Grave robbing and ethics in the 19th century.
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The widespread retention of thousands of children's organs in the UK without parental consent has met with public outrage and calls for government intervention. These issues are brought to the fore by developments in molecular genetics that allow a person's full DNA sequence to be obtained from miniscule samples. The molecular genetic testing of retained organs and human tissue can greatly benefit family members and future research, but only if proposals to alter regulation can be successfully implemented. A review of present UK regulation indicates that it is both unclear and inadequate to ensure sufficient ethical/legal safeguards to satisfy public expectations. This paper reviews the legal and ethical status of previously retained samples. It discusses whether they may be regarded as abandoned if the patient cannot be traced and then used anonymously in ethically approved research. The legal status of retained samples is discussed as regards ownership and commerciality. This raises the question of who is the next of kin to give consent if the samples are to be regarded as gifted. Present proposals risk damaging the future by too much sensitivity. Getting the balance of interests right at this juncture is vital groundwork for such beneficial medical developments.
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The teaching of anatomy in England and Scotland from the 16th to the 19th centuries was carried out by the Companies of Barber Surgeons and also there were a number of private schools. The only sources of material for dissection and study were the gallows or the grave and the supply from the former was limited by law. Therefore the latter became the source of a saleable commodity, and so the profession of grave robbing became established. The taking of bodies was abhorrent to the populace, fights and riots would sometimes occur and public outrage was directed towards anatomists. The passing of the Anatomy Act of 1832 helped bring an end to the grisly business of snatching bodies, but the supply of material for study still remained a problem. In the 1920s there was a change in public attitude toward dissection which resulted in an increase in the donation of bodies.
Asiatic cholera reached Britain for the first time in late 1831, with the main epidemic occurring during 1832. The disease caused profuse diarrhea, severe dehydration, collapse, and often death. There was widespread public fear, and the political and medical response to this new disease was variable and inadequate. In the summer of 1832, a series of "cholera riots" occurred in various towns and cities throughout Britain, frequently directed against the authorities, doctors, or both. The city of Liverpool, in the northwest of England, experienced more riots than elsewhere. Between 29 May and 10 June 1832, eight major street riots occurred, with several other minor disturbances. The object of the crowd's anger was the local medical fraternity. The public perception was that cholera victims were being removed to the hospital to be killed by doctors in order to use them for anatomical dissection. "Bring out the Burkers" was one cry of the Liverpool mobs, referring to the Burke and Hare scandal four years earlier, when two men had murdered people in Edinburgh in order to sell their bodies for dissection to the local anatomy school. This issue was of special concern to the Liverpool citizenry because in 1826, thirty-three bodies had been discovered on the Liverpool docks, about to be shipped to Scotland for dissection. Two years later a local surgeon, William Gill, was tried and found guilty of running an extensive local grave-robbing system to supply corpses for his dissection rooms. The widespread cholera rioting in Liverpool was thus as much related to local anatomical issues as it was to the national epidemic. The riots ended relatively abruptly, largely in response to an appeal by the Roman Catholic clergy read from church pulpits, and also published in the local press. In addition, a respected local doctor, James Collins, published a passionate appeal for calm. The Liverpool Cholera Riots of 1832 demonstrate the complex social responses to epidemic disease, as well as the fragile interface between the public and the medical profession.
The concept of dissection for acquiring knowledge about the structure of human body was started in 15th century and barber--surgeons used to demonstrate various structures at the professors command. Andreas Vesalius (1514-1564) was the first medical student to dissect the cadaver and also continued with it even as a professor. Slowly and steadily its importance was realised. Once autopsy was accepted as a ideal parameter to establish the causes of death, the importance of dissection got enhanced. Cadavers were obtained earlier from the grave robbings and mortuaries, which was followed by, an Anatomy Act of 1832, by which unclaimed bodies were provided to the anatomy department. For last two decades, many persons started donating their bodies to the department of anatomy. In India, mostly unclaimed bodies are handed over to anatomy department for teaching and research purpose. Cadavers teach students during 1st professional course, autopsy teaches again in IInd and IIIrd professional courses and even later on throughout the career. Dissection helps in developing a spatial and tactile appreciation for the fabric of the human body that cannot be achieved by prosection or computerised learning aids alone.
When the practice of hands-on anatomical dissection became popular in United States medical education in the late 18th and early 19th centuries, demand for cadavers exceeded the supply. Slave bodies and thefts by grave robbers met this demand. Members of the public were aware that graves were being robbed and countered with various protective measures. Since the deterrence of grave robbing took time and money, those elements of society who were least economically and socially advantaged were the most vulnerable. Enslaved and free African Americans, immigrants, and the poor were frequently the target of grave robbing. The politically powerful tolerated this behavior except when it affected their own burial sites. Slave owners sold the bodies of their deceased chattel to medical schools for anatomic dissection. Stories of the "night doctors" buying and stealing bodies became part of African American folklore traditions. The physical and documentary evidence demonstrates the disproportionate use of the bodies of the poor, the Black, and the marginalized in furthering the medical education of white elites.
During the reconstruction of the water pipe lines, in Pionirska street, at Bechej in 1989, a part of a large graveyard was uncovered. Human remains were found in graves, below the level of the underground water, so that the most of the human skeletons were either completely destroyed, or partly preserved. A few graves were damaged during excavations in previous ears and some of the graves were robbed also at an earlier period. Paleopathological and anthropological investigation carried out at the Department of Anatomy, Faculty of Medicine in Novi Sad, revealed that these remains belong to an Avarian population which had similar epigenetic and anthropometric characteristics as the Avarian population found at the well known site at Kiskoros Vagohid, in Hungary, precisely the skeleton from the grave No. XXXV. Study of the teeth and jaws complete these results. At six mandibles, which belong to the mature skeletons, was found narrowness in the frontal region of the mandibular alveolar arch was recorded. Degree of narrowness of the frontal mandibular dental arch, deficient in space at mandibles was different, and varied from 2 mm to 8.5 mm, or 3 to 24.38%, which is necessary to set the teeth in the correct line in a mandible.
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Public mistrust in the medical profession is not new. We describe a series of street riots that took place in the city of Liverpool in north-west England in 1832 during a cholera epidemic. The disturbances were directed primarily against the local medical fraternity. The episode is of interest, since the same city recently experienced a similar crisis of confidence between doctors and public. On this occasion the cause was not cholera, but rather the reports from Alder Hey Children's Hospital that organ parts from deceased infants undergoing necropsy had been kept for several years without parental consent.
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