The Evolution of the Public's Views on Autopsy & Dissection: From Ancient Greece to 19th Century England

BY KATE PORTER

ABOVE: Study from Andreas Vesalius’ De corporis humani fabrica libri septem (1543)

Popular crime TV shows like CSI, Bones, and Forensic Files have romanticized a distinct image of crime scene investigators, specifically depicting an unusual stigma around coroners and other death workers in the industry. Why are we as a society so disgusted and perhaps afraid of these professions? Why are doctors seen as heroic, while medical examiners are seen as creepy because they examine dead bodies? Just as other facets of science have been affected by societal impressions, the progression of medical autopsy and human dissection practices have also been largely influenced by public opinion. Whether it was backlash from religious authority or distrust from the general public, there were many centuries in which performing dissections proved to be extremely difficult for physicians. Many factors including religion, crime, public spectacle, and an increased thirst for knowledge have shifted public reaction to autopsy from disgust, to fear of punishment, to a morbid curiosity for anatomy, influencing the image of dissection and medical examiners throughout the centuries.

The Beginnings of Human Dissection

Born in the golden period of scientific inquiry in Ptolemaic Alexandria, Herophilus of Chalcedon (330-260 BC) is known as the first-ever anatomist, whose dedicated work would soon be cited by other famous anatomists such as Galen. Autopsy was a concept that originated during the times of Ancient Greece and means “to see one’s self” (1). Sanctioned by the royal family, Herophilus utilized the bodies of executed criminals for his work covering topics including, but not limited to, therapeutics, anatomy, and gynecology. However, he was known mostly for his phenomenal work on the nervous system; he most famously distinguished between the motor and sensory nerves and also described many other cranial nerves (2).

Before Herophilus, demons and spirits were seen as the causes and spreaders of disease; however, after his dedicated work, supernatural explanations began to slowly dissipate from the medical field. Despite his strong foundation in now-debunked humoral theory, he provided some pathological explanations for certain diseases, and was inspired by Aristotle’s work on animal vivisection to perform dissections on humans. The public did not react well to human vivisection, as it was considered amoral and religious taboo at the time. The Third Syrian War (246-241 BC) further devastated anatomical progress, as the Alexandrian fires caused a major loss of Herophilus’ findings and took a toll on the economy, thus affecting the funding of future anatomical experiments (3). Anatomical research would remain stagnant for almost 2000 years.

ABOVE: Portion of Veloso Salgado’s A Medicina Científica (1906) depicting Herophilus (right) teaching anatomy”

Christianity, particularly its view of the body as sacred, would continue to disparage human dissections for centuries. A misinterpretation of Pope Alexander III’s 1163 reforms on the roles church beneficiaries could perform only decreased the amount of potential anatomical scholars, as most men in scholarship at the time had some sort of religious affiliation. While it was banned for “clerics to involve themselves in the studies of physical nature and the canon (directive) was named... meaning ‘The church abhors blood,’” this was misinterpreted as a ban preventing clerics from practicing surgery or studying anatomy (2). This was clarified in 1231, when Holy Roman Emperor Frederick II would officially allow dissection in his hopes to further scientific progress, leading to the creation of several universities throughout Europe. The next few Popes would go back and forth on their positions on anatomical study, but in 1315 the first truly sanctioned human dissection since Herophilus was performed.

Major Medical Players of the 16th-18th Century

Towards the end of the 1400’s, there was a growing reinterest in anatomical study due to the popularization of the naturalism movement in art. This reinvigorated interest in the works of Galen and Herophilus, also reiterating ancient humoral theory of the body. Naturalism would not only gain contributions from artists such as Leonardo da Vinci, but also the famed anatomist Andreas Vesalius (1514- 1564). Looking to correct Galen’s earlier errors, as well as increase the knowledge of human anatomy, Vesalius was able to get a Paduan judge to approve autopsies in 1539. Only criminals could be the subjects of autopsies, but the judge made sure to schedule his executions at the convenience of Vesalius (1). Vesalius’ 1543 publication De Humani Corporis Fabrica Libri Septem (On the fabric of the human body) was rooted in logic and observation, showing a combination of anatomical knowledge and popular naturalistic art. The need for bodies quickly began to increase, and Vesalius was one of the first to point out that physicians should figure that problem out “for themselves.” This led to a rise of the “body business” – selling freshly procured bodies to medical schools at high prices. Medical schools only encouraged this business, instating ‘don’t ask, don’t tell’ policies for the received corpses (1). With hanged murderers being the only legal source for bodies, there was an enhanced need for autopsy subjects in the medical community. Families grew to be terrified of so-called ‘resurrection men’, and many resorted to hiring guards to protect their recently-buried loved ones (4). This unethical business would continue to thrive for the next several hundred years as the need for bodies swelled across Europe.

Trained with a Galenic and humanistic background at the University of Padua, William Harvey became yet another famed anatomist. Attending the autopsies of his own father and sister, Harvey encouraged the tradition of keeping anatomical knowledge within the family for further research. He valued the direct experience of cutting the body himself, rather than depending solely on text to learn anatomy. This stress on relying on the eyes caused him to be embraced by the surgical community, truly cementing his place among medical professionals. Published in 1628, his work Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus (Anatomical Account of the Motion of the Heart and Blood) catapulted him into the image of the hero of medicine we know today, but he was not universally celebrated. One critic of Harvey’s work went as far as comparing anatomists and surgeons to cannibals, and as a result the public image of autopsy was desecrated further.

ABOVE: From Harvey’s De Motu Cordis (1628)

Known to many as the “Father of Pathology,” Giovanni Battista Morgagni, a professor of anatomy at the University of Padua in the early 1700s, considered himself a medical practitioner as well as a clinical consultant to his colleagues. Inspired to remove any inaccuracies within his contemporaries’ work, such as those within Theophilus Bonetus’ treatise of 1679. Morgagni’s work would be cited by many anatomists and medical professionals in the future. In 1764, his most famous work, De Sedibus, was officially translated to English, allowing for the transfer of his knowledge to other Western areas. Translations comprised only about 40% of his work, with the rest remaining in his distinct Italian prose. Morgagni was devoted to promoting knowledge and scholarship of the human body. He acted not only as a clinician, but also a historian. Looking at past experiments and the work of comparative anatomy, he was able to conclude “that the nature and causes of any disease cannot be established without appropriate dissection of cadavers” (5). Focusing on gross anatomy rather than microscopic work, Morgagni performed many experiments on the venous system and utilized mechanical philosophy to explain how the system worked. Repulsed by this vicious vision of destroying the human body, the public commonly became frightened and sickened by the idea of death and the human cadavers. Some scholars argue that “initially [the public’s] reservations” with anatomists “were based on traditional issues like funerary ritual and family honour,” but with time there was “a fear of being buried alive and coming under the anatomist’s knife” (2). With the public still seeing anatomists as “dissection-crazed physicians” it was work from heroes like Vesalius, Harvey, and Morgagni that began to help place these physicians back into a more respected position within the medical community (6).

The Public Spectacle of Cadavers during the 18th-19th Century

Anatomic theaters for university lectures would become popular in the 1500’s, around the same time that graverobbing was at the forefront of the public’s mind. Tracing all the way back to the 14th century, the initial idea for the common placement of bodies began, with corpses being dumped in one primary location in the dungeon of the Chatelet. 1651 marked the beginning of record keeping of the corpses, denoting their names and ages when possible. At this time, the Paris Chatelet was associated with criminals, cementing the idea of a scary, unknown realm in the public’s eye. In 1713, it then became customary for the cadavers to be publicly displayed in order to be identified by family members. This shifted the public’s reaction of death from that of repulsion and fear to that of a public spectacle. Listed in guidebooks, the morgue became an infamous tourist attraction, allowing for increased chances of identification while also quenching the public’s morbid curiosity.

ABOVE: Le Grand Châtelet by Charles Meryon (1861)

The Murder Act of 1752 allowed the bodies of murderers to be publicly dissected in great exhibition halls. This caused the community to see dissection as a form of punishment increasing fear of anatomists and medical professionals throughout society. The infamous murders of William Burke and William Hare in 1828 fueled the fear of graverobbing and body-snatching, heightening the terror and disgust for anatomical work.

Public riots ensued, causing troops to be called to protect surgeons between 1803-1823. With the public in an uproar, the Selection Committee on Anatomy was formed in England in 1828 to consider the law and regulated the process for obtaining cadavers. This led to the creation of the Anatomy Bill, which tried to ease the public’s unease by taking dissection out of the bill and replacing it with ‘anatomical examination.’ Officially passed on August 1st, 1832, this act not only allowed criminals to be used by anatomists, but the ‘unclaimed poor’ as well. The public reacted angrily, but surgeons and anatomists respected the choice (4). Due to the obvious class bias, “dissection was perceived as a penalty for poverty” (2). Though there were unethical actions stemming from this act, some positive outcomes included the creation of illustrative guide books like Gray’s Anatomy, which displayed over 360 diagrams from dissections legalized by Anatomy Act (4).

With the rise of deaths and suicides in Paris, the morgue quickly became too small for the number of bodies it was receiving. A new morgue was built in 1864 to accommodate for the increase in deaths and to sustain the growing number of visitors to this newfound ‘attraction.’ Complete with a large exhibition hall for the cadavers, the morgue quickly adapted to the public’s growing curiosity for death. Collaborating with nearby universities, it became a custom for these cadavers to be used by students and faculty for anatomy classes. By the 1880’s, a refrigeration system was installed, reducing visibility and therefore taking away the attraction for tourists and lessening the spectacle of death that had been promoted by the institution. Accommodating for new collaboration with law enforcement, the building was split into distinct areas with a chemical analysis lab and a photography room for more adequate record keeping. This layout of the Paris Morgue was widely recapitulated throughout Europe, cementing a common image of a classic morgue. To assist with identification and the difficult task of preserving faces (due to their rapid decomposition) wax masks of the cadavers’ faces were popularly utilized. No longer simply a location to house bodies, the morgue shifted from a place of fear and revulsion to public spectacle. Law enforcement officials began to see the value of housing cadavers and began to collaborate with the morgue to identify victims of crimes, allowing for the progression of chemical analysis and preservation in forensic science (7).

ABOVE: Diagram from Gray’s Anatomy

By this time, more institutions were able to provide bodies for the increasing field of anatomy. By the late 1800’s charitable hospitals began to donate unidentified patients, while poor houses also sold the bodies of their deceased tenants to teaching hospitals. This greater availability of bodies would lead to the creation of several anatomical museums around Europe, solidifying the cadavers once as a public spectacle full of curiosities and valuable teaching information. One such museum was Rackstrow’s Museum, built in the late 18th century with over 6,000 human and animal specimens (8). With such mixed feelings from the public over the centuries, it is no wonder that working with the dead and performing autopsies, although respected, is still considered strange and peculiar by modern society.

Conclusion

Over the last several hundred years, death work and medical autopsy gained several different reactions from the European public. From disgust and fear to morbid curiosity and desire for spectacle, the public continued to change their opinion of human dissection. With the help from great anatomists like Herophilus, Vesalius, Harvey, and Morgagni, human dissection finally became a respected act among the medical community and other facets of society. The progression of anatomical knowledge was affected by society’s views of dissection; however, due to the work of these famous physicians who ignored society’s protests, we were able to procure a more complex image of the human body. Overall, these reactions to dissection and autopsy allow us to understand why death workers are still seen in an unusual light today.

ABOVE: Study from Andreas Vesalius’ De corporis humani fabrica libri septem (1543)