Houses of Death: Walking the Wards of a Victorian Hospital

9deb7918e7e1d5281d6cfba4eafb711dThe following blog post relates to my forthcoming book THE BUTCHERING ART, which you can pre-order here

Today, we think of the hospital as an exemplar of sanitation. However, during the first half of the nineteenth century, hospitals were anything but hygienic. They were breeding grounds for infection and provided only the most primitive facilities for the sick and dying, many of whom were housed on wards with little ventilation or access to clean water. As a result of this squalor, hospitals became known as “Houses of Death.”

L0059152 Trade card for a 'Bug Destroyer' Andrew Cooke, LondonThe best that can be said about Victorian hospitals is that they were a slight improvement over their Georgian predecessors. That’s hardly a ringing endorsement when one considers that a hospital’s “Chief Bug-Catcher”—whose job it was to rid the mattresses of lice—was paid more than its surgeons in the eighteenth century. In fact, bed bugs were so common that the “Bug Destroyer” Andrew Cooke [see image, left] claimed to have cleared upwards of 20,000 beds of insects during the course of his career.[1]

In spite of token efforts to make them cleaner, most hospitals remained overcrowded, grimy, and poorly managed. The assistant surgeon at St. Thomas’s Hospital in London was expected to examine over 200 patients in a single day. The sick often languished in filth for long periods before they received medical attention, because most hospitals were disastrously understaffed. In 1825, visitors to St. George’s Hospital discovered mushrooms and wriggling maggots thriving in the damp, soiled sheets of a patient with a compound fracture. The afflicted man, believing this to be the norm, had not complained about the conditions, nor had any of his fellow convalescents thought the squalor especially noteworthy.[2]

Worst of all was the fact that a sickening odor permeated every hospital ward. The air was thick with the stench of piss, shit, and vomit. The smell was so offensive that the staff sometimes walked around with handkerchiefs pressed to their noses. Doctors didn’t exactly smell like rose beds, either. Berkeley Moynihan—one of the first surgeons in England to use rubber gloves—recalled how he and his colleagues used to throw off their own jackets when entering the operating theater and don ancient frocks that were often stiff with dried blood and pus. They had belonged to retired members of staff and were worn as badges of honor by their proud successors, as were many items of surgical clothing.

llanionmilitaryhospitalmoreThe operating theaters within these hospitals were just as dirty as the surgeons working in them. In the early decades of the nineteenth century, it was safer to have surgery at home than it was in a hospital, where mortality rates were three to five times higher than they were in domestic settings. Those who went under the knife did so as a last resort, and so were usually mortally ill. Very few surgical patients recovered without incident. Many either died or fought their way back to only partial health. Those unlucky enough to find themselves hospitalized during this period would frequently fall prey to a host of infections, most of which were fatal in a pre-antibiotic era.

419c2b28d1b137197a21298b24a604c0In addition to the foul smells, fear permeated the atmosphere of the Victorian hospital. The surgeon John Bell wrote that it was easy to imagine the mental anguish of the hospital patient awaiting surgery. He would hear regularly “the cries of those under operation which he is preparing to undergo,” and see his “fellow-sufferer conveyed to that scene of trial,” only to be “carried back in solemnity and silence to his bed.” Lastly, he was subjected to the sound of their dying groans as they suffered the final throes of what was almost certainly their end.[3]

As horrible as these hospitals were, it was not easy gaining entry to one. Throughout the nineteenth century, almost all the hospitals in London except the Royal Free controlled inpatient admission through a system of ticketing. One could obtain a ticket from one of the hospital’s “subscribers,” who had paid an annual fee in exchange for the right to recommend patients to the hospital and vote in elections of medical staff. Securing a ticket required tireless soliciting on the part of potential patients, who might spend days waiting and calling on the servants of subscribers and begging their way into the hospital. Some hospitals only admitted patients who brought with them money to cover their almost inevitable burial. Others, like St. Thomas’ in London, charged double if the person in question was deemed “foul” by the admissions officer.[4]

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Before germs and antisepsis were fully understood, remedies for hospital squalor were hard to come by. The obstetrician James Y. Simpson suggested an almost-fatalistic approach to the problem. If cross-contamination could not be controlled, he argued, then hospitals should be periodically destroyed and built anew. Another surgeon voiced a similar view. “Once a hospital has become incurably pyemia-stricken, it is impossible to disinfect it by any known hygienic means, as it would to disinfect an old cheese of the maggots which have been generated in it,” he wrote. There was only one solution: the wholesale “demolition of the infected fabric.”[5]

fitzharris_butcheringart_021417It wasn’t until a young surgeon named Joseph Lister developed the concept of antisepsis in the 1860s that hospitals became places of healing rather than places of death.

To read more about 19th-century hospitals and Joseph Lister’s antiseptic revolution, pre-order my book THE BUTCHERING ART by clicking here. Pre-orders are incredibly helpful to new authors . Info on how to order foreign editions coming soon. Your support is greatly appreciated. 

 

1. Adrian Teal, The Gin Lane Gazette (London: Unbound, 2014).
2. F. B. Smith, The People’s Health 1830-1910 (London: Croom Helm, 1979), 262.
3. John Bell, The Principles of Surgery, Vol. III (1808), 293.
4. Elisabeth Bennion, Antique Medical Instruments (Berkeley: University of California Press, 1979), 13.
5. John Eric Erichsen, On Hospitalism and the Causes of Death after Operations (London: Longmans, Green, and Co., 1874), 98.

Pre-Order My Book! The Butchering Art

fitzharris_butcheringart_021417

I’m thrilled to reveal the cover for the US edition of my forthcoming book, THE BUTCHERING ART, which will be published by FSG on October 17th.

The book delves into the grisly world of Victorian surgery and transports the reader to a period when a broken leg could result in amputation, when giving birth in a squalid hospital was extraordinarily dangerous, and when a minor injury could lead to a miserable death. Surgeons—lauded for their brute strength and quick knives—rarely washed their hands or their instruments, and carried with them a cadaverous smell of rotting flesh, which those in the profession cheerfully referred to as “good old hospital stink.” At a time when surgery couldn’t have been more dangerous, an unlikely figure stepped forward: Joseph Lister, a young, melancholic Quaker surgeon. By making the audacious claim that germs were the source of all infection—and could be treated with antiseptics—he changed the history of surgery forever.

Many of you have been devoted readers of my blog since its inception in 2010, and I can’t thank you enough for your continued interest in my work. Writing a book has been the next logical step for a very long time. The idea of telling this particular story arose during a very difficult period in my life when my writing career was at risk. It is therefore with great pride (and some trepidation) that I am turning this book loose into the world, and humbly ask you to consider pre-ordering it. All pre-orders count towards first-week sales once THE BUTCHERING ART is released, and therefore give me a greater chance of securing a place on bestseller lists in October. I would be hugely grateful for your support.

Pre-order from any one of these vendors using the links below:

*Please note that THE BUTCHERING ART will also be published by Penguin in the United Kingdom, as well as several other publishers around the world. I’ll be revealing covers for these foreign editions in the coming months, along with information on where to buy a copy.

The Chimp & The Surgeon: A History of Heart Transplants

Today isn’t just Valentine’s Day. It’s also the end of Congenital Heart Defects Awareness Week. With that in mind, here’s a short piece on the history of heart transplants.

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When Boyd Rush, aged 68, was admitted to the University of Mississippi Medical Center on 23 January 1964, Dr James Hardy [below] was waiting for him. Hardy, who had been conducting research on organ transplantation since the mid-1950s and had successfully performed a lung transplant the year before, wanted to replace Rush’s heart with a human equivalent. Unfortunately, strict medical regulations did not recognise brain cessation as a sign of death, which meant that a surgeon had to wait till a person’s heart stopped before it could be used for transplantation.

_100On the day Rush was brought to the hospital, none were available. As the minutes passed, the situation became more and more critical.

‘The prospective recipient went into terminal shock at approximately 6 p.m., with a blood pressure of 70 and virtually without respiration except for the continued use of the mechanical ventilation through a tracheotomy tube’, Hardy later recalled in his memoirs. ‘Death was clearly imminent and it was obvious that if heart transplantation was to be performed, it had to be done at once’. [1]

Rush was wheeled into the operating theatre, where Hardy polled his surgical team about whether or not a transplant attempt should be made using a chimpanzee’s heart.

‘I polled each of the five primary members of the transplant team individually, and their votes were recorded. Four voted to proceed with transplantation… The fifth abstained’. [2]

The surgery went ahead even though everyone in the room was ‘well aware that any transplantation of a heart in man would be followed by public consternation’ and that ‘the use of a chimpanzee heart would augment the criticism immeasurably’. Hardy later described it as a ‘profoundly sober moment for all’. [3]

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Several hours later, Hardy and his team made history by performing the first ever heart transplant. The chimp’s heart beat for 90 minutes inside Rush’s chest, but unfortunately proved too small to keep its new human body alive. Hardy’s patient died shortly after the operation was complete.

Hardy’s decision to use a chimpanzee’s heart fell under immediate attack from both the public, as well as those within the medical community. The operation ‘precipitated intense ethical, moral, social, religious, financial, governmental and even legal concerns’, Dr. Hardy wrote years later. ‘We had not transplanted merely a human heart, we had transplanted a subhuman heart’. [4]

_100Undeniably, the heart is one of the most vital organs in the human body. Without it, we would die. However, the controversy that arose in the 1960s when Hardy implanted a chimpanzee’s heart into Rush had less to do with physiology than it had to do with philosophy. For thousands of years, the heart was considered to be the seat of the human soul. Over time, the scientific community came to recognise the role the brain played in human consciousness. Nevertheless, people continued to equate emotions with the heart. Indeed, to some extent, we still do this today.

The ‘criticism from the media and our peers was vicious’, Hardy’s daughter remembered. ‘Many believed that if you transplanted the heart, you transplanted the soul. Even at school, we were aware that people were upset. As a child, it was difficult to understand why’. [5]

Hardy’s systematic murder of chimpanzees for use of their organs was also controversial. Invited to speak at a surgical conference in New York City several days after the historic operation, Hardy was shocked when the moderator introduced him by saying: ‘In Mississippi, they keep the chimpanzees in one cage and the Negroes in another cage, don’t they, Dr. Hardy?’ [6]

_100Over the next several months, some of the criticism within the medical community waned after Hardy published a paper in the Journal of the American Medical Association in which he described the strict ethical guidelines he and his team had followed when evaluating both donor and recipient. [Note: for more about the use of animals in medicine, click here].

It wasn’t until 1967 that the first human-to-human heart transplant took place at the Groote Schuur Hospital in Cape Town, South Africa, where a young surgeon named Christiaan Barnard was experimenting with pioneering surgical procedures. Barnard’s patient was 55-year-old Louis Washkansky, who was suffering from incurable heart disease. Washkansky could either wait for death, or risk undergoing surgery.

‘For a dying man it is not a difficult decision because he knows he is at the end’, Barnard later recalled. ‘If a lion chases you to the bank of a river filled with crocodiles, you will leap into the water convinced you have a chance to swim to the other side. But you would never accept such odds if there were no lion’. [7]

So the surgeon and his patient waited for the right moment. Then one day in early December, a woman named Denise Darvall was brought to Barnard’s hospital after incurring fatal injuries in a car accident. She and Washkansky shared the same blood type; her heart was still healthy. On the 3rd, Barnard prepped his patient for surgery. Over the next 5 hours, he would successfully replace Washkansky’s diseased heart with Darvall’s healthy one.

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Washkansky’s new heart beat strongly and steadily. Unfortunately, due to a suppressed immune system, he contracted double pneumonia and died 18 days later. Nevertheless, his case would signal a turning point in the history of medicine.

Years later, Barnard recalled how the landmark surgery changed his life: ‘On Saturday, I was a surgeon in South Africa, very little known. On Monday, I was world-renowned’. [8] Barnard, more than Hardy, was celebrated for his accomplishments, appearing on the covers of magazines and touring the world with stories of his success.

_100Christiaan’s brother, Dr Mario S. Barnard, published a paper in the South African Medical Journal describing the historic operation. In it, he credited Hardy and the Mississippi team for paving the way, arguing that this earlier operation proved that ‘the feasibility of cardiac transplantation was now irrefutable’. [9]

Even after the first successful human-to-human heart transplant, surgeons continued to experiment with animal hearts. Between 1964 and 1977, sheep, baboon and chimpanzee hearts were transplanted into at least four adults, all of whom died within a few days of the operation. It wasn’t until 20 years after Hardy’s operation on Rush that surgeons were somewhat successful with a cross-species heart transplant.

On 14 October 1984, Stephanie Fae Beauclair was born prematurely with hypoplastic left heart syndrome, a rare congenital defect in which the left ventricle is severely underdeveloped. Baby Fae’s parents took her to Loma Linda University Medical Center in California, where they met with Dr Leonard Bailey.

‘In those days, the advice to parents was to leave the baby here to die or take it home to die’, Bailey recalled. [10]

Bailey, who had performed more than 150 heart transplants on various species over the past 6 years, offered the grief-stricken parents a second option. He proposed replacing their daughter’s defective heart with that of a baboon. On 26 October 1984, Bailey and his surgical team did just that.

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Baby Fae lived for 21 days, two weeks longer than any previous baboon heart transplant recipient. At a news conference following the child’s death, Bailey told reporters: ‘Infants with heart disease yet to be born will some day soon have the opportunity to live, thanks to the courage of this infant and her parents’. [11]

Shortly after this feat, surgeons abandoned inter-species heart transplants due to the high risk of infection that followed such operations.

Today, approximately 3,500 human heart transplants are performed annually worldwide. The vast majority of these are done in the United States. Due to the development of powerful anti-rejection drugs, 85% of patients survive up to one year after surgery; 75% make it to their third year.

And it all began on 23 January 1964 with the heart of a chimpanzee.

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

1.James Hardy, According to The World of Surgery 1945-1985: Memoirs of One Participant.
2. Ibid.
3. Ibid.
4. Ibid.
5. Quoted in Lynne Jeter, ‘Having a Heart-to-Heart’,
Mississipi Medical News (2008).
6. Quoted in Tony Stark, Knife to the Heart: The Story of Transplant Surgery (1996), p. 162.
7. Quoted in D. McRae, Every Second Counts: The Extraordinary Race to Transplant the First Human Heart (2007).
8. Quoted in Fred C. Pampel & Seth Pauley, Progress Against Heart Disease (2004), p. 78.
9. M. S. Barnard, ‘Heart Transplantation: An Experimental Review and Preliminary Research’, South African Medical Journal (30 December 1967), p. 12.
10. Quoted in Ansel Oliver, ‘Surgeon Bailey Reflects 25 Years After “Baby Fae”’, Adventist News Network.
11. Quoted in Claudia Wallis, ‘Medicine: Baby Fae Loses Her Battle’, Time Magazine (26 November 1984), p. 88.

Resurrecting the Body Snatchers: The Halloween Edition

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I’ve written about body snatchers several times on this site, and each time, readers ask for more. Given that it’s Halloween, I thought I would give into that request and return to the subject in a longer, more comprehensive article about these fascinating creatures from the early 19th century. Happy Halloween!

It is half past two in the morning on October 10th, 1777. The new moon casts a bluish light over St George’s burial ground off Hanover Square in London. Two men, clad in dark clothes, enter the cemetery. They have been tipped off by the grave-digger who accompanies them that the body of Mrs. Jane Sainsbury was buried earlier that day.

Carefully, they navigate around the tombstones until they come to the freshly dug grave. With spades and shovels, they begin soundlessly removing the dark, damp earth, digging deeper and deeper into the ground. Within fifteen minutes, they hit a hard, solid structure: the coffin. One man readies a cloth sack while the other two pry the lid open. A terrible odour escapes: the smell of death. The woman’s eyes have sunk deep into her skull. Her jaw hangs open, stretching her lips into a ghoulish grin.

All three struggle to remove the rotting corpse from its wooden enclosure and strip it of its clothes and burial shroud. Slowly, the woman’s fleshy remains are stuffed inside the sack, limb by limb. One snatcher tosses the woman’s possessions carelessly into the coffin while another silently shuts the lid. All three begin to shovel dirt back over the gravesite, hoisting the sack up as the hole slowly fills.

The job is finished in less than thirty minutes. [1]

_100The words ‘body snatcher’ conjure up all kinds of sordid images: crude men with fingernails caked in dirt; corpses crammed into sacks, bodily fluids leaking through the cloth; murder. But the truth is that relatively little is known about the men who stole away in the middle of the night to collect bodies for the anatomists and their students in the 18th and 19th centuries. Yet, they are an important and integral part of our medical past.

During the 17th century, medical students in London were not required to study anatomy or physiology through clinical dissection. The act of cutting open dead bodies was generally believed to be ‘noe more able to direct a physician how to cure a disease than how to make a man’. [2] This is not to say, however, that medical students knew nothing of anatomy. Many attended public dissections conducted by the Barber Surgeons Company. There, they observed and watched, but did not participate (see above, dissected skull from Museum of London Archaeology).

This changed in the 18th century with the proliferation of private medical schools that gave students an opportunity to learn anatomy through dissection. To do this, however, bodies were needed. Lots of bodies.

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From what little records exist, we know that body snatchers required some level of moonlight in order to conduct their work in cemeteries, although not all bodies were obtained through exhumation. The body snatchers might steal as many as six bodies in a single night and often worked in small gangs which fought each other for a monopoly over the cadaver trade. This might involve desecrating a graveyard that supplied bodies to a rival gang in order to arouse fury from the local population who would then secure the cemetery, making it difficult for future attempts.

_100Cemeteries underwent dramatic makeovers as the public’s fear over body-snatching escalated. Mortsafes (left)—or iron grills—were placed over gravesites to prevent snatchers from disturbing the dead. Loose stones were put on top of surrounding walls, making it nearly impossible to scale. Churchyards became fortified with spring guns and primitive land mines. Cemetery ‘clubs’ were formed in which members would watch new graves until ‘decomposition rendered the cadavers useless for anatomical instruction’. [3]

In one instance, a father—grieving over the recent loss of his child—enclosed a ‘small box, [with] some deathful apparatus, communicating by means of wires, with the four corners, to be fastened to the top of the coffin’. As the child was lowered into the ground, he threw gunpowder into the box so that ‘the hidden machinery [was] put into a state of readiness for execution’. [4]

During this period, a human corpse did not legally constitute property, and therefore punishment for stealing one was not nearly as severe as the general populace thought it should be. In 1832, two medical students in Inversek—a village just outside Edinburgh—were caught trying to steal a body from a local churchyard. After being kept in a private house over night, they were moved to a prison at their own request because they believed it was a ‘place of greater security from the threatened vengeance of the outraged citizens.’ The next day:

…a crowd of several hundreds assembled round the gaol, provided with axes and other implements to break it open, and do execution upon the offenders, who … had been previously remitted to the sheriff. [5]

_100The general population abhorred body snatchers and the surgeons who employed them, and went to great lengths to prevent their loved ones from ending up on the dissection table. Coffin collars, like the one seen on the right, were invented to thwart the inexhaustible efforts of the resurrection men. These was fixed around the necks of a corpse and bolted to the bottom of a coffin, making it nearly impossible to remove the body from its grave.

Cemetery guns, as well, were designed to keep body snatchers at bay. These were set up at the foot of a grave, with three tripwires strung in an arc around its position. Those unfortunate enough to stumble upon one in the dead of night may find themselves in a grave of their own.

As ingenious as these devices were, they only protected the dead whose families were wealthy enough to purchase them. It is not a surprise, then, that many of the bodies that ended up in the hands of the surgeons were those of the poor. Making the jobs of the body snatchers even easier was the fact that many paupers were buried in pits which would remain open, sometimes for several weeks. One resurrectionist wrote:

I like to get those of poor people buried from the workhouses, because, instead of working for one subject, you may get three or four; I do not think, during the time I have been in the habit of working for the school, I got half a dozen of wealthier people. [6]

Historian Ruth Richardson points out that the depth of pits varied ‘depending on land available, soil type, and the pecuniary interests of those involved in graveyard “management.”’ [7] Some pits were as deep as twenty feet. In St Botolph’s, Aldgate, two men died at the bottom of one such pit from asphyxiation after stumbling into it in the 1830s.

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The body snatchers continue to live in the public’s imagination as criminals of the lowest form, partly because so little is known about them. Reports about their alleged activities are often exaggerated in newspapers and literature from the period. In 1824, the surgeon, William Mackenzie, complained that a week rarely passed without ‘the circulation of exaggerated stories of atrocities in the procuring of subjects for dissection’. [8]

But, of course, body snatchers were hugely important to medical schools at that time. Their presence could not be avoided. On 8 October 1793, James Williams—a 16 year-old surgical student—described his living quarters in John Hunter’s anatomy school to his sister living in Worcester. He wrote:

My room has two beds in it and in point of situation is not the most pleasant in the world. The Dissecting Room with half a dozen dead bodies in it is immediately above and that in which Mr Hunter makes preparations is the next adjoining to it, so that you may conceive it to be a little perfumed. There is a dead carcase just at this moment rumbling up the stairs and the Resurrection Men swearing most terribly. I am informed this will be the case most mornings about four o’clock throughout the winter. [8]

Before the discovery of anesthetics, surgery was a brutal affair. The patient had to be restrained during an operation; the pain might be so great that he or she would pass out. Dangerous amounts of blood could be lost. The risk of dying was high; the risk of infection was even higher. The surgeon was so feared that in many cases, patients waited until it was too late before approaching one for help.

Dead bodies, on the other hand, could not scream out in agony, nor would they bleed when sliced open. In this way, the novice could learn how to remove a bladder stone or amputate a gangrenous arm at his own leisure, observing the anatomical structures of the human body as he went along. Ultimately, this prepared the student to operate on the living (see 19th-century dissection table below from the Science Museum, London).

18th/19th century wooden dissecting table from the Doctors, Diss

In this way, body snatchers were crucial to the advancement of medicine. Unfortunately, historians find it difficult to track them as they often use numerous aliases to hide their true identities. One snatcher may appear in multiple court records under half a dozen names. There is simply no way to know.

It is unlikely that many body snatchers were murderers. The punishment for stealing a body was too low; the punishment for murder was too high. The payout for a body was the same no matter how one procured it. Yet undeniably, the resurrection men are a part of the medical profession’s dark and sordid past—a past that for the most part has received only cursory acknowledgement.

Still, we must ask ourselves where we would be today without the body snatchers and the bodies which they stole.

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

 

1. Based loosely off a true account. The three body snatchers were eventually apprehended. One was acquitted while the other two were sentenced to six months imprisonment. They were paraded through the streets and whipped publicly. L. Benson, The Book of Remarkable Trials and Notorious Characters (1872?).
2. Probably the fragment of 1668, Anatomie, most of which is in John Locke’s hand. Originally quoted in Andrew Cunningham, ‘The Kinds of Anatomy’, Medical History (1975), p. 3.
3. Ian Ross and Carol Urquhart Ross, ‘Body Snatching in Nineteenth Century Britain: from Exhumation to Murder’, British Journal of Law and Society (Summer, 1979), p. 114.
4. J.B. Bailey, The Diary of a Resurrectionist: 1811-1812 (1896), p. 80.
5. True Sun, 29-5-1832. Originally qtd in Ruth Richardson, Death, Dissection and the Destitute (1987),
6. Ibid., p. 60.
7. Ibid.
8. MacKenzie, ‘An Appeal to the Public and to the Legislature, on the Necessity of Affording Dead Bodies to the Schools of Anatomy, by Legislature Enactment’, Westminster Review (1824), pp. 83-86.
9.Qtd in Jesse Dobson, John Hunter (1969), p. 178.

Ten Terrifying Knives from Medical History

I’m excited to announce that I’ve just finished filming the first episode of my new YouTube series, Under The Knife, and will be releasing it very soon (please subscribe to my channel for video updates). Unsurprisingly, that got me thinking about, well, knives. Here’s a list of some rather terrifying knives from our medical past.

  1. VALENTIN KNIFE, 1838. This knife was one of the few able to cut slices of organs and soft tissues for microscopic examination. The double-bladed knife worked best when the blades were wet – best of all when submerged in water. Named after its inventor, Professor Gabriel Valentin (1810-1883), a German-Swiss physiologist, the knife was invented in 1838. This example, however, dates from 1890.

  2. BISTOURY CACHÉ, c.1850. Invented in the mid-19th century, bistoury caché literally translates from the French as ‘hidden knife’. The device was used to cut internal organs or to open cavities, particularly during the surgical removal of a bladder or kidney stone – a practice known as lithotomy.
  3. CIRCUMCISION KNIFE, c.1775. Circumcision – the removal of the foreskin of the penis – is practised across the world often for cultural and religious reasons. In some countries it is also promoted for reasons of hygiene and health. This knife dates from the late 18th century.
  4. CATARACT KNIFE & NEEDLE, 1805. Georg Joseph Beer (1763-1821), an Austrian professor of ophthalmology, invented this cataract knife and needle around 1805. Cataracts cause blurred vision as the lens becomes cloudy and if left untreated can cause blindness. These instruments allowed for the surgical removal of some of the cloudy mass and, if necessary, part or all of the lens itself. Prior to effective anaesthetics, this was an excruciatingly painful process. This particular example dates from 1820.
  5. ORTHOPEDIC KNIFE, 1855. William Adams (1820-1900), an English surgeon, invented this type of knife for his new procedure called periosteotomy in 1855. This involved un-fusing the bones of the hip joint by cutting the neck of the femur (upper leg bone). He affectionately called it ‘my little thaw’, because the knife was used to cut through and ‘melt’ fused bones.
  6. LISTON KNIFE, c.1830. Robert Liston (1797-1847), a Scottish surgeon renowned for his speed and precision in surgery, invented this double-edged amputation knife in the 1830s. This particular example is made of steel with a nickel-plated handle. Nickel plating was introduced in the 1890s and meant that the knife could be boiled without it rusting and was therefore ideal for aseptic surgery. It was made by Down Bros, a leading surgical instrument maker, in the 1920s.
  7. SYRIAN SURGICAL KNIFE, c.900 AD. Most of the blade of this ancient surgical knife is rusty and part of it is broken. The steel blade is slotted into a brass handle. The loop at the end may have been used as a finger hole for gripping. This knife dates to a period when the Islamic world became a major centre for medical study and practice.
  8. PLAGUE LANCET, c.1600. Plague epidemics ravaged Marseilles in France throughout the 17th and 18th centuries. Lancets, such as the copy shown here, were used to open buboes in order to relieve pressure and also remove poisons from the body – an unsuccessful attempt to cure the patient. The lancet would have been stored in a brass case.
  9. DOUBLE BLADED LITHOTOME, 1812. This object was used to cut the bladder in order to remove stones – a practice known as lithotomy. Baron Guillaume Dupuytren (1777-1835), a French surgeon and pathologist, invented this double bladed lithotome for the bi-lateral lithotomy procedure he developed in 1812. This procedure became widely used from the 1850s onwards, and this example dates from 1825.
  10. FALCIFORM AMPUTATION KNIFE, c.1700. The curved shape of this amputation knife was common in the early 1700s. Amputation knives became straighter once the practice of leaving a flap of skin to cover the limb stump became the preferred amputation method. Ebony was a common material for handles as it is a hard-wearing wood. This knife was probably made by Eberle in Germany, as indicated by the inscription on the silver blade.

     

WARNING: TOXIC! The Deadly Dead

When a person thinks of anatomical specimens from the past, he or she may think of disembodied remains floating in glass jars filled with alcohol. The Hunterian Collection at the Royal College of Surgeons in London is full of such specimens—unborn foetuses suspended in time as if still incubating in the womb; a hand, puffy and swollen from chronic lymphedema; a pock-marked face submerged in yellowing liquid.

But not all specimens were preserved in this way. Beginning in the middle of the 18th century, surgeons and anatomists began experimenting with arsenic and mercuric chloride as a means of preserving human remains.

Of course, arsenic had long been used for medicinal purposes before it was ever used for preservative purposes. It was prescribed in small doses for all types of disorders including tuberculosis, rheumatism, and syphilis. During the 15th century, William Wirthering remarked: ‘Poisons in small doses are the best medicines; and the best medicines in too large doses are poisonous.’ [1]

Soon, however, surgeons and anatomists began recognising the preservative qualities of arsenic when creating dry mount displays from cadaverous remains. Mixtures of arsenic and soap were sometimes used to bathe the insides of a specimen in order to prevent decomposition and insect infestation. This method, invented by the French ornithologist Jean-Baptiste Becoeur (1718 – 1777), was especially popular with taxidermists. In fact, arsenical soap was used in museums around the world until the 1980s when it was finally banned due to its dangerous levels of toxicity.

In 1838, the French chemist, Jean Gannal, introduced a new method for preserving human remains using arsenic as a main ingredient. This was intended to allow anatomists to dissect corpses or prepare anatomical specimens without worrying about putrefaction or decay. He described his method as such:

[A] corpse is injected by the carotid with from five to seven quarts of the acetate of alumina at 20°, and containing in solution about two ounces (fifty grammes) of arsenic acid. Four days after this injection, if it is intended to prepare the large and small vessels, inject by the aorta half a quart of a mixture, equal parts, of the essence of turpentine and essence of varnish; finally, make a single cast of a hot injection of a mixture of suet and of rosin, in equal parts, coloured with cinabar [sic] for arteries, and with a black or blue colour for the veins. Then, the corpse, or the part of the corpse which it is intended to preserve, is prepared and dissected at leisure, according to the wish of the operator. [2]

By 1846, however, Gannal’s technique was outlawed in France. This was due in part to the fact that anatomists themselves were suffering the effects of arsenic poisoning.

Around the same time, anatomists also began using mercuric chloride as a preservative. The specimens were dipped in the solution, or painted with it.  Mercury, as well as arsenic, had also been used for medicinal purposes during the early modern period, when its toxic qualities had not yet been fully recognised.

Today, these types of anatomical specimens pose all sorts of dangers to museum staff who might be handling or interacting with these objects on a regular basis. Both substances can be absorbed through the skin. In cases of arsenic poisoning, severe headaches and confusion first appear, followed by discolouration of skin and fingernails, convulsions, stomach pain, hair loss and eventually death. (Find out here what happens if you ingest arsenic).

Unfortunately, there is no way of knowing whether arsenic or mercuric chloride is present simply by looking at a specimen.  Many curators have turned these objects over to laboratories for testing, while others have developed their own methods for determining whether specimens are toxic. Nonetheless, the fact remains that any of the dry mount specimens lurking in museums and private collections are potentially hazardous, as was discovered in this episode of Oddities.

It turns out what you don’t know can in fact hurt you.

1. Qtd in S. M. Aronson, ‘Arsenic and Old Myths’, R I Med (1994) 77: 233-234.
2. J. N. Gannal, Preparations in Anatomy, Pathology and Natural History (1838), translated by R. Harlan (1840), p. 182.