Inside the Cadaver Lab Part 1: The Past, Present, and Future of Cadaver Dissection

Posted on 6/27/19 by Laura Snider

Dissection-simulating technology is certainly a useful addition to the curriculum in many labs and classrooms, but performing dissections of real cadavers is still an important part of medical education for students all over the world.

Working with a real human body is as much a psychological experience as it is a technical one. Many students have an emotional reaction to working with their “first patient,” and this gives them a deeper appreciation of what it means to be a doctor.

In this first installment of our cadaver lab series, we’re going to talk about the history of cadaver dissection, because understanding how we got to where we are now helps us appreciate just how fortunate today’s students are to learn from the bodies of willing donors.


The Dawn of Dissection

Procuring human cadavers for dissection has never been easy. But how did we go from seeing dissection as a fate worse than death to encouraging people to will their bodies to science? Did grave robbers really sell corpses to medical schools back in the day? (Spoiler: yes.)

In the 3rd century BCE, the physicians Herophilius and Erasistratus conducted dissections in the scholarly city of Alexandria. However, the practice became less common after their deaths, and from the destruction of Alexandria in 389 CE until universities started popping up around Europe in the 11th century, there were no (official) human dissections. Because dissecting humans was prohibited in the Roman Empire, early anatomists like Galen often based their work on animal dissections instead.

The “first officially sanctioned systemic human dissection since Herophilius and Erasistratus” took place at the University of Bologna in 1315. Dissections like this one were very different from the ones being conducted in labs today. Three people were in charge of the presentation—a Lector read from an anatomy text (Galen’s works, for example) while a Sector did the actual surgical procedure and an Ostensor pointed to the relevant body parts.

As time went on, the size of the audience for anatomical dissections grew. Once Pope Clement VII gave the OK for human dissections for the study of anatomy in 1537, dissection sessions were increasingly attended not only by scholars but also by the general public. Anatomical theaters were built to accommodate the large crowds attending these public dissections, with the University of Padua establishing the first one in 1594. Other universities quickly followed suit—Bologna in 1595, Leiden in 1596, and Paris in 1604.

defaultAnatomical dissection by Andreas Vesalius of a female cadaver, attended by a large crowd of onlookers. Woodcut, 1555.  Credit: Wellcome Collection. CC BY.


"Body Snatchers" vs. "Resurrectionists"

Though dissection became an increasingly vital element of medical education, the supply of cadavers (pretty much all executed criminals up to that point) had trouble keeping up with the increase in demand. Grave robbing was a particularly common way of bridging this gap in 18th–19th century Britain and the US. Though many referred to grave robbers as “body snatchers,” some medical professionals called them “resurrectionists."

In order to discourage grave robbing, new legislation was passed. The 1788 New York Doctors’ Riot, in which an angry mob stormed New York Hospital, influenced the passage of a 1789 law prohibiting grave robbing in New York. The law also expanded the variety of crimes for which death plus dissection was a sentence—it used to be just murder until this law allowed executed burglars and arsonists to be punished by dissection as well. England had already passed similar legislation (the Murder Act) in 1752, legalizing the dissection of executed murderers’ bodies and expanding the variety of crimes that could be punished by hanging.

defaultWilliam Cheselden giving an anatomical demonstration ca. 1730/1740.
Credit: Wellcome Collection. CC BY.

However, the bodies of criminals alone could not supply all the cadavers required for research, so grave robbing continued. It was laws called Anatomy Acts that really curtailed the practice in the UK and the US. These laws allowed for unclaimed bodies from public institutions such as charity hospitals, workhouses, asylums, and prisons to be used for medical dissection. Bodies could also be donated to medical schools by the families of the deceased. England’s 1832 Warburton Anatomy Act added the additional stipulation that the bodies of executed criminals were no longer allowed to be used for dissection. Massachusetts was the first US state to pass Anatomy Acts (in 1830 and 1833), though these did not explicitly prohibit the dissection of executed criminals’ bodies.


Body Donations in the 20th and 21st Centuries: “They Chose to Be Here”

Laws like the Anatomy Acts may have discouraged grave robbing, but they didn’t do much to remove the stigma surrounding cadaver dissection—having one’s body dissected post-mortem was considered a mark of poverty. It wasn’t until the 20th century that the stigma against donating one’s body to science abated.

In the 50s and 60s, several journalistic exposés about the high cost of funerals in the US—“The High Cost of Dying” by Bill Davidson, “Can You Afford to Die?” by Roul Tunley, and The American Way of Death by Jessica Mitford—were published. In response, many people decided they would prefer to donate their body to science rather than pay for an outrageously expensive funeral. Therefore, 1968 saw the passage of UAGA, the Uniform Anatomical Gift Act, which legally established a person’s body as their property: if someone willed that their body be donated, their next of kin couldn’t act against that wish. It was adopted by 48 states by 1972, and now all 50 states have similar regulations.

Fortunately, the bodies dissected in US medical schools today are donated. In fact, many doctors make the choice to donate their own bodies after they die, since they know how valuable working with real specimens is to medical education.

Mark Cicchetti, the managing director of Harvard Medical School’s anatomical gift program, tells his students that the donors are “all so different, but the one thing they have in common is they all chose to be here.” And that’s a big deal! Given the history of body procurement, the success of willed body programs is a considerable achievement.

Having one’s body studied by trainee doctors after death is not a punishment but a gift to the next generation of medical professionals. As Dr. Jeffrey Laitman (former president of the American Association of Anatomists (AAA) and current director of anatomy and functional morphology at the Icahn School of Medicine) told the AAMC, one’s body is viewed as “a socially important thing to give.”

Such gifts are appreciated by students and faculty alike—medical schools often hold memorial services where students honor their “first patients” alongside the donors’ families. This video, containing excerpts from Oakland University’s donor memorial ceremony, shows just how far society has come in making sure lab cadavers are treated with respect commensurate with the generosity it takes to donate one’s body to further scientific understanding.

 

Stay tuned for the next Inside the Cadaver Lab post, where we’ll hear from a professor who teaches a gross anatomy lab!

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