The Afterlife of the Leiden Anatomical Collections

Hands On, Hands Off

Hieke Huistra

• Publisher: Routledge
• Year: 2018
• ISBN:
  9781317123903
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

The Afterlife of the Leiden Anatomical Collections starts where most stories end: after death. It tells the story of thousands of body parts kept in bottles and boxes in nineteenth-century Leiden – a story featuring a struggling medical student, more than one disappointed anatomist, a monstrous child, and a glorious past. Hieke Huistra blends historical analysis, morbid anecdotes, and humour to show how anatomical preparations moved into the hands of students and researchers, and out of the reach of lay audiences. In the process, she reveals what a centuries-old collection can teach us about the future fate of the biobanks we build today.

1 Remove lid before use

How students handled anatomical preparations

One of the most famous gothic stories in Dutch literature features a Leiden medical student and his finest anatomical preparation. In the depths of a stormy night, the student, as pale as the moonlight, breaks into the anatomy building. He uses a smelling bottle to revive the body of a hanged man and then steals the man’s head while it – he? – is still alive. After connecting the head to an array of bottles, pouches, and wires, the student takes this living preparation to his room, where he stores it behind his bookcase. Late in the evening, when no one will come, the student takes out the head. He interrogates it, and microscopically examines the tears it sheds out of despair. One night, the head bites the student’s finger, just as the police are banging on the door. The student pulls the head from the apparatus to release his finger and jumps out of the window. The head is found dead on the floor; the student is never seen again. All that is left is a mysterious book, kept in some old libraries: Caput sedes animi: disquisitio, qua probatur artem fungi posse vice corporis, dummodo caput supersit (The head as the seat of the soul: an investigation, with which it is proven that art can execute the duty of the body, as long as the head is still alive).¹ The author remains unknown to this day.

The story was written by the Dutch artist Alexander Verhuell (1822–1897), known for his satirical drawings of student life.² It first appeared in the Leiden student almanac of 1847, in blood-red ink; it has remained in print ever since.³ Although Verhuell implied the story was set long before his time, it reflects nineteenth-century medical theories and practices and the anxieties they aroused in society, as did much gothic horror writing.⁴ Verhuell and other writers, including Mary Shelley, Jules Janin, and Georges Balzac, captured the fears of their contemporaries.⁵ People feared anatomists because the latter acquired bodies in ways that, especially in Britain, were murky at best, murderous at worst, and because their experiments dehumanized these bodies. Verhuell’s experiment is fictitious only in that the student succeeds in keeping the head alive; several actual nineteenth-century researchers attempted to do the same, but failed.⁶ Galvanists tried to resurrect bodies using electricity; mesmerists tried to communicate with the dead, something that Verhuell himself had attempted to do as well.⁷ Theories like galvanism and mesmerism are reflected in Verhuell’s story, as are practices such as body snatching, dissecting, and – the topic of this chapter – student handling of anatomical preparations.

Verhuell’s student engaged with his treasured head just like nineteenth-century medical students worked with their preparations: in a hands-on, emotionally detached, and question-driven way, outside the medical museum. Used thus, preparations helped students learn basic anatomy, become familiar with rare pathological conditions, study phenomena invisible in fresh corpses, answer research questions for their dissertations, and get used to working with dead bodies. This chapter shows how anatomical preparations helped medical students to become better doctors. It starts with an overview of nineteenth-century medical education, which will show that medical students visited many spaces: lecture rooms, dissection halls, museums, hospitals, and laboratories. Guided by a Leiden student – proper introductions will follow shortly – we enter these spaces one by one to see how preparations assisted students’ learning in all of them. The experiences of our Leiden student will be supplemented with examples of students and teachers from elsewhere in Europe and the United States. Their educational systems differed, but, as we will see, their handling of preparations was remarkably similar: lids off and hands on.

Medical education in the nineteenth century

On Tuesday 20 August 1833, the Leiden medical student Jan Bastiaan Molewater (1813–1864) started a diary.⁸ He chose that particular day because he was ‘in a fairly calm, diligent mood and reasonably pleased with myself’ – something that did not happen very often, at least not on the days he wrote his diary.⁹ Many of the entries are self-reproachful. Despite repeated resolutions, Molewater failed to get out of bed early, study as planned, and stop sleeping with the mysterious L. J. In other words, he seems to have been a typical student, and his diary may show us how nineteenth-century medical students studied medicine on the days they succeeded in getting out of bed early enough to make it to class.

Molewater’s classes involved more than simply sitting and listening to professors lecturing. Nineteenth-century medical students had to use their hands, eyes, and noses in addition to their ears. This distinguished them from their predecessors at early modern universities: until the second half of the eighteenth century, formal medical teaching was mainly theoretical. Even in Leiden, little practical teaching took place. The Leiden medical faculty would later become famous for its teaching hospital, where Herman Boerhaave supposedly taught students during his rounds in the early eighteenth century. However, the hospital housed hardly any patients in Boerhaave’s day, making it unlikely that he carried out much clinical teaching.¹⁰ University medical students would treat their first patients when they started practising as physicians – a practice that in itself was hands-off, consisting mainly of listening to symptoms, deducing diagnoses, and prescribing treatment. Physicians left hands-on treatment to other healers, such as surgeons and midwives. These healers had their own, informal training methods, often apprenticeships where pupils were taught hands-on, on the job.

The shift from theory to practice in formal medical teaching, the type of teaching in which the Leiden collections functioned, occurred throughout Europe.¹¹ Its origins are often traced back to late eighteenth-century France, where post-revolutionary educational structures brought together surgeons and physicians, and increased the importance of hands-on practices in teaching. However, as medical historian Thomas Bonner has shown in his comparative history of modern medical education, things had already started to change before the French Revolution, both in and beyond France.¹² From 1750 onwards, surgery and medicine grew closer together in many European countries. Simultaneously, medical teachers and students explored more practical training methods. Students increasingly left lecture rooms to visit hospitals and dissection halls. They engaged with patients in the flesh instead of on the page, practiced procedures hands-on, and carried out experiments. Around 1800, the movement towards more practical teaching was well under way and it continued to grow stronger as the nineteenth century progressed. In the middle of the nineteenth century, another hands-on teaching space would be introduced: the teaching laboratory.

The ideal of practical, hands-on teaching was widely embraced, but its institutional embedding varied between countries. In Germany and the Netherlands, the universities remained central in training future physicians; in many other countries, the role of the universities decreased. In France, medical schools were often tied to hospitals, while British medical education relied heavily on private medical schools. In all countries, the state began to play a greater role in medical education and the licensing of medical practitioners, but more so on the Continent than in Britain. For example, British medical practitioners were licensed by two medical professional organizations, the Royal Colleges of Surgeons and of Physicians, until 1858, whereas in many continental countries, the state already controlled access to the medical profession by then. This difference mattered because the criteria established for medical licensing defined the objectives of medical training.

Although the organizational structures of nineteenth-century national educational systems diverged, we should not see them as strictly separated. Many students travelled abroad and followed part of their training in different educational systems. Paris was a popular destination, as were Vienna and Berlin, but students also visited smaller, less famous cities and institutions.¹³ Medical historian Stephan Curtis has argued that such travels (which were undertaken not just by students but also by practitioners) contributed to the emergence of a ‘European medicine’: a shared body of knowledge and practices that transcended national borders.¹⁴ Hands-on teaching in hospitals, museums, dissection rooms, and laboratories was part of this European medicine.

The travels also illustrate how students shaped their own education, which they could likewise do if they stayed at home. They could choose their own teachers, topics, and schedules, although some systems offered more freedom to do so than others. The Dutch system was highly prescriptive. Physicians had to be medicinae doctor, which meant that they had to go to university – unlike surgeons, pharmacists, and midwives, who were trained outside the university as well. Until 1865, a medicinae doctor could start practising immediately; after 1865, new legislation required an additional practical exam to be taken outside the university. University curricula were set out in the Royal Decree on Higher Education (1815), the law that regulated Dutch higher education until 1876, when the Higher Education Act was issued.¹⁵ The Royal Decree prescribed which courses universities should offer, ensuring that Molewater’s curriculum resembled that of students in Groningen and Utrecht, the other Dutch universities at the time. Students at all three universities had to satisfy the same requirements to be awarded a medical degree. They had to pass exams in anatomy, physiology, pathology, pharmacy, materia medica, practical medicine, surgery, and obstetrics; attend classes in natural history, comparative anatomy, dietetics, and forensic medicine; perform a dissection; participate in clinical teaching; and demonstrate their ability to interpret Hippocrates. The exact content of the classes depended on the professors teaching them, so some variation existed between universities.

The Royal Decree also stated which ‘material assistance’ had to be present at the universities.¹⁶ For medical teaching, it prescribed a collection of medical books in the library; an academic hospital for clinical teaching; a collection of surgical and obstetrical instruments (both contemporary and historical); and collections of anatomical, pathological, physiological, and comparative-anatomical preparations.¹⁷ Hospital, library, and collections were considered crucial resources; without them, according to the Decree, medical education would be ‘inadequate’.¹⁸ Medical professors agreed and urged university governors to implement these requirements. Since all universities already owned substantial libraries, most of their time and money went to building the required collections and establishing teaching hospitals (later followed by teaching laboratories, which would become mandatory in the 1876 Higher Education Act). In response to the Royal Decree, Leiden University acquired two anatomical collections, together containing al...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of figures
• Acknowledgements
• Introduction
• 1. Remove lid before use: how students handled anatomical preparations
• 2. Make do and mend: how researchers used old collections in new medicine
• 3. Dead body in the closet: how lay visitors disappeared from institutional anatomical collections
• 4. Adieu Albinus: how the university governors lost their status symbol
• Conclusion: in perpetual motion, anatomical collections then and now
• Index