Student Research at the Dittrick, part 2

Last week, we featured some of the work being done by undergraduates pertaining to the Dittrick collections. Today’s student guest post talks about an unusual artifact from the museum: the compression chamber of nobel-prize winner John James Rickard Macleod.

compression-chamberUnder Pressure: How a Metal Tube Saved Lives

Caisson disease was a mystery. It had no visible cause and no known treatment. The people who witnessed this were dumbfounded at how random it seemed. The symptoms were varied and sudden and even the healthiest of men could be stricken. How do you guard yourself against an invisible, undiscriminating affliction? Framed like this it sounds scary even know, but there is a more common name that is slightly less intimidating: the bends. Most people associate the bends with divers, but the term is synonymous with caisson disease. The term caisson disease actually originated with caisson workers in the late 1800s (Butler 446). A caisson is a hollow chamber that is lowered onto the seabed to dig up mud and install bridge bases and supports. The chamber is filled with high pressure gas to prevent water from entering (Butler 445). As the workers ascended, the pressure they experienced would drop to normal, atmospheric pressure. This sudden change in pressure is what causes caisson disease. There was little understanding of the effects of high pressure on humans at this time. They did not know that at high pressures, the blood is able to absorb more gases than usual. The oxygen could be used by the body and carbon dioxide could be exhaled, but nitrogen got stuck in the body. As the pressure rapidly dropped, the nitrogen formed gas bubbles in the blood, which impaired breathing and proper blood flow (Caisson illness and diver’s palsy: an experimental study 407). Even mild cases resulted in death due to a lack of treatment. People saw workers bending over in pain, throwing up and dying (often hours after they left the caisson) with no visible cause or way to treat it. John James Macleod’s work with the compression chamber helped shed light on the mysterious caisson disease and was ultimately adapted for use in medicine.

Macleod constructed the compression chamber for his research. It consisted of a bronze tube with thick, glass walls on both ends and valves to control the internal pressure (Dittrick Museum). He placed mice inside the chamber and subjected them to differing pressures and changes in pressure. He looked at the physiological changes experienced by the mice to hypothesize how the pressures would affect humans. Specifically, Macleod focused his attention on the caisson workers from the Eads and Brooklyn bridges (Compression Chamber, 1904)

The Eads and Brooklyn bridges were both constructed in the 1870s using a pressurized, metal chamber called a caisson (Butler 448-452). The workers would ascend from the caisson quickly, the pressure dropping just as rapidly. What made the situation worse was that the gas that was pumped into the caisson was not controlled. It was the same air that was in the surrounding area. If the workers had known the dangers of nitrogen gas, they could have limited illness by pumping in air with higher concentrations of oxygen. Andrew Smith studied the Brooklyn workers and devised a preventative plan to reduce caisson disease. He advocated for gradual introduction to high pressure for new works and staged decompression both entering and exiting the caisson (Butler 452-457). Alphonse Jaminet came up with very similar preventative measures during the construction of the Eads Bridge. Unfortunately, there was very little medical evidence and employers were hesitant to implement them for fear of losing productivity. Word of caisson disease was already out there, and the pool of potential employees had already shrunk. To implement these preventative measures would mean more shift rotations, more workers and possibly better compensation.

Macleod’s experiments were conducted after the bridge incidents, but he helped to shed light on the mystery of caisson disease and provided scientific evidence to back up the claims made by Smith and Jaminet. Macleod started at the source. He first looked at cases of illness in caisson workers to determine what kinds of symptoms were related to the disease (Caisson illness and diver’s palsy: an experimental study 404-406). He also observed autopsies to see what physical changes occurred inside the body. From this information, he tried to predict the length and intensity of pressure a person could be exposed to before suffering noticeable ill effects. Through his observational research, Macleod was able to formulate a plan for experimentation with high pressure without using human guinea pigs. What Macleod did do was use mice as the guinea pigs. His observation oh caisson workers had allowed him to guess that long exposure and high pressure were the causes of caisson disease (Caisson illness and a diver’s palsy: an experimental study 425). With the mice, he noticed that they suffered less ill effects if the pressure was increased incrementally (The influence of compressed air on the respiratory exchange 494-495). He determined that the best way to prevent caisson disease was to stage the decompression process so that the body would have time to adjust and expel gasses, eliminating the toxic buildup of nitrogen. Macleod’s discoveries helped ease the minds of everyone—they now knew the cause of caisson disease and how to prevent it. Furthermore, the evidence was enough for employers to start tentatively implementing the safer working conditions advocated for by Smith and Jaminet. Workers now knew that at higher pressures, they were to get more frequent breaks along with staged decompression. Research concerning compressed air and the human body continued on after Macleod and the compression chamber grew from an experimental tool to a medical one.

Macleod created the compression tube so he could study caisson disease without exposing people. Ironically, a larger version is now in use specifically for people, utilizing a process called hyperbolic oxygen therapy (HBOT). The high pressure in the chamber allows more oxygen to be absorbed by the body (National Institutes of Health). This absorption process aids in the healing of bones and burns as well as gas poisonings and embolisms. The addition of pure oxygen speeds up this process and limits exposure time to high pressures, and thanks to the work of Macleod, the patients are carefully and slowly returned to normal pressure. The compression chamber is also available to help people who have already succumbed to caisson disease (National Institutes of Health). It is mostly for divers since working conditions are now under stricter safety controls. The compression chamber helps to ease people back to standard pressure in a controlled setting.

The compression tube helped to shed light on the mysteries of caisson disease and has even led to some helpful medical uses. Though Macleod was just one of many scientists looking into caisson disease, he was one of the few to have a laboratory compression tube. His model compression experiments allowed him to discover symptoms and causes of caisson disease without having to expose humans to those conditions. His discoveries eventually led to safer working conditions being implemented for caisson workers and the compression tube was later adapted for medical use.

ABOUT THE AUTHOR

Masato Miyagi: Born in Okinawa, Masato moved to the U.S. at the age of three. He is a second year student at Case Western, studying psychology. He hopes to work as a sports psychiatrist in the future.

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Works Cited

Butler, W.P. “Caisson disease during the construction of the Eads and Brooklyn Bridges: A review.” Undersea Hyperbaric Medical Journal. 31.4 (2004): 445-459. Web. 14 September 2014.

“Compression Chamber, 1904.” Dittrick Medical History Center. Case Western Reserve University, 2014. Web. 14 September 2014.

Dittrick Museum. “Compression Chamber.” Case Western Reserve University: Dittrick Museum, 2014. Placard.

Hill, Leonard; Macleod, J.J.R. “Caisson illness and diver’s palsy: an experimental study.” Journal of Hygiene 3 (1903): 401-445. Web. 14 September 2014.

Hill, Leonard; Macleod, J.J.R. “The influence of compressed air on the respiratory exchange.” Journal of Physiology 29 (1903): 492-510. Web. 14 September 2014.

National Institutes of Health. “Hyperbaric oxygen therapy.” Medline Plus. 30 August 2012. Web. 14 September 2014.

Student Research at the Dittrick

The Dittrick Medical History Center welcomes researchers from the community, the region, the nation, and abroad. We’ve been pleased to host a number of colleagues, including David Jones, Diana Day, Mike Sappol, and many others. But seasoned scholars and PhDs are not the only visitors to the collections here; Case Western Reserve University students frequently attend classes in the museum’s Zverina room. Today, we begin a three part series featuring some of their work. As always, we welcome all curious and intrepid explorers of our medical past!

Bowles Stethoscope Bowles Stethoscope from the Sharp & Sharp Catalog of Instruments, 1905.

Bowles Stethoscope from the Sharp & Sharp Catalog of Instruments, 1905.

There are few instruments more recognizable or emblematic of medicine than the stethoscope. Today’s post, from Cara Smith, will look at its history and development.

Sounds like Progress: The Stethoscope’s Impact on Medical Diagnosis and Knowledge

Medicine in the early 1800’s was a removed practice; doctors diagnosed and treated patients based on observations and conversations. During that era, physical contact and even physical observation was considered “unseemly” (Aronson 171). As a result, one can imagine the difficulties that this incurred in the field of medicine. In order to treat patients properly, doctors need direct and often physical observations, something patients of this time were not eager to provide to the prying gaze of a doctor. However, in 1816, Dr. Rene Laennec, in an imaginative improvisation, created a medical instrument that helped to break down this barrier between patient and doctor and initiate a shift in the mentality of medicine: the stethoscope (Aronson 171). At this point in time, auscultation, the art of listening to the human body to determine ailments, was already in existence.   However, this process was done in an extremely invasive and uncomfortable manner, especially for females. The doctor would place his ear directly upon the patient’s chest and try to discern the sounds coming from within, a method known as immediate auscultation (Sterne 120). Because of the social stigma surrounding direct patient care, this method was only undertaken in dire circumstances, such as the case Dr. Laennec was faced with. An already socially awkward situation was made even more so as Dr. Laennec realized that the weight of his female patient prevented him from hearing her heart (Aronson 171). Thus, to solve this issue, Dr. Laennec improvised and “rolled a quire of paper into a kind of cylinder and applied one end of it to the region of the heart and the other to my ear, and was not a little surprised… to find that I could thereby perceive the action of the heart in a manner much more clear” (Sterne 117). This seemingly simplistic adjustment was anything but simple; Dr. Laennec’s invention of the stethoscope, a device that allows doctors to obtain a direct audio of a patient’s insides from a socially acceptable distance, introduced an entire new mode of medical investigation and diagnosis that would eventually answer many questions of medicine -but would also create many unforeseen problems as well.

The invention of the stethoscope was so beneficial in answering questions of medicine because it began to melt away the social barrier placed between doctors and patients. The stethoscope was “designed to operate within the parameters of a set of social relationships, and it helped to cement and formalize those relations: the doctor-patient relationship, the structure of clinical research and pedagogy” (Sterne 116). Despite strict moral standards, the stethoscope allowed doctors to begin to transcend the stigmas of morality and privacy of the era. Patients became much more comfortable with physical examination, allowing doctors to not only diagnose and treat more effectively, but also to learn much more about the human body. Prior to the progress in the doctor-patient relationship initiated by the stethoscope, doctors had to resort to autopsy as their “primary site of knowledge” of the human anatomy (Sterne 125). While this source of data provided doctors with invaluable knowledge of the inner systems and structures of the body, the fact remained that these autopsies were performed on failed cases; patients who, unfortunately, were not provided with proper treatment either because they were not diagnosed properly or the treatment they sought simply did not exist. Armed with the stethoscope and patients’ trust, doctors were now able to begin delving into the mysteries of the living body without violating a patient’s comfort. Instead of observing human bodies in which the blood has stopped moving and the lungs have stopped breathing, doctors were able to shift the “primary site of knowledge in pathological anatomy back from the dead to the living” (Sterne 126). Thus, doctors could observe diseases and other medical problems inside of the body as they were occurring, granting them a new depth of insight. As a result, doctors were able to begin formulating a more detailed and accurate image of the human anatomy as well as the diseases that ravaged it, initiating a new era of medical investigation.

However, as with all major discoveries that initiate rapid progress, the stethoscope precipitated multiple concerns. For instance, the stethoscope created a concern of dealing with the accuracy of the information being obtained. First of all, because of the time period, many questioned the validity and accuracy of observations made with the stethoscope (Sterne 121). The philosophy of the time focused on the idea of the separation of mind and body. Descartes, a major philosopher of the time, claimed that any knowledge obtained through the human senses is inherently flawed. Because the body is separated from the “immaterial mind,” senses are easily deceived (Skirry). With this in mind, the question arises whether a diagnosis based solely on the sounds that doctors perceive to emanate from the body is valid enough to consider using as a basis for discovery, especially considering the difficulty to interpret sounds into symptoms (Sterne 132). In addition, another major problem was that many of the discoveries doctors were making in their living patients were those of diseases that had yet to be fully analyzed. Thus, the discoveries that doctors were making unfortunately caused patients great dread, as in many cases “diagnostic knowledge preceded any notion of a cure” (Sterne 129). While doctors were able to take these discoveries and eventually craft cures, the patients had to live with the dread of knowing they carried an incurable disease. Ethically, this relates to the idea of whether certain knowledge is worth the accompanying consequences. Do patients want to know if they have a disease that they will eventually die from? The patient has a right to know his or her ailment, but should the technology exist that can provide them this information if it is inherently unwanted?

In conclusion, despite the multiple drawbacks that the stethoscope inherently possesses, the stethoscope still persists today as one of the most widely recognized medical symbols. It has essentially inspired the modern medical attitude of “a diagnostically assertive domain” in which doctors depend on the “inner dynamics of the body’s organs… to infer the physical nature of the underlying pathological process” (Aronson 171). Once doctors realized the value of being able to interpret the inner workings of the human body, the idea of the stethoscope and auscultation expounded upon itself; doctors were eager to discover what other sounds they could interpret from different parts of the human body. New instruments and technologies from today reach even further inside of the body, revealing everything from broken bones to mutated DNA. As with the stethoscope, these new technologies such as X-Ray, MRI, and echocardiographs also risk moving at too fast of a pace, diagnosing patients with diseases that are currently beyond modern medicine’s healing capabilities. However, similar to the stethoscope, these developing technologies continue to play an integral role in identifying the causes of these incurable diseases, perpetuating the culture of discovery in medicine for years to come. Thus, the stethoscope can be considered one of the first steps toward the modern medical mentality; the mentality that understanding the inner workings of the body is the key to new knowledge.

ABOUT THE AUTHOR:

Cara Smith, a native Clevelander, is currently a sophomore Biomedical Engineering major at Case Western Reserve University. Within this field, she hopes to eventually pursue further education in neural engineering as well as travel as much as possible. Apart from being a student, she is also a supplemental instructor for Principles of Chemistry for Engineers and a member of multiple wind ensembles on campus in which she plays the flute.

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Works Cited

Aronson, Stanley M. “A Heart-Beat Is Amplified and Then Resonates In History.” Medicine & Health Rhode Island 95.6 (2012): 171. Academic Search Complete. Web. 13 Sept. 2014.

Skirry, Justin. “Rene Descartes (1596-1650).” Internet Encyclopedia of Philsophy. Nebraska-Wesleyan University. IEP. Web. 15 Sep 2014.

Sterne, Jonathan. “Mediate Auscultation, The Stethoscope, And The “Autopsy Of The Living”: Medicine’s Acoustic Culture.” Journal Of Medical Humanities 22.2 (2001): 115-136. Academic Search Complete. Web. 13 Sept. 2014.

[Various stethoscopes; Blaufox Hall of Diagnostic Instruments]. [c. late 1800s early 1900s]. Metal and wooden stethoscopes. Dittrick Museum of Medical History, Cleveland.

 

Buried History: A Halloween Post

RockefellerWe’ve spent the last few posts describing the famous–and the infamous–body snatching incidents of our local, regional, and national past. What better way to follow up all that grave-robbing that with a Halloween post about our favorite Cleveland “graveyard”: The Lakeview Cemetery.

But what is a graveyard? And is it the same thing as a cemetery? The words are often Allen Severance famsused interchangeably, but there are historical reasons for the shift in terminology. Traditionally, the green space or yard area surrounding a church housed the graves of its parishioners, thus a grave-yard. But by the late 18th century, many of these areas were full. Add to that an increasing secularization and a desire to make the grave-site a “final resting place” of more park-like appearance, and you have the impetus for change. The word “cemetery” comes from the Greek word koimētērion ‘dormitory’, from koiman ‘put to sleep’ [1]. It was originally applied to the Roman Kelley 2catacombs, but became increasingly used to describe the new burial grounds. Here in Cleveland’s Lakeview Cemetery, we see some of their best features: beautiful trees and plantings, natural elements like hillsides and streams, and a general sense of peace and calm in nature. Even so, some of the people buried here were quite lively characters in their lifetimes, including Dr. Horace Ackley (1810-1859), who appeared in last week’s post for, let’s say, “borrowing” a pauper’s body for dissection purposes.

Ackley 3Speaking of Horace, here he is just in front of me (at right; Brandy Schillace). Dr. Ackley’s career was remarkable and anything but dull. Co-founder and first professor at the Cleveland Medical College (which later became Medical Department of Western Reserve College and eventually Case Western Reserve University School of Medicine), the first physician to use ether for surgical anesthesia in Northern Ohio, and the “father” of the Northern Ohio Insane Asylum, Ackley personally combated and contained an outbreak of Asiatic cholera in Sandusky in 1849 (2). He was also responsible for stealing bodies (on one occasion, a “body” turned out to by quite alive but very drunk), for attacking a bank with a sledgehammer when they refused to pay back his money, and for an urban legend that suggests he *might* have shot one of his patients. (Not that seriously, mind. But still). NessColorful and fascinating stories lie behind many of Cleveland’s medical professionals, making each grave marker a kind of touchstone for rich and varied lives. And that’s hardly all Lakeview has to offer. Did you know Rockefeller is buried here? And Elliott Ness? There’s more to tell and more to see, proving that a place doesn’t have to be “haunted” to tell stories–or to stir the soul.

On November 1st, the Dittrick staff will be leading a tour around the cemetery. It’s a revival of tours given a number of years ago, and we hope to make it a twice yearly occurrence. I hope you will join us in the future–and in the meantime, visit the Dittrick online “tour” for more (or print the map and take a tour yourself!)

OnlineEx_Lakeview_nextstop_org

REFERENCES

[1] “cemetery, n.” OED Online. Oxford University Press, September 2014. Web. 31 October 2014.

[2] “Horace Ackely” Lakeview Cemetery. Dittrick Museum of Medical History. Web. 31 October 2014

A Grave Matter: Legislating Dissection

It’s 1855 in Cleveland, Ohio and you need a surgeon. There were quite a few local options including the physicians out of the Cleveland Medical College and the Western Homeopathic College of Cleveland. In soliciting one of these (mostly) men, you assume that they have the adequate experience to perform whatever operation you need. But where did they get it?

Cleveland Medical College c. 1865

Cleveland Medical College c. 1865

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Grave Robbing for “The Benefit of the Living”

Rattle his bones over the stones,
He’s only a pauper, whom nobody owns. [1]

Imagine you are a sick pauper living in Cleveland, Ohio in 1855. For shelter and medical attention, you stay at the newly built City Infirmary, where faculty and students of the Cleveland Medical College offer their services. Alas, your illness cannot be cured and you die – friendless and alone. Your body is taken to the Potter’s Field in Woodland Cemetery across town. But there it is not to stay.

Map of Cleveland in 1861, with the relative locations of Woodland Cemetery, the Cleveland Medical College, and the Cleveland Infirmary marked.

Map of Cleveland in 1861, with the relative locations of Woodland Cemetery, the Cleveland Medical College, and the Cleveland Infirmary marked.

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Madame du Coudray: A Midwife in a Man’s World?

Coudray-plate-XV

From Madame du Coudray’s book, plate XV

Here on the Dittrick Blog, we’ve begun a series on body-snatching for the purpose of anatomy… but today, we’d like to interrupt that history with another, equally fascinating but focused on the other end of the life spectrum. It’s National Midwifery Week, and today we present the history of a “woman in a man’s world,” the midwife Madame du Coudray.

Angelique Marguerite Le Boursier du Coudray (1712-1790) was the “King’s Midwife” in France. And yet, Madame du Coudray left no journal and few personal papers, meaning that while her deeds are well-recorded, her life is still somewhat mysterious. She remained unmarried, though took on the title of Madame, appropriate to her work as a sage femme (literally “wise woman,” but also the French term for a midwife).

Mission and Machine: “Saving Babies for France”

“Th[e] paradox of the singular, idiosyncratic woman who follows a ‘quest plot’ instead of a ‘marriage plot”

–Nina Gelbart, The King’s Midwife, 13

angelique-marguerite-le-boursier-du-coudrayAfter ten years as a midwife in Paris, Madame du Coudray was hired by King Louis XV to travel across France to better train rural midwives. There were political motivations for this; Louis wanted to boost a “declining” population, and more subjects also meant more capable soldiers. Unlike Queen Charlotte of England who chose William Hunter as the royal obstetrician, Louis appointed du Coudray, a woman, to train women. Madame du Coudray became the national midwife in 1759, earning 8,000 livres a year (equal to that of a decorated military general).[i]

Madame du Coudray’s accomplishments are remarkable even by our own standards, but this is especially true considering the time period. After all, in Britain, midwives had been replaced by man-midwives (or surgeon/obstetricians) by the middle of the eighteenth-century. What led to so radical a shift? And why was du Coudray so successful, even in a “man’s world”?

L0018481 Carciature of a man-midwife as a split figureMan-Midwives

Adrian Wilson traces the English history of male practitioners to Percival Willughby of Derby, who served in “the midwife’s bed” from 1630 to 1670[ii]. This phrase, which comes from Willughby’s Observations, suggests a clandestine affair, a blushing sneak, almost unmentionable. In fact, most early male practitioners were called surgeons, which, as Wilson points out, “tends to conceal their obstetric practice.”[iii] Surgeons attended at the behest of the midwife, and Willughby himself only served in place of the midwife for three expecting mothers over the course of many years.[iv] Male involvement was unusual, but by the eighteenth century, midwives like Elizabeth Nihell could accuse man-midwives like William Smellie of releasing “swarms” of male midwives into practice.  A variety of things contributed to this change–so many, that we probably can’t point to a single event.  The advent of lying-in hospitals, as well as changes in fashion, politics, and social structure in England were part of the shift.[v]  It is also true that cases like the “Rabbit Breeder of Godalming” brought midwifery to embarrassing public notice in England.

‘Breeding Rabbits’ and the Power of Instruments

Wellcome Image: Toft

Wellcome Image: Toft

In 1727, Mary Toft mimicked birth pangs and contractions and fooled many into believing she had given birth to a brood of baby rabbits. The case was finally overturned by surgeon Sir Richard Manningham, who threatened to cut her open in a live vivisection. Toft confessed to the hoax–(who wouldn’t?) While Manningham’s threat was probably an empty one, it is useful case study for two reasons; first, Toft—as an uneducated woman—was thought incapable of fooling the medical men (who presumably “knew” more about birth than she).[vi] Second, Manningham’s threats were of a particularly surgical kind. The mystery of female anatomy would be rendered plain through the surgeon’s instruments. Instrumentation had been one of the ways in which male surgeons protected their interests, for only a surgeon could wield instruments, and only those wielding instruments could be considered surgeons. The fact that only man-midwives could use forceps helped to build their practice. The rise of the man-midwife and the rise of forceps tend to go together. So–given that all of this occurred around the same time du Coudray was practicing in France–how did she gain such a powerful position? Why wasn’t a surgeon obstetrician chosen as the national midwife?

Madame du Coudray among the Surgeons

pelvimeter

pelvimeter

In France, there was also a contest between male and female practitioners. After all, André Levret is considered one of the  most powerful and influential figures in French obstetrics. The procedure for breech delivery, “Mauriceau-Levret manipulation,” is named after him and physician François Mauriceau. At the same time, Jean-Louis Baudelocque was working with William Smellie’s methods to “modernize” obstetrics in France–and he did so partly through instrumentation. His pelvimeter measured  pelvic dimensions (to see if the pelvis was wide enough for uncomplicated birth). These two men were critically important for turning midwifery into a science in France, and it should be noted that Baudelocque was named the first chair of obstetrics by Napoleon in 1806. The tide was turning, therefore, and yet Madame du Coudray held a prominent position well into the 1780s. How did she accomplish this?

_MG_7276_1

Madame du Coudray’s manikin in Rouen, France (images c/o James Edmonson, chief curator)

As Nina Gelbart points out in The King’s Midwife, du Coudray was not a feminist or even an advocate for other women. If anything, she de-emphasized her gender as much as possible, preferring instead to consider herself an equal to men. That means she often worked within the status quo rather than trying to change it. She wrote a medical text, amply illustrated, just as the man-midwifes had done, and as Gelbart explains, Coudray envisioned herself as a “man of action” [my emphasis]. Working within the system meant courting powerful friends–often among surgeons. Levret and an acquaintance of du Coudray, César Verdier, inspected her miraculous “machine” (or manikin) in 1756, approving of it and helping to spread her fame. This also helped to validate her practice. And what is this machine, but a kind of instrument–a piece of the mechanical and technological revolution for turning midwifery into a science? As Gelbart reminds us, even the language du Coudray uses is aimed at men–and though she taught mechanical means of birth to her female midwifery students, she also rapidly became the exception that proved the rule. She defied the marginalization of women by demanding attention, recognition, and payment for her work. Even so, she was also a vehicle for the very progress that was a distinct goal of the male physicians, obstetricians and surgeons.

_MG_7257

Fetus in placenta, Rouen, France (photo c/o James Edmonson)

Madame du Coudray was a remarkably successful woman, especially in terms of her legacy. Like Smellie, she developed a machine for teaching. Also like Smellie, she trained an enormous number of students (by 1780, two-thirds of the midwives in France were Madame du Coudray’s pupils!) Her career ended in obscurity, partly due to the revolution in France, but during her tenure and her travels, she was the most successful of all female midwives of the period.


[i] Gelbart, Nina. The king’s midwife: a history and mystery of Madame du Coudray. (University of California Press, 1999): 177

[ii] Wilson, Adrian. The Making of Man-Midwifery. (Cambridge: Harvard University Press, 1995): 6.

[iii] Ibid, 47.

[iv] Ibid, 48

[v] Wilson, Making, 6.

[vi] I do not wish to overstate this claim, but it seems apparent from the case that the surgeons felt justified upon discovering that Toft’s mother-in-law (a midwife) was behind the hoax. It did not occur to the male midwives that a woman, by virtue of being a woman alone, might know more about the workings of the female anatomy than the practitioner.


Body Snatching, You Say?

Part of the Dittrick collection; Dissection: Photographs of a Rite of Passage

Part of the Dittrick collection; Dissection: Photographs of a Rite of Passage

Gross Anatomy, or the dissection of bodies by medical students for study has not always been a given of medical training. In fact, the practice has been fraught almost since the first, a battleground over bodies from the religious prohibition of the pre-modern period to a “gory” New York City riot in the eighteenth century when an enraged public rose up against body-snatching anatomists. What caused these tensions? Inconsistencies of jurisprudence and issues of class and race were all factors in the race to obtain a suitable corpse… And, given shortages, that sometimes meant “by any means necessary.” Let’s have a look at the issue in British and US history:

The 1832 Anatomy Act in England intended to provide greater access to cadavers for medical science, but it was viewed with enormous suspicion and public outcry. Called the ‘Dead Body Bill’, the ‘Dissecting Bill’ and the ‘Blood-stained Anatomy Act,’ it allowed the unclaimed bodies of paupers to be given to the anatomy schools.[i] The bodies consisted of poor, indigent, trod-upon groups. The 1834 Poor Law that followed added to the unease for the laboring poor in Britain; Peter Bussey, a 19th century Bradford Chartist, who claimed in 1838 that “If they were poor they imprisoned them, then starved them to death, and after they were dead they butchered them.”[ii]

Similar incendiary attacks were made in the United States, both before and after the New York “Doctors Riot” of 1788. The riot itself killed as many as twenty people and was sparked by a series of newspaper stories. In a Smithsonian article titled “The Gory New York City Riot that Shaped American Medicine,” author Bess Lovejoy remarks that a rash of media tales about grave-robbing medical students helped to stir unrest. Most of these robberies took place at potter’s field and the city’s so-called “Negroes Burial Ground.”[iii] Lovejoy quotes from a petition in February of that year: “young gentlemen in this city who call themselves students of the physic […] under cover of the night, in the most wanton sallies of excess … dig up bodies of deceased friends and relatives of your petitioners, carrying them away without respect for age or sex.”[iv] The practice of robbing graves among poor and minority groups persisted, however, well into the 19th century; John Harley Warner, co-author of Dissection: Photographs of a Rite of Passage in American Medicine, notes that in Boston in the 1840s, the influx of “Irish paupers” shifted the balance, though even in the twentieth century, African-Americans remained the primary “at-risk population.”[v] The New York riot—and subsequent laws in the US—were driven primarily by breaches in this “acceptable” practice of dissecting along race and class boundaries. Sentiments “boiled over” in New York when the body of a white woman was stolen from Trinity Churchyard.[vi] Warner cites a similar example of public outcry when the body of a former senator and son of President William Henry Harrison was discovered (by his son, no less) hanging in a dissection lab in Ohio in 1878.[vii] However, so long as the “resurrectionists” followed what a 19th century anatomist called the “prudent line of stealing only the bodies of the poor,” the practice continued unabated.[viii]

Securing the Specimen

Anatomical specimens must be procured somehow. Occasionally, students themselves might work to get a body, but in places where body trafficking was heavy, professional “resurrectionists” held sway.[ix] The means of securing specimens may seem barbaric to us now, but could be very workman-like; a good resurrectionist would have an extensive network that included undertakers, graveyard workers, and even other doctors who might be called to the deathbed of a patient and so provide first notification. The coffin would be uncovered and the top broken to allow access to the body, which would be drawn forth by a rope tied around the neck.[x] The bodies were stripped of incriminating identification and the dirt, flowers, and other grave arrangements would be replaced to disguise interference.

L0019663 Burke and Hare suffocating Mrs Docherty for sale to Dr. Knox

Wellcome Collection image of Burke and Hare suffocating Mrs. Docherty for sale to Dr. Knox

In Britain, the practice was largely the same, though the at-risk population was that of the poor. The graves of paupers were not deep and a single one might have as many as four bodies. Resurrectionists in urban areas worked late at night, using wooden shovels to avoid the tell-tale “clank” of digging.[xi] A “gang” could remove a body and replace the dirt in twenty minutes or less.[xii] Then there were those, like Burke and Hare, who got a head start–they didn’t quite wait for people to die, and were guilty of killing 16 people in Edinburgh and selling their bodies. It’s little wonder the practice was viewed with suspicion.

In much of the United States, laws against grave-robbing were slow in coming (in Nashville, it wasn’t officially outlawed until the twentieth century), and in Britain, the practice was a misdemeanor; only when an object was stolen from the body did it become a felony. Buyers and sellers squabbled over the “specimens,” which were subject to supply and demand, and cadavers traveled about like the other goods produced by the industrial age. The examination of the corpse may have brought about the modernization of medicine, but it did not change the view of the horror-stricken bereaved. What we see instead is a contest of sorts between the medical professional and the public over the sanctity of death, and a real fear that dissection “dehumanized” the doctor as well as the deceased.

Next week, tune in for a look at grave-robbing in our own back yard–Cleveland, Ohio body snatching!

~Brandy Schillace, PhD, research associate

REFERENCES

[i] Knott, John. “Popular Attitudes to Death and Dissection in Early Nineteenth Century Britain: The Anatomy

, 1

[ii] Quoted in Ibid., 2.

[iii] Lovejoy, Bess. “The Gory Riot New York City Riot that Shaped American Medicine.” History. Smithsonian Magazine. June 17, 2014.

[iv] Ibid.

[v] Warner, John Harley “Witnessing Dissection.” Dissection: Photographs of a Rite of Passage in American Medicine 1880-1930. John Harley Warner and James Edmonson, Eds. New York: Blast Books, 2009.

[vi] Lovejoy, 2.

[vii] Warner, 19.

[viii] Ibid., 18.

[ix]  Warner, 17.

[x] Ibid.

[xi] Knott, 2.

[xii] Ibid.