February 7, 2024
Editor's note: This article is based on the first-place winning entry in the 2023 History of Surgery Poster Competition, which occurred in conjunction with Clinical Congress.
Historically, surgeons were often misunderstood or even feared for their close knowledge of anatomy. Society in the Middle Ages would not place any importance on the corporal form because of its transience when compared to the immortal spirit.
The Renaissance period would lead to advances in art, culture, medicine, and science. However, despite this age of scientific awakening, it was the barber-surgeons who dissected cadavers while the physicians and their students, widely considered social and professional superiors, observed from a distance. Nevertheless, from this tradition arose the legacy work of Andreas Vesalius: De Humani Corporis Fabrica (Of the Structure of the Human Body), published in 1555.1
From the mid-1500s to the modern era, the anatomist would alternate from social deviant to valued scientist. In fact, laws in Britain and Massachusetts in the US sentenced offenders to dissection following capital punishment as an attempt to deter crime.2
Later, in the 19th century, medical curriculum changed to embrace a more methodical rather than dogmatic approach to treatment of disease. This perspective brought a greater focus on anatomical dissection, increasing the demand for cadavers.1,2 Capitalistic markets emerged to supply this need. Incentivized by monetary gain, bodies were raised from the grave and, in more extreme cases, brought to the grave.
The flourishing grave robbing industry needed to be stopped. The issue became especially urgent when high-profile individuals could not be guaranteed their final resting place. Notably, in 1878, after Senator John Scott Harrison of Ohio died (son of US president William Henry Harrison), witnesses saw his body being taken into a dissecting room as the Harrison family was searching for the body of a family friend believed to have suffered the same fate at the Ohio Medical College.2 Finding a president’s son on an anatomist’s table quickly led to legislation to prevent resurrectionists from taking bodies from their graves in Indiana and Ohio.2
More heinous were the actions of Hare and Burke who murdered 16 people at their lodging house, earning approximately £7 apiece in Scotland and leading to legislative action. The law’s response was to destroy the market in each case by supplying the anatomist with the corpses of the unclaimed.2
Uniform adoption of laws was not achieved in the US at a federal level. As Manifest Destiny (the divine right to expand westward) led to growth in the US, new states were admitted that would establish new medical schools, frequently featuring dissection within their curricula.1,2 This reality re-established the demand for the trafficking in dead bodies, whether by legal or more sinister means.
The Medical Department at the University of Iowa, Iowa City, enrolled its inaugural class in the fall of 1870.3 The fees paid by those first 37 students were directed into maintaining facilities and supplies. The school board refused to charge exorbitant fees, ensuring that lack of wealth would not drive students to false medical schools and denigrate the profession. However, this fee model meant the first faculty did not receive a salary from the school.3
Dr. James Boucher
The inaugural staff of the Medical Department included James H. Boucher, a Civil War brigade surgeon and colonel who was recommended by the likes of Generals William T. Sherman, Ulysses S. Grant, John A. Logan, and Don Carlos Buell, for the position of anatomy professor. Despite the more lauded and senior Dr. Boucher aspiring to the role, the position of professor of surgery and dean of the medical department would go to the much younger Washington F. Peck.3
The two had a tense relationship, not only over the matter of roles and experience, but particulars of practice. Dr. Boucher ascribed to new theories of antisepsis from Joseph Lister—a British surgeon and medical scientist who was the founder of antiseptic medicine and a pioneer in preventive medicine—while Dr. Peck did not, leading to further disagreements between the two clinicians. As an anecdote in the papers of John Thomas McClintock noted, Dr. Boucher would apply carbolic acid to the wounds of Dr. Peck’s patients when he was looking away.3,4
To adhere to rigorous standards, the curriculum required anatomic dissection of cadavers. As John P. Irish, a member of the university governing board, local journalist, and Iowan politician, wrote, “. . .the surgeon must dissect the dead or mangle the living.”3 However, there were no laws in Iowa or the west regarding the possession of cadavers for dissection. All cadavers had to be obtained from out of state at costly sums of $25 to $30 each with no guarantees regarding the condition of the deceased in an era without refrigeration.3 These circumstances presented a notable limitation to the medical school with its limited finances, particularly for the anatomy course. Therefore, the entrepreneurial spirit would compensate for this limited access to cadavers with unlawful exhumation.1-3
Mary Herrick—a senior citizen of Iowa City and mother-in-law of George Kimball, a respected local physician—died December 26, 1870, and was buried 2 days later. Her remains were exhumed by Dominick Bradley, the medical school janitor, and allegedly sold to Dr. Boucher.3-9 However, Bradley’s testimony would deny the involvement of Dr. Boucher.5 The local citizens were outraged over the disturbed grave. A mob surrounded the medical school, attempting to catch the medical students in the act of moving or dissecting the cadaver until a warrant was executed to search the department.3,8,9
As news spread through the community, Irish was roused from his sleep by some involved students. Though disturbed by the exhumation of the mother-in-law of a close friend, he warned the medical students of the impending search and had them abscond with the body to save the fledgling medical department as much as their own hides.
The cadaver was moved to a haystack out of town prior to the search and would not be found on the medical campus.3,8,9 Irish and Dr. Kimball were instrumental in arranging for the return of the cadaver to the undertaker, brokering deals to avoid charges in exchange for the remains.3,5-7 Herrick’s body was found and returned to the undertaker in an advanced stage of dissection with a mutilated face and red lead injected into the arterial system.5,8,9
Despite these deals, multiple members of the medical faculty and students were charged with disturbing the sepulcher of Herrick, and a grand jury was empaneled to investigate and collect evidence.3,5,8,9 The testimony of the various faculty, students, and community members did not openly accuse Dr. Boucher of being involved in Herrick’s exhumation. However, the verbose John North, who was the demonstrator of anatomy and responsible for the maintenance and acquisition of cadavers, described the presence of an unidentified, female cadaver in her sixties in the dissecting room. Dr. North also described an interaction with Bradley regarding this corpse. Bradley stated that the body belonged not to Dr. North but to Dr. Boucher. Dr. North also would imply, but not confirm, that the cadaver was Herrick.8,9
None of the accused were ultimately brought to trial as those who originally testified to the grand jury could no longer be found. This may reflect some backroom dealing as Irish resigned from the governing board of the university around this time and took political office.3,4 Dr. Boucher, despite never standing trial, already had been tried in the court of public opinion. Dr. Peck took advantage of the circumstances to force Dr. Boucher to resign.4
The grave robbing incident of a respected citizen in Iowa City exposed the flaws in the process of obtaining cadavers. Drawn by the desire to preserve the sanctity of the grave and a commitment to providing adequate training to physicians, this event prompted important legislation in Iowa for the legal acquisition of unclaimed cadavers. However, the modern bequeathment of cadavers was still quite novel, with the dissection of unclaimed bodies occurring until 1968.2
In 1872, Senate File (SF) 117: An Act to Promote the Science of Medicine and Surgery in the State of Iowa would pass. This legislation established a legal route to obtain cadavers for study. Cadavers would be delivered directly from the undertakers and coroners to the medical school for educational and scientific purposes.10
The stipulations in the law included that the decedent must be a resident of a community with a population greater than 1,000 for at least 6 months and exist without familial or personal requests to be interred without dissection. Families had 36 hours to claim the remains before delivery to the medical school but could claim the corpse after that date. Additionally, the cadavers had to be properly interred following the dissection. And perhaps most importantly, financial incentives were removed as no deals could be made to secure cadavers.10
This policy joined a plethora of laws worldwide that struggled to end grave robbing for dissection. SF 117 would be superseded by the Uniform Anatomy Gift Act in 1968, which allowed individuals to donate their bodies to science and education at the time of their demise, ending the practices of default dissection of unclaimed residents.2 These laws marked a crucial shift in public opinion from dread related to their eventual desecration on the anatomist’s table to a societal commitment to the anatomical training of physicians.2
Dr. Carine Dornbush is a general surgery resident at the University of Iowa Health Care in Iowa City, Iowa.