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Chiropractic History Assignment


June 7, 2010
By Steve Zoltai

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Instruction in anatomy is a fundamental cornerstone of the education of
all chiropractic professionals and dissection has been an integral part
of anatomy education for generations of chiropractors.

ANATOMY LESSONS
Instruction in anatomy is a fundamental cornerstone of the education of all chiropractic professionals and dissection has been an integral part of anatomy education for generations of chiropractors. For much of history, however, the internal arrangement of the human body has been the subject of philosophical debate, speculation and educated guesswork, and, not surprisingly, often has been grossly inaccurate. On the other hand, the methods used to teach human anatomy have changed relatively little over the centuries even though the content bears, at best, faint resemblance to what was taught in the past. For chiropractors, the roots of anatomy instruction begin in the distant past.

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Photo 1:  Rembrandt got it wrong: In The Anatomy Lesson of Dr. Nicolaes Tulp, Rembrandt mistakenly puts the origin of the exposed forearm muscles at the lateral epicondyle. He should have consulted Vesalius. Until Vesalius, much of the understanding of the internal arrangement of the human body relied on speculation or animal models.

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Anatomy education has been central in the teaching of western medicine since at least the Renaissance. While evidence of the study of anatomy extends as far back as New Kingdom Egypt – about 1600 BCE – the first recorded use of human dissection for anatomical research occurred in the fourth century BCE when the Greeks Herophilos and Erasistratus helped found the great medical school at Alexandria.1 Herophilos was the first to perform systematic dissections on the human body and established a core of anatomical knowledge enlightened by the actual structure of human anatomy. Until this time, much of the understanding of the workings of the human body relied either on speculation or extrapolations of function derived from animal dissections rather than empirical observation. Credited also with the discovery of nerves, Herophilos can lay legitimate claim to being the earliest and most distant ancestor of chiropractic.

A prohibition against human dissection by Rome in 150 BCE arrested this process of enlightened discovery and forced a return to the practice of broadly applying observations from animal dissection to human anatomy. In the second century CE, the Greek physician Galen compiled much of the knowledge obtained by earlier writers and formulated a body of physiological ideas that influenced all biological thought until the dawn of the modern scientific era.2 His collection of drawings, based mostly on ape anatomy, became the standard anatomy textbook for 1,500 years and helped inform – and confound – medical thinking for centuries.

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Photo 2: The Resurrectionists by Thomas Rowlandson, circa 1780.


 

With the collapse of the Roman Empire, scientific inquiry passed to the Arabic world which expanded on the knowledge of the ancients. Islamic physicians were among the earliest proponents of human dissection and postmortem autopsy. Foremost among Islamic scientists was Avicenna – considered the father of modern medicine – who combined his own research with that of traditional Islamic medicine, Galen, Aristotle and elements of ancient Persian, Mesopotamian and Indian medicine. The author of numerous medical treatises, his most influential work, The Canon of Medicine, which sought to explain the causes of health and disease, was completed in 1025. In it, Avicenna argued that, while the causes of disease may be elucidated by conjecture and reason, anatomical knowledge could only be gained through observation and dissection.3

The works of Galen and Avicenna, especially The Canon, which incorporated the teachings of both, were translated into Latin, and The Canon remained the most authoritative text on anatomy in European medical education until the 16th century. The earliest serious challenge to the accuracy of Galen’s depictions occurred in 1543 with Andreas Vesalius’ publication of the first modern anatomy textbook, De Humani Corporis Fabrica (Fabric of the Human Body). In compiling the classic text, Vesalius travelled to Italy, where sympathetic authorities made the bodies of executed criminals available to him. His drawings highlighted the sometimes major discrepancies between animals and humans and underlined the need for anatomical dissection to test speculation.  Moreover, Vesalius’s Fabrica re-established anatomy as a subject that relied on observations taken directly from human dissections.4

Although anatomical knowledge flourished in the 17th and 18th centuries, only certified anatomists were allowed to perform dissections, and then only under strict conditions. Dissections were social events open to the general public and sponsored by the city councilors, who often charged an admission fee. Many European cities had royal anatomists tied to local government. Nicolaes Tulp, featured in the 1632 Rembrandt masterwork, The Anatomy Lesson of Dr. Nicolaes Tulp, was both the mayor and official City Anatomist. Tulp was permitted only one public dissection of an executed criminal a year.5 In fact, Rembrandt’s depiction of the exposed forearm – officiously displayed by Tulp – is anatomically inaccurate, presumably because of the Dutch master’s own lack of access to accurate information concerning the internal human arrangement. Since Tulp fancied himself “The Vesalius of Amsterdam,” the hefty tome that Rembrandt features in the lower right corner is likely a reference to Vesalius’s iconic Fabrica.6,7  Rembrandt should have consulted it before committing oil to canvas.

Given the limited and unpredictable nature of public dissections, serious anatomy students were often compelled to travel around Europe from dissection to dissection during the course of their study. This process was complicated by the lack of modern means to slow decomposition, which meant that dissections had to be performed quickly before decay set in to the point where bodies became unusable. Italy was a favourite destination on the dissection tour because it alone allowed dissections on women.8

Anatomists largely finalized and systematized descriptive human anatomy in the 19th century. The demand for cadavers for research and medical instruction, however, grew so great that grave robbing became an overnight growth industry. There were also those not above giving nature a little assistance in order to acquire fresh specimens for the surgeon.

THE BODY SNATCHERS
If the public desire good surgeons and physicians these men must learn their anatomy. This can only be done by dissection of the human body.  – The Canada Medical Record, March 1884

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Photo 3: A 19th-century anti-ghoul device. Mortsafes were heavy iron contraptions of rods and plates, padlocked together to foil body snatchers. This example comes from Edinburgh, a hotbed of the Resurrection trade.


 

Motivated by the lack of legally available cadavers, medical students were often forced to rely on their own devices to obtain the raw material for their anatomy education. In Canada, body-snatching began almost the moment the first medical school opened its doors in Montreal in 1822. Francis J. Shepherd, a colleague of Sir William Osler, wrote in his Reminiscences of Student Days and Dissecting Room:

“When I was a medical student at McGill University, in 1869–73, nearly every subject for dissection was obtained illegally, by the old method of body-snatching. Although there was an Anatomy Act on the statutes of the Province of Quebec, and an Inspector of Anatomy, yet as no penalty was attached to the law it was never carried out. . . . On my return from Europe in the autumn of 1875, to assume the duties of Demonstrator of Anatomy, I found immediately that to provide subjects for the dissecting room I had to accept those obtained from “Resurectionists.” The body snatchers were usually medical students . . . who by the process of their nefarious occupation paid their fees . .  .”9

In one 1876 incident, The Montreal Daily Witness reported that a farmer living near Cornwall, Ontario, lodged a complaint with Montreal’s chief of police that the remains of his wife had been stolen from the churchyard in which she had been interred. The farmer and police officials “searched several medical colleges, and at length found the body on a dissecting table, cut up by the students’ knives. The farmer claimed the remains, and they were given up by the Dean of the Faculty, who was not, however, in the best humour, complaining that the Government was neglecting its duty in not providing subjects for the use of the College.” The students were even less amused having paid the sizable sum of $20 to $30 for each subject.10

Incidents of this kind were no less common in Ontario where, west of Kingston, the focus was on supplying the medical schools in Toronto. Perhaps the most gruesome involved a doctor in Waterloo. In 1859, a Dr. Frederick Christ was convicted of robbing a grave for the body of a child to make a skeleton. Apparently Dr. Christ had performed the operation on a number of bodies and made no secret of the fact. “One witness testified that he saw the doctor boiling what the doctor affirmed to be human bones in a kettle, another that he saw human bones in a tub in the doctor’s barn.”11 It appeared the accused was in the business of selling mounted skeletons to the local medical community.

Although Dr. Christ and an accomplice were each sentenced to three months in the common jail, in reality, practitioners of the Resurrection trade were virtually never prosecuted because authorities were aware of the limitations the law placed on the availability of cadavers for anatomy education and sympathized with the plight of the medical schools. There was the added concern that, as long as a lucrative trade in bodies existed, there would always be the temptation for criminals to secure salable product by committing murder –as in the celebrated case of Burke and Hare in Scotland in the 1820s – particularly where the freshness of cadavers fetched a premium. Hypothetically, at least, the trade also provided a convenient and profitable means for murderers to do away with their victims and abortionists to dispose of their less successful treatments.12

Eventually, “emphasis shifted from punitive legislation to the creation of laws that would make corpses available. An Act to Regulate and Facilitate the Study of Anatomy was passed in the Legislative Assembly of the Province of Canada in 1843 and later amended in 1883.”13 The Anatomy Act, in its various incarnations, allowed unclaimed bodies in government institutions to be turned over to the medical schools and provided the legal means to compel public institutions to comply. As a result, The Canada Medical Record was able to report in 1884 that “all that was required to make body-snatching a thing of the past was to grant a legitimate supply, and attach to the reception of a stolen body a heavy penalty.”14

In Part 2 of The Body in Question – Dodging a Bullet – the Chiropractic Branch of Second World War veterans spearhead efforts to have CMCC officially recognized as a School of Anatomy before a crucial deadline. Also: Duckie Tales and the future of human dissection in anatomy education.

It will appear in the July 2010 issue of Canadian Chiropractor magazine.

References:

  1. Barnes, Jonathan. Hellenistic Philosophy and Science. In Boardman, John; Griffin, Jasper; Murray, Oswyn (ed.) The Oxford History of the Classical World. Oxford University Press: New York, 1986: pp. 383-384.
  2. Miller, Jonathon. The Body in Question. London: Jonathon Cape Ltd, 1978: p. 146.
  3. Savage-Smith, Emilie.”Attitudes Toward Dissection in Medieval Islam”, Journal of the History of Medicine and Allied Sciences, 1995, 50 (1): pp. 67-110.
  4. O’Malley, C.D. Andreas Vesalius of Brussels, 1514-1564. Los Angeles: University of California Press, 1964: pp. 181-183.
  5. http://en.wikipedia.org/wiki/Anatomy_Lesson_of_Dr._Nicolaes_Tulp
  6. Rembrandt, Art Classics. New York: Rizzoli International Publications, 2006: p. 80.
  7. http://en.wikipedia.org/wiki/Anatomy_Lesson_of_Dr._Nicolaes_Tulp
  8. http://en.wikipedia.org/wiki/History_of_anatomy
  9. Andermann, Anne. “Respect for the Dead,” The Left Atrium, CMAJ, 2007, 176 (12): pp.1738-1739.           
  10. MacGillivray, Royce. “Body-Snatching in Ontario,” CBMH/BCHM, 1988, 5: p. 52.
  11. Ibid, pp. 53-54.
  12. Ibid, pp. 58.
  13. Francis, Deepa. “Bodysnatching in Canada,” The Left Atrium, CMAJ, 2001, 164(4): p. 530.
  14. The Canada Medical Record, Montreal, March, 1884: p. 142.

Steve Zoltai is the collections development librarian and archivist for CMCC and is a member of the Canadian Chiropractic Historical Association. He was previously the Assistant Executive Director of the Health Sciences Information Consortium of Toronto. He has worked for several public and private libraries and with the University of Toronto Archives. Steve comes by his interest in things historical honestly – he worked as a field archeologist for the Province of Manitoba. He can be contacted at szoltai@cmcc.ca.


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