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. It might be
changed easily. We agree with Mr. Mackenzie, that legislative
interference is necessary; we are satisfied that nothing will be done in
England without it. The plan which Mr. Mackenzie suggests is as follows:
1. That the clause of our criminal code, by which the dissection of the
dead body is made part of the punishment for murder, be repealed. 2.
That the exhumation of dead bodies be punishable as felony. 3. That no
diploma in medicine or surgery, be granted by any faculty, college, or
university, except to those persons who shall produce undoubted evidence
of their having carefully dissected at least five human bodies. 4. That
in each of the hospitals, infirmaries, work-houses, poor-houses,
foundling-houses, houses of correction, and prisons of London,
Edinburgh, Glasgow, and Dublin, and if need be, of all other towns in
Great Britain and Ireland, an apartment be appointed for the reception
of the bodies of all persons dying in the said hospitals, infirmaries,
work houses, poor-houses, foundling-houses, houses of correction, and
prisons, _unclaimed by immediate relatives, or whose relatives decline
to defray the expenses of interment_. 5. That the bodies of all persons
dying in these towns, and, if need be, in all other towns, and also in
country parishes, _unclaimable by immediate relatives, or whose
relatives decline to defray the expenses of interment_, shall be
conveyed to a mort-house appointed in the said towns for their
reception. 6. That no dead bodies shall be delivered from any hospital,
infirmary, work house, poor-house, foundling-house, house of correction,
prison, or mort-house for anatomical purposes, except upon the
requisition of a member of the Royal College of Physicians or of
Surgeons, of London, Edinburgh, or Dublin, or of the Faculty of
Physicians and Surgeons of Glasgow, and upon the payment of twenty
shillings into the hands of the treasurer, of the hospital, infirmary,
work-house, poor-house, foundling-house, house of correction, prison, or
other officer appointed to receive the same. [This is too large a sum.]
7. That no dead body shall be conveyed from a hospital, infirmary,
work-house, poor-house, foundling-house, house of correction, prison,
or mort-house, to a school of anatomy, except in a covered bier, and
between the hours of four and six in the morning. 8. That after the
expiration of twenty-eight days, an officer appointed for this purpose,
in each of the four towns above-mentioned, shall cause the remains of
the dead to be placed in a coffin, removed from the school of anatomy,
where the dead body has been examined, to the mort-house of the town and
decently buried. 9. That the expenses attending the execution of these
regulations, be defrayed out of fees paid by teachers and students of
anatomy, on receiving dead bodies from the hospitals, infirmaries,
work-houses, poor houses, foundling-houses, houses of correction,
prisons, and mort-houses.
To this plan there is but one objection, viz. that it is making the
bodies of the poor public property. The answer is, that the limitation
in the proposed law, which the objection does not notice, entirely
removes the weight of that objection. Though no maxim can be more
indisputable than that those who are supported by the public die in its
debt, and that their remains at least, might, without injustice, be
converted to the public use, yet it is not proposed to dispose in this
manner of the bodies of all the poor: but only of that portion of the
poor who die unclaimed and without friends, and whose appropriation to
this public service could, therefore, afford pain to no one. If any
concession and co-operation on the part of the public, for this great
public object is to be expected, and without concession and co-operation
nothing can be done, it is not easy to conceive of any plan which
requires less public concession or implies less violation of public
feeling. In point of fact it would put no indignity, it would inflict no
injury on the poor; it is the rejection of it that would really and
practically be unjust and cruel. The 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 will and must be. The rich will always have it in their
power to select, for the performance of an operation, the surgeon who
has already 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
rises to 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. The effect of the entire abolition of the practice of dissecting
the dead, would be, to convert poor-houses and public hospitals into so
many schools where the surgeon, by practising on the poor, would learn
to operate on the rich with safety and dexterity. This would be the
certain and inevitable result: and this, indeed, would be to treat them
with real indignity, and horrible injustice; and proves, how possible it
is to show an apparent consideration for the poor, and yet practically
to treat them in the most injurious and cruel manner.
Nor would the proposed plan be the means of deterring this class of
people from entering the hospitals. There is something reasonable in the
apprehension on which this objection is founded: but the answer to it is
complete, because it is an answer, derived from experience, to an
objection, which is merely a deduction from what is probable. The plan
has been acted on, and found 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.
The great advantages of the plan are, that it would accomplish the
proposed object, easily and completely, whereas the plan in operation
effects it imperfectly and with difficulty; and it would put an
immediate and entire stop to all the evils of the present system. At
once it would put an end to the needless education of daring and
desperate violators of the law. It would tranquillize the public mind.
Their 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 have stated, that the plan has been tried. Experience has proved its
efficacy. It was adopted with perfect success in Edinburgh 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. We have obtained from a friend in Paris,
a gentleman who is at the head of the anatomical department in that
city, the following account of the manner in which the schools of
anatomy are supplied. It is stated; 1. That the faculty of medicine at
Paris is authorized to take from the civil hospitals, from the prisons,
and from the depôts 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 2000 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 1000 or
1200. 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 of 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 investigation. 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 regarged as
the most ignorant of men.
It is time that the physicians and surgeons of England, should exert
themselves to change a system which has so long retarded the progress of
their science, and been productive of so much evil to the community. We
are persuaded, that there is good sense enough, both in the people and
in the legislature, to listen to their representations. We would advise
them to avail themselves of the means they possess to communicate
information to the people, and to make individual members of parliament
acquainted with the subject. With this view we would recommend the
whole body to act in concert, to appoint a committee for conducting the
matter, and to petition parliament, as soon as they shall have made the
nature of their claims, and the grounds on which they rest, more
generally known. If they act in co-operation with each other, and pursue
their object temperately, and steadily, we cannot but believe, that
their efforts at no distant period, will be crowned with success.
FOOTNOTES:
[1] Since the above was written, we have learned that this man has been
recently liberated, and his fine remitted.
[2] A winter never passes without proving fatal to several students who
die from injuries received in dissection.