Under the Lid with #BrainAwarenessWeek

For #BrainAwarenessWeek, we go to Georg Bartisch, 16th century surgeon and inventor, and his  Ophthamoduleia (”eye-service”), published in 1583. But in looking so closely at disorders of the eye, Bartisch necessarily became incredibly interested in the brain. The incredible wood cut prints show the delicate internal parts through the use of book-flaps. Layers of paper could be lifted away to reveal more detailed anatomy!

Many books contained such flaps, including the work of Vesalius, often considered the father of anatomy. (An excellent point about flap books may be found here, from the Bodleian). Bartisch performed surgeries on the eyes, and even advised his students on how best to hold patients down for the procedure. (Eye surgery would continue to be a horribly painful affair until 1884, when Austrian ophthalmologist Carl Koller realized that a few drops of topical cocaine solution rendered the eye immobile and numb).

While Bartisch does not focus on brain surgery, he nevertheless saw anatomy of the brain cavity as crucial for understanding disorders of sigh. One of the more interesting features of Bartisch’ text involves the beautifully rendered brain flaps. They could be colorized for greater effect, but the Dittrick’s copy appears as they might have hot of the block press. Stunning detail, rendered plain through innovative “paper” anatomy, Bartisch provided a glimpse “under the lid.”

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REF:

Bartisch, George. Ophthalmodouleia, das ist, Augendienst. Newer und wolgegründter Bericht von Ursachen und Erkentnüs aller Gebrechen, Schäden und Mängel der Augen und des Gesichtes. [Dreszden, Matthes Stöckel] 1583

For the LOVE of Medical History

For our final #MuseumWeek post we’re talking about why we LOVE medical history and why we hope that love is contagious! #loveMW


It’s not uncommon for the Dittrick Medical History Center to be referred to a bit like a cabinet of curiosities,  a niche museum, or perhaps more kindly, a “hidden treasure.” Although we’ve always worked to make collections accessible and major public engagement efforts are underway, we still often have to make the case for the (sometimes not so) implicit question “Why should I care about medical history?”

The answer tends to go a little like this:

Medical history is the history of how we come into the world. Our Re-conceiving Birth gallery is not only about doctors, nurses, and midwives — it examines the experiences of women and babies from the 18th century to the 1940s. Beyond the particular questions of labor position, pregnancy diet, and types of forceps, this gallery calls visitors’ attention to larger, still pertinent questions: Is birth a normal or pathological event? Who’s experiences and knowledge are important during labor? Should birth hurt? How are difficult decisions made when both the mother and infant are at risk?

By framing these questions through history, we hope to add to modern debates that these are not new concerns and that “traditional” approaches are not singular or homogenous.

Medical history is the history of how we change and respond to our environments. Humans have faced a range of emerging health concerns through travel to new places, movement into cities, changing diets, and exposure to industrial hazards. Many of the museum’s exhibits examine both the impact of these shifts, such as crowded city-dwelling facilitating the transmission of infectious diseases, and how we respond to these novel health environments. For example, Cleveland was racked by a deadly and disfiguring smallpox epidemic in 1901 and 1902, which was halted through a coordination of efforts to develop and widely distribute a safe vaccine.

These stories speak to the dynamic relationship between humans and their environment and cautions against assumptions that medical progress has eliminated any risk of new health challenges.

Medical history is the history of how we manage pain and suffering. When visitors arrive at the museum, they are greeted with display cases that detail “If you were sick in…” various years throughout history. These exhibits contextualize both the conditions and therapeutics Americans encountered in 1810, 1860, and 1910 including purgatives and emetics of humoral medicine and the sanitizing devises and techniques developed under germ theory. The types of surgeries, pharmaceuticals, and instruments used by practitioners and the popular advertisements for health restoring or ensuring products reveal the way the body and illnesses are understood.

Conceptions of the body and what it means to be healthy are not static, but reflect contemporary challenges and concerns. For example, medicine during WWI developed ways to address mass trauma in the form of gunshot, shrapnel and shell wounds and fractures through pain-free, sterile surgeries that prevented patient shock and hemorrhage. Meanwhile, home front practitioners sought to ensure the continued well-being of citizens living under rations. We’re taking a closer look at these wartime public policies and their attempts to ensure health on April 7th.

Medical history is the history of how we mediate sexual relations and family size. The museum prominently features the Skuy Collection on the History of Contraception, the world’s largest and most comprehensive collection of historical contraception artifacts. This space provides a chronological look at the way fertility has been understood and managed, starting with early texts like the 17th century Aristotle’s Masterpiece, through the 19th century Comstock Laws, the development of the birth control pill, to modern contraceptive devices. Controlling fertility is not a modern pursuit, but has been shaped through history by contemporary social and cultural values regarding family size, appropriate sexual behavior, and the alignment (or not) between biomedicine and popular beliefs about reproduction.

Today’s discussions about access to fertility controlling pharmaceuticals and procedures is part of a longer history of politicized decisions about what is best for certain bodies and for the general public at large. The gallery highlights that “best medical practices” have been occasionally overruled by social pressures against contraception, as well as how a lack of oversight in the development and use of some contraceptive technologies lead to suffering or death of unprotected citizens.

Medical history is the history of how and why we die. Even the way death is depicted — as a failure of medical treatment or an inevitable end — is shaped by the unique historical ways health has been understood. For example, diphtheria, once a deadly disease for children in the late 19th century, became both relatively treatable and preventable within a few decades through use of diphtheria antitoxin and large-scale immunization efforts.

Other exhibits tell about the detective-like work of medical practitioners in discovering the causes of death. For example, development of the stethoscope allowed physicians to hear inside the body, however what they heard was not immediately clear. Doctors used the stethoscope to listen to ill patients’ breathing and heartbeats in the early 19th century and attempted to treat their conditions. When the patients almost invariably died from their diseases, the practitioners conducted post-mortem  examinations to match the sound they’d heard with internal abnormalities. The Blaufox Hall of Diagnostic Instruments illustrates how this process led to an improved ability to diagnose pathologies in living patients while providing directed treatment for their particular needs. Understanding why and how we die improves how we interpret our bodily experiences into symptoms and causes for concern.

Our forensics collections offer a different way of understanding causes of death. New methods to detect poisons or cause of death not only reveal how our bodies function, but also speak to larger stories about personal relationships and the integration of science into courts of law.

Basically, medical history is the history of people. Through a shared focus on the biological, environmental, and social aspects of people’s lives, engaging with medical history not only allows for a more nuanced perspective on how people have lived, but tells us something about the diversity of challenges and responses that await us.

 

The People Behind (and in) the Museum

It’s #MuseumWeek, where museums around the world take to Twitter in a behind-the-scenes look at collections! Today’s theme is people. Follow us here on the blog, on Twitter and on Instagram all week to keep up with each event! #peopleMW

Skull Specimen
A toothless male skull featured in a case of 19th century surgical instruments. Gift of Charles A. Muncaster, 1968.

Although the Dittrick Museum’s collections primarily focus on medical tools and  artifacts, a close look around the galleries reveals a few human specimens ever ready to greet visitors with perpetual (and sometimes toothless) smiles. Like the surgical sets and pharmaceuticals they’re featured next to, these specimens were also tools — tools used to teach students about the human body.

Dissection Dittrick
Class Portrait from Dissection: Photographs of a Rite of Passage in American Medicine, 1880-1930

Our collections include many historic images of medical students engaged in dissection, often with each trainee’s name inscribed on the photo. Meanwhile, the identities of the cadavers, like our featured human specimens, remain unknown. Little information is available to answer questions such as: Who were these people? Why did they become objects of anatomical study?

For example, the young male skeleton featured in our period doctor’s office came from Dr. Charles A. Muncaster, a graduate of the Western Reserve School of Medicine, class of 1919. He had acquired the specimen during his studies in 1915, a time when an articulated skeleton sold for $45 to $75. Advertisements for osteological specimens offered no details about the source of their materials, only the quality of the articulation.

1915 Osteological Speciments.jpg
Osteological Preparations from Halsam & Co. Catalog  (1915).

In 1968, besides the two human specimens shown above, Muncaster donated his complete obstetrical bag, providing a snap-shot of early 20th century physician-assisted childbirth.  Like Dr. Muncaster, the museum’s collections have been greatly enriched by generous patrons’ donations of their professional tools. The artifacts tell not only the stories of individual practitioners, but also of patients, education and historical understandings of health and the body.

Muncaster OB Bag
Obstetrical Bag and Artifacts, c. 1920. Gift of Charles A. Muncaster, 1968.

The Eye as Art: Anatomy and Vision in the 18th Century

Engraving of the eye in DeGravers' A Complete Physico-Medical and Churugical on the Human Eye and the Demonstration of Natural Vision (1780).
Fig. 1: Engraving of the eye in  A Complete Physico-Medical and Churugical on the Human Eye and the Demonstration of Natural Vision (Degraver, 1780).

There is not one Part of the whole Body, that discovers more Art and Disign (sic), than this small Organ: All its Parts are so excellently well contrived, so elegantly formed and nicely adjusted that none can deny it to be an Organ as magnificent and curious, as the Sense is useful and entertaining.

— William Porterfield in A Treatise on the Eye, The Manner and Phaenomena of Vision, 1759

The Dittrick Museum is thrilled to have Dr. Jonathan Lass present “Eye of the Artist” for the upcoming Zverina Lecture on Oct. 14th. Dr. Lass, the Charles I. Thomas Professor, and formerly chair, in the Department of Ophthalmology and Visual Sciences at Case Western Reserve University and Medical Director of the Cleveland Eye Bank, will discuss the ways eye conditions impacted the work of artists including Pissaro, Monet, Degas, and O’Keefe, and how individual vision could influence major artistic movements throughout history.

Fig. 2: Engraving of how the parts of the eye create an image of an object. From Chandler (1780).
Fig. 2: Engraving of how the eye creates an image of an object. From Chandler (1780).

Although Dr. Lass will focus on pathological conditions for his lecture, today’s post looks at how 18th century physicians described “normal” or “natural” vision. These authors’ considered the eye, with its delicate structures and wondrous design, as a work of art. To disseminate research about these intricacies, engravers used immense skill and detail to produce anatomical representations (Fig. 1) and optics diagrams (Fig. 2).

Aside from graphical renditions, these early writings on the eye relied on artistic terms. Rays of light “paint” images onto the retina and these unique “strokes” are received by the Sensorium (the sensory part of the brain) and interpreted as “sketches of nature” by a viewer’s Mind.

Fig. 3: Structure of the eye and optic nerves from
Fig. 3: Structure of the eye and optic nerves from Degravers (1780).

Medical authors’ use of this artistic terminology reflected contemporary discussions surrounding the relationship between vision and reality. Were the perceptions of the Mind accurate depictions of the environment or were they truly only “sketches”? Could the eyes be trusted as empirical tools in science, or were external devices, like microscopes, necessary to ensure precise experimental data? Do eyes act as artists or instruments? Debates about the nature of colors (inherent in objects, dependent on light, created by the eyes) and the origins of delusions (originating from the mind or the organs) circled in scientific communities where the hallmark of research was eye-witnessed experimentation.

We hope you join us for the Zverina Lecture to hear more about how the eyes’ structure and function influence perceptions of reality, and how major artists’ health impacted the way they saw and portrayed the world around them.

The talk begins at 6:00PM, followed by a reception in the Dittrick Museum gallery. There is no charge, but you must register to get a seat! Please RSVP to Jennifer Nieves at 216/369-3648 or via email at jks4@case.edu

Continue reading The Eye as Art: Anatomy and Vision in the 18th Century

Are We Running Out of Bodies? Dissection and Medicine

I’ve spent a surprising number of hours unearthing the unusual history of anatomy, dissection, and yes–body snatching. That story links early anatomists like Vesalius (Fabric of the Human Body) to murderers Burke and Hare, to the grave-robbery that supplied bodies to a growing medical community. Here at the Dittrick Museum, we have a comprehensive collection of dissection photography as a rite of passage in American medicine 1880-1930, and curator James Edmonson and John Harley Warner put together an entire pictorial book of them. Between my work on the history of medicine and my research for Death’s Summer Coat (US in 2015), I’ve become very aware of the progress–and problems–of cadaver use, storage, and procurement. So, when the Economist ran a story last year about cadaver shortages, I took notice.

Male figure, anterior view showing blood vessels, liver heart and bloodletting points.  Woodcut circa 1530 - 1545
Male figure, anterior view showing blood vessels, liver heart and bloodletting points.
Woodcut circa 1530 – 1545

“THEY are inert, smelly and upsetting to look at—it’s a wonder that dead bodies are in such high demand. But for medical students they are an indispensable learning tool,” says the author. But are they? Even now with so much modern technology? Many say yes. Some, however, aren’t so certain. In 2013, the Case Western Reserve University School of Medicine and the Cleveland Clinic Lerner College of Medicine, both located in Cleveland, Ohio, announced plans to build a joint medical education building. The historic partnership will result in a state-of-the-art facility to the tune of more than eighty million US dollars. The plan is to be at the forefront of technology, a forward-thinking institution of the medical future. There is one thing that this new building will probably not have, however. There will be no cadaver lab for the purpose of human dissection.

51O9RjsA1UL._SY344_BO1,204,203,200_As I say in chapter 5 of DSC, the decision by CWRU and CCLCM wasn’t made in a vacuum. A brief search of medical journals reveals a sizzling debate. To quote the title of a 2004 debate forum in The Anatomy Record, ‘To What Extent Is Cadaver Dissection Necessary to Learn Medical Gross Anatomy?’[i] That is, do we need a dead body to prepare medical students for practice? The forum was collegial, but not all discussions and rebuttals have been so friendly. Among medical faculty, the argument is not merely philosophical – and sometimes it simmers with bitter rancour. Human dissection has not, however, always been an element 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 do these tensions mean? How does the cadaver relate to conceptions of death, then and now? These questions have to do with more than medicine; they get at the heart of how we deal with death as an event (with a body) and dying as a process (with an overseeing physician) today.

dissectionIn the first of a series of blog posts for Dittrick Museum, I explained the tension in social terms. 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. 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] Our other posts covered the supposed “positive benefit” such actions were to have, Grave Robbing for the Benefit of the Living, and a bit more about some of the doctors in Buried History (including the infamous Ohioan, Horace Ackley). But in all of these, we see a graduated tension: not whether doctors should dissect, but the ethics of procuring the body. No one wanted to see the remains of a loved one strung up in a student lab (and this, in fact, did happen–one of the driving forces behind changes to the laws). And yet, other attitudes were changing too, and people began to donate their bodies to science at an increasing rate. Surely, between donation and modern means of preservation, we have no need to go hunting grave yards… can there really be a shortage of cadavers to go around?

The funny thing about history is how often it repeats itself. According to the Economist article, growing numbers of medical students has, in fact, off-set the balance. We have a tendency, at times, to consider things only from a Western perspective; when we look globally, we see that more and more people are choosing medical careers worldwide–sometimes in cultures where body donation sits in opposition to religious practice. The solution is not to malign the spiritual or ritual treatment of bodies; it is an important part of cultural and individual processing of death. But of course, this is only one small part of the larger issues surrounding body donation and cadaver availability–some others mentioned by the article include: better identification and so fewer unclaimed bodies, fewer bodies “fit” for dissection (that is, fewer young and healthy persons dying ‘before their time’).[iii]

fig26So where does that leave us? Perhaps the most interesting–and alarming–statistic comes from the body retrieval sector, what Michel Anteby, professor at Harvard Business School, calls “a market for human cadavers in all but name”. [iii] Does that mean we are returning to the practice of paying for cadavers (which is, after all, what supplied the murder trade of Burke and Hare)? Not necessarily. In May 2014, Canada’s Globe and Mail reported that approximately half of Canadian medical schools have cut back on using cadavers, opting for pre-cut body parts and high-tech imaging technology [iv]. And this new technology also has its antecedents. I spoke about SynDaverTM Labs in DSC; the company constructs simulated tissue, organs, or whole bodies for dissection. Their ‘Synthetic Human’ includes skin with fat and fascia, bones, muscles, tendons, and ligaments, articulating joints, a functioning respiratory system, a complete digestive system, visceral and reproductive organs, and a circulatory system. And yet, simulated cadavers appeared far, far earlier–from the Wax Venus to the papier mache models build by Auzoux in the 19th century [for more, see Paper Woman or my upcoming chapter in Steampunk Guide to Death]. The Independent‘s claim that a “lack of anatomy training could lead to a shortage of surgeons” –or the worry that such shortages might lead to nefarious activity–is probably overstatement. It may be true, indeed, that dissecting models isn’t like the real thing (though Auzoux claimed it was precisely the same). On the other hand, medical schools have adjusted already, along with changing ideas about who dissects and who doesn’t (notably, still a must for surgeons!) And, as the debate surrounding cost of new facilities in medical schools continue, no doubt the profession will continue to be as creative as ever in their solutions.

But not too creative. A body is more than muscle and tissue, meat and bone. As any student of anatomy (or forensic anthropologist) will tell you: this is (or was) a person. The respect given to the cadaver in the years after those “rite of passage” photographs has, at least seemingly, deepened. This is your teacher, your instrument, your body. Protect it, guard it, learn from it. True for all of us, who get but one body–doubly true of the medical doctor in training, who–if he or she is very lucky–will have two.

[i] G. D. Guttmann, R. L. Drake, and R. B. Trelease, ‘To what extent is cadaver dissection necessary to learn medical gross anatomy? A debate forum’, Anatomical Record 281(1): 2–3.

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

[iii] R. MCS. “Why there is a shortage of cadavers” The Economist. Jan 19, 2014. http://www.economist.com/blogs/economist-explains/2014/01/economist-explains-10

[iv] Harrah, Scott. “Global Cadaver Shortage & Why Almost Half of Canadian Medical Schools are Cutting Back” The UMHS Endeavor. May 12, 2014. https://www.umhs-sk.org/blog/the-global-cadaver-shortage-why-canadian-med-schools-are-cutting-back/Caribbean-Medical-School

Nancy Talbot Clark and her sisters at Western Reserve in the 1850s: pioneers of medical education of American women

On Monday, March 8, Case Daily hosted a trivia quiz in honor of women’s history month. They asked this question: “In 1876, fifty years after it was established, the first woman graduated from Western Reserve College. Who was she?” While they sought the first female graduate of our undergraduate school, it brought to mind a similar question regarding our medical school and its early women graduates. So, I pose a variant of the question appropriate for women’s history month:“Who was the first female graduate of the medical department of Western Reserve College?” The answer is simple: Nancy Talbot Clark. Going beyond, we find that her experience reveals an intriguing, complex, and instructive story about women entering the ranks of the medical profession. Permit me to elaborate.

Nancy-Talbot-Clark-BinneyNancy Talbot Clark graduated in 1852, making her the first female medical graduate of Western Reserve College and the second woman graduate of a co-ed regular (non-sectarian or allopathic) medical college in the entire Unites States. This last point is significant, for the medical establishment of 19th century America discounted the value of medical degrees conferred by sectarian (homeopathic, eclectic, &c) or all female schools. Elizabeth Blackwell merits distinction as the first woman in this country to graduate from a regular (or allopathic) co-educational medical school, having graduated from Geneva Medical College in 1849. Clark came next when she matriculated at Western Reserve, and was in turn followed by five more women who graduated before 1856. In that year Dean Delamater, who championed women’s medical education, retired and his successor, and the rest of the all-male faculty, deemed it “inexpedient” to continue admitting women. Decades passed before women again matriculated at Western Reserve.

The rich narrative of Clark’s career shows clearly that the path for women entering medicine was fraught with challenge and frustration. Tragedy, misogyny, and purported moral and social propriety all conspired to thwart what might otherwise have been a promising professional life for Nancy Talbot woman dissectingClark. An early marriage in 1845 to dentist Champion Clark seemingly precluded a career at all, medical or otherwise, for society expected married women to remain at home, not enter the marketplace. At 22 she bore a daughter who died within a year, and then her husband succumbed to typhoid fever in March 1848, leaving her a young widow. How she found her way to Cleveland is unclear, but biographical notes indicate that the wife of Dean Delamater came from nearby Sharon, Massachusetts, Clark’s hometown. Whatever the route, Clark studied for two years, graduating in March 1852. The school took special notice, publishing in the local newspaper that “Among the graduates is Mrs. Nancy E, Clark of Sharon, Mass., a lady who has, during the past two sessions, commanded the respect of Instructors and members of classes by her lady-like deportment and faithful intelligent attention to her duties as a Medical Student.”

pulse-lo-resClark returned to Boston, Massachusetts, where she practiced medicine from April 1852 to August 1854, and tried unsuccessfully to gain admission to the Massachusetts Medical Society. Male members rejected her application, asserting that “their duty requires them to examine male candidates only for membership.” Like Elizabeth Blackwell before her, Clark departed for France with her physician brother. There, she studied and interned at La Maternité the premiere obstetric hospital in the French capital. On the journey over she met the recently-widowed Amos Binney of Boston, whom she later married. A family of six children ensued and predominated until 1874 when Clark opened a free dispensary for women in Boston.

By focusing this cohort of early women graduates of Western Reserve we gain a sense of the diversity of their career trajectories. No single career arc applies to these women. As noted, marriage comprised a career-ending event for Clark, despite her evident skill and talent. Emily Blackwell, younger sister of Elizabeth, followed and went on to found the New York Infirmary for Indigent Women and Children and ended her career at the London School of Medicine for Women. Marie Zakrzewska, trained as a midwife in Berlin, emigrated in hopes of becoming a physician. Prominent women of Cleveland sponsored her through the Female Medical Education Society of Ohio, and she went on to a distinguished career in women’s medical education. Cordelia Greene pursued a career in the so-called “water cure” or hydropathy movement, starting at a spa in Cleveland, and ending in a western New York water cure establishment. Sarah Chadwick’s career included a year of service as a surgeon to Civil War troops, but married afterward, and retired from medicine. Elizabeth Griselle rounded out the group, with perhaps the most conventional private medical practice in Salem, Ohio. So, we at CWRU can justly take pride in the early strides to promote women as medical professionals, but need to go beyond a cursory mention to more fully understand the challenges these pioneering women faced in their struggle to attain equality in the workplace and in society more generally.

ABOUT THE AUTHOR: James Edmonson, PhD, chief curator of Dittrick Medical History Center and Museum

For more on our pioneering medical women at Western Reserve, see

Linda Lehmann Goldstein. “Roses Bloomed in Winter: Women Medical Graduates of Western Reserve College, 1852-1856,” Case Western Reserve University, May 1989.

Linda Lehmann Goldstein, “ ‘Without compromising in any particular’: The success of medical coeducation in Cleveland, 1850-1856, Caduceus 10 (1994): 101-116.

Dittrick Book Launch Event: Rhetoric in the Flesh

Contributor: Julia Balacko

EVENT: Book Launch for T. Kenny Fountain’s Rhetoric in the Flesh

hRecently, I had the pleasure of attending the book launch for T. Kenny Fountain’s Rhetoric in the Flesh: Trained Vision, Technical Expertise, and the Gross Anatomy Lab at the Dittrick Museum. At the event, Fountain discussed some of the key arguments from the book, and shared anecdotes from his participant observation in the human gross anatomy lab.

Fountain’s text is an ethnographic account penned from the perspective of a rhetorician of science communication. His focus on language offers a lens into anatomical learning and clinical training that is at once pointed and engrossing. Through his account, Fountain reveals the underlying relationships and tensions between students of anatomy and the bodies they dissect.

As I learned from the book launch talk and from an initial reading of the text, one term that Fountain’s participants in the laboratory often returned to was “making.” This word appears counterintuitive, given that dissection entails acts that are more closely associated with destruction than creation: scraping fat from tissues, disarticulating bones, removing organs to see structures beneath of them. However, “making” had a particular cadence in the interviews and interactions that Fountain had with students and faculty in the lab.

Students, instructors, and teaching assistants in the cadaver laboratories employed “making” to describe cutting and preparing the corpse in ways that would mimic the beautifully colored, flawlessly sketched anatomical drawings in their medical atlases. To dissect a body in a careful fashion that would reveal biological structures as cleanly and as clearly as the textbooks was to “make” the body, both into a mimicry of the visuals in the textbooks, and into a body that was representative of what the books deemed anatomical truth. Some students alternatively deemed this process “Netterizing,” or rendering their cadaver’s anatomy to appear as manifestly as the eminent anatomical artist and physician Frank Netter did in his illustrations.

Students in the past have also “made” cadavers into new visual things, as the Dittrick Museum’s collection of rare photographs from 19th century medical schools reveal. Medical students in that era would commonly photograph themselves and their classmates standing over the body they were dissecting. These photographs were frequently sent as postcards to family members as a sign of pride, demonstrating the students’ hard work in medical school and their experience in the anatomical laboratory. In these images, the cadaver represented how they were becoming professionally distinct as physicians: they could learn by dismembering real human bodies, a privilege not extended to other professions and certainly not to a scientifically-minded lay person.

The Dittrick Museum Chief Curator, James M. Edmonson, published these photographs along with historical commentary in the book Dissection: Photographs of a Rite of Passage in American Medicine 1880-1930. Yale professor John Harley Warner, also a historian of medicine, coauthors the book.

As we see, the students dissecting bodies can transform these cadavers into something else. Yet bodies can be “made” by more than the students and faculty alone. Fountain’s text argues that bodies can make themselves. In one case in his book, a woman who donated her body to science accompanied her anatomical gift with a letter. The letter contained details of the domestic abuse she suffered, as she explained the scars medical students would discover on her skin when they began to dissect her. The woman cast her body in a context that the students who received her body, and read her correspondence, could not ignore when considering the conditions under which that body lived and died. This woman “made” her body a representation of its life, its embodied struggles, and its significance as a precious gift to the students who received it.

Cadavers can also “make” themselves in death. One cadaver in the laboratory Fountain observed at had late-stage cancer that had not been reported on her medical records before she was embalmed for dissection. The cancerous tissue was stiff and impossible to cut through. It obscured structures, encased organs, and halted the dissection. In this instance, the cadaver makes itself both anomalous– by not representing “true” anatomical structures like the textbooks– and simultaneously representative of the reality of disease, which medical students will confront as future physicians.

In the past and today, cadaver dissection stands an important source of experiential and visual knowledge of the material human body for medical professionals. Like the 19th century medical students who posed proudly next to their cadavers, medical students today are equally as privileged to gain firsthand knowledge from the human body. Although students’ relationships to their cadavers have no doubt changed, as Fountain’s book suggests, the study of anatomy remains an exceptional experience in the education of future physicians.

You can learn more about and purchase Rhetoric in the Flesh here: http://www.attw.org/publications/book-series/rhetoric-in-the-flesh

To learn more about the Dittrick Museum’s photographs, get Dissection: Photographs of a Rite of Passage in American Medicine here: http://www.amazon.com/Dissection-Photographs-American-Medicine-1880-1930/dp/0922233349

ABOUT THE AUTHOR:

Julia Balacko is a second-year PhD student in medical anthropology at Case Western Reserve University. Her research explores the history, development, and cultural meaning of cadaver dissection in American medical education.