 Organs could be preserved in sprits of wine and turpentine and suspended in glass jars using thread attached to the lid of the jar. Dry bone specimens were prepared by boiling the corpse until the soft tissues began to fall off the skeleton and then cleaning and whitening the bones. Bones were whitened by either boiling in pearl-ash solution or leaving them on the seashore. By the mid nineteenth century entire bodies could be preserved by a combination of injection of blood vessels and hollow organs with volatile oils, balsam and resins dissolved in alcohol and soaking the entire body in a solution of oxymuriate of mercury and spirits of wine for two weeks. The soft tissues were then hardened with a coat of varnish.16 Organs such as the eye remained particularly challenging to preserve, as white spirit caused the eyes to shrink and become opaque. Glycerine maintained the transparency, but caused the eye to swell. Formalin was introduced in 1894 and preserved specimens much better since it hardened the eye, kept the original colours, and did not cause swelling or loss of transparency.17 Hal Cook and others have described the early history of the preservation of tissues for study and display in pathology museums in the past.18

These are some of the major areas that have been explored in the past, and might be considered as what is already known about the field of anatomy and pathology museums. While this appears a quite a coherent model of understanding, teasing apart the topic can highlight significant areas of unknowns, where either sources of evidence are scanty or research interest has been less.

What is not well known

Much of what is known about anatomical dissection, teaching and pathology museums relates to London, and considerably less is known about other parts of Britain. While the size of London might explain the concentration of anatomy schools there, and its being a capital city could explain the presence of museums, there is no reason to think that interest in anatomical research, teaching and museums would have been absent from other regions of the country. Some studies have aimed to address this imbalance, such as work on the Birmingham medical school pathology museum.19 However, the weight of published evidence remains quite uneven and new studies of anatomical activities outside London would clearly be of Great value in highlighting any geographical variations that may have existed in the past. It is also unknown how smaller or less prestigious anatomy schools and medical schools may have differed in the way they taught anatomy and in the preparations they chose to hold in their museums. Little is known about whether the curators of these less prestigious teaching institutions published their interesting cases and their research findings in journals in the way well-known curators of prestigious museums in London did.

As well as geographical differences, we would expect the nature of anatomical research and teaching to have changed over time. We know that techniques for preservation of specimens changed significantly between the 1600s and the 1800s, so allowing for the longer survival of soft tissues in museum collections. However, it is not known to what degree the choice of specimens placed in such a museum might have changed over the same time period. The content of museums and collections might have reflected the diseases present at the time the collection was compiled, or they might have been skewed towards particular diseases by factors that may not appear obvious to us today. The acquisition of preparations might have reflected the diseases incidentally picked up during the dissection of a random sample of bodies that underwent dissection as part of the teaching process, or there could have been a deliberate and targeted search for specific pathologies that were regarded as essential for such a museum. The criteria for desirability may have also changed over time so the collections may have expanded in a nonuniform way. Early specimens could have been discarded to make room for new specimens, which may have lead to change in the proportion of specimens with different conditions. We must not assume that the contents of museums today have the same balance of specimens as they did in the past, but they do provide a starting point (or perhaps more correctly an end point) from which to evaluate the organic process by which the museum grew.

The vast majority of our understanding of anatomical dissection, autopsy and pathology museums from the Enlightenment and subsequent periods comes from textual evidence. Written sources are very helpful and in many cases can be reliable. However, these sources are not comprehensive as not all have survived, some were written from a viewpoint that might not have been impartial and there may be little or no evidence for anatomisation in the smaller or less prestigious institutions that were nevertheless engaged in this field. Furthermore, it is well known in the history of medicine that theory may not have matched practice, so just because a textbook explained how to dissect a body did not necessarily mean that this was how it was done. One very suitable technique for evaluating practice from non-textual sources is the examination of human skeletal remains that have undergone anatomical dissection, autopsy or a combination of these. Very few publications exist describing the discovery of human skeletal remains from anatomy schools, medical schools, prisons and workhouses where written sources suggest dissected corpses would have been buried.

Such excavations would help us to fill in many of the blanks left by the textual sources. It is unclear what proportion of men, women and children underwent dissection. We do not really know for sure whether bodies were dissected whole or divided between different groups of students. It is unknown to what detail dissection and dismemberment took place before putrefaction prevented further work. We are unclear as to whether the techniques for opening corpses to access internal organs varied in different parts of the country. The dissection of animals for comparative anatomy is referred to in documents of the period but the species used, the proportion of animal and human dissection and the techniques used to dissect animals are all unknown. Museum textbooks describe how to inject mercury or wax to highlight hollow anatomical structures, but it is unknown how often this might have taken place or how successful such a procedure was. Furthermore, the written sources give no account of how the dissected human corpse was subsequently disposed of: were the parts of the same body kept together or was the coffin filling up with whichever body parts were finished with until it weighed the same as a typical corpse? All these questions can be answered by studying the anatomical parts found together in burials at locations where dissection took place; through the identification of species from the bones, the location and nature of cut marks; by the presence of artificial materials such as wax casts in the shape of hollow organs, dye on bones, or high mercury levels in certain burials; and by whether or not the body parts in a grave match.

The records of pathology museums, combined with their specimens, could be a tremendous source of information for the lived experience of ill health in the past. Many pathology museum records use the diagnostic terms current when the preparation was added to the collection, and analysis of the specimen can help us to understand past diagnostic terminology better and how it relates to our current understanding of disease. Some museum records give specific details such as the name and date of birth of the individual whose body part was preserved, so allowing a historical investigation of the life of that individual. Some specimens were also preserved with further evidence for the nature of the illness and how it affected an individual, such as medical descriptions of symptoms and treatment or letters and diaries written by patients detailing their experiences. Limited exploration of these resources has been undertaken to date,20 but clearly has Great potential to help us understand the lives of those whose body parts have been preserved for generations after direc...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• List of Figures
• List of Tables
• List of Contributors
• 1 There’s More to Dissection than Burke and Hare: Unknowns in the Teaching of Anatomy and Pathology from the Enlightenment to the Early Twentieth Century in England
• 2 Morbid Osteology: Evidence for Autopsies, Dissection and Surgical Training from the Newcastle Infirmary Burial Ground (1753-1845)
• 3 A Star of the First Magnitude: Osteological and Historical Evidence for the Challenge of Provincial Medicine at the Worcester Royal Infirmary in the Nineteenth Century
• 4 Early Medical Training and Treatment in Oxford: A Consideration of the Archaeological and Historical Evidence
• 5 William Hewson and the Craven Street Anatomy School
• 6 Patients, Anatomists and Resurrection Men: Archaeological Evidence for Anatomy Teaching at the London Hospital in the Early Nineteenth Century
• 7 Dissection and Display in Eighteenth-Century London
• 8 Barts and the London’s Medical Museum Collections
• 9 Understanding the Contents of the Westminster Hospital Pathology Museum in the 1800s
• 10 A Doorway to an Invaded Mind: Using Pathology Museum Specimens to Understand the Effects of Neurosyphilis in 1930s London
• Bibliography
• Index