Medicine and mutilation: Oxford, Manchester and the impact of the 1832 Anatomy Act
From the archive (this feature originally appeared in Wellcome History issue 29, summer 2005) – by Fiona Hutton
In the late 18th century, the knowledge of anatomy was increasingly accepted as the linchpin of medical training, which therefore relied on a supply of cadavers. Large numbers of bodies were required by growing ranks of medical students, as there was no satisfactory method of preserving bodies. The Anatomy Act was introduced in 1832 to remove the taint of body-snatching from the profession. It allowed anatomists to request so-called unclaimed bodies from workhouses.
Historiographers of the Anatomy Act remain divided over its impact. Ruth Richardson’s path-breaking study elevated its importance in the decline of private medical schools and as a fore-runner of the 1834 Poor Law Amendment Act. But several Poor Law historians contest this focus, and the Anatomy Act has been labelled “a peripheral piece of legislation”. Russell Maulitz and Adrian Desmond argue convincingly that the private schools disappeared as a result of the metropolitan hospital bias of the Royal College of Surgeons and not, as Dr Richardson asserts, as a result of the Anatomy Act. Elizabeth Hurren has adjusted the historiography further with her work on Cambridge anatomy in the late 19th century, discovering a thriving anatomy school and concluding that: “We still have scant knowledge of the inner workings of anatomical schools and their acquisition activities.” My own work engages with these debates by re-examining the Anatomy Act and the provision of medical education outside of the often traditional focus on London.
There came in the early 1800s in England a gradual acceptance of the European model of medical training, with the hospital at the centre of education and research, complemented by a range of lectures and demonstrations at the medical school that correlated closely with clinical observation. This model had developed out of the rise of morbid anatomy within French medical education, rejecting “an earlier interpretation of diseases as general physiological imbalance” in favour of a “clinical view of a specific disease linked to lesions observable at autopsy”. Promoting this approach helped to elevate the role of surgery and dissection over physic, and anatomical training relied on the many cadavers provided by large Paris hospitals with high mortality rates.
Manchester and Oxford provide a contrast between an ambitious new centre with the first fully organised provincial medical school, and a highly traditional centre for medical training. Before the Anatomy Act, the only legal source of bodies for anatomists in England had been the gallows, giving a supply of murderers as a result of the 1752 Murder Act. Oxford University benefited from this, acquiring bodies from Oxford, Reading and Abingdon Assizes, albeit in very limited numbers. There is no evidence of a thriving trade in cadavers (unlike in Manchester). John Bellers believed that there were few bodies available for the Oxford anatomists, given that “the mob are so mutinous to prevent their having one”. Yet the recent discovery of a cache of 2000 bones in a pit at Oxford’s Ashmolean Museum (the original University anatomy school) provides contradictory evidence from an early period. The collection includes dissections that took place prior to 1767, when the school moved premises. The number of remains found – and the presence of children – suggests that body-snatchers were the suppliers.
The private anatomy schools of Manchester received very few bodies from the gallows and were dependent on resurrectionists for teaching material. A survey of the Manchester Guardian of the 1820s demonstrates that this supply was abundant, with surpluses being sent on by stagecoach to Dr Robert Knox in Edinburgh (the anatomist supplied by Burke and Hare) and to London medical schools.
Following the Anatomy Act, anatomists could claim bodies from workhouses and other public institutions, including voluntary hospitals. Regrettably, the records for the Oxford and Manchester anatomy schools rarely refer to sources of supply, and the Poor Law records are scant, so my research has focused on the minutes of the relevant voluntary hospitals, the national Anatomy Inspectorate and personal papers and newspapers.
After the Act, special arrangements were made for Oxford to receive bodies from the floating prison hulks (as Cambridge did). Anatomy Inspectorate figures show that Oxford had a very poor supply from these and did not develop an alternative. Oxford’s Radcliffe Infirmary rarely granted unclaimed bodies to the anatomy school at the University, going to great lengths to locate relatives or parishes willing to undertake burial. In 1839 the Governing Board (composed of lay members) ruled that no dissections were permitted, saying that while it was “favourable to scientific enquiries of this sort it forbids the dissection of any Patient in the Infirmary for the sake of mere anatomical demonstration”. There are no surviving records from the Oxford workhouse for the 19th century, but in 1861 the Professor of Anatomy wrote to the neighbouring Poor Law Union in Headington. The Guardians of the Union resolved unanimously that no bodies would be sent to the school.
Elizabeth Hurren has outlined the costly determination of Cambridge anatomists to procure a supply of bodies. The Oxford Professor of Medicine Henry Acland recognised that Oxford did not have the necessary dedication: “A practical school of medicine might be founded in Oxford; but the difficulties would be great and the cost enormous.” At the end of the 19th century, Professor of Physiology John Scott Burdon-Sanderson agreed with the commitment made by Cambridge University: “Cambridge has had the advantage of a great scientific surgical teacher who possessed or made opportunities we have not.” Acland and his colleagues attempted to develop Oxford’s role in general scientific education over medical specialisation. The geographical position of the University meant that practical training was available at other centres and Acland recognised that the cost of developing a clinical school was difficult to justify: “If Oxford attempts to rival the great metropolitan schools, or the Victoria University [the University of Manchester], it will fail.”
As many of the Poor Law records for Manchester have been destroyed, much of my research has focused on the Anatomy Inspectorate, the archives of the Manchester Royal Infirmary and the limited records of several competing private anatomy schools. It seems that Manchester experienced a problem in maintaining
a regular supply, and acted in accordance with the Anatomy Inspector’s conviction of 1832: “The existence of two or more schools in some of the smaller towns where the supply of dead bodies is limited is an evil so self evident that I have endeavoured to impress the advantages of a coalition on the minds of the teachers and I hope successfully in more than one instance.” The two major anatomy schools of Manchester united
to become the Royal School in 1836, and further amalgamations took place in the 1850s. Despite this, the Anatomy Inspector often expressed his frustration over the poor supply from Manchester workhouses, gaols and the county lunatic asylum.
Much of my research supports Ruth Richardson’s contention that the Anatomy Act was a fatal blow to the private anatomy schools of London and the provinces, but the new bylaws of the Royal College of Surgeons were certainly a factor that requires investigation. In 1822 the College refused to recognise dissection taking place in the summer, arguing the practice was a health hazard to students and the wider public. This was a direct attack on the private schools, where anatomy was taught throughout the year to reduce costs. The College also demanded longer periods of ‘ward-walking’ in the provincial hospitals than those required in London; Manchester Royal Infirmary complained vociferously about this throughout the 1830s, requesting the same status as the hospitals in London, Dublin, Edinburgh, Glasgow and Aberdeen. It seems that the private medical school in Manchester may have suffered from periodic shortages of cadavers, but many of its struggles were with the Royal College of Surgeons.
Oxford University, on the other hand, found it difficult to respond to the transformation of medicine and became a limited, provincial medical school for physicians who would have to complete the practical side of their training elsewhere. Oxford’s lack of success in procuring cadavers was a major reason for this failure to adapt.