Anatomies: A Cultural History of the Human Body (10 page)

Not all of Colombo’s experiments were as informative. In one spectacularly tasteless public demonstration, he excised a puppy from the womb of a pregnant bitch, injured it and then showed it to the mother, who licked it solicitously, heedless of her own pain. The scene apparently delighted clergy in the audience as a demonstration of the strength of maternal love even in brute creation.

Colombo’s work prepared the ground for William Harvey’s discovery of the circulation of the blood around the body as a whole. Harvey – yet another graduate of the Padua school of medicine – was the physician to James I and Charles I of England. In his 1628 book,
The Movement of the Heart and Blood in Animals
, or
De Motu Cordis
, he includes a fulsome dedication to the latter, drawing an analogy between the heart in the body and the king within his kingdom. ‘Placed, best of Kings, as you are at the summit of human affairs, you will at all events be able to contemplate together a piece of work principal in the human body and a likeness of your own royal power,’ he wrote.

Anatomy, Harvey was accustomed to tell his students, ‘informs the Head, guides the hand, and familiarizes the heart of a kind of necessary Inhumanity’. As the historian Ruth Richardson has pointed out, this ‘necessary Inhumanity’ is what we now call clinical detachment. Harvey certainly had it in abundance. He dissected his own father post mortem and, when his sister died too, completed his knowledge with a complementary dissection of the female anatomy – a stark reflection on the shortage of cadavers available for medical experimentation. In England, a royal annual allowance of four cadavers to surgeons established under Henry VIII was raised to just six by Charles II a century later.

Harvey achieved his breakthrough almost in spite of himself. He was a deeply conservative man who once recommended the diarist John Aubrey go back to sources such as Aristotle and the eleventh-century Persian Avicenna if he wanted to learn medicine, and to ignore trendy ‘shitt-breeches’ like Vesalius. Fortunately, though, like Vesalius, Harvey believed the evidence of his own eyes. His examination of the beating heart in animal vivisections revealed that its valves work in one direction only, so that oxygen-rich blood returning to the heart from the lungs can only leave again through the aorta, meaning that there must be a circulation of blood around the body equal to that circulating between the heart and lungs discovered by Colombo. Harvey measured the amount of blood pumped by the heart – equivalent to about a double measure of spirits in a pub for every beat. At this rate, the body’s full quota of a gallon of blood passes through the heart in no more than a minute! It was clearly impossible that the liver, previously believed responsible for the manufacture of blood, could produce the stuff at such a rate, so Harvey concluded that it must be reused. He pointed to the width of the veins and arteries entering and leaving the heart as further evidence that great volumes of blood must be transported and, holding a beating animal heart in his hand, noted how hard it became each time its powerful muscle contracted.

The discovery of the circulation of the blood caused Harvey some consternation. Others now saw the heart as a mechanical pump in line with René Descartes’s conception of the body-as-machine, but Harvey resisted this interpretation. He was more excited by the diagrammatic circularity of the blood’s motion through the body, which for him reinforced older ideas of cycles on the cosmic scale. Harvey’s discovery was nevertheless of fundamental importance for surgery and all branches of medicine, for example providing new clues to how disease can spread so rapidly through the body, something that had greatly puzzled physicians until then.

On paper at least, the availability of cadavers in Britain should have improved after the passage of an act of Parliament ‘for better preventing the horrid crime of murder’ in 1752. This stipulated that the bodies of hanged criminals were not to be buried in a normal Christian fashion, but their subsequent dissection could be considered as part of their punishment. Even this step was not enough to sate the demands of the growing medical profession, however. Edinburgh was one city where medical science prospered and the demand for bodies was correspondingly high. In the graveyard of Greyfriars church, you can still see mortsafes, the iron grilles placed over graves in order to prevent the body-snatching that occasioned serious social unrest here and in other British cities throughout the eighteenth century. The body-snatchers, or resurrectionists as they were known, could get good money for fresh cadavers rifled from newly filled graves. (They took care to snatch just the body and not any possessions that might have been buried with it lest they be charged with theft – a dead body belonged to no one, but property still belonged to the relatives.)

In Edinburgh, even the supply of dead bodies from the city’s graveyards soon proved inadequate. Between November 1827 and October 1828, William Burke and William Hare, two casual labourers from Ulster, murdered at least sixteen people in the city in order to sell their bodies for the anatomy classes of Dr Robert Knox. It was important that the bodies were not mutilated or damaged, and so Burke and Hare selected victims who would likely be easily subdued. They then plied them with whisky before one of them would place a hand over the nose and mouth while the other lay on top of the body to suppress any struggle. For the best cadavers, Knox gave the men ten pounds.

Knox was not especially well suited to his profession. He found the interior of the human body unpleasant and untidy, lacking in any ‘form that sense comprehends, or desires’. He couldn’t help seeing his own end in the bodies he cut open. But the external human form, it seems, was another matter. Burke’s and Hare’s third victim was an eighteen-year-old prostitute called Mary Paterson, whom Knox found so beautiful to behold that he could not bring himself to wield the knife. Instead, in a macabre reversal of the Pygmalion story, he arranged her body into a suitable reclining pose and directed an artist to produce a drawing of her as if living. He preserved her untouched body in whisky for three months more before letting his students demonstrate their skills on her. Many years later, the by then disgraced Knox published
A Manual of Artistic Anatomy
, in which he recalled the perfect body of Mary Paterson, like that of Venus de Milo, with no sign upon its surface to indicate ‘the presence of any internal organ or cavity’. This is a revealing definition of human beauty, especially coming from a surgeon, and a telling reaction against scientific reductionism and its body made up of parts.

Edinburgh was not a large city, and the disappearance of familiar figures soon began to be remarked. Burke and Hare were almost exposed when some of Knox’s students identified their fifteenth victim on the anatomy table as a mentally retarded lad called James Wilson, well known about town as ‘daft Jamie’. Knox denied that it was him, but began the anatomy unusually that day by cutting away the face. The assassins were finally caught when the body of their next and last victim was discovered in their lodgings before they could get it out to Knox’s college. Hare escaped the death sentence by giving testimony against Burke, who, in a rich twist of irony, became one of the last murderers in Britain to be sentenced to death and dissection. His skeleton is on display today in the medical museum at the University of Edinburgh.

Burke and Hare are infamous for their deeds, but an earlier episode in British anatomical history is possibly still more gruesome, and goes to the very top of the medical establishment. In 1774, William Hunter published
The Anatomy of the Human Gravid Uterus
, an illustrated atlas of the female reproductive system and the development of the foetus, based on twenty-five years’ work and the acquisition of at least fourteen fresh bodies of women who had died during childbirth or in various stages of pregnancy. How did Hunter get hold of these bodies? As we’ve seen already, heavily pregnant women tend not to fall ill (or to commit hanging offences), so fresh graves and the gallows would offer meagre rewards. As Hunter himself wrote: ‘the opportunities for dissecting the human pregnant uterus at leisure, very rarely occur’. Indeed, a major reason for writing the textbook was to give medical students an insight they were unlikely to be able to gain from actual dissections. Nevertheless, it might just be possible in a crowded city such as London, where Hunter worked, to arrange to have placed at one’s disposal more or less legitimately fourteen cadavers over a period of more than two decades. In 2010, however, an art historian named Don Shelton subjected Hunter’s
Anatomy
to a statistical analysis, and came to the conclusion that he must have worked from the bodies of more women than could conceivably have been sourced from ‘random resurrections’, and that some of them could therefore only have been obtained by a sustained campaign of murder.

The weak link may have been William Hunter’s younger brother, John, who assisted him in his work. John went on to make contributions to many branches of medicine and is acknowledged as the father of scientific surgery. He may have been the first to use the word ‘transplant’ in relation to human tissue. His experiments in this field seem distasteful and misguided today: transplanting tissue from one part of the same animal to another – moving a spur from the foot to the comb of a cockerel, for example – as well as transplanting tissue between animals and between species.

He also experimented by replacing his patients’ rotten teeth. Some human teeth may have been supplied by body-snatchers. But he got better results using living teeth, and in particular young second teeth harvested from children. Because second teeth are full-size, and so a typical boy’s tooth would be no smaller than a typical man’s, he recommended especially using teeth taken from girls for ease of fit. Even then there might be trouble achieving a match. In that case, wrote Hunter, ‘The best remedy is to have several people ready, whose Teeth in appearance are fit; for if the first will not answer, the second may.’ Dental transplantation became widespread until 1785, when it was established that a young woman had died of syphilis contracted from an infected implant. As one modern history observes, ‘Hunter seems to have been impervious to ethical criticism.’

There is no doubt that both Hunters would cause some disquiet in today’s medical ethics committees. There is equally no doubt that they greatly influenced the teaching of obstetrics and helped to save many infant lives. Their reputation is high today: Glasgow’s Hunterian Museum and Gallery is named after William Hunter, while the museum of the Royal College of Surgeons in London is named for his brother John. Yet Don Shelton invites us to draw a parallel between them and Nazi scientists such as Josef Mengele, whose data obtained from experiments on Auschwitz concentration camp victims are also available for use by researchers, though frequently shunned. Others have raised similar objections to an anatomical atlas first published in Germany in 1943, which may have made use of bodies harvested from concentration camps. Its author, Eduard Pernkopf, was an enthusiastic Nazi, and some of the artists who produced its coloured illustrations signed their drawings embellished with the SS symbol. As with the Hunters, the moral problem is compounded by the fact that Pernkopf’s work is technically excellent, recognized as perhaps the best anatomical atlas since Vesalius. The atlas is still available today in a revised edition with new drawings added since the Nazi period and the offensive SS insignia deleted – except, apparently, in two instances which escaped the publisher’s notice.

No name is more closely linked with anatomy in the popular imagination than that of Gray. A few men in time become their books – Webster’s Dictionary, Roget’s Thesaurus – but rarely one about whom so little is known as Henry Gray. Webster’s and Roget are general reference works. So, in their day, were Baedeker’s guides and Bradshaw’s railway timetables. But why should
everybody
know about Gray’s
Anatomy
?

Born in London on an unknown date in 1827, Henry Gray rose without trace. The first records of him show that he entered medical school at St George’s Hospital near the family home in Belgravia at the age of fifteen. He did so without having served the usual apprenticeship with an apothecary, suggesting that he had resolved to be a surgeon at a very young age. In a photograph taken by a student friend, he appears with a high forehead and wavy dark hair, somewhat lantern-jawed, with a mouth that dissolves at the corners, Mona Lisa-like. He has dark eyes with a straight gaze and dark eyebrows projecting low over them, giving him a hooded appearance with more than a suggestion of the Romantic poet. Gray quickly showed his mettle by winning important essay prizes – one on comparative anatomy, which was very fashionable at the time, in which he compared the optic nerves of all sorts of (edible) creatures, clearly taking what specimens he could get at the London markets. He followed this with another prize essay, on the spleen, which he converted into his first book in 1854. It was not a success.

Undaunted, however, Gray and his publisher now reached for the broadest possible canvas – the whole human body. Despite its appellation, Gray’s
Anatomy
is not the work of Gray alone. It relies heavily on the drawings of one Henry Vandyke Carter, who also entered St George’s medical school young, a few years behind Gray. Carter too was studying to be a surgeon, and trying to make a little money on the side by illustrating zoological specimens for the famous naturalist Richard Owen, when Gray approached him to illustrate his new book.

By 1855, when they agreed to work together, both men were qualified surgeons and held teaching positions at the hospital, Gray aged twenty-eight and Carter twenty-four. Their ambition was to produce a new kind of anatomy that would be modern, clear and affordable. The collaboration was necessarily close and prolonged, but not without tension. In the space of less than two years, working at the medical school’s dissection room in Knightsbridge, they dissected sufficient bodies to produce 360 illustrations. It is not known how the men obtained the cadavers because the hospital records for the period do not survive, but in general at this time hospitals relied on the bodies of those who died in workhouses and in their own wards. Whatever the truth, their debt goes unacknowledged. According to Ruth Richardson: ‘There is a silence at the centre of
Gray’s
, as indeed there is in all anatomy books, which relates to the unutterable: a gap which no anatomist appears to address other than by turning away.’