Under The Knife, Episode 4 – ‘Twas the Night Before Christmas

In this special, festive episode of Under The Knife, we take on a Christmas classic and give it a morbid twist. Using the talents of Adrian Teal (artwork), Joel Mishon (animator), and the vocal stylings of Alex Anstey, this video is the first of its kind in our series. So sit back, relax and enjoy my rendition of `Twas the Night Before Christmas as you’ve never heard it before!​ Featuring myself as the dissected criminal (Thanks, Adrian!).

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Disturbing Disorders: FOP (Stone Man Syndrome)

F1In a letter dated 14 April 1736, the surgeon John Freke (picture below) wrote to the Royal Society regarding a highly unusual case involving a patient at St Bartholomew’s Hospital in London.

A boy, who looked ‘about Fourteen Years old’, had come into the hospital to ask ‘what should be done to cure him of many large Swellings on his back’. These growths—some of which had started to develop three years prior—were now as large as a ‘penny loaf’. Freke continued with his description of this horrifying condition:

They arise from all the Vertebrae of the Neck, and reach down to the Os Sacrum; they likewise arise from every Rib of his Body, and joining together in all Parts of his Back, as the Ramifications of Coral do, they make as it were, a fixed bony Pair of Bodice.

Freke ended the letter by adding that the boy ‘had no other Symptom of Rickets on any Joint of his Limbs’. [1]

F4What Freke was describing is a rare condition now known as fibrodysplasia ossificans progressiva (FOP). A mutation of the body’s repair mechanism causes fibrous tissue—muscle, tendon and ligament—to ossify when damaged (pictured right: torso of man suffering from FOP). Although FOP is not fatal, most die young, starving to death after their jaws freeze shut or suffocating when new bone develops, making it impossible to breathe.

Freke was the first to describe the condition in detail. However, a French physician by the name of Gui Patin may have come across FOP in the 17th century when he wrote to a colleague that he ‘saw a woman today who finally became hard as wood all over’. [2]

F3Today, FOP affects approximately 3,300 people worldwide, or 1 in 2 million. A more recent example showing the effects of the disease can be found in the Mütter Museum in Philadelphia. In 1938, a 5-year-old boy named Harry Raymond Eastlack broke his leg while playing with his sister. Shortly afterwards, bone growths began to develop on the muscles of the boy’s thigh. Within years, the condition began to spread throughout Harry’s body so that by his mid-20s, his entire vertebrae had fused together. In 1973, Harry died of pneumonia, just four days before his 40th birthday. By that time, his body had completely ossified. Even his jaw locked up, leaving only his lips to move. Before he died, Harry had agreed to donate his body (pictured above, both alive and after death) to the museum for further scientific research, where it continues to be studied today.

Given the rarity of the condition, I was surprised to find an 18th-century skeleton showing the tell-tale signs of FOP in the Hunterian Collection at the Royal College of Surgeons in London. And yet there it was, catalogued simply as RCSH/P 804.


I wondered: whose bones were these? And how did they end up in the hands of the anatomist, John Hunter (below), for whom the collection is named after?

It turns out that when the surgeon, George Hawkins, died suddenly in 1783, he left behind a collection of anatomical specimens that were then auctioned off. Amongst them was the skeleton of an adult male with an excessive number of bony outgrowths on his rather twisted frame. Hunter—always on the lookout for rare and unusual specimens—purchased the skeleton for the extraordinary sum of 85 guineas. [3]

F6Records at the Royal College of Surgeons describe the skeleton as belonging to a 39-year-old man named Mr Jeffs. Hunter’s assistant, William Clift, later reported that he had been told that the skeleton had been buried for seven years before it was procured, presumably by Hawkins. According to Hunter,  this was ‘evident from the state of the softer parts of most of the bones’. [4]

Was this the body of the young boy whom had sought Freke’s help in 1736? If the boy was indeed 14-years-old, as Freke had guessed, that would put his death sometime around 1761. Add to that 7 years before his skeleton was recovered, and it is very possible the specimen now residing in the Hunterian Collection once belonged to the boy described in the letter.

F7Of course, like so many of the specimens residing in medical collections today, we will never be able to confirm the skeleton’s former identity. What I can say with some degree of certainty is that he must have suffered greatly in the 18th century. With no real way to manage his pain, everyday life would have been excruciating. It is also likely that he would have been unable to work at the end of his life. Depending on his financial circumstances, this could have been just as crippling as his debilitating condition.

Today, Mr Jeffs ‘stands’ next to Charles Bryne, the famous Irish Giant (right). Visitors to the Hunterian are often mesmerised by Byrne’s 7’7’’ frame, and rarely cast more than a fleeting glance at the twisted skeletal remains next to him.

Hidden in the shadows of something much bigger than himself, Mr Jeffs is to visitors what he likely was to surgeons in his day: a passing curiosity. His story, however, warrants further attention, for FOP remains incurable. There is still much to be learned from Mr Jeffs and his skeletal remains.

If you enjoy reading my articles, please consider becoming a patron of The Chirurgeon’s Apprentice. Support my content by clicking HERE.

1. Philosophical Transactions of the Royal Society 41 (January, 1753): pp. 369 – 370.
2. Qtd in Thomas Maeder, ‘A Few Hundred People Turned to Stone,’ The Atlantic (Feb., 1998). I cannot track down the original source for this quote; although I do know that most people incorrectly date this letter to 1692. Gui Patin died in 1672, and his letters were posthumously published in 1692.
3. L. W. Proger & J. Dobson, comps., Descriptive Catalogue of the Pathological Series in the Hunterian Museum of The Royal College of Surgeons of England, vol. 2 (1972), pp. 68-70.
4. Ibid.

Relic Face-Off: Trailer

We’re excited to release the trailer for a new mini-series on Under The Knife! In Relic Face-Off, contestants will be invited onto the show and asked to bring with them an object related to a chosen theme. I will then try to ‘one-up’ them with an object of my own, and the audience will be asked to vote in the comment section on which oddity they think is more fascinating. Click here to view.

In the first challenge, Chris Skaife–Yeoman Warder and Ravenmaster at the Tower of London–will face-off with me on TORTURE DEVICES. Please subscribe to our YouTube Channel for updates. We hope you enjoy the trailer (and the concept)!

Under The Knife – Episode 3: Victorian Anti-Masturbation Devices

In the 3rd Episode of Under The Knife, I discuss the medical thinking behind Victorian anti-masturbation devices, and the surprising history of one of the world’s most beloved breakfast cereals.  Alex Anstey, Adrian Teal and I have worked hard on this video – we hope you like it!

If you enjoy Under The Knife, please consider becoming a patron of our project. Producing high quality content is time-consuming and expensive, so we could really use your support! We’re offering fun perks, like postcards, DVDs, artwork and even a chance to get animated into the series! Click here for more info.

Holding a Book Bound in Human Skin

B3It is hot and muggy in the upstairs gallery of Surgeons’ Hall in Edinburgh. I walk past shelves upon shelves of jars that contain 18th-century specimens suspended in liquid: an amputated arm here, a cancerous bowel there. Compared with the lower level of the museum, it is eerily quiet up here. This section is not open to the public and so these objects are rarely gazed upon with such naked curiosity as I am experiencing now.

In this instance, I am not Dr Lindsey Fitzharris, medical historian. I am as inquisitive as any person who would be granted access to the collection up here, bubbling over with questions and observations about the bits of body parts floating before my eyes. But before I can seek answers to these questions, I must first view the object I’ve come to write about: a pocketbook bound in the skin of the 19th-century murderer, William Burke.

B2I make my way to the end of the gallery where the Director of Heritage, Chris Henry, is standing in the corner. In his gloved hand, he holds the notorious pocketbook which has attracted tourists from around the world to Surgeons’ Hall for decades. I have never seen it outside of a glass case. It looks less ‘sacred’ without the dim spotlights and laminated cards describing its origins.

It looks almost normal.

But of course, it isn’t normal. Far from it. In 1828, William Burke and William Hare murdered 16 people over the course of 10 months. Masquerading as bodysnatchers, the two murderers then sold the fresh corpses onto surgeons in Edinburgh where the bodies were then dissected in private anatomy schools dotted around the city.

Burke and Hare were eventually apprehended when one of their victims was discovered in the dissection room of Dr Robert Knox, who had been purchasing many of the suspiciously fresh bodies from the two men over the past several months. Hare turned King’s evidence and was released, while Burke took the blame and was sentenced to death. What awaited him at the end of the rope was much worse than even he could imagine.


Chris hands me a pair of white gloves. He’s an expert on this object, so the interview flows easily. He regales me with stories about how it came into existence, telling me that Burke’s body was privately dissected as a mob of several hundred people gathered outside the surgeons’ window demanding to be let in.

As Chris speaks, it suddenly happens. He hands me the pocketbook, almost as if he is handing me any book from a library shelf. I can’t feel it in the same way I would if I wasn’t wearing gloves, but I have a visceral reaction to the object nonetheless. This is the actual skin of a notorious murderer–a man I had been reading about for years in my own research.

Burke1This is the closest I will ever get to Burke’s physical self. It’s as if I’ve reached out and touched his arm, which of course I just may have given the material this object is made from.

After my initial reaction, I begin inspecting the pocketbook more carefully. It is remarkably well preserved considering this was meant to be a functioning item. Indeed, the original pencil that came with the pocketbook is still tucked neatly inside its covers. Looking at it, I can hardly believe someone would use it to carry money. Even for me–the Queen of Macabre–this is all a bit too much.

Its covers are soft and pliable after all these years, reminding me that this was indeed used on a regular basis. In faded gold letters, the front reads: BURKE’S SKIN POCKET BOOK. When I turn it over in my hands, the words–EXECUTED 28 JAN 1829–complete the story.

B5Emma Black, who heads public engagement at the museum, talks to me after the interview. As with any museum containing human specimens, Surgeons’ Hall has several pieces on display that are controversial. Interestingly, Burke’s skin book isn’t often mentioned as one of them. She wonders if, given the atrocity of the crimes committed, some of us have come to accept that this object is suitable for display. At the time, the dissection and book acted as a further punishment for Burke’s crimes and was seen as a form of justice which fitted the horrific nature of the murders themselves. Burke’s skeleton is also on display at the University of Edinburgh’s Anatomical Museum (right).

For me, however, the pocketbook is much more than this. It represents the growing need for bodies in the dissection room at the beginning of the 19th century, and the willingness by some anatomists to turn a blind eye to the dubious doings of those who procured the dead on their behalf.

In short, the pocketbook represents a dark and sordid part of our medical history.

After several minutes, I hand the pocketbook back to Emma. Once more back in its case, the object takes on that ‘sacred’ glow.

If you enjoy reading my articles, please consider becoming a patron of The Chirurgeon’s Apprentice. Support my content by clicking HERE.

*Please note that Surgeons’ Hall Museum is closed for redevelopment and will reopen in Summer 2015. 

Death is All Around Us: The Plague Pits of London


If you walk down Victoria Street in London on a beautiful, sunny afternoon, you’ll find dozens of picnickers sitting in Christchurch Gardens. Some will be suited up in jackets and ties, clutching briefcases in one hand and local supermarket sandwiches in another. Others will be tourists taking a moment to rest their wary bones before heading down the road to visit Parliament Square or Westminster Abbey. And then there are ‘the loungers’—youths sprawled out on bed sheets, iPods blasting in their eardrums, books pushed up to their noses.

Most if not all of these people will be unaware that they are sitting atop a 17th-century plague pit.

P6‘Death is all around us’ is not just a turn of phrase. It’s an actual fact, at least for those living in London. When the bubonic plague swept through the city in 1665, over 100,000 people perished. Those more poetically inclined might say these people ‘disappeared’ off the face of this Earth, as if by magic. But the truth of the matter is that they didn’t disappear. They suffered excruciating and agonizing deaths, and left behind thousands upon thousands of stinking, rotting corpses in the wake of their collective demise.

Where, exactly, did these bodies go?

Well, for starters, they were buried in Christchurch Gardens, and other areas of London which could accommodate burial pits in the 17th century. You can find them dotted all around the city, in places you wouldn’t expect because modern constructions like supermarkets, theatres and apartment buildings make it difficult to imagine a time when most of London was blissfully devoid of concrete structures. There are plague pits located in Vincent Square, Holywell Mount, and Knightsbridge Green—to name but a few. You can even find the remnants of one beneath Aldgate Underground Station. [For a comprehensive list, click here].

At first, those who died from the plague were laid to rest in churchyards, like the ‘ordinary’ dead. But as more and more people succumbed to the disease, the churchyards became overcrowded. On any given day, there could be as many as 300 deaths in a single parish. The poorer areas of London—where people were crammed together in terribly unhygienic conditions—were hit hardest. Even today, you can see the effects of the plague in Clerkenwell and Southwark, where the churchyards are above street level due to the number of bodies buried beneath.

The epidemiology of the disease contributed to the problem—something I discuss in detail in Episode 2 of Under The Knife. Plague is caused by a bacterium called yersinia pestis, and takes three forms: bubonic, pneumonic and septicemic. All three are highly contagious, though pneumonic is the worst since the bacterium is concentrated in the lungs which causes the victim to cough violently, spreading the disease to anyone in close proximity. Under the Plague Orders of 1666:

[I]f any House be Infected, the sick person or persons [shall] be forthwith removed to the said pest-house, sheds, or huts, for the preservation of the rest of the Family: And that such house (though none be dead therein) be shut up for fourty [sic] days, and have a Red Cross, and Lord have mercy upon us, in Capital Letters affixed on the door… [1]

In a period when the law dictated that you be literally shut up in the house where someone else had contracted a deadly disease, it is easy to understand how so many people perished so quickly.


At this time, funeral processions and other public gatherings were also suspended in a futile attempt to stop the spread of plague. In some parishes, people would come rumbling through the streets at night with large carts to collect the dead. Burials of plague victims were almost always done at night under the new regulations. This was done, again, to help control the spread of disease, as far less people would be out wandering the streets at midnight than would be at midday.

In the wake of this disaster, emergency pits were dug to dispose of the dead. Not only was this the quickest way to bury plague victims, but it was also the cheapest as many families were not able or willing to contribute to the cost of burial during this crisis.

In Daniel Defoe’s Journal of a Plague Year, he describes one such pit.

A terrible pit it was, and I could not resist my curiosity to go and see it. As near as I may judge, it was about forty feet in length, and about fifteen or sixteen feet broad, and at the time I first looked at it, about nine feet deep; but it was said they dug it near twenty feet deep afterwards in one part of it, till they could go no deeper for the water… [2]

P4Mass graves were never dug in London outside of epidemics, and contrary to popular belief, the dead were not thrown into them haphazardly. Excavations reveal that bodies were laid out in a respectful, orderly fashion. Nor can we assume the land used to bury plague victims was unconsecrated. The lack of documents on this issue is probably symptomatic of the fact that these pits came about at the height of the epidemic, when mundane tasks like record-keeping were not at the top of anyone’s ‘to-do’ list. [3]

It’s worth noting that burial pits in London were born out of necessity and not purely as a way of segregating infected bodies from non-infected bodies, like in many European cities. In 1630, Florence banned the burial of suspected plague victims in the city, insisting instead that they be buried ‘in the countryside far from the high roads, a hundred arms’-lengths from the houses’. In Paris, those who died from plague were allowed to be buried in churchyards, but not the church itself. In one instance, a young man was dug up several months after he died (when the danger of infection had passed) and reburied in his ancestral chapel alongside his other kin. [4]

So, who was given the grisly task of burying these plague-riddled bodies in the 17th century? Well, it’s difficult to know. Undoubtedly, local gravediggers took on some of the work. Also, people who had contracted and survived the plague might perform these grim duties, as the job could be quite lucrative. That said, officials knew how high mortality rates were amongst gravediggers and sometimes withheld payment while still expecting service. In Montelupo, Italy, two gravediggers were tortured after they threatened to begin burying plague victims in the mayor’s front garden because they hadn’t been paid. When the mayor himself perished from the disease, they gladly buried him! [5]


Today, we know of 35 plague pits located in London. Some have been excavated; some we know about because of contemporary sources. The majority of these sites were originally on the grounds of churches, but as the death toll rose, pits were also dug in fields surrounding the city.

The truth is that the total number of plague pits could easily be in the hundreds given the number of people who died during the epidemic. Sadly, we’ll never know. Many of these burial pits are lost to history, much like the names of the thousands of people who perished during the Great Plague.

If you enjoy reading my articles, please consider becoming a patron of The Chirurgeon’s Apprentice. Support my content by clicking HERE.


1. The National Archives, London. Orders for the prevention of the plague, 1666 (SP29/155 f.102).
2. Daniel Defoe, A Journal of the Plague Year (Penguin Classics edition, 1986), p. 246.
3. Vanessa Harding, ‘Burial of the Plague Dead in Early Modern London’, in Epidemic Disease in London, ed. J.A.I. Champion (1993), pp. 53-64.
4. Bibliothèque Nationale, Paris. MS Fr 32589 (extracts from parish registers of Saint André des Arts): burials on 5/11/1580, 15/9/1591 (exhumed and reburied 2/4/1592), 23/8/1606, 1/7/1628. Originally quoted in Harding, ‘Burial of the Plague Dead’.
5. Joseph P Byrne, Encyclopedia of Black Death (2012), p. 166.

Under The Knife – Episode 2: The Plague Doctor

In the 2nd Episode of Under The Knife, I discuss the history of bubonic plague and that notorious beaked mask that has come to symbolize one of the world’s most terrifying diseases. Alex Anstey, Adrian Teal and I have worked hard on this video – we hope you like it!

If you enjoy Under The Knife, please consider becoming a patron of our project. Producing high quality content is time-consuming and expensive, so we could really use your support! We’re offering fun perks, like postcards, DVDs, artwork and even a chance to get animated into the series! Click here for more info.