The Italian Boy
Page 18
That Mayo’s lectures were hard to follow would have been of significance to Thomas Wakely, surgeon, founder of the Lancet, and, later, member of Parliament. The Lancet had been set up, in October 1823, to prod the medical establishment (mainly, but not solely, those men who ran the hospital-linked anatomy schools) into reforming itself. Wakely perceived the men in charge of the profession as mediocre, highly resistant to change, and, in certain cases, driven less by interest in science than by petty rivalries, indulging in rancorous feuds that could last for years. His name for them was “bats”—creatures that thrived in the dark, in the gloom of an aristocratic system of patronage that exhibited all the perceived corruption and skulduggery of the Hanoverian age. And now, many influential people believed, it was time for this age to end.
Herbert Mayo
To Wakely, nothing embodied the establishment more than the Royal College of Surgeons of England, and he labeled it a “selfish oligarchy,” even a “junta.”6 The Royal College had been granted its charter in 1800, changing its name from the Company of Surgeons, the organization formed in 1745 when the surgeons broke from the medieval Barbers and Surgeons Company, thereby throwing off any connection with tonsure, shaving, and teeth pulling. Run by a small, self-selecting council of senior surgeons/anatomists, the Royal College was the only body entitled to grant qualifications in surgery in England; whoever wanted to qualify as a surgeon—and thereby become a member of the college—had to fulfill its requirements. And as of 1823, these requirements underwent a controversial change. Summer courses in anatomy, which were taught only at private schools, were delegitimized, and the sole acceptable lectures in surgery and anatomy were those given at London’s teaching hospitals (St. Thomas’s and Guy’s, known until 1826 as the United Hospitals; St. Bartholomew’s; and the London Hospital, in Whitechapel) or, later, at a university-linked institution such as King’s College’s medical school and, even later, the one at University College London. Before undergoing examination at the Royal College, a candidate had to produce certificates of attendance from one of these schools (and then cough up fees for the examiner). So, no matter how good the anatomy teaching at London’s various private schools—and much of it was said to be excellent, with Joshua Brookes, Edward Grainger, Joseph Carpue, and Edward Tuson reputed to have superior learning and technical skill—these courses would no longer count toward qualification.
Teaching standards were of particular concern to Thomas Wakely, since he believed that medical education was the field in which change was most urgently needed. Students paid fees directly to the teaching surgeon/anatomist; the more pupil revenues, the wealthier the institution. But, as Wakely revealed, pupils rarely got their money’s worth at the hospital schools. Teachers who did not turn up for lectures, who were too busy or too lazy to field questions, who refused even to acknowledge complaints, whose information was out of date or simply wrong, who would peremptorily shun or exclude any student—these were the men Wakely was out to shame.
Wakely’s views were not unusual within medical circles. Comparatively few autobiographies and reminiscences from these years are free from at least implicit criticism of senior surgeons and how they ran the medical profession. Joseph Carpue—founder of the Dean Street School of Anatomy, where John Bishop had tried to sell the fresh boy on 4 November—told the Parliamentary Select Committee on Medical Education that he was “disgusted” by the council of the Royal College of Surgeons: “I considered the council a select vestry, which did not like to let in any but the friends, allies and connections of their own body.”7 Its exclusivity expressed itself in the college building: the council entered through the main entrance fronting Lincoln’s Inn Fields; mere members came and went by the back door, which opened onto filthy, tumbledown Portugal Street—the haunt of James May and site of the noxious, much-pillaged St. Clement Danes graveyard.
Quite apart from alleged poor teaching and social and familial exclusivity, hospital schools had two major drawbacks for the medical student: their courses were expensive and instruction stopped in April for five months. A pupil who wanted to study under England’s most famous surgeon, Sir Astley Cooper at Guy’s, would pay the baronet ten pounds and ten shillings for his course of lectures and a further ten pounds and ten shillings for his dissection course.8 But for ten guineas total a pupil could, for instance, attend lectures and perform dissections at Joshua Brookes’s school in Blenheim Steps, in the West End.9 Brookes was an outstanding anatomist and had founded his school in 1787, closing it down in 1826 because of ill health—he was by then sixty-seven and had worked for nearly forty years in typically appalling conditions: his school stank of rank meat because of his unique method of preserving Subjects by injecting them with potassium nitrate (which was more usually the method of extending the shelf life of ham and sausages) and filth was present on every floor of the school. (Such an environment was the norm in these pre–Florence Nightingale, pre–Joseph Lister days. Joseph Carpue was remembered as having dirt-encrusted hands and nostrils exuding snuff, no doubt placed there to keep out the stench; Edward Tuson’s Little Windmill Street School was said to be rat-ridden.)10 The Brookesian Comparative Osteological Museum filled the two upper stories of the tall, narrow house in Blenheim Steps, and, with around six thousand specimens—including three elephants and a number of whales—it was said to rank second only to the famous collection amassed by celebrated eighteenth-century anatomist John Hunter; many of Brookes’s exhibits had been donated by his brother, who kept a small indoor zoo in a crumbling house in Exeter ’Change in the Strand.11 While it was debatable whether much of use could be learned from pickled oddities in jars, the Royal College used as one of its weapons against private schools the argument that since private schools did not have access to museums, their teaching was likely to be defective. In fact, the existence of the Brookesian collection and those of Sir Charles Bell and Herbert Mayo proved that private anatomists often had very good museums in the 1820s; but the Royal College and the hospital schools bought up the private museums (starting with the Hunterian collection as soon as the Royal College was formed), thereby making its original accusation become true in time.12
The top floors of Joshua Brookes’s private school, the Brookesian, in Great Marlborough Street, housed a museum of six thousand specimens. His garden contained his Vivarium—a chunk of Gibraltar Rock to which were chained unusual animals and birds, many of which were on loan from his brother’s private zoo in the Strand.
The Hunterian Museum at the Royal College of Surgeons
Upon qualification, the next step for the surgeon-to-be was to become a “dresser,” or paying apprentice, to a surgeon, the more illustrious the better. These positions earned the surgeon around fifty guineas a year per dresser; and as each surgeon had between four and six dressers, he was ensured an annual income of at least two hundred pounds. Only students who could afford such fees were likely to make it into the top echelons of medicine, and those who had blood ties or who enjoyed other forms of favoritism were first in line for dresserships. As “A Student of 1815” commented in the Lancet: “Tell me the name of the successful individual and I will tell you who his uncle was.”13 The consequent waste of talent was lamented by those campaigning for reform. Sir Astley Cooper played straight into their hands when he expressed his pride that, of the surgeons at St. Thomas’s and Guy’s, Joseph Green was his godson, while Charles Aston Key, Bransby Cooper, and Frederick Tyrrell were his nephews.14 Bransby Cooper was a mediocre surgeon, as Thomas Wakely pointed out in the Lancet and was sued for his pains. To accusations that the wrong man had reached the wrong position for the wrong reasons, Sir Astley said: “I do not say that he is a perfectly good surgeon, but give him time, gentlemen, give him time. Do not crush him in the outset of his career.”15 At this point, Bransby Cooper had been operating for three years. It was a reply that would be extremely funny if it could be forgotten how many lives Bransby brought to a painful, premature end.
Wakely persistently depicted the
iniquities and inequities of the London medical establishment as stemming from an as yet unrevoked age of aristocratic misrule; unfair systems, networks, and behaviors were, he and others believed, poisoning all of Great Britain’s institutions. Wakely had written: “We hope the age of Mental Delusion has passed and that mystery and concealment will no longer be encouraged.” And of Bats, he wrote: “In youth they are always, by the instinctive precautions of their parents, kept from contact with the ground; and before these disgusting creatures are allowed to take their flight in the air, they are invariably either forced upon some eminence by parental exertion, or they succeed in crawling to some elevated point, through, possibly, the most filthy channels of rottenness and corruption.”16 Many (perhaps most) Bats were in fact “self-made” men of comparatively humble beginnings, but it is true that their careers flourished only when they managed to get patronage to work on their behalf; it was vital that they accepted and manipulated the networks and never challenged them.17 And once they rose up the hierarchy, the Bats ensured that their own offspring or relatives were favored over “outsiders.” George Guthrie would not resign his post at the Westminster Hospital until his son was ready to take it over in 1843.
Wakely was to feel badly let down when two of his medical-reform allies went over to “the other side” as soon as they achieved good positions within hospitals. The more usual fate of the bright and able but not well connected was either to become a surgeon in the army or navy or to set up practice in the provinces. Sir Astley Cooper told the talented and assiduous Edward Grainger to try his luck in Birmingham; Cooper had refused Grainger the post of demonstrator of anatomy at Guy’s, appointing instead his own unremarkable nephew, Charles Aston Key. But Grainger decided to join the ranks of London’s independent anatomy teachers and in June 1819, at the age of twenty-two, he rented an attic in a tailor’s shop on the edge of the graveyard of St. Saviour’s church, Southwark, just across the street from Guy’s, and began to teach a summer course in anatomy. A few months later he moved the school to a former Catholic chapel in nearby Webb Street, where he was able to offer year-round classes at around half the price of those at the United Hospitals of St. Thomas’s and Guy’s. It is not known whether Grainger availed himself of the slumberers in St. Saviour’s graveyard, but what is certain is that, like all other private teachers, he relied on the resurrectionists for Subjects, since he had no hospital morgue to supply any of his teaching material. Between 1819 and 1824, the year of his death from consumption, a turf war seems to have broken out, not among the resurrectionists but between London’s anatomy teachers—a battle between the buyers, not the sellers. The story goes that Sir Astley, furious at the success of what he called “the cheap school of anatomy,” sought to pay resurrectionists not to supply Grainger, with the aim of driving him out of business. The resurrectionists, seeking to capitalize on this schism, chose instead to supply Grainger almost exclusively, in order to bolster his school and maintain another outlet for their goods. The hospital schools had therefore to offer higher prices to the resurrectionists, forcing the hospital surgeons to break their own club-cum-cartel, the Anatomical Society (set up some time in the first decade of the century to keep fees to resurrectionists as low as possible); prices, as a result, were said to have hit a high of twenty guineas per corpse. Grainger, in reply, offered even higher prices, thereby securing for himself a good supply of corpses and, as a result, more pupils.18 According to Grainger’s friend and competitor Joseph Carpue, an estimated 250 to 300 pupils a year were enrolling at the Webb Street School in the early 1820s, a very impressive figure, particularly since the number of medical students in London was declining. Pupils were increasingly heading for Paris to study surgery, since the French state supplied a steady—and free—flow of corpses for dissection from centralized public morgues.19 And fewer students meant lower revenues for the hospital surgeons of London.
The lecture theater at King’s College; the brand-new institution boasted bright, airy teaching facilities, but nevertheless included a room set aside to receive body snatchers’ produce.
Edward Grainger had managed to upset the medical hierarchy in a way that Joshua Brookes, Joseph Carpue, Edward Tuson, and other noteworthy private teachers in London had not. Perhaps it had seemed like a personal affront to Sir Astley that a man who was not related to him had defied his patronizing advice and set up in direct opposition, geographically and commercially, to Guy’s and prospered, all the while disturbing the uneasy but workable relationship between the Bats and the body snatchers. Sir Astley had in the past praised Joshua Brookes’s academy, saying that his summer courses could be a useful adjunct to hospital teaching; and he would, in the future, support Richard Dugard Grainger, who would take over the running of the Webb Street School on his brother’s death. But Edward Grainger’s refusal to accept the status quo would not be forgiven.
In her book Death, Dissection and the Destitute, historian Ruth Richardson notes that Edward Grainger’s action, and the Anatomical Society’s reaction, in part triggered the events that would lead to the passage of the 1832 Anatomy Act, which made legally available to surgeons the bodies of paupers unclaimed by family or friends. Richardson writes: “In 1823, probably as a result of the failure of the Anatomical Society to control corpse prices, Astley Cooper solicited from several fellow anatomists ideas about what could be done to break the power of the bodysnatchers.… It is remarkable that most of the replies seem to favour covert official connivance at existing supply routes.”20 As Richardson points out, “official connivance” was vital to the nation’s surgeons if they were to avoid the implications of the Rex v. Lynn case of 1788, which made taking a body from a churchyard a misdemeanor. For thirty years, only resurrectionists had gone to prison or been fined for obtaining or possessing corpses for dissection; the price paid by the surgeons was comparatively low, consisting of coming up with bail fees and legal defense costs, providing jail “comforts,” and helping to support the family of the imprisoned man. (The “humble petition” found on Sarah Bishop when she was arrested at the Fortune of War was just such a calling in of a debt.) But in February 1828, a Liverpool anatomy teacher was convicted of causing a body to be disinterred, and one month later, a Lancaster court convicted three of a gang of five—which included a surgeon and a medical student—of possession of a body that had been obtained illegally. The Edinburgh Horrors provided another spur to legislation, and the first Anatomy Bill was introduced to Parliament by Henry Warburton in March 1829, just six weeks after William Burke had been hanged for the murders he had committed with William Hare. The bill’s supporters declared that burking would end as soon as a legal supply—the unclaimed poor from workhouses and hospitals—was made available to the surgeons. But while Warburton’s bill passed in the Commons, it failed in the Lords; and not until 1832 would its heir successfully proceed through Parliament.
* * *
So, in 1831, London’s anatomy teachers—at both hospitals and private schools—were still relying on the authorities to turn a blind eye to the trafficking of corpses, on policemen not to make arrests or at least to leave the buyer out of the charge, and on magistrates and the higher courts to ensure that a surgeon or school was not implicated when a resurrectionist was in the dock. Discretion was also paramount if doctors, schools, and hospitals were to avoid being the target of the angry crowds that seemed to materialize as though from nowhere whenever resurrection was suspected—just as they did when a beggar was being arrested. Reliable reports of attacks and threats by the London public on individual doctors or medical institutions are not easy to come by; whether this indicates that there was less interest in the issue in London than elsewhere in the country or whether it reflects the underreporting of popular dissent in the metropolis cannot now be known. There were violent attacks on provincial medical schools both before and after the passage of the Anatomy Act, and the Burke and Hare case caused citywide civil disturbances in Edinburgh in 1828–29; but in London, no medical school was
burned down, no doctor hanged in effigy.21 The extent of opposition to London anatomists, and the risks that doctors ran of exposure and attack, can only be guessed at by the ripples—memories, anecdotes, hearsay—caused by individual events. One old, oft-repeated story underlined the perils of treating dead flesh irreverently: in 1810, a medical student at the Great Windmill Street School climbed onto the roof of the building carrying a human leg and dropped it down the chimney of the house next door, where it fell into a pot of stew cooking over the fire. A hue and cry was raised, angry citizens gathered, and they were dispersed only when the surgeons of the school paid them to go away.22 Nineteen years later, after Burke and Hare, the misdeeds of medical students were more likely to lead to a hearing before the magistrates, even if it was quite cursory. In October 1829, London’s chief magistrate, Sir Richard Birnie, found before him at Bow Street a “very elegantly dressed young man” who was charged with attempting to burke a seventy-year-old woman in St. Martin’s Court, off St. Martin’s Lane. The young man was a medical student and along with three other students had been drinking in the Shades tavern on Leicester Square; by seven o’clock in the evening the four were very drunk. The student in the dock had seized the old woman by the throat and she had lost consciousness; when passersby rushed to help her, the students assaulted them. Birnie made light of the matter, chortling that it looked to him as though they were carrying out some sort of experiment on the woman but that “the burking system, thank God, was not prevalent in the metropolis.” He remanded the student for a further hearing, however, perhaps fearing public reaction if he did anything less.23