If you died young in a 19th-century slum, there was a good chance that your body would be sold for medical research. The trade in corpses was a shadowy one but, asks Elizabeth T Hurren, who has written a book on the subject, where would modern medicine be without it?
John Unsworth was an ordinary office clerk, who plied his trade in the City of London. In 1834, he had a run of bad luck in the financial markets. This was far from uncommon at the time, yet John was crippled by the shame of his spiralling debt. Before long, he had concluded that there was only one way to avoid the ignominy of debtor’s prison: commit suicide.
John stole some petty household goods and pawned them, using the money to hire a room at a lodging house near Smithfield market. He then bought a phial of opium from a local apothecary, swallowed it, and hoped to die alone, from poison. Unfortunately the dose was not, at first, strong enough to kill him. His landlady and her servant found John frothing at the mouth in excruciating pain. They ran for a local doctor, who rushed John across to St Bartholomew’s Hospital as an emergency admission. But it was too late.
At his death, nobody knew John’s real name, as he’d been using an alias. There was no family to claim his body for burial, so he was sold on for anatomy by a body dealer and dissected over the next 48 hours.
The St Bartholomew’s anatomist noted in the dissection register that John was “cut to his extremities… a useful teaching tool”. His human material was then sewn together into a cotton sheet for burial. Normally this would have been in a large public grave, where corpses were covered in lime and earth, usually six deep. But on this occasion, John’s friends saw a coroner’s notice in the London newspapers and came to collect the body for burial. They carried it through the streets, shoulder-high, in a basic coffin made of cheap deal-wood (pine). Cheapside parish churchyard was to be its final resting place.
The story of John Unsworth’s death and dissection is a sad, even a grisly one, but it was far from unique. In the 19th century, thousands of corpses – bodies that had belonged to living, breathing people just a few hours earlier – were spirited away from workhouses, undertakers and coroners to local medical institutions to go under an anatomist’s lancet.
The trade in dead bodies in Victorian Britain was large and highly lucrative. Driving it was a six-fold increase in the number of doctors in training in the second half of the century. To qualify in medicine, under the Medical Act in 1858 and its extension in 1885–86, each trainee doctor had to dissect two bodies in a two-year teaching-cycle. These students needed human material before they could register with the General Medical Council, and most were prepared to pay for extra bodies and body parts to qualify quicker and start earning back their expensive tuition fees.
Where there’s a demand for a commodity, there’s always someone willing to meet it. In this case, it was a network of body-dealers that stretched across London and out into the provinces. These shadowy figures made their money by sourcing and selling corpses that, in most cases, were unclaimed either because the deceased had no known relatives, or their relatives were too poor to pay for a pauper’s funeral.
In total, English medical schools traded some 125,000 bodies between the Anatomy Act in 1832 – passed to help meet a shortfall in bodies for medical training by the Victorians – and 1930, when the workhouse system was abolished. That’s not to mention another 125,000 financial transactions in that same period involving body parts – it was more profitable to break up a body than to sell it complete.
Although the trade in dead bodies was secretive, it has been possible to retrace its economics, demography, mortality trends and the geographical reach of its trading networks.
We know that all of London’s major teaching hospitals employed body-dealers. At St Bartholomew’s Hospital, each night the porters would leave large wicker laundry-baskets on wheels under the King Henry VIII gate opposite Smithfield market. These would be picked up by people who looked like they were collecting soiled bedclothes for laundering. In reality, however, they were body-dealers who walked the streets of the poorest districts after dusk buying the dead.
The dealers would place the bodies in the laundry basket under the soiled sheets. With common diseases like tuberculosis rife in the East End slums, most of the baskets were filled by morning.
So how much money did the dealers have to part with to buy a body? That depended on the type of corpse they were procuring. Medical students preferred to dissect young bodies whose tissue was least affected by the degenerative changes of old age. So while a week’s wage would secure the body of an older person with an interesting anatomy (who perhaps had a specific cancer or an enlarged heart), a month’s wage would be required for someone aged 30 or less.
Pregnant women, her stillbirths, or young infants would cost more still – up to a year’s wage, in some cases. That’s because, with childbed fever (a sepsis womb infection) one of the biggest killers of new mothers in the 19th century, anatomists were eager to do further research on miscarriages or abnormalities in childbirth.
St Bartholomew’s records show that prostitutes, servants and the dispossessed living in overcrowded lodging houses were the staple of the dissection room and that, between 1832 and 1930, they accounted for over 6,000 dissected bodies.
Paupers were aware of, and prepared to protest about the trade in body parts. Yet historians of medicine have tended to neglect the thousands of letters of complaint that the poorest members of society wrote on the topic to local Poor Law officials or civil servants at the Local Government Board in London.
Despite the shroud of secrecy that enveloped the trade, body-dealers weren’t able to completely avoid the limelight – in fact, a number of court cases were prosecuted at the Old Bailey. One of the best-documented involved Mr Alfred Feist, master of St Mary’s Newington workhouse in south London, who, in 1858, was accused of profiting from “63 counts… of selling bodies” and “other dealings”.
The testimony in court uncovered how an average body-dealer ran a business of anatomy from the dead-house at the back of a typical workhouse. When a pauper died, their relatives were invited to briefly view the body, laid out in a parish coffin. At a pauper funeral, the bereaved each had to pay a fee of 1s 6d to the Poor Law undertaker. He then chalked the pauper’s name on the coffin and
then quietly alerted the master to a potential anatomy sale. If the deceased was aged less than 50, then the corpse was sold on.
In the case of St Mary’s Newington, bodies were sold for dissection to the medical school at Guy’s Hospital. Albert Feist saw to it that the young body in the coffin was swapped for an older corpse, before staging a false funeral.
Feist was found guilty of profiteering – he made about 21 guineas a year – but got off on appeal on a legal technicality. The Anatomy Inspectorate always closed ranks to protect the business.
Hospitals weren’t the only grand institutions stoking the trade in dead bodies in the Victorian era. The universities of Cambridge, Oxford and Manchester bought corpses in large numbers too but, whereas hospitals tended to buy bodies from local slums, universities often sourced theirs from further afield.
Cambridge University, for example, bought bodies from Hull, a port city blighted by epidemics connected to poor sanitation. Yet this presented Cambridge with a dilemma: how, in the days before refrigeration, could it move rotting corpses over a distance of 100 miles at speed? The answer was the ‘dead-train’, a twice-weekly, high-speed service that ran from Hull to Cambridge railway station via Leeds.
The corpses made the journey in the train’s rear freight-carriages. Each one was placed in a double ‘dead-box’ made of two layers of elm (waterproof case) and pine (cheap lining) wood to prevent body-fluids from leaking. Usually the cargo was loaded up late at night and unpacked once passengers had disembarked in the morning. The human material was then taken in an undertaker’s carriage to the anatomy school in central Cambridge.
Today, family historians are often unable to trace an ancestor because they have unaccountably disappeared from local records. This is often because they were one of those dead bodies dispatched on the railways to be dissected and buried on location.
That this was a thriving trade is proved by the fact that around 3,500 dissected paupers from the north of England and East Anglia were buried in large common graves in one cemetery alone – Mill Road in central Cambridge – between 1858 and 1914. This is another grisly statistic in the history of the trade of body parts, but before condemning our forebears’ conduct, we should consider this: on 29 February 1896 the British Medical Journal published one of the world’s first skiagraphs of a child. Skiagraphs – now better known as x-rays – were being trialled in a laboratory hut at Cambridge University. Today it is worth recalling that this technology has not only benefited countless millions of people around the world, but that it was an x-ray diffraction taken by Rosalind Franklin in 1951 that enabled James Watson and Francis Crick (both based at Cambridge) to recognise the double helix-shape of DNA.
The uncomfortable truth behind this story of great advances in the field of medicine is that Cambridge anatomists often supplied cadavers for experimental skiagraphs. Because the technology was shaky and it was important to get a stable image, it made sense to use a dead pauper for skiagraphing before dissection. And, because small human trunks were easier to photograph than adult ones, that dead body often belonged to a child. It is compelling to think that the imagery created from a young pauper in 1896 – just one example of many scientific breakthroughs connected to dissections – has contributed to everyone’s medical future in the genome era.
Examining the Victorian body trade can produce thought-provoking historical parallels. When you are hungry, have a family to feed, and are living in abject poverty, sometimes a human body is all you have left to sell. It is easy to forget just how demeaning poverty can be for a friendless servant, a prostitute on the streets, or a disabled person. This was the case for those that supplied the anatomy business in Victorian England, and continues to be so in socially disadvantaged parts of the world today.
Whereas in the 19th century, the unscrupulous dealers hid corpses in laundry baskets, today they trade organs, limbs and tissue culture on the internet. Harvesting the human body has always been a material fact of life. This human dilemma has to be set in its proper historical context so that we can engage together in a dialogue of consensual medical ethics that works with real-life lessons we’ve learnt from the past.
If in the future you ever need an x-ray, or tissue culture treatment in a burns unit, or are reassured by your doctor explaining how your body works, then you too are a direct beneficiary of the 300,000 or so dissections that were performed during the reign of Queen Victoria. Science has needed the nameless and the friendless to help us all get where we are today in modern medicine.
Dealing with the dead today
In 2005 the Human Tissue Act finally repealed the Anatomy Act of 1832, which was passed to help meet a shortfall in bodies for medical training by the Victorians. Today nobody can be dissected without the written consent of their living relatives or by a solicitor preparing a living will for someone who wishes to donate their body to medical science.
Human cadavers cannot be used for anatomical education, transplant surgery or scientific research without a post-mortem schedule overseen by the Human Tissue Authority.
This legal correction of medical ethics followed public revulsion when Sir Liam Donaldson (the chief medical officer responsible for investigating the Liverpool Alder Hey scandal) announced in February 2001 that 105,000 organs, body parts and fetuses had been retained in 210 English NHS Trusts and medical schools. Of those 210, around 25 leading institutions accounted for nearly 90 per cent of the body parts retained. Donaldson found that over 16,000 organs had been kept illegally.
Michael Redfern QC specifically discovered that at Alder Hey children’s hospital pathology organs were stockpiled for processing as clinical waste between 1970 and 1990. These official disclosures raised important historical and moral questions. Not least, how is it that some doctors assumed the legal right to simply do what they wanted with the dead?
Dr Elizabeth T Hurren is a reader in the medical humanities in the School of Historical Studies, the University of Leicester. She is the author of Dying for Victorian Medicine, published by Palgrave.