Doctor's Review: Medicine on the Move

October 23, 2017
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Invasion of the body snatchers

A morbid cottage industry sprung up around the corpse-crazy anatomists of yesteryear

Once upon a time, nobody willed their earthly remains to science. Moral and legal roadblocks surround the issue even today, so back when Greece was the centre of the medical universe, physicians found it nearly impossible to get their hands on hands -- and feet and spleens and brains and all the other parts they needed as both study and teaching tools. In Victorian times, too, throughout Europe and North America, the human form was considered sacrosanct, and everyone from the castle-dwelling aristocrat to the beggar who died in the street was afforded a proper burial, regardless of their ability to pay. Unfortunately, this left the scientific community in a bit of a pickle.

Though advances in medical research were coming in leaps and bounds during the 19th century, anatomists, physiologists and pathologists faced a constant struggle against church and state in their quest for knowledge. Necropsies -- the slicing and dicing of cats and dogs -- were one thing, but the public still wasn't ready to see the same fate befall a human being. Autopsies, when permitted, were limited to cases of foul play. And so the anatomical and functional aspects of disease remained mysteriously elusive; the more macabre elements of human anatomy were considered anathema to God and country.

In Ancient Greece, Herophilus (c. 335-280 BC), by all accounts the Father of Anatomy, was the first to perform public dissections on human corpses for his students. He described all the major organs, as well as the nervous system, in which he further distinguished sensory and motor pathways. His contemporary, Erasistratus (c. 304-250 BC), focused on cardiac function; he traced the veins and arteries to the heart, and identified and named the tricuspid valve. The bodies they examined to gain these startling new insights were likely stolen, since dissection was illegal. Soon, however, the forward-thinking Greek public concluded that any moral problems were trumped by the good that could come of it.

This moral vision prevailed -- until the Catholic Church came along. With the rise of the Church, all forms of bodily desecration were once again declared off limits. Not only were autopsies and dissections illegal, but so were surgeries on living persons. It was the sort of thinking that had Leonardo Da Vinci and Michelangelo cutting up cadavers in secret, and surgeries of any kind relegated to the domain of the lowly barber. With the Enlightenment, however, thinking once again took hold throughout Europe. Surgery slowly established itself as a noble profession. Strangely, those who wanted to cut up people who were already dead remained on the fringes, challenging society's comfort level at every turn.

DOCTOR OF DEPRAVITY
Nowhere was this more evident than in 19th-century England, where human dissection was totally taboo. Med students, anatomists and researchers interested in examining the post-mortem human form had to resort to the only candidates deemed worthless enough -- executed criminals. Although there were plenty of pickpockets being marched to the gallows in those days, demand still far outweighed supply. And without dead bodies to use for teaching, medical educators worried they'd have trouble filling classroom seats with the living.

A solution sprung up for those willing to look the other way. Instead of waiting around for someone to be hanged, a few enterprising MDs began working outside the law. One of the first to start the trend was a young surgeon and professor from Leeds by the name of Robert Baker (1803-1880). He was, by all accounts, a fairly decent chap, but also one extremely frustrated by the lack of, er, school supplies. Baker put the word out that he'd be willing to pay £4 apiece -- or a month's salary -- for human bodies in good condition. Not surprisingly, there was no shortage of thugs with strong stomachs willing to take him up on his macabre offer.

Baker struck a deal with a pair of local bad guys, who promptly dug up and delivered a corpse to him under the cover of darkness. Alas, the thugs, being thugs, didn't bother filling in the grave once they'd sacked it. When the grieving (and wealthy) family returned to the cemetery the next day, the scene that greeted them wasn't exactly what they were expecting. The police were called in, and the city was plastered with posters. A huge manhunt ensued to find both the grave robbers and the missing corpse.

The doctor panicked, packed the body into a box and tried to ship it to Edinburgh. But the police intercepted it en route. Soon, the entire plot was exposed. The thugs were jailed, although the judge took pity on Baker since his motive, to advance knowledge, was pure. Nevertheless, his reputation as a doctor was ruined, and he was forced into the only profession that would have him -- politics. In his defence, Baker dedicated the rest of his life to helping improve conditions for poor factory workers.

 

DEATH WATCH
Despite Baker's failure, other doctors followed his lead. Pretty soon, a peculiar brand of thief had become a staple on the Victorian criminal scene -- the body snatcher, striking fear in the hearts of grieving loved ones everywhere. These nefarious thieves would hover around graveyards waiting for fresh specimens to be buried, then disinter the bodies the moment the coast was clear. Guards were posted in graveyards, but not every church could afford to hire them. Alternately, families joined so-called "Grave Clubs," made up of concerned citizens who offered to stand watch over their charges' final resting place for a period of five weeks, after which time a body was useless to anatomists, and therefore safe from grave robbers. Sometimes, corpses were buried at twice the normal depth of 1.8 metres or iron bars were laid at various intervals, all designed to deter thieves.

But the robbers were resourceful -- they had a lot riding on their booty, after all. Not only were the thieves paid well, but their powerful medical patrons often offered them protection from prosecution should they be caught. Slowly, public opinion started to shift. Body snatching was necessary for dissections, after all, and the advancement of medicine was in everyone's best interest. Law enforcers and city officials began to look the other way, provided the corpses in question belonged to nobody important and provided they were indeed corpses.

WANTED: DEAD OR ALIVE
This was fundamentally the problem that led to the downfall of Scotland's naive Dr Robert Knox (1791-1862). The hapless doctor had in his employment two dubious drunks named William Hare and William Burke, who provided him with a steady supply of corpses. Knox was generously paying them £10 a pop, money which Hare and Burke liberally reinterpreted as a bounty, rather than the finder's fee. Poor Knox believed the corpses were coming from local graveyards, when in fact Hare and Burke were drowning live out-of-towners and prostitutes in beer barrels and then selling their remains to the good doctor.

The bumbling homicidal duo bragged of their scheme and it wasn't long before local law enforcement caught on. The story broke after police found a body stashed in Hare's basement, and it was soon discovered that Knox had unwittingly purchased 13 such "cadavers."

The whole affair soon turned into a trial-of-the-century type situation, with the vengeful Scottish public out for Knox's blood and the blood of anatomists in general. In the end, Hare turned on Burke to save himself, though legend has it he was later blinded by an angry mob. Burke was ceremoniously executed in 1829 -- and poetically ended up on the anatomist's slab soon afterwards -- while Dr Knox fled his post at the University of Edinburgh in shame.

Things calmed down, but after a while public outcry arose again. Thanks to a few high-profile snatching cases and Mary Shelley's best-seller Frankenstein -- in which a crazed, body-snatching anatomist with a God complex creates a monster out of spare parts -- people were becoming more than a little bit leery of anatomists and their behind-the-scenes work.

DISSECTION DEBATE
Corpses, and what those crazy medical monsters wanted to do with them, became a hot-button topic among the elite inspiring the same sort of frenzied ethical debates that stem-cell research, cloning or abortion inspire today. Meanwhile, the powerless poor just sat around and waited for it all to play out in the press. Though the lower classes (correctly) feared they would be the ones to end up on the receiving end of the anatomist's scalpel, science soon won out over superstition.

In order to ensure a legal and ample supply of corpses, British officials passed the Anatomy Act of 1832. It allowed hospitals to sell the unclaimed bodies of the poor to medical teaching facilities. The city-run workhouses -- those frightening Dickensian factories where dozens of society's less important labourers dropped dead every day -- were also given the right to hawk corpses.

And so cadavers became fair game. From that point on, body snatching became the stuff of nightmares and B-movies. Today, with their owners' pre-mortem consent of course, corpses advance medical science in teaching and research facilities around the world. Still, the perception of the anatomist as grave robber sometimes persists, and in England, a telltale nursery rhyme lives on:

Up the close and down the stair,
In the house with Burke and Hare.
Burke's the butcher, Hare's the thief,
Knox, the boy who buys the beef.

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