Death, Dissection, and the Destitute

by Ruth Richardson

In the early nineteenth century, body snatching was rife because the only corpses available for medical study were those of hanged murderers. With the Anatomy Act of 1832, however, the bodies of those who died destitute in workhouses were appropriated for dissection. At a time when such a procedure was regarded with fear and revulsion, the Anatomy Act effectively rendered dissection a punishment for poverty. Providing both historical and contemporary insights, Death, Dissection, and the Destitute opens rich new prospects in history and history of science. The new afterword draws important parallels between social and medical history and contemporary concerns regarding organs for transplant and human tissue for research.

Genres: History, Nonfiction, Death, Science, Medicine, Medical, Politics

426 pages, Unknown Binding

First published January 1, 1983

Reviews

[Elaine · Rating 5 out of 5]

I purchased this book at the Museum of London, where I went to see their recent exhibition on the study of anatomy and bodysnatching. It is a fascinating read for anyone interested in medical history.

Richardson focuses the book on the British 1832 Anatomy Act, by which the state laid claim to any "unclaimed" bodies in hospitals and workhouses and allowed them to be given to anatomists for dissection. To analyse the impact of the Act, Richardson provides a background study of the human corpse in British culture, looking at religious concerns and funeral customs. She also looks at the development of the study of anatomy and how the dissection of human bodies became the focus of medical training, creating a large demand for corpses. The unwillingness of the public to offer their bodies for this purpose led to freshly buried bodies being stolen from graves in the night and offered for sale at anatomy schools. This would culminate in the creation of bodies via murder by the infamous "burkers". It was the scandal over "burking" that ultimately prompted the Government to legislate for the provision of corpses for study.

Richardson is very thorough in her approach and takes a good look at the social, medical and highly political aspects of this intriguing piece of legislation. Whilst seemingly a measure that would benefit medical progress and ultimately the good of everyone, she illustrates how it was also a shrewd and intentional social project, designed to specifically target only those who were least able to defend themselves. In this new edition of the book, Richardson has also included a new Afterword in which she updates her work and discusses the Anatomy Act in the light of more modern debates about compulsory organ donation.

A thought-provoking and absorbing read.

[Jerrod · Rating 4 out of 5]

Two sentence review: Death, Dissection, and the Destitute provides a great overview of the various issues (economic, social, cultural) involved in the illegal and legal allocation of corpses in nineteenth century England. While there are flaws (especially in Richardson's evaluation of the alternative sources of corpses), this book would make an excellent companion to a class or lecture on the economics of black market goods.

I found this history of the Anatomy Act truly engrossing. Richardson does a nice job of describing the market for bodies before and after the Anatomy Act. Some of the most fascinating tidbits were the descriptions of how ordinary people (rich and poor) tried to mitigate the risk of having their loved ones' bodies taken. There were the huts in which bodies were locked until they started putrefying, making them worthless to "resurrectionists". The rich could afford vaults in the church and iron coffins, making their bodies much harder to steal. The poor set up night watches to protect the bodies of deceased loved ones. There was always the option to riot as well. Some hospitals and anatomy schools were destroyed through this violent collective action when evidence of body snatching emerged. Even planned dissections of murderers made the anatomist performing the dissection unsafe. There is a little bit of industrial organization in the description of how hospitals and large medical schools associated with them have an easier time getting bodies (both before and, especially, after the anatomy act) and that the restriction on certification of anatomy schools tended to increase market power of established schools and lead to concentration of schools in more urban areas, leaving areas outside of large cities without anatomy schools (this reduced the potential of utilizing corpses from rural areas due to the time it took to deliver corpses to the cities).

Richardson also discusses the industrial organization issues of setting up a market in corpses. Does this lead to increased murders a la Burke and Hare? If people can preemptively sell their corpses, does the potential of family members reneging foreclose the possibility of a functioning market? Given the Burke and Hare murders, some might conclude that a market in bodies inherently incentivizes murder, but keep in mind that these murders also occurred while the market for corpses was forbidden. It is plausible that with some sort of clearinghouse or central source of bodies, those incentives would be much reduced, just like the incentive for violence in the drug trade is reduced when drugs are legalized.

There are a few nitpicky things that I didn't enjoy about the book:
- As with most sociologists/anthropologists, Richardson is willing to condemn the superstitions of those in power without critiquing the beliefs of the poor. That is par for the course and is expected.

- After several pages describing the class distribution of robbed graves (poor are more affected because the "mass" graves are easier to obtain bodies from (there're scale economies from robbing mass graves)), Richardson approvingly quotes Wakley who, in critiquing a proponent of the Anatomy Act, claims the "resurrectionists have no respect for classes". While middle and upper class bodies were taken pre-Anatomy Act, it seems disingenuous to imply that the bodies of those classes were stolen at anywhere near equal rates as those of lower classes.

- The alternatives (bequests, importation from abroad, and purchase of bodies) to retrieving "unclaimed bodies" from poor houses and hospitals that Richardson suggests were certainly not actually feasible alternatives. She provides all the rebuttals to these alternatives throughout the text. No way would Georgian and Victorian society norms allow for the open sale of corpses (think Al Roth's idea of repugnant markets). Importation from abroad only pushes the issues one link up the supply chain while also adding in the difficulty of preserving the bodies. And bequests, while supported by some, were nowhere near enough to provide a steady supply of bodies.

- The only other feasible alternative (dissecting those who die in prison) was not supported by the medical community as they wanted to remove the punishment stigma from dissection. I think Richardson's critiques of the Anatomy Act have to rest on this being the path not taken.

I get the sense, however, that Richardson thinks that bodies were overused and that much of the advance in medical knowledge could have been gleaned from more experienced anatomists performing fewer but more economical dissections (which might have made bequests an adequate source). While anatomical and medical knowledge might have increased at the same rate, I'm not sure surgery (no matter how horrifying and ineffectual at the time) would have progressed much if the number of bodies were restricted.

I read the first edition, which does not include a later afterword she wrote relating this work to organ donations. Maybe I'll come across it and add to the review later.

**Addendum**
I recently read the afterword that is included in the second edition. This is Richardson's attempt to connect her work on corpses to the current state of organ transplantation. She makes the case for transplants as another example in which the poor are harmed to benefit the rich. In some cases, this is certainly true, but her claim that the majority of transplant tissue in circulation has been illegally obtained just doesn't pass the smell test. She rightly chides doctors who have harvested tissues and organs from those bodies undergoing autopsies without the consent of the survivors, but she doesn't (and can't) give us an indication of how widespread the practice is (keep in mind the afterword was published in 2001 and the events she described occurred in the early 1990s).

She also rails on any kind of presumed consent and speaks of it as if those people under that type of regime will just have their organs harvested willy nilly when they die. This is far from the case as the number of deceased organ donors is 2 to 3 orders of magnitude smaller than the number of deceased in the countries with a system of presumed consent. In the same vein, she wags her finger at presumed consent of unclaimed bodies in the US. She does discuss how problematic this term (and how the definition was put into action) in the 1800s in England. I'm not quite sure how relevant those critiques are in the modern day system (given how much easier it is to locate family of deceased). So if there is someone who is unclaimed in the US and their dead body can lead to 10 life-saving surgeries and dozens more life-improving surgeries, I say harvest those organs. We should respect the wishes of the deceased and (lacking any knowledge of their preferences) the deceased's family, but we should also not let superstition and taboo hinder life-saving work that can be done.

Another critique she gives is the money organ distributors (companies that allocate the organs) make off of this "natural resource" (as this tissue is called in the 1984 US transplant law). She suggests that (like in the 1820s and 1830s) the problem is too much commodification. What seems to be the case is not too much, but too little commodification. The Anatomy Act and modern day transplant laws foreclose any possibility of the donor making any money off of her donation but explicitly allow other entities to profit from it. She fails to note that the only country in the world that does not have a death-inducing wait list for kidneys is Iran, which allows for donor compensation. For those interested in the topic, I highly recommend James Stacey Taylor's book Stakes and Kidneys (a robust defense for why people should at least support a regulated organ market) and (for a more skeptical take) Cohen's Patients with Passports has a few chapters on the issue.

Even though this afterword is week on content and analysis, I still highly recommend the book for all the reasons listed above.

[Moira Rivas · Rating 4 out of 5]

The afterword is worth reading, it makes correlations to todays practices that are interesting.

[Marjolein · Rating 5 out of 5]

A very interesting, well research and above all accessible history of the Anatomy Act. Throughout her book Richardson aims to provide the reader not just with the facts surrounding the act itself, but also with the wider implications which the act held not just for the poor, but for society as a whole.

[Trina · Rating 5 out of 5]

Oh my goodness I loved this book. Richardson does a brilliant job at analyzing the dissection of the poor in 19th Century London. This has been a phenomenal help for my essay, and was a really interesting and engaging read besides that.

A+ job, thank you very very much to the author.

[Marsha Altman · Rating 2 out of 5]

Very thorough and well-researched book on the history of the Anatomy Act. Unfortunately, 2/3rds of it is about the technical aspects of passing bills in Parliament, and is not very interesting.

[Bruce · Rating 3 out of 5]

Between 3 and 3.5. It was a good subject and this book did have some very interesting history in it, but man a large portion of this book is filled with a lot of mind numbing legislation.

[Michael Shtur · Rating 3 out of 5]

What an exciting topic; imagine a time where scientists had to provide their own experimentation material. This was a tumultuous time in medical history, where the need to progress our knowledge crashed with religion and obscurantism. Scientists were the "rock stars" of the age, and they risked everything, at times, to advance our knowledge of our bodies. Aren't we all happy they did? Because of these pioneers, we can have surgery without invariably dying. Richardson does an enigmatically wonderful job at researching, obsessively even, a rather obscure and dark topic; and the beginning of the book is captivating. However, the bulk of the writing is, to say the least, dry. She spends an inordinate amount of time on the process of legislation. In her defense, though, this is an academic work; a monograph, not a novel or a creative nonfiction book.

[Bones · Rating 4 out of 5]

Richardson provides a very well-researched history of the creation of the Anatomical Acts in Britain. Apart from her very well done documentary research, Richardson also provides the reader with the cultural implications of dissection and grave robbing. She is keen to point out how class and social position also played important roles in the legislation. Overall, I found the book very informative and very applicable to the anatomical acts passed in late nineteenth century America.

[C. B. · Rating 4 out of 5]

As many have said, the opening parts of this book are really fascinating and compelling, but it gets really in-depth after that. It's still strong overall despite this!

[Sophie · Rating 4 out of 5]

truly fascinating; just a reminder that all of your modern medicine was based on the things doctors learned by stealing poor, working-class bodies (w/o permission!)

[Duntay · Rating 5 out of 5]

An important work about the commodification of the corpse, outlining how the poor were not just the primary victims of burking and body snatching, but after the Anatomy Act was passed, it was their bodies that were taken from workhouses and hospitals for dissection. Commodification of the corpse also includes the funeral industry, and the desperate attempts to avoid a pauper's funeral.

[Geevee]

Cited as source and for further reading by James McGee in his enjoyable book Resurrectionist the fictional account of his main character Matthew Hawkwood the Bow Street runner and body snatchers and medical experimentation.

[Clinton Smith · Rating 2 out of 5]

My "stars" rating probably has more to do with how I think a non-specialist audience would receive "Death, Dissection and the Destitute". There are some interesting parts in it where the intersection of the political and the scientific is catastrophic (ie, the use of the cholera epidemic to attempt to sort of "sneak" the second iteration of the bill through in the midst of riots; the competing factions [Royal College of Surgeons, hospitals vs smaller-scale anatomists] attempting to more or less shape a trade in corpses to their advantage), and those were worth the careful read. However, in the end we mostly have an Anatomy Act that doesn't resolve the core issue of social inequity in the respect that a culture shows for its dead—thereby in whole demonstrating the lack of interest in a resolution of this in the culture at the time—while being described in very minute detail in prose that could be best described as serpiginous, circling back and forth around the same 3 or 4 ideas. Likely not of great interest for someone who isn't already deeply interested in the subject—but the same, of course, can be said of many scholarly books.

[Lea · Rating 5 out of 5]

I read this for a paper I am writing for university, and it has been immensely helpful! It is very well researched and detailed, starting from the evolution of the study of anatomy in Britain, to then explain the importance of the sanctity of the body, before looking at the practice of bodysnatching, and even murder, for anatomy and the ensuing legislation, as well as how this legislation affected the poor in particular.

I did not expect the close link between anatomy and class injustice, and at times this was a truly heartwrenching read. I can only recommend this book for anyone interested in the history of medicine in the 19th century and one of its most important legislations, the Anatomy Act, which has long been merely a footnote in historical writing.

[Monica · Rating 4 out of 5]

Very interesting book. First part was fascinating, but I found the second half to be repetitive. Overall lots of good information on the Anatomy Act, and the social climate of the UK during the early 1800s.

[Lauren · Rating 4 out of 5]

Incredibly detailed and exhaustively researched with an expansive bibliography and appendix as well as pages of references, it took me forever to get through but it’s absolutely a fascinating topic.

[Kacper Maciejewski · Rating 4 out of 5]

Fabulously researched book on a super fascinating topic. Sentences oftentimes flowery to the point of superfluity, highly interesting and informative nonetheless :P

[Stacy · Rating 1 out of 5]

DNF. its not terrible, I just knew a lot of this already