dissection is on many accounts highly repulsive: it is even not without
danger to life itself.[A] To men of clear understandings, to those
especially of a philosophical turn of mind, the pursuit is its own
reward; they are so fully satisfied that the more it is cultivated the
more satisfaction it will afford, that they need no stimulus to induce
them to undergo the drudgery. But this is by no means the case with
ordinary minds. The fatigue and disgust of the dissecting-room are
appalling to them, and they need the stimulus of necessity to urge them
to the task. The court of examiners of the College of Surgeons requires
from the candidates for surgical diplomas certificates that they have
gone through at least two courses of dissections; the examiners at
Apothecaries’-hall do not require such certificates. The consequence is,
that many young men content themselves with attending lectures, and with
passing their examinations at Apothecaries’-hall, and do not apply for a
diploma at the College of Surgeons. This single fact is sufficient to
demonstrate to the public that, instead of throwing obstacles in the way
of dissection, it is a duty which they owe to themselves to afford every
possible facility to its practice, and to hold out to every member of
the profession, the most powerful inducements to engage in it, by
rewarding with confidence those who cultivate anatomy, by making
excellence in anatomy indispensable to all offices in dispensaries and
hospitals, and by thus rendering it impossible for any one who is
ignorant of anatomy, to obtain rank in his profession. When a candidate
presents himself for a diploma in Denmark, in his first trial he is put
into a room with a subject, a case of instruments, and a memorandum, and
informed that he is to display the anatomy of the face and neck, or that
of the upper extremity or that of the lower extremity: that by the
anatomy is to be understood, the blood-vessels, nerves and muscles; and
that as soon as he has accomplished his task, the professors will attend
his summons to judge of his attainments. These professors are the true
examiners!
We shall have entered into the discussion of this subject to little
purpose, if we have not produced in the minds of our readers a deep
conviction, that anatomy ought to form an essential part of medical
education; that anatomy cannot be studied without the practice of
dissection; that dissection cannot be practised without a supply of
subjects, and that the manner in which that supply is obtained in
England is detestable and ought immediately to be changed.
The plan we would propose to substitute is the following:--
1. That the bodies of those persons who die in all infirmaries and
hospitals throughout the kingdom, _unclaimed by immediate relatives_, be
appropriated to the purpose of anatomy.
2. That the bodies of those persons who die in all work-houses and
poor-houses be appropriated to the same purpose.
3. That the bodies of those persons who die in all houses of correction,
in all prisons, and in the hulks, be thus appropriated.
An objection may be anticipated to such an appropriation of the bodies
of those who die in infirmaries and hospitals. And it is admitted, that
in the present state of public feeling it would not be right thus to
appropriate the bodies of _all_ who die in those public charities. But
this is not proposed: what is proposed is to appropriate to this use the
bodies of those ONLY _who die unclaimed by immediate relatives_. No
reasonable objection can be urged to this measure thus guarded. No one
who has not inquired into the subject can have any conception of the
number of persons who die in the public hospitals in London, unvisited
by friends during life, unclaimed by them after death. Surely to devote
to this use the bodies of those who die under such circumstances can
inflict no wound on any private individual--can violate no public right.
Still there is one objection to the measure which is specious but not
solid. It is urged that it might be the means of deterring this class of
persons from entering the hospitals. The answer to this objection is
complete, because it is an answer derived from experience. The measure
has been actually adopted, and found in practice to be unattended with
this result: it was tried in Edinburgh and the hospital was as full as
it is at present: it is universally acted on in France, and the
hospitals are always crowded.
It has been stated that this plan has been tried in Edinburgh, and that
experience has proved its efficacy. It was, in fact, adopted in that
city with perfect success more than a century ago. In the Council
Register for 1694, it is recorded that all unclaimed dead bodies in the
charitable institutions or in the streets, were given for dissection to
the College of Surgeons, to one or two of its individual members, and to
the professor of anatomy. This regulation, at that period, excited no
opposition on the part of the people, but effectually answered the
desired object. All the medical schools on the continent are supplied
with subjects, by public authority, in a similar manner. The following
account of the mode in which those of Paris in particular are supplied,
has been obtained from the gentleman who is at the head of the
anatomical department in that city. It is stated; 1. That the faculty of
medicine at Paris is authorized to take from the civil hospitals, from
the prisons, and from dépôts of mendicity, the bodies which are
necessary for teaching anatomy. 2. That a gratuity of eight-pence is
given to the attendants in the hospitals for each body. 3. That upon the
foundation by the National Convention, of schools of health, the
statutes of their foundation declare, that the subjects necessary for
the schools of anatomy shall be taken from the hospitals, and that since
this period, the council of hospitals, and the prefect of police, have
always permitted the practice. 4. That M. Breschet, chief of the
anatomical department of the faculty of Paris, sends a carriage daily to
the different hospitals, which brings back the necessary number of
bodies: that this number has sometimes amounted to 2,000 per annum, for
the faculty only, without reckoning those used in L’Hôpital de la Pitié,
but that since the general attention which has recently been bestowed
upon pathologic anatomy, numbers of bodies are opened in the civil and
military hospitals, and that the faculty seldom obtain more than 1,000
or 1,200. 5. That, besides the dissections by the faculty of medicine,
and those pursued in L’Hôpital de la Pitié, theatres of anatomy are
opened in all the great hospitals, for the pupils of those
establishments: that in these institutions anatomy is carefully taught,
and that pupils have all the facilities for dissection that can be
desired. 6. That the price of a body varies from four shillings to eight
shillings and sixpence. 7. That after dissection, the bodies are wrapt
in cloths, and carried to the neighbouring cemetery, where they are
received for ten-pence. 8. That the practice of exhumation is abolished:
that there are insurmountable obstacles to the return to that system,
and that bodies are never taken from burial grounds, without an order
for exhumation, which is given only when the tribunals require it for
the purpose of medico-legal investigations. 9. That though the people
have an aversion to the operations of dissection, yet they never make
any opposition to them, provided respect be paid to the laws of decency
and salubrity, on account of the deep conviction that prevails of their
utility. 10. That the relatives of the deceased seldom or never oppose
the opening of any body, if the physicians desire it. That all the
medical students in France, with scarcely any exception, dissect, and
that that physician or surgeon who is not acquainted with anatomy, is
universally regarded as the most ignorant of men.
To the other parts of the plan proposed above for supplying the
anatomical schools in Great Britain, there appears to be no objections
whatever. No one can object to such a disposal of the bodies of those
who die in prisons; no one can reasonably object to such a disposal of
the bodies of those who die in poor-houses. These persons are pensioners
upon the public bounty: they owe the public a debt: they have been
supported by the public during life; if, therefore, after death they
can be made useful to the public, it is a prejudice, not a reason--it is
an act of injustice, not the observance of a duty, which would prevent
them from becoming so. It is true that many of these persons are honest
and respectable; and have been reduced to indigence by misfortune: were
they all so it would not alter the state of the argument. Some
concession and co-operation on the part of the public, for this great
public object, is indispensable, without which nothing can be done: but
if any concession be made, it can be made with respect to this class of
persons better than any other, because it can be made with less
violation of public feeling. Nor is any indignity either intended or
offered to these persons. They are appropriated to this service not
because they are poor, but because they are friendless: because, that
is, no persons survive them who take such an interest in their fate as
to be rendered unhappy by this disposal of their remains. That they are
without friends is no good reason why their memory should be treated
with indignity; but it is a good reason, it is the best possible reason
why they should be selected for this public service. Poverty, it is
true, is a misfortune: poverty, it is true, has terror and pain enough
in itself: no legislature ought by any act to increase its wretchedness;
but the measure here proposed is pregnant with good to the poor, and
would tend more than can be estimated to lessen the misery of their
condition. For it would give knowledge to the lowest practitioners of
the medical art; that is, to the persons who are at present lamentably
deficient, and into whose hands the great bulk of the poor fall. And,
after all, the true question is, whether the surgeon shall be allowed to
gain knowledge by operating on the bodies of the dead, or driven to
obtain it by practising on the bodies of the living. If the dead bodies
of the poor are not appropriated to this use, their living bodies must
be--and will be. The rich will always have it in their power to select,
for the performance of an operation, the surgeon who has signalized
himself by success: but that surgeon, if he have not obtained the
dexterity which ensures success, by dissecting and operating on the
dead, must have acquired it by making experiments on the living bodies
of the poor. There is no other means by which he can possibly have
gained the necessary information. Every such surgeon who has attained
deserved eminence, must have risen to it through the suffering which he
has inflicted, and the death which he has brought upon hundreds of the
poor. What would be the immediate and constant effect of an abolition of
the practice of dissecting the dead? It would be to convert poor-houses
and public hospitals into so many schools where the surgeons, by
practising on the living bodies of the poor, would learn to operate on
those of the rich with safety and dexterity. Thus the poor would be
tortured, and many of them would be put to death in order that the rich
might be saved from pain and danger. This would be the certain and
inevitable result--this would indeed be to treat this class of the
people with real indignity and horrible injustice, and proves how
possible it is to show an apparent consideration for the poor, and yet
practically to abuse them in the most cruel manner.
The plan now proposed for remedying the evils which have been stated
would accomplish the object easily and completely: it would inflict no
injury on any private individual: it would do no violence to the public
feeling: it would render the dread of anatomy, as far as that dread were
really operative, directly beneficial to the community: it would
terminate at once the evils of the present system: it would put an end
to the education of daring and desperate violators of the law: it would
tranquillize the public mind: the dead would rest undisturbed: the
sepulchre would be sacred, and all the horrors which the imagination
connects with its violation would cease for ever.
We submit these observations to the calm and serious consideration of
our countrymen. We address them especially to the members of our
legislature. Upon the attention of the latter we would particularly urge
this further consideration, the importance of which they well know how
to estimate. In consequence of the difficulty of procuring subjects in
England, every medical student in Great Britain who can possibly afford
the time now goes to Paris to perfect himself in anatomy. Accordingly
the number of English students in Paris is already immense: that number
increases rapidly every year: it increases by the desertion of the
schools in Edinburgh and London. The consequence is obvious, and will be
surely and deeply felt in a few years. Anatomy will be neglected in
England, and for this indispensable branch of knowledge England will
become entirely dependent on France. There cannot be a doubt that there
is good sense enough among the people of England to submit to whatever
regulations may be necessary to prevent evils so serious and so fatal,
provided such regulations are framed in a proper spirit, and observed
with a due regard to decorum, and it is certain that those persons who
co-operate to establish these regulations will ultimately receive, as
they will deserve, the gratitude of their country.
FINIS.
T. C. Hansard, Pater-noster-row Press.
FOOTNOTE:
[A] A winter never passes without proving fatal to several students who
die from injuries received in dissection.