Journal of Historical Sociology Vol. 5 No. 1 March 1992 ISSN 0952-1909 Michel Foucault, Body Politics and the Rise and Expansion of Modern Anatomy* JAN C.C. RUPP Abstract The New Science and the arts flourished vigorously in the seventeenth century Netherlands. Of special importance were the anatomical theatres in Leiden, Delft and Amsterdam. These theatres were important cultural centres in the sense that they were centres of arts and sciences. meeting places for artists and scientists. and places with a public function. What role did anatomy played in the rise and expansion of modern science. Many scholars assume that religion, and more generally speaking, morality, was strongly opposed to anatomy, but then it is difficult to explain how anatomy and anatomical theatres could be of such central significance. It is Michel Foucault's thesis. however. that there was no hindrance by religion and morality, but an antagonism between two medical discourses. the clinical (life) and the anatomical (death). This thesis is tested by exploring anatomy practices and regulations in early-modern Italy, Holland, England and France. The results indicate that, not only antagonism between medical discourses, but also conflicting opinions on teaching and the conditions for scientific progress. and. most of all. the interest taken by government in anatomy, played a part. The question as to whether moral standards were a hindrance to the advance of science. was primarily dependent on body politics. Introduction The New Science and the arts were flourishing vigorously in the seventeenth century Netherlands. Comparable with Italy, but different from England and France with their Royal Academies, the cities in Holland were economic, as well as political and cultural centres of the nation. They played a major part in the establishment of universities and athenea, but also of anatomy theatres, as is confirmed by contemporary authors such as Johan de la Court.! Such theatres were founded in more than twelve cities. Of special importance were those in Leiden (1597), Delft (1614) and Amsterdam (1619).? They became important cultural centres and greatly contributed to the production, diffusion and consumption of the arts and sciences." Learned men organized scientific meetings and stimulated the Practice of the New Science at or around the anatomical theatre. Scientists, who contributed to the advance of the new science, made important discoveries and had an international reputation, were connected with each of them (Delft: Reinier de Graaf and Antoni van Leeuwenhoek; Leiden: Johannes Van Horne, Franciscus Deleboe Sylvius, Herman Boerhaave and Bernardus Albinus; Amsterdam: Nicolaas Tulp, Frederik Ruysch, and Johannes Swammerdam).‘ The32 Jan C.C. Rupp anatomy theatre was one of the places for the demonstration and discussion of new findings and experiments. In the same building weekly anatomy lessons were given to chirurgy apprentices, medical students and midwives. The theatre had a scientific library and a museum in which a collection of ‘curiosities’, that is to say of objects of natural history and of natural science were exhibited. Important works of art were produced connected with the theatre. not only paintings of dissections (such as Rembrandt's ‘Dr Tulp’)), anatomy books such as Bidloo's Anatomia illustrated by the painter Gerard de Lairesse, and Anatomy Cabinets like Ruysch’s. but also the Leiden’ Vanitas paintings and the Delft’ Church interiors.® It was also a museum for art collections. The anatomy theatres were public cultural centres. The dissections of the dead body of a criminal were annual manifestations around Christmas-time for a general public of 300 to 600 people, consisting of officials, medical doctors, chirurgians, students and other interested persons. A dissection was carried out according toa special programme, in which experiments with (living) animals were included, and could last for some weeks. The museum, library and botanical garden were also open to the general public. Amongst all strata of the population, there was more interest in the anatomical demonstrations and for the collections than for any other event. In this paper the question is posed about the part anatomy played in the rise of modern science. It is known that many scholars assume that religion, and more generally speaking, morality, was strongly opposed to anatomy, but then it is difficult to explain how anatomy and anatomy theatres could be of such central significance. It is Michel Foucault's thesis. however, which in our opinion is highly worthwhile, that there was no hindrance by religion and morality, but an antagonism between two medical discourses, the clinical (life) and the anatomical discourse (death).° This thesis will be tested by exploring (i) anatomy discourses and (ii) regulations in early-modern Italy, Holland, England and France. Religion and the Rise of Modern Anatomy’ In addition to astronomers and mathematicians, medical men have generally been of great importance in the rise of modern science. Within medical science, the development of clinical teaching (the prescription of diets, the administering of medicines) and of anatomy (surgery) played a crucial role. In the history of science literature the dominant opinion assumes that there have been many ages of very slow progress in the sciences since the writings of Hippocrates and Galen in Antiquity. The original texts by the classical Greek and Arab scholars became available in the 15th century. They were againThe Rise and Expansion of Modern Anatomy 33 translated and encouraged. in particular at the Italian universities of Bologna and Padua. Clinical (bedside) teaching and anatomy flourished at Padua. The great complete Latin edition of the works of Galen appeared in 1541, two years before De Fabrica corporis humanae by Andreas Vesalius, the work that is regarded as the starting point of modern medicine. Vesalius ‘revised. and almost re-wrote the translation of three treatises by Galen’ for this work.* Vesalius, professor in anatomy at Padua, was, after Modino. the first medical scholar who conducted the (public) anatomical dissection with his own hands and based his anatomical knowledge on direct observation. In this way he discovered many errors in the books of Galen, who probably dissected only monkeys and pigs. The symbol] of this difference as represented by Vesalius himself is the dissection of the arm.° Vesalius broke very consciously with the tradition that had developed in earlier centuries when the actual dissection was done by an ordinary (barber)-surgeon, the lector read from a text (by Galen) what the surgeon was doing, and the professor in anatomy, either on that day or at another time, held his philosophical lecture. '° Dissections were conducted mainly on the corpses of criminals in the case of the yearly public dissection, but also on other cadavers in the case of a legal problem (such as a suspected murder by poisoning) or a medical problem (as to what was the cause ofa death: sections were even conducted on the bodies of popes). After, or even during the anatomical demonstration on the criminal body, several animals were dissected and vivisected (we see dogs and monkeys on the frontispieces of many anatomy books). The anatomy theatre gradually acquired a permanent base. In Padua one of the first permanent theatres was established. Leiden soon followed (1579).!! Many scholars have sought the reason for the long-lasting'stagnation’ in the field of medicine, especially in anatomy ina presupposed negative attitude of the church towards the opening of dead bodies, especially human bodies. The theory is that every religion holds the dead body as something sacred. C.D. O'Malley, for example, takes this view with Tespect to the Renaissance and early modern time. This argument is used to explain the many complaints about the shortage of corpses the anatomists would have had from the fifteenth century onwards.'?In the seventeenth century one finds a similar opinion that in the very old times, however brave and intelligent and however much inclined to the knowledge and the art of anatomy he might have been, nobody could have done great things, because dead bodies were regarded as sacred and the hands that touched them as contaminated: that is why so many cleanings, sprinklings and solemn purifications were installed by the overbelieving religion of the ancients." In a recent book on Medieval anatomy '', Marie-Christine Pouchelle emphasizes with a good sense of drama:34 Jan C.C. Rupp It is well known that in the Middle Ages the cutting open of bodies in search for knowledge was subject to taboos deeply rooted in the mentality of the time. It could not be accepted (and is it even wholly accepted nowadays, except in strictly scientific circles?) that. for sake for knowledge, one had the right to invade a body. a microcosm in which dwelt a soul. or to dissect with an intrusive knife the most intimate parts of areal person. And: Ifthe anatomist trespassed radically on the integrity of a corpse, the surgeon felt the body's vital forces, even the soul itself, glow through his fingers with its blood.'5 Pouchelle, however, does not give any indication in the works of the French medieval anatomist Mondeville, who is the central person in her book, that bears witness of this presupposed religious taboo against dissection. According to Ludwig Edelstein, various testimonies report unquestionably that dissection not only took place in the Middle Ages. but also that Alexandrian physicians dissected and vivisected humans at around the start of our era. Nevertheless, most scholars claim that in Greece dissection was utterly unthinkable. Religious and magical concepts. veneration of the dead, and dread of the corpse were believed to have made dissection impossible. Likewise, vivisection seemed unthinkable for humane reasons. One was unwilling to attribute so much cruelty to physicians, the helpers. The accounts of dissection and vivisection were declared to be wicked inventions by which one school sought (o discredit the other." The reports were not believed to be true, because for the ancients reverence for the dead was a duty of the most binding sort. It was everyone's duty to see to it that a corpse was buried. and there existed no greater obligation toward relatives. How then can it be possible that the ancients ravaged dead bodies in order to find out the structure of human organs. (...) The Soul finds no peace in the underworld, until the body is safely interred. This repose must never be disturbed.'” In Edelstein’s opinion, the question as to whether it was possible or impossible to dissect and vivisect, depends not on ideas held by ‘the superstitious masses’, but by the discourses of the scholars and scientists. In contradiction to his own thesis, however, he states, in respect of an earlier epoch, that Homeric physicians did not dissect because investigation for the sake of knowledge was still far from the naive mind of man, and above all because respect for the dead and dread of cadavers were then too ‘great for men to dare to interfere with them. One might offer up a human sacrifice to the God if he demanded it, one might leave a dead enemy or a criminal unburied, but one could not force oneself, as yet, to the extent of cutting open the dead body. Alengthy development was Fequired before the religious and magical opposition was overcome. and before dissections were thus. at a certain ™moment, rendered feasible.'*The Rise and Expansion of Modern Anatomy 35 Foucault's Thesis It is Ludwig Edelstein’s main thesis that the demand for dead bodies depends on the medical discourse, on the advance of science and education and the supply of dead bodies on the interest taken in medicine by the state. Despite all obstacles. even medieval plysicians were able. through the intervention of the state or robbery. to obtain the cadavers necessary for dissection. In the Renaissance and in modern times they succeeded in the same way in dissecting. Thus it was not impossible in Greece either. It must be added that dissections were certainly not more frequently performed in Greece than at the beginning of the Renaissance and in the Middle Ages, perhaps even more seldom. This seems to follow from the fact that the necessity for dissections was by no means universally recognized. Only the Dogmatic school of Alexandria insisted on them. while both the Empiricist and the Methodist schools rejected them. Teaching was done largely by demonstration and did not require many corpses. '* Michel Foucault, in his classic book The Birth of the Clinic,?° formulated the hypothesis that it was neither religion nor the church that prohibited the development of the anatomy of dead bodies but rather the so called ‘clinical discourse’ which. in his opinion, was the dominant medical discourse until the end of the eighteenth century. For the eighteenth century and for a whole tradition that was already familiar in the Renaissance, the knowledge of life was based on the essence of the living, since it, too. is no more than a manifestation of it. That is why one never attempted to conceive of disease other than ”! on the basis of the living. or of its (mechanical) models and (humoral. chemical) constituents; vitalism and anti-vitalism both sprang from this fundamental anteriority of life in the experience of disease.” It is at the end of the eighteenth century that such men as Bichat. came to formulate a completely opposite discourse (clinical-anatomical medicine), which implicates an epistemological break, that only at death disease and life speak their truth. Until that time disease was seen as something evil coming from the outside into the body and death as the opposite of life: in other words, while the eyes of doctors were turned towards elimination of disease, towards cure, towards life, death was seen as the dark threat in which his knowledge and skill were abolished. as the failure of medicine; now for men like Bichat and Morgagni ‘knowledge of life finds its origin in the destruction of life and in its extreme opposite: it is at death that disease and life speak their truth’ *. This epistemological breaking point is related to Bichat’s finding that on the basis of tissues alone, nature works with extremely simple materials. They are the elements of the organs, but they traverse them, relate them together, and36 Jan C.C, Rupp constitute vast ‘systems’ above them in which the human body finds the concrete forms of its unity.2* Changes in the tissues of (the organs of) the human body are the cause of diseases and at the same time manifestations of the process of dying. Anatomical dissection of the (tissues of the) dead body is necessary to gain true knowledge of the disease and of the death. Prior to that epistemological turning point. anatomy was oriented towards the localization of the disease in the (geography of) the human body. while the clinicians were concentrating on the history of the symptoms of the disease on the surface of the human body and on the classification of correlated symptoms into a system of diseases. Disease is no longer a bundle of characters disseminated here and there over the surface of the body and linked together by statistically observable concomitants and successions; it is a set of forms and deformations. figures and accidents and of displaced, destroyed, or modified elements bound together in sequence according to a geography that can be followed step by step. It is no longer a pathological species inserting itself into the body where possible: it is the body itself that has become ill.2> When the insight became general that pathological anatomy is the very fundament of medicine, a whole myth was created as a retrospective justification, the myth that the developments of the new modern insights has been hindered by the old, religious and moral, beliefs, that the doctors in all times had ‘in their depths of their scientific appetite the repressed need to open up corpses’.”6 This myth includes also the rumours about the body snatching practices of Vesalius and anatomists in general. Foucault asserts that, in the eighteenth century, anatomists or clinicians had no difficulty at all in finding corpses. 1 Medical Discourses What kind of evidence has been produced in respect of the question as to whether religion was or was nota hindrance for the development of anatomy? In the first place, it can be said that there was not only a stagnation in medicine, but in astronomy and mathematics as well2’ The collections in the museums of the anatomical theatres, the books written by the anatomists and the connections between medical and other scientists around the theatre, bear witness to the fact that the anatomists and the medical doctors in general saw their activities as part of the New Science and compared their work with that of astronomers, geographers, mathematicians, and physicians. No single clerical or governmental document has been found to the present day in which dissection of human corpses is declared to be forbidden.The Rise and Expansion of Modern Anatomy 37 The big dispute between Vesalius and his former teacher Sylvius was on the question as to whether Vesalius had wrongly or rightly ‘accused’ Galenus of not having dissected human corpses.** However serious their dispute may have been, dissection of human dead bodies was seen by both men as quite natural and not to be questioned at all. Vesalius mentioned Aristotle and Hippocrates as anatomists who dissected human cadavers, so that one can speak of conflicting opinions, in the old times too, about the usefulness of the anatomy of dead human bodies for medicine, for curing diseases. Autopsy was a very regular practice, as we have already mentioned. What have been found are documents in which dissections are regulated, which points to a practice that already existed. The first documents we know of in which public anatomies are regulated, are from the beginning of the fourteenth century. The first documents on anatomical theatres are from the beginning of the sixteenth century.*° Heckscher mentions such a document in Alessandro Benedetti's (Benedictus’) book Historia corporis humani sive Anatomice, first published in 1497 in Venice. This physician from Verona wrote in Book I, Chapter i (translation by Heckscher): Of the uses of public anatomies, the selection of a cadaver, and the arrangement*' of a temporary theatre. It has come down to us that the very kings, solicitous of the general welfare, took criminals out of prison and dissected them alive, in order that they might probe the secrets of nature and nature's internal cunning while consciousness was still present ~ the location, color, shape, size. arrangement. development. and deterioration of the organs. many of which undergo changes in the dead - and that they might make accurate rather than reverential observations... But this practice our religion forbids. inasmuch as it is of the utmost cruelty and charged with abominations of the torturer, and to die in despair of such torments means the pitful loss of hope ofa future life. Be these usages applied by the barbarians and foreigners that devised them. who takes pleasure in those evildoings and culpabilities. But Iet us more mercifully spare the living and investigate the inmost secrets of nature in the corpses of criminals. In this document the church is seen as forbidding the vivisection of human beings. The ‘barbarians’ are accused of vivisection of criminals, and an already existing practice of public anatomy of dead bodies of criminals is regulated. half an age before Vesalius published his famous book. The reason for vivisection of (criminal) human beings is the search for the most essential forms of life (the secrets of nature while consciousness is present), but this kind of vivisection is, at the same time, regarded as destroying the essence of life (and bad for the reputation of the judges/kings and for the executioners). Edelstein reports testimonies that Alexandrian physicians dissected and vivisected humans. Dissection and vivisection began there in the third century B.C. and was still possible in the second century A.D. In the view of the Dogmatic school of Alexandria, which was influenced38 Jan C.C. Rupp by Aristotle, dissections were useful, because they taught morphological data. but the true substance of life could not be discovered in this way. A dead man still retains the same bodily form, yet he is no longer a human being. ‘Therefore what is important in the living cannot be the shape, which remains in death although the true substance of life has disappeared. Knowledge of the living human being is of fundamental importance. Ifthe nature of man is regarded as changing in death, then vivisection is absolutely necessary. The Empiricist school, however, rejected dissection and vivisection as unnecessary, because what one must know about man can be learned from the living subject during treatment. Moreover, one cannot succeed in vivisection, because a human being dies under the knife. In Alexandria vivisection was practiced on criminal bodies. In Edelstein's view, Thus the decision to be made between dissection and vivisection alsoturns, from being a purely medical problem, into a philosophical and scientific one. Andreas Vesalius In the Preface to his De Fabrica, Vesalius stated that the medical doctors were responsible for the decline of medicine because they no longer did the practical work of nursing, giving medicaments and surgery. But that can not be the reason why Galen did not dissect human dead bodies. Galen dissected and vivisectioned animals with his own hands. The problem seems to be an essentially epistemological one. Vivisection of animals was a practice in Galen's time. Galen refused only to dissect the sexual organs of living animals and ‘seems to have avoided distasteful operations, when: carrying out public vivisections’.* In Vesalius’ time, vivisection of human beings had already been forbidden for a long time. It is known that De Vesalius left out some passages of Fabrica in the second edition, because they reminded one of vivisection.* For Vesalius the importance of the vivisection of animals was not in question. At the end of every public anatomy of a dead (criminal) body he vivisected one or more animals, chiefly repeating Galen's experiments; the first action to demonstrate the structure of the human body, the second the functioning of parts of the (living) body. Vivisection is furthermore useful for surgical practice.** Vesalius carried out experiments by the vivisection of animals on the function of the heart, of the lungs, of the voice (‘It is better to choose a sow on account of the voice. For a dog, after being bound for some time, no matter what you may do to it, finally neither barks nor howls, and so you are sometimes unable to observe the loss or weakening of the voice)**, of fetuses, etcetera. But Vesalius did not Carry out experiments on the functions of the brain.The Rise and Expansion of Modern Anatomy 39 Well. then in examination of the brain and its functions very little is to be observed by vivisection, since in this matter. whether we like it or not. but merely out of consideration for our native theologians, we would be more guilty of depriving brute creatures of memory. reason and thought. as*’ their structure is the same as that of man. And so the student of anatomy, and he that is practised in dissecting dead bodies, and tainted by no heresy. clearly understands to what risks I should expose myself if ~a thing which I should otherwise above all else gladly do-I were to make any attempt at vivisecting the brain. As far. however. as concerns sense and motion. it is possible to observe that both perish when the brain is removed, And here the same method of experimentation is to be employed as | prescribed in dealing with the nerves. Indeed the question whether the brain has sensation can be investigated in man: for a man whose brain is cut or pressed can tell whether he feels pain or whether he had any sensation at the point where the brain is affected.* In the debate on the essence of life, Vesalius as well as Galen and Aristotle distinguish between ‘the vital spirit’ (the intestines), ‘the natural spirit’ (the heart) and the ‘animal spirit’ (the ‘princeps anima’). In Vesalius's view, the animal spirit is the essence of life in-so-far as it concems ‘memory, reasoning and thinking’, while ‘motions and sensations’ are also part of the life of animals (‘brute creatures). By means of animal vivisection, all functions of the human body including, to some degree, those of the brain (motions and sensations) can be discovered, but not those of ‘memory. thinking and reasoning’.** Although Vesalius may have detected many faultsin Galen's description of the structure of the human body, he does not differ from Galen ona very central issue, namely the importance of the vivisection experiments, nor in the opinion that the brains of animals do not differ from those of man except in quantity. It was a general opinion that the faculties of thinking etc. were situated in one of the ventricles of the brain, an opinion that gets into trouble as soon as it appears that animal brains have the same structure as human ones, as longas one thinks that man differs from animals; animals have a ‘soul too, in-so-far as the ‘princeps anima’ concerns motions and sensations. In Vesalius's discourse on life, disease and death, everything is aimed at life and living, and most of all at touching what is, in his opinion, the essence of human life (thinking etc), but dissecting the brain of animals is forbidden and, what is the most fundamental problem, insufficient in-so-far as these functions of the brain are concerned. The opening of dead bodies as a means of mapping the structure and proportions of the body was seen as useful in Renaissance medicine, especially for surgery. It was the discovery by Vesalius that knowledge of the geography of the human body. required (epistemologically) a comparison to be made between the anatomy of human corpses with that of animal bodies. The vivisection of animals was important for knowledge of the lower functions of the body. including motions and sensations, but not necessary. Brain functions such as motions and sensations can also be studied on wounded40 Jan C.C. Rupp human beings. The essence of life can neither be touched by the anatomy of human corpses. nor by the vivisection of animals who miss the functions of memory, thinking and reasoning. In the seventeenth century very important experiments were carried out on living animals, such as Harvey's blood circulation experiment, De Graaf's with the working of the pancreas-gland, and Boyle's with the air-pump. Vivisection experiments were regarded to be the most important medical experiments, the dominant medical discourse was still ‘clinical’. Harvey stated his priorities very clearly in his letter to Jo. Riolan on the occasion of the publication in 1648 of Riolan’s book Encheiridium Anatomicum et Pathologicum: And indeed, the physiological consideration of the things which are according to nature is to be first undertaken by medical men: since that which is in conformity with nature is right, and serves as a rule both to itself and to that which is amiss: by the light it sheds. too, aberrations and affections against nature are defined: pathology then stands out more clearly: and from pathology the use and art of healing, as well as occasions for the discovery of many remedies are perceived. Within the context of pathology he ventures to say, that the examination ofa single body of one who has died of tabes or some other disease of long standing. or poisonous nature. is of more service to medicine than the dissection of the bodies of ten men who have been hanged.*” But in the last quarter of the seventeenth century what Foucault has called the anatomical discourse won ground. The Amsterdam anatomical school, for example, was persistent in its search for the essence of life in human corpses. Frederik Ruysch (who had an aversion to animal vivisection) came very close to Bichat’s discovery that tissue is the basic fundamental element of human life. Human Bodies In Vesalius’ work, no place can be indicated where he spoke of a shortage of human bodies (O'Malley and others only suggest this). He was dependent on ‘sponsors’, as everyone was at that time (the costs of an anatomy were concerned firstly with the transportation of the body, the sheets, the servants employed, and secondly with the payment of the anatomist). One of them was Judge Contarini*'! who even fixed the time of the execution of the criminals and the way in which they were executed according to Vesalius’ wishes. Neither did I find any indication that doctors did not have enough corpsesat their disposal in sixteenth and seventeenth century Holland. Kroon mentiones a document from 1593 in which the States of Holland and West-Friesland give the privilege to Leiden University that all dead bodies of criminals who are to be executed in the winter in theThe Rise and Expansion of Modern Anatomy 4l territories of the two States outside Leiden must be delivered to the professors of anatomy at Leiden.” ‘When many persons would be executed the nearest by should be delivered immediately.’ Sometimes it was a problem to find a servant to bring the corpses to Leiden, to clean the theatre etc., because they were badly paid. One can find several places in the books of the anatomists in which they that they had plenty of corpses for dissection. Thijssen concluded in 1881: "In Amsterdam one had as it seems in the seventeenth century rather less objection to the opening of corpses than in our very enlightened century’.#$ What the writings of Vesalius and also of such Dutch scientists as De Graaf, Tulp and Ruysch demonstrate is a shortage of time for anatomy because, as they put it, they were so involved in their clinical practice. Vesalius wrote in his Epistola, a letter in which he, being criticized for challenging the authority of Galen, gives an account of his work and methods, that anatomy is for the young, when one is not yet mature enough to earn money. In other words. one cannot make a living from anatomy, anatomy has not enough status for that.*+ He complained that he had to do dissections for painters and sculptors, so that he felt more miserable than the dissected person. Conflicting Interests Even Vesalius left his anatomy practice to become the emperor's doctor, just as his father and grandfather had before him. L.S. Feuer ascribes Vesalius’ withdrawal from anatomy to feelings of guilt evoked by his dissections, especially of young girls, a way of reasoning that keeps the myth about anatomy intact. O'Malley has tried to make a plausible case that Vesalius tried to leave the emperor's service secretly to pick up his anatomical practice again. This way of reasoning does not differ from that of Feuer in that the anatomist is depicted as a hero, dedicated to the very painful practice of anatomy, which appeared in the late 18th century to be the most important practice of all for humanity.** Harvey left his experimental anatomy practice to be the King’s doctor. Tulp in Amsterdam gave up his anatomy, but not his general practice, when he became burgomaster of Amsterdam. Professor Sylvius from Leiden wrote to his pupil Reinier de Graaf at Delft that he no longer had any time for anatomy because he had so many other things to do.*° All these findings indicate more conflicting (medical) interests rather than moral and religious hindrances.*” First Discussion Anatomy and anatomy theatres were very important in the Dutch Golden Age, a fact that does not seem to harmonize easily with the thesis42 Jan C.C. Rupp that religion strongly opposed anatomy. Reexamination of this question leads to the conclusion that it was not the dissection of human corpses but the vivisection of human beings that was strictly forbidden by the Christian Church and also vivisection of the brains of an animal. This kind of anatomy would destroy the ‘soul’. For Vesalius and for anatomy in general this moral law functioned as a barrier, because they were, first of all, aiming at knowledge of the functioning of the living body. Since Vesalius demonstrated that the opening of (dead) human bodies compared with those of animals is necessary to gain knowledge of the human body, and since he distinguished within the ‘princeps anima’ between the part that was related to motion and sensation (present too in brute animals) and the part related to thinking. memory and reasoning (specifically human), he could not touch what was, for him, the essence of (human) life. Motion and sensation could be studied, in spite of the prohibition of vivisection of the animal brain, in injured human beings. In the seventeenth century, physicians were also primarily interested in the functioning of the (living) body by experimenting, on the basis of heuristics derived from physics (mechanics) and chemistry. Experiments on living animals were seen as a necessary source of knowledge in this context. The clinical discourse was continued, until the second half of the seventeenth century which accords with Foucault's thesis of the antagonism between the clinical outlook and the anatomical. The causes of diseases and of death had to be looked for in the living body, death was seen as the opposite of life. Knowledge of the structure of the body was seen as very important for surgery. In the tradition of the autopsies the pathological anatomist sought the cause in terms of the locus of the illness, but the locus does not explain the disease. Ifa medical doctor had to choose, he chose the clinical practice and not the anatomical practice. Since the 1760's, however, the anatomical discourse became more and more important. The Amsterdam school of Frederick Ruysch, for example, was investigating the human corpse for its basic, essential element and came pretty close to Bichat’s findings at the end of the eighteenth century. 2 Anatomy Regulations A second source for testing Foucault's thesis is the anatomy regulations, because they reflect moral and political opinions on anatomy. Anatomy of human corpses, and vivisection experiments on animals, may have had the (relative) importance ofbeing necessary for knowledge of the structure of the human body (the situs of the organs, theThe Rise and Expansion of Modern Anatomy 43 proportions, etc), and useful for surgery, but why had this anatomy a public character? Why a theatre for public anatomies, which was also a museum? The two most important reasons seem to be that anatomy had to be in the public interest and needed regulation. - The Dutch city governments thought that anatomy should not stay in the hands of, in their view, injudicious and lax chirurgians guilds * and appointed graduates in medicine as the city anatomists (with the title of ‘professor of anatomy’), to which the privilege of the dissection ofa criminal corpse was granted. In this way, anatomy secured more status. Moreover, dissections in the private sphere were prohibited.*” Physicians had often called suspicion on themselves (e.g. Vesalius) to provide themselves with corpses in an illegal way, for example by stealing or having corpses stolen from cemetaries and the gallows. ‘Stealing’ cadavers and bones from churchyards and selling and buying them from churchyards was a regular activity at that time », only not done by gentlemen, but by servants or students. There was a trade in bones, skeletons, stuffed parts of bodies, etcetera, strongly stimulated by the interest in collections of natural history. The authorities tried to stop these illegal activities, which probably were the cause of many popular uprisings. Public anatomy can be regulated and the compliance with the regulations can be overseen. There are several documents which testify that the surgeons and medical doctors at first only got dead criminal bodies for anatomy if they carried out a public anatomical demonstration once a year. In the second half of the seventeenth century. anatomy became increasingly a ‘private’ (professional) affair of the medical class, which gradually had incorporated in its medical code the most relevant public regulations.®' Physicians were then provided with corpses from hospitals for their private practice and informal learned societies, as long as they complied with the regulations. The second reason for the prohibition of private anatomical practices and the promotion of public ones, was that anatomy had to be in the public interest. politically, culturally and morally. According to Govardus Bidloo’s 1690 Introduction to his Ontleding des Menschelyken Lichaams, the anatomy in Amsterdam was ‘noodzakelijk, heerlijck en vermakelijk’.’ Anatomy is ‘necessary’ because it is the foundation of entire medicine. Anatomy is the compass of medicine, for otherwise it would be very difficult to do surgery without damaging sound parts of the body or to prescribe medicines properly. Anatomy is ‘noble’ because important men in Amsterdam have always been greatly interested in anatomy and have practiced it. Quite a few city anatomists became burgomaster of the city. Anatomy is ‘delightful’ because nowhere else will one find as many curious things as in the human body, more curious than what44 Jan C.C. Rupp astronomers and geographers find when they travel through the great world. Bidloo indicated three ways in which anatomy had to be in the public interest: ~ Anatomy had a high status because of the importance attached to it by important people; it gives status to the city as the protagonist of arts and sciences: according to Ferrari, this could be called the ceremonial interest; ** - Anatomy is of scientific interest; it is important for the education of chirurgians, medical students and midwives and it contributes to the advancement of science: - Anatomy draws a big audience by the curious and amusing nature of what is found in a human body; anatomy is of general cultural interest, though the spectators differ greatly in the nature of their interest; some authors (e.g. Ferrari) call this the carnavalesque interest, but, in my opinion, this term is inappropriate because it implies that ‘ordinary people’ would have had no genuine interest in anatomy: ~To this, a fourth interest should be added: the moral interest; in earlier research it is reported how a Vanity-morality dominated the Dutch anatomy theatres and their museums.™ The public dissection was also amoral lesson. in general to remind people of the fragility of human life (homo bulla’) and in particular to warn citizens of the criminals fate. Some ‘bodies’ were made public again when the skeleton was erected in the theatre with placards such as ‘the famous thief Galewaard, who ....a typical sign of the traditional exclusion from society of the criminal and of the crime. According to W.S. Heckscher and Bryan S. Turner, public anatomies were penal anatomies, the criminal died a second death, and the anatomy was a general warning to the public.® Heckscher places the public anatomy in the tradition of ‘Exempla’ in the sphere of ‘barbarous vivisection’, a tradition that was already developed in the Middle Ages.* Many stories circulated about vivisection as a penal anatomy and there are famous ‘justice pictures’ as that by Gerard David."’ Foucault speaks of the ‘theatre’ of torture, supplice and capital punishment. but, surprisingly, not of anatomy theatres and public dissection in this context!.5* Italian Regulations Heckscher's thesis can be tested by considering the regulations for public anatomy demonstrations, such as were formulated in the 1497 book by Alexander Benedictus, regulations which were copied in many other countries: Only humble and unknown persons, then, and those from distant regions may rightly be claimed for dissection, that there be no outrage to neighbours or relatives. ThoseThe Rise and Expansion of Modern Anatomy 45 are chosen who have been strangled by hanging and who are middle-aged, neither lean nor fat, and of rather large frame. that their components may be of more generous size and more distinctly visible to the onlookers. In addition severe winter cold is needed, lest the cadavers putrefy too soon. Furthermore a properly adapted theatre should be arranged in a spacious and well ventilated place. with ranks of seats like those of an amphitheatre, as at Rome and at Verona: and it should be large enough to accommodate all the spectators comfortably. that the barber-surgeons who do the dissecting may not be jostled by the crowd. Only those who have great skill must continue to dissect. The seating arrangement is to be according to rank. There must be some in charge who oversees and arranges everything. Warders are to be provided for regulation of the unruly incoming rabble. Two reliable stewards are appointed who out of admissions fees supply the necessary surgical instruments. The cadaver should be placed at the centre of the theatre on a fairly high bench in a well lighted place convenient for the dissectors. The time of reconvening should be announced at the end of each session. that the work may be entirely completed before decomposition sets in. The anatomy theatre was seen in Italy as the best proof of the care that authorities take of public welfare.® The anatomy demonstrations in the theatres were attended by more important as wellas unimportant people than any other event.*! The monarch was regarded as an authority with power of life and death over his subjects and hence also the power to leave the cadaver unburied or to bestow it for dissection. The view of a proper burial as a matter of the greatest weight, can be traced back into distant antiquity. Not being granted this right is experienced as the severest punishment, that nobody would wish even on their worst enemies.® It is questionable as to whether the people accepted the omnipotence of the monarch, because in Italy it was regulated that only corpses of criminals from another city could be dissected, in order to prevent the outrage of relatives and friends of the victim. In later times the anatomists were supplied even with bodies of subjects born within the territory of the city, providing they were not ‘honoured citizens’. Moreover, in the Bolognese theatre in the seventeenth century, masses were celebrated to the souls of those publicly dissected in an adjacent chapel. The people and the clergy protested when students or scholars tried to obtain the corpses of people who had died by accident or murder, against the rules of the jurisdiction.® In the seventeenth century the authorities allowed the dissection of dead bodies of poor people who had died in a hospital and bodies from pauper’s churchyards. Benedetti’s regulation indicates that the public dissection was no quiet meeting at all. The dissection could go on for weeks: the huge crowd of spectators, from all strata of society, including young people, beggars and monks, often disturbed the precise examination of the human body.” To prevent unrest and to ensure that the demonstration could be followed with ‘modestia’, supervisors were appointed who had to see that only officials, physicians and other ‘well educated’ people attend the dissection, but without success. In46 dan C.C. Rupp 1596, the admission to the theatre in Padua was free, so that everybody could come to the theatre and follow the lessons. In Bologna, in 1616, the admission was free for everyone who wished to attend the anatomy.™ The Italian regulations paid much attention to the debates during the public anatomy demonstrations. Particularly in Bologna. where the ceremonial aspects held a prominent place. the disputatio came to be at the centre of the meeting. The anatomy often led to long philosophical debates. The Bolognese theatre remained in function until the middle of the eighteenth century. According to Ferrari, the demonstrations had no great scientific value: science was practiced in the innumerable learned academies and in the private sphere. where microscopes and other instruments could be used. Dutch Regulations Similar regulations were drawn up in the Netherlands, such as those by the Amsterdam city government in 1606. These regulations stipulated that the public dissection of a corpse of a criminal would be permitted once a year. in the winter, around Christmas. The cold was necessary to prevent the immediate decay and putrefaction of the corpse. The body was male or female, and of average age. so that comparative anatomy was possible. The criminal should come from a city other than where the dissection was to take place out of consideration for the feelings of the friends and relatives of the subject concerned.” The physicians involved had to be in possession of a license to dissect, and in most cases members of a chirurgical or a medical guild were given the privileges: barber-surgeons were the first to be involved, followed later. towards the end of the sixteenth century. by learned medical men. praelectores and professors. Places in the theatre were allocated according to rank and class. In particular the allocation of the seats between regents. medical doctors and surgeons was a source of conflict. the section of the theatre allocated to a group had to be separated from the section of another group to prevent fights. An entrance-fee was introduced and children were not admitted. Spectators had to behave in an orderly manner and questions had to be asked in a proper way. During the anatomy lessons or discussions relating to the anatomy, nobody was allowed to disturb audience or lecturers by talking, laughing or otherwise making noise. The lecturer had to respond to the questions at the next meeting. When asking questions, in the response and all further discussions, all ridicule and ‘smadelijkheid’ were to be avoided and mutual politeness and respect displayed. According to Nuyens this article was particularly aimed at the conflicts between the surgeons and the medical doctors.”! No parts of the dissectedThe Rise and Expansion of Modern Anatomy 47 corpse might be taken away under penalty of a fine: during the dissection, dissected parts were passed around so that everyone, including the spectators on the upper rows of the theatre, could have a good look at them: these parts were very much sought after for constructing a skeleton or for stuffing.” The remains of the body were to be buried with due care. This regulation was crucial. It is known. for example. that at Franeker, the authorities were very reluctant to give permission for public anatomy for fear that no proper funeral would take place afterwards.”* The same regulations became effective in later times for the dissection of dead bodies from the hospital.” The dead body was to be transported quietly from the hospital to the dissection room and brought back again for a funeral. It had to be the dead body of a foreigner, who was not a citizen of the city where the dissection took place and had no relatives there. This regulation considerably restricted the number of potentially available dead bodies. Thijssen calculated that from 1693-1774 357 criminals were executed in Amsterdam: in the periods of 1631-1645 and from 1693-1770 a total of 42 dead bodies were dissected and publicly anatomized. Neither Thijssen nor any other author mentions the regulations as a cause of this difference.” It is clear that arguments for this regulation must have been very forceful. One reason given is that one tried in this way to prevent the outrage of the relatives and neighbours of the executed criminal. Vivisection of criminal bodies was forbidden, because then the soul of the victim would be destroyed and the name of the ‘king’ and the executioner burdened. A proper funeral was also a fundamental right. even for ‘criminal persons of humble origin’. Public dissection was experienced as a disgrace. the authorities therefore took great care that the event took place as anonymously as possible. Autopsies were a regular practice in the upper classes of society. The death of an important person was so important that the cause of death (and of the failure of the doctor) had to be established. The public anatomy ofa criminal body was not an ‘autopsy’, but sometimes a dissection to establish the cause of his or her crimes, which had led to the penalty of death.”* Asecond reason for the anonymity of the criminal body was that the person and the crime were of no further interest. and so the criteria for choosing the dead body for anatomy were scientific: that it should be of average height and age. in good health, etc, so that comparative anatomy would be possible. What had to be regulated were the ranking of the seats, the order of questions etc., indicating that the central issue was the interpretation of what the dissection uncovered. The criminal, so declared the Dutch poet Barleus in 1632, who had done so much harm to society, can now. after his death, be of great use to society!” Life and death (the dead body) are not complete opposites any more. Just48 Jan C.C. Rupp ; as Amsterdam was the first city in the world where the authorities. forced criminals to work, so that the prison became economically productive: similarly the executed criminal could. after his or her death, through his or her death, also be of use to society. The power of exclusion transformed into the power of disciplining the (criminal) bodies, a power that now extended beyond death.”* Increasing doubt on the scientific value of the public anatomy, caused the physicians to insist on obtaining permission for private anatomy and in the informal learned societies and for the supply of bodies from the hospitals. Besides, at the end of the seventeenth century, such anatomists as Frederik Ruysch invented methods by which corpses and parts of bodies could be preserved for an unlimited period and dissections could take place at any time of the year.” The huge public anatomy demonstrations were seen as unsuitable for good teaching and for scientific research. English Regulations The view of Heckscher and Turner, that the public dissection was a ‘second death’, does hold for the English situation, except that the dissection was not public here. A ‘second death’ comes up in so many words in the so-called ‘Murder Act’ of 1752. Until that time, the Royal College of Physicians and the Company of Barber-Surgeons had the patent, granted to them by Elizabeth and Charles II, to the annual dissection of some executed criminals. According to Peter Linebaugh, the Crown and the legislature were less interested in the advance of science, than in the anticipation of dishonour to the “scum of the People”.*° The preamble to the ‘Murder Act’ of 1752 stated, ‘it is become necessary that some further Terror and peculiar Mark of Infamy be added to the Punishment’. Dissection by the Surgeons of the corpse was added to death by hanging. as a means to make the death sentence more terrifying. The Act gave judges discretion in death sentences for murder to substitute dissection for gibbeting in chains, the body treated with tar and a prey for the birds. As an exemplary punishment gibbeting was exceeded in power only by dissection. It was explicitly stated that in no case whatsoever the body of any murderer should be suffered to be buried.*! The provision denying Christian burial to murderers is singled out for particular praise and justification in the Bible, which talks of burning in hell, which is the second death. Unlike in Italy, Holland and France, dissections in England never became public. They were carried out in the private sphere of the College of Physicians or the Surgeons Company and only attended by chirurgians, physicians and medical students (Linebaugh unjustifiably speaks of public dissections). Officials or the general public wereThe Rise and Expansion of Modern Anatomy 49 absent from the anatomical demonstrations. This situation was reflected in the outcome of an important debate in England on the question as to whether. for the advancement of science, experiments and other scientific procedures should be witnessed and discussed by colleagues in the private sphere of the scientific community or by the general public in a general debate. Robert Boyle represented the first view, which became the dominant opinion, Thomas Hobbes the second one.** Although illegal, many private schools were founded by physicians in the second half of the eighteenth century, in which empirical science and learning by doing were stressed. as opposed to the method of demonstrations and disputations of the Royal College. The demand for corpses suddenly increased. while for the demonstrations of the Royal College and the Company of Barber- Surgeons the royal grant of four criminal corpses a year was sufficient. A private trade in corpses developed, which were taken, by specialized gangs, from the gallows. graveyards, hospitals, and even from private homes. The English people have frequently risen in revolt against these practices, as it has revolted against barbarous forms of public execution. In England the regulation was unknown that only ‘foreign’ criminals could be dissected and that everyone had the right to a proper burial.*° In particular the right to a proper burial is regarded as an inalienable right. Ruth Richardson stated: The infliction of damage upon the corpses of executed criminals - the quartering of traitors, and the use of dissection upon murderers - historically constituted a deliberate juridical breach of society-wide norms and values. Had Britain lacked a consensus attaching deep importance to the post-mortem care and integral burial of the corpse, such punishments could have held no cultural meaning.” Relatives, neighbours, friends, colleagues and fellow countrymen (confederates & other disorderly people’) invented all kinds of methods to rescue the bodies of their beloved ones from the hands of the physicians and to give them a ‘decent burial’ ‘in a Christian Manner’.*7 People were prepared to travel great distances by foot to Tyburn in London, which was a risky enterprise, where the executions took place. Sometimes, they succeeded making a deal with the executioner. In the period that hanging took place by strangling, the executioner took care that the hanged only lost consciousness, so that the family could claim a ‘resurrection’**; when this was recognized, the victim could not be hanged again. Fights for corpses between the accomplices of the physicians of the Royal College and the private schools, and between them and the relatives and friends of the criminal. occurred regularly and led tohuge conflicts. Physicians and barber-surgeons were frequently threatened with death on these occasions.50 Jan C.C. Rupp Physicians such as Bernard de Mandeville provided the first utilitarian defence of the dissection of condemned criminals, when he stated that he was not intending cruelty or indecency towards a human body, but that the ‘superstitious reverence of the vulgar for a corpse, even of a malefactor’, were ‘prejudicial for the publick’; dissection was needed for the improvement of medicine.*° It took until 1832. the year of the ‘Anatomy Act’, before the traffic in corpses and the uprisings against the dissections suddenly stopped. One of the problems was, that in English law, a corpse was nobody's property. The Anatomy Act implied that henceforth also corpses from the workhouses could be used, if at least no family claimed the body. and a burial was taken care of. In the debates on this Act. Jeremy Bentham proposed to offset the shortage of corpses by forcing hospital patients to place their bodies at the disposal of the physicians who would be responsible for ensuring a Christian burial. in order to spare the feelings of the relatives. He himself, quite consistently, placed his body at the disposal of science after his death. In the words he used on that occasion, we remember the words of the Dutch poet Barleus in 1632: ‘so that my last moments have for their comfort the assurance that how little service soever it may have been in my power to render to mankind during my lifetime. I shall at least be not altogether useless after my death’.”’ French Regulations William Hunter. an important London anatomist, spoke of the ‘Paris Manner' of dissection, when he referred to the method by which each individual student dissected a whole corpse. (92) The French tradition was, in many ways, different from that in Italy, Holland and England. Gelfand’s research indicates that there was a multiplicity of regulations owed to the various authorities. In addition to the authority of the Crown and the parliament, there were the Church's authority over the hospitals, the academic authorities and the colleges of physicians and barber-surgeons. In the seventeenth century, just in Paris, anatomy could be practiced at six official institutions, added to by various private schools. The Faculté de Médicine de Paris took care of lessons in anatomy for barber-surgeons and medical students from the beginning of the fifteenth century. The dissection was left by the physicians to the barber-surgeons; in private lessons they did it themselves. Sometimes the students themselves (for example, Andreas Vesalius) got the opportunity to dissect.% In the sixteenth and seventeenth century, the Parliament granted the medical faculty the monopoly to distribute corpses and teach anatomy.” I did not find any documents that indicated that in France only corpses from ‘foreigners’ could be dissected.The Rise and Expansion of Modern Anatomy 51 Paris also had the Hotel Dieu. The famous surgeon Ambroise Paré practiced anatomy here in in the sixteenth century. The courses included pathological as well as normal anatomy, in particular with respect to surgical illnesses. Physiological experiments were included in the program. Anatomical material was available in great abundance in the hospital. although the official policy prohibited dissections as being in conflict with Christian charity and humanity. A regulation permitted autopsies to be carried out in the hospital by the surgeons of the hospital and in the presence of the hospital's physicians. In 1706. a regulation stated that only the mother superior could give permission for the supply of corpses from the ‘salle des morts’, on the recommendation of the master-surgeon of the hospital. Special times were indicated for the preparation of parts and for demonstrations in the theatre. Surgeons from outside the hospital could only attend the anatomy with permission from the hospital board.®* From these regulations it can be deduced that the hospital was not very eager to renounce bodies to authorities outside the hospital, despite urgent requests and sometimes even Royal decrees. As reasons for its opposition to anatomy, the Hospital board cited public indignation, fear and religious sentiments. In 1749 the board reported that the distribution of bodies for anatomy outside the hospital was faced by great resistance from the public and evoked disgust and aversion against the hospital.® By giving anatomy the look of the respected autopsy, an attempt was made to avoid these problems. In 1668 the Court surgeon became the master of the Paris Guild and of all the guilds in the country. The King and his ministers were very interested in surgery because of their preoccupation with warfare. This caused a great flourishing of anatomy and surgery. By Royal decree in 1673 the Jardin du Roy was allowed to do surgical interventions, dissections and anatomical demonstrations with complete freedom. The Jardin was given priority over the Medical faculty in the disposal of bodies from the hands of the public executioner. These anatomy demonstrations were public dissections. They attracted the Parisian elite and a general public of four to five hundred people, many foreigners included. In Gelfand’s view, philosophers and authors were particularly interested in the eloquence of the anatomist and the spectacle. The professors in anatomy disposed of corpses from the gallows, the Chatelet, where those who were found murdered on the streets were brought, and from the hospitals. The Board of the hospital hesitated in supplying bodies, because it suspected the anatomists of the Jardin of the illegal purchasing of cadavers from the gravedigger at the hospital cemetery.” The King also stimulated anatomical and surgical education at the school of Saint Céme and in the hospital Le Charité. In Le Charité autopsies were performed on all patients and complete dissections in the cold winter for an audience of barber-surgeons and physicians. It52 Jan C.C. Rupp 7 was strictly forbidden to touch corpses that were already buried. One had to ensure a proper burial of the remains after autopsy, or dissection. Finally, there were private courses at the écoles particulieres, where students could practice anatomy themselves. Although only public schools and hospitals were provided with corpses, it was, quite paradoxically, easier for private teachers to purchase bodies, predominantly from cemeteries. The reason was that dissection took place in the private sphere, unless accidents or indiscretions created a scandal and necessitated police intervention.® The need for good surgeons resulted in the King and the government looking the other way, as long as the traffic in corpses was conducted discretely.* In the course of the eighteenth century, the ‘philosophes’ of the Enlightenment criticised what they called superstition with respect to dissections. It was said by Diderot, for example, that ina civilised society, priests should only receive corpses after they were dissected by the anatomist. The law should forbid a fu neral without preliminary autopsy. in view on the advancement of science. The board of the Hopital Général declared, in 1731, that the natural disgust of the inhabitants towards dissection was understandable, but the poor had to realise their obligations to a society that took care of them.'” Second Discussion In the beginning of the section on anatomy regulations, it was assumed that anatomy adopted the form of public dissections in an anatomy theatre, because, in this way, the authorities were able to supervise the supply of corpses for dissection and the compliance with other regulations for anatomy, and to prevent illegal traffic in bodies. This assumption appears to hold true for those countries where the sovereign or the city government attached great importance to anatomy for the benefit of public welfare. In France the King managed to acquire the necessary central authority only in the second half of the seventeenth century. England never knew public anatomy theatres. The dissection of the criminal body was seen there as a second death, which was executed in the private circle of the medical doctors; moreover, the criminal could be denied a burial by the Monarch and the Parliament. The medical men were the extension of the omnipotence of the monarch. In Holland, the public anatomy was seen as a moral lesson in the fragility of the human existencé and as a warning of the consequences of criminal behaviour, but the entitlement to a proper burial was strongly emphasized in the anatomy regulations. A second reason for the English lack of public anatomy is that English medical doctors have always had strong doubts with respect to the scientific and educational value of public dissections. It wasThe Rise and Expansion ef Modern Anatomy 53 assumed that advancement in science could only be made by empirical education and by debates in the private circle of learned societies. Only such philosophers as Thomas Hobbes held the opinion that a general public debate was necessary for scientific Progress. In the other countries, the usefulness of public anatomy was gradually questioned. Anatomy was privatized, for example in Holland, in the 1670s. Only in the private sphere, could indispensable instruments such as microscopes be used. In Italy, France and Holland, where the authorities took a great interest in anatomy. there was no shortage of corpses: in England where the Crown was less interested in scientific progress as well in punishing criminals, there was a real shortage of bodies, as soon as empirical teaching was stressed and private schools founded, as opposed to the anatomical demonstrations in the College of Physicians. In making arrangements for public anatomy, it was a problem how the various conflicting general interests could be harmonised. Besides the general interest of progress in medical science (for the benefit of surgery, midwifery, and the general progress of medicine), there was the entitlement to a proper burial. Considering the reactions of the people in each of the countries investigated, this right appears as an unalienable basic right of every human individual and his social milieu. In the Republic of the United Netherlands, medical men seem to have complied to this law the best. Moreover, in the Netherlands and in Italy, only bodies of non-citizens were allowed to be dissected in order to prevent the outrage of relatives and friends. Different from France and England where ‘citizens’ were subjects of the Crown, ‘citizens’ in Holland and Italy were people born in a city or permanently inhabitants of a city, which was a relatively autonomous political unit. These problems became more sensitive, when the authorities proceeded to supply bodies from hospitals for dissection. This involves anatomical research carried out in the private medical sphere. In Holland, France and Italy the medical doctors also had to comply to the right to a proper burial and they had to manoeuvre as carefully and inconspicuously as possible when transferring the corpses. In England, only after 1832 were physicians obliged to ensure a proper burial after dissection. Before that time, the criminal was denied a burial and his or her relatives and friends rose up frequently to rescue the body from the hands of the physicians. A third general interest was the interest of the patients and the reputation of the hospitals. Supplying bodies from the hospitals meant the provision of corpses from the poor. Particularly in France, the Church boards of the hospitals were very concerned for their good reputation. They insisted that the physicians should give the anatomy the standing of an autopsy. This form of anatomy was well known for54 Jan C.C. Rupp 7 quite a long time in prominent families in the case of a legal or a medical problem. For the moral conflict that is implied in using corpses of criminals and the poor for science, the Dutch had in 1632 already constructed a justification in terms of the usefulness of the criminal for society after his or her death. It was a discourse of the French Enlightenment philosophers that the poor for whom society had done so much, were indebted to society. Jeremy Bentham was truly enlightened when in 1832, he voluntarily placed his body at the disposal of the science of medicine. During the public dissections, all kinds of regulations were applied. The mixed audience, consisting of groups with very different interests in the event, created chaotic scenes. The rules were that everybody had to behave quietly, that the various groups had to keep the places that were reserved for them, that nobody's view of the scene should be obstructed, and that the discussions had to be orderly and friendly. These regulations also applied in learned societies and, at the end of the nineteenth century, in theatres, concert halls and other cultural centres. According to Norbert Elias'®', this development could be called formalization of human relationships. Conclusions Analysis of anatomy practices and regulations in pre-modern Italy, Holland, France and England, indicate that Foucault's thesis is only partly confirmed. Until the second halfof the seventeenth century the ‘clinical discourse’ was certainly dominant. Medical doctors felt frustrated by the Church’s verdict on the vivisection of humans and of the brain of animals and preferred physiological experiments on living animals such as Boyle’s air-pump experiment. However, after the 1670s, the ‘anatomical discourse’ gained in importance. The question as to whether a real shortage of corpses occurred, is not only dependent on conflicting medical discourses, but also on conflicting opinions with respect to teaching and to the conditions for scientific progress and, most of all, on the interest taken in anatomy by a government. Moreover, morality played a significant role, particularly in the form of the entitlement to a proper burial of the remains. Despite all efforts by scientists and philosophers to degrade this right as ‘superstition of the masses’, it was finally recognized in all countries. Morality was not necessarily a hindrance to the advance of science, but dependent on body politics. *Earlier versions of this paper were presented at the Staff/postgraduate students Seminar, Department of Sociology, University of Essex, November 1990. and on the Conference of the Dutch Society for the Study of the History of Society, May 1991. I am greatly indebted toThe Rise and Expansion of Modern Anatomy 55 Catherine Crawford, Bryan S. Turner and two anonymous reviewers for their comments. Address all correspondence to: University of Utrecht, Kromme Nieuwe Gracht 35A, 3512 HD Utrecht, the Netherlands. Notes ‘J. de la Court Politike Discoursen (Amsterdam, 1662) pp.46-7, 78. ? In 1622 Amsterdam had about 105.000 inhabitants, Leiden 45,000 and Delft 23,000. Leiden and Delft are situated between Amsterdam and The Hague/Rotterdam. * See Jan C.C. Rupp ‘Matters of life and death: the social and cultural conditions of the rise of anatomical theatres, with ‘special reference to the seventeenth century Netherlands’ History of Science Vol. 28 (1990), Part 3, no. 81, pp.263-287. * Reinier (Regnerus) de Graaf Opera Omnia (Leiden. 1677). In Dutch: Alle de wercken, zo in de ontleedkunde als andere deelen der medicynen (Amsterdam, 1686). The Collected Letters of Antoni van Leeuwenhoek. Alle de brieven van Antoni van Leeuwenhoek (10 Vols.. Amsterdam, 1939-1979). Johannes van Horne Microcosmos seu brevis manuductio ad historiam corporis humani (Leiden, 1660). Franciscus Deleboe Sylvius Opera medica {Amsterdam, 1630, 2nd edn. 1679, 3rd edn. 1695). Hermanus Boerhaave and Bernardus S. Albinus Andreae Vesalii, invictissimi Caroli V. Imperatoris medici, opera omnia anatomica & chirurgia T. I-Il (Leiden, 1725). Nicolaus Petreus Tulp(ius) Observationum Medicarum (Amsterdam, 1641); later (enlarged) editions Observationes medicae (Amsterdam 1652. 1672, 1685, 1716). Frederik Ruysch Opera Omnia anatomica- medico- chirurgica (5 Vols., Amsterdam, 1737); in Dutch: Alle de ontleed- genees- en heelkundige werken (3 Vols, Amsterdam, 1744). Jan Swammerdam Tractatus physico-anat.- medicus de respiratione usuque pulmonum (Leiden, 1667). Jan Swammerdam Historia insectorum generalis (Leiden, 1669). Jan Swammerdam Miraculum naturae, sive uteri muliebris fabrica, etc. (Leiden, 1672). Jan Swammerdam Ephemeri vita of afbeeldingh van ‘s menschen leven, vertoont in de wonderbaarlijcke en nooyt gehoorde historie van het vliegent ende een-dagh- levent haft of oever-aas (Leiden, 1675). Jan Swammerdam Biblia naturae (Bijbel der Natuure), edited by H. Boerhaave and H.D. Gaudius (3 Vols, Leiden 1737, 1738). * Rembrandt's painting The anatomy lesson of Dr Tulp’ (1632) is in the Mauritshuis in The Hague. Govard Bidloo Anatomia humani corporis. centum et quinque tabulis per artificiosissimum G. de Lairesse ad vivum delineatis illustrata (Amsterdam, 1685). In Dutch: Ontledingdes Menschelyken Lichaams. Gedaan en beschreeven door Govard Bidloo. Uitgebeeld, naar het leeven, in honderd en vijf aftekeningen, door de heer Gerard de Lairesse. (Amsterdam, 1690). In the Dutch edition Bidloo’s inaugural lecture in 1688 in The Hague is included as an introduction. Frederik Ruysch Museum Anatomicum Ruyschianum sive catalogus rariorum (Amsterdam, 1691; 2nd edn. 1721; 3rd edn. 1737). Frederik Ruysch Thesaurus Anatomicus 10 Vols. (Amsterdam, 1702-1716). For painters in Leiden see: Ingvar Bergstrom Dutch Still-Life Painting in the Seventeenth Century (London, 1956) pp. 154-190. Cornelis de Man ‘The anatomical lesson of Dr. Cornelis ‘s Gravesande’ (1681, Oude en Nieuwe Gasthuis at Delft). De Man once participated in a group of the socalled Delft Church Painters. These men, Carel Fabritius and later on Johannes Vermeer56 Jan C.C. Rupp experimented with perspectives, fish-eye and tele-lenses. See A.K. Wheelock Perspective. Optics and Delft Artists around 1650 New York (1977): John Michael Montias Artists and Artisans in Delft (Princeton. 1982). W.A. Liedtke Architectural Painting in Delft (Doornspijk. 1982): Dutch Church Painters. Saenredam's ‘Great Church at Haarlem’ in context (National Gallery of Scotland, Edinburgh. 1984): John Michael Montias Vermeer and his Milieu. A Web of Social History (Princeton, 1989). The Delft’ painters were the avant- gardists of the seventeenth century. © Michel Foucault La naissance de la clinique; une archeologie du regard medical (Paris, 1963); The Birth of the Clinic. An Archeology of Medical Perception (London: Routledge, 1973). pp.124-148. 7 Important literature on this field is: B. Farrington ‘The last chapter of the De Fabrica of Vesalius’ Transactions of the Royal Society of South Africa Vol.20 (1932). pp.1-14: FJ. Cole A history of comparative anatomy. From Aristotle to the eighteenth century (London, 1944): Charles Singer Vesalius on the human brain (London, 1952): W.S. Heckscher Rembrandt's Anatomy of Dr. Nicolaas Tulp. An Iconological Study (New York, 1958): C.D. O'Malley Andreas Vesalius of Brussels (Los Angeles, 1964) pp.1-20; including a translation of the Preface of the Fabrica of Vesalius of 1543. pp.317-324: Ludwig Edelstein Ancient Medicine ed. Owsei and C. Lilian Temkin (Baltimore: TheJohns Hopkins Press, 1967): Michel Foucault The Birth of the Clinic; A.B. de Vries, et al. Rembrandt in het Mauritshuis (Alphen aan de Rijn, 1978). pp.94f: Jerome J. Bylebyl The school of Padua: humanistic medicine in the sixteenth century’. Charles Webster (Ed) Health, medicine and mortality in the sixteenth century (London, 1979) pp.335-70; D.L. Hodges Renaissance Fictions of Anatomy (Amherst, 1985). * Farrington ‘The last chapter’ p.1. * Andreas Vesalius Epistola de radicis chynae decocto (Basel, 1546). In Dutch Brief behelzende de aanwending van het decoct van chynawortel (Amsterdam 1915). Opuscula selecta neerlandicorum de arte medica III. See here, Brief chynawortel p.70 (my translation). ‘© For ages people had used translations (in Latin) of translations (in Arabic) of the classical Greek texts, and Latin translations of original Arab texts. The Greek texts moreover were edited mostly in terms of a commentary, the socalled ‘articella’. See Peter Murray Jones Medieval medical miniatures (London, 1984) pp.23-4. The reading of the lector during the dissections was partly purely symbolic. One can say that it was a general attitude of the new scientists not to believe what was written but only to believe observations. Simon Stevin thought that the observations on which the classical works were based, were lost. See Simon Stevin De Wysentyt (1608): The Age of the Sages, in: The principle Works of Simon Stevin Vols. 1-5 (Amsterdam, 1955- 1966) p.593. '! See E. Ashworth Underwood ‘The early teaching of anatomy at Padua with special reference to a model of the anatomical theatre’ Annals of Science Vol. 19 (1963), pp. 1-26; H.J. Witkam lets over Pieter Paaw en zijn Theatrum Anatomicum en over het bouwen van de anatomieplaats en de bibliotheek (Leiden, 1967); Th.H.Lunsing Scheurleer, ‘Un amphithéatre d’anatomie moralisée’, Th.H. Lunsing Scheurleer and G.H.M. Posthumus Meyjes (Eds) Leiden University in the Seventeenth Century. An Exchange of Learning (Leiden, 1975) pp.217-277, footnote 11. " See Gottfried Richter Das Anatomische Theater [Abhandlungen zur Geschichte der Medizin und Naturwissenschaft Heft 16 (Berlin, 1936; reprint 1977)] p.23; O'Malley Vesalius pp.100, 113, 117, 118, 200, 201. *8 Bidloo Ontleding des menschelyken lichaams p.4 (my translation). TheThe Rise and Expansion of Modern Anatomy 57 same reasoning can be found in 19th century books on the history of anatomy. See e.g. A. van der Boon Cz., Geschiedenis der ontdekkingen in de ontleedkunde van den mensch. gedaan in. de Noordelijke Nederlanden, tot aan het begin der negentiende eeuw (Utrecht, 1851). passim. ‘8 Marie-Christine Pouchelle, The Body and Surgery in the Middle Ages (Oxford: Polity Press. 1990) p.1. 6 Pouchelle, Body and Surgery p.86. ‘* Ludwig Edelstein ‘The History of Anatomy in Antiquity’. Ludwig Edelstein Ancient Medicine. 247-301 pp.248-9. ‘7 Edelstein Ancient Medicine p.273. '* Edelstein Acient Medicine pp.252-53. * Edelstein Ancient Medicine p.299. °° Foucault Birth of the Clinic pp.124-148. *! In the English translation ‘other than’ is forgotten. * Foucault Birth of the Clinic p.145. E.g. Pierre Huard and Mirko Drazen Grmek La Chirurgie modeme (Paris. 1968) p.10. 2° Foucault, Birth of the Clinic p.145. 24 Foucault, Birth of the Clinic p.128. 5 Foucault, Birth of the Clinic p. 136. °6 Foucault, Birth of the Clinic p.126. *’ It is doubtful if ‘stagnation’ is a correct term to characterize that epoch. See Ludwig Edelstein ‘Recent Trends in the Interpretation of Ancient Science’, in: Ancient Medicine pp.401-40. 28 See Vesalius Brief chynawortel 37f. 7° Richter Anatomische Theater, pp.14, 28-9. Pouchelle The Body and Surgery, pp.25 and 83. In 1955, Amsterdam got the prerogative to have yearly a public anatomical demonstration on a executed criminal from Philips II. See De Vries et al. Rembrandt, p.94. *° See Richter Anatomische Theater pp.26-7. “'W.S. Heckscher Rembrandt's Anatomy of Dr. Nicolaas Tulp. An Iconogical Study (New York, 1958) pp.182-3. The translation by Hekscher ‘installed’ instead of ‘temporary’ gives the wrong impression that the theatre was already permanent. See Richter Anatomische Theater p.24; Lunsingh Scheurleer ‘Un amphithédatre’, n. 11. * Edelstein Ancient Medicine pp.290. * Nicolaas A. Rupke (ed) Vivisection in historical perspective (London, 1987) p.16. Anita Guerrini, The ethics of animal experimentation in seventeenth-century England’ Journal of the History of Ideas Vol. 50 (1989). Nr. 3, pp.391-407. *4 O'Malley Andreas Vesalius p.101. * Vesalius De Fabrica p.658; e.g. Farrington ‘The last chapter’. In 1538 for example, Vesalius, invited by students, dissected three human bodies and six dogs at the Bologna theatre. that was erected in a church. O'Malley Andreas Vesalius pp.98-9. % Farrington The last chapter p. 10. Hieronymus Fabricus Ab Aquapendente was Vesalius’ most important successor in experimenting. See his Opera Omnia Anatomica et Physiologica (Editio Novissima, Leiden 1738). *”In the translation of Farrington it is ‘although their structure ....’, but this is incorrect. ‘In cerebri igitur ipsius, partium examine, parum omnino in viva sectione videndum est, quum hic velimus nolimus, vel theologorum nostratium causa, memoriam, rationem & cogitationem brutis animalibus adimere debeamus, utcunque illis cum homine eadem sit constructio.’ ** Farrington ‘The last chapter’ p.10. * Singer Vesalius on the human brain pp.1, 4 and 40.58 Jan C.C. Rupp 4° The works of William Harvey; translated from the Latin by Robert Willis (London, 1847) p.91. First editions: William Harvey Exercitatio anatomica de motu cordis et sanguinus in animalibus 1628. From the same author De generatione animalium (1651). William Harvey Lectures on the Whole of Anatomy tr. C.D. O'Malley et al. (Berkeley, 1961). +1 Vesalius De Fabrica p.650; O'Malley Vesalius p.113. “JE, Kroon Bijdragen tot de geschiedenis van het geneeskundig onderwijs aan de Leidse Universiteit 1575-1625 (Diss. Leiden. 1911) p.134. 43 E.H.M. Thijssen Nicolaas Tulp als Geneeskundige Geschetst. Eene Bijdrage tot de Geschiedenis der Geneeskunde in de XXVIIde Eeuw (Diss. Amsterdam, 1881) p.30. +4 Vesalius Brief chynawortel pp. 186-7. 45 LS. Feuer The scientific intellectual. The psychological and sociological origins of modern science (London, 1963), pp. 167-182. O'Malley Vesalius pp.289-90, 296 and 307. 46 De Graaf Alle de wercken, Preface. 47 They also indicate a lack of money. Bidloo makes no secret of the fact that he looked for sponsors in Amsterdam, ‘devotees of the art, men famous by their offices and science’ to supply him with the dead bodies he needed for his complete atlas of the ‘fabrica’ of the human. body. Bidloo Ontleding des Menschelyken Lichaams, Preface. 48 Thijssen Nicolaas Tulp pp.11 and 14. 48, Ashworth Underwood ‘The early teaching of anatomy at Padua, with special reference to a model of the Padua anatomical theatre’ Annals of Science, 19 (1963), 4-26, pp.4, 7 and 18. 5° Kroon Bijdragen tot de geschiedenis pp.53 and 134. 51 E.g. the request made by Frederick Ruysch in 1697 to the inspectores Collegii Medici in Amsterdam. Thijssen Nicolaas Tulp pp.27-31. 52 Govardus Bidloo Ontleding des Menschelyken Lichaams (1690). 53 Giovanni Ferrari ‘Public Anatomy Lessons and the Carnival: The Anatomy Theatre of Bologna’ Past & Present Vol.117 (1987). pp-50-106. ‘4 Rupp ‘Matters of life and death’. 58 Heckscher Rembrandt's Anatomy. Bryan S.Turner Medical Power and Social Knowledge (London, 1987) pp. 28f and 34f. and by the same author ‘The anatomy lesson: a note on the Merton thesis’ Sociological Review Vol. 38 (1990), Nr.1, pp.1-18. 56 Heckscher Rembrandt's Anatomy pp.85-90. 57 Gerard David, ‘The Judgment of Cambyses’ (dated 1498; Groeningemuseum, Bruges). 58 meEet Foucault Discipline and Punish: the Birth of the Prison (New York, 1977). 59 Heckscher Rembrandt's Anatomy pp. 182-3. ® Richter distinguishes between a Paduan type of public anatomy, as an academic scientific ceremony, and a Bolognese type, as a social representation of the academy during a popular festival (‘funzione’); a difference which, in his opinion, was reflected in the architectural form, in Padua a theatre, in Bologna an auditorium. Richter Anatomische Theatre pp.56-60. But in Leiden as in the other Dutch cities, where the theatre was built according the Paduan model, the public anatomy also had a representational aspect. It can be deduced from descriptions made at that time about the Dutch situation that the anatomical manifestations attracted a mass audience. For the situation in Leiden see J.J. Orlers Beschrijvinge der Stadt Leyden (Leiden 1614, 2nd edn. 1641). If the anatomical dissection of a criminal dead body as a public manifestation took place around Christmas, Easter broughtThe Rise and Expansion of Modern Anatomy 59 another public event, the ‘Paasdol’. See A. van Hulzen Utrechtse kloosters en gasthuizen (Baarn, 1986) p.152. During Easter one could visit the madhouse to look at the lunatics, for a small fee. The fees were an important source of income for the management of the madhouse and that was one of the reasons why this custom was abolished only in the late 18th century . *! Ferrari ‘Public Anatomy Lessons’ pp.81-2. © Ferrari, ‘Public anatomy lessons’ p.60. “ E.g. Edelstein Ancient Medicine p.273. ® Ferrari, ‘Public Anatomy Lessons’ p.66. °° Ferrari, ‘Public Anatomy Lessons’ p.88. % Ferrari, ‘Public Anatomy Lessons’ p.87. °’ Arturo Castiglioni The origin and development of the Anatomical Theatre to the End of the Renaissance’ Ciba Symposia Vol. 3 (1941), Nr 2, 826-845, p-833. ® Ferrari ‘Public Anatomy Lessons’ pp.98-9. © The relevant literature on the Dutch regulations is: Thijssen Nicolaas Tulp pp.33-44; Kroon Bijdragen tot de geschiedenis pp.49-50; B.W.Th. Nuyens Het ontleedkundig onderwijs en de geschilderde anatomische lessen van het Chirurgiinsgilde te Amsterdam. in de jaren 1550-1798 (Koninklijk Oudheidkundig Genootschap te Amsterdam, Jaarverslag 1928) pp.45-90. Heckscher Rembrandt's. Anatomy pp. 182-87; De Vries et al. Rembrandt in het Mauritshuis p.219: H.L.Houtzager Medicyns, vroedwyfs en chirurgyns. Schets van de gezondsheidszorg in Delfien beschrijving van het Theatrum Anatomicum aldaar in de 16e en 17e eeuw (Amsterdam, 1979). * Thijssen Nicolaas Tulp pp.38-9. ”) Nuyens Het ontleedkundig onderwijs p.56. ” Thijssen Nicolaas Tulp p.34. ” Thijssen, Nicolaas Tulp p.32. ** Thijssen. Nicolaas Tulp pp.28 and 30. ** Thijssen, Nicolaas Tulp p.31. ® Bleyswijck Beschryving Der Stadt Delfi (Delft, 1667) pp.575-76. 7 Nuyens Het ontleedkundig onderwijs p.75. * Foucault Surveiller et punir. Naissance de la prison (Paris, 1975) pp.208- 211; Discipline and Punish: the Birth of the Prison (New York, 1977). 79 See Rupp ‘Matters of life and death’ p.277. ® Peter Linebaugh The Tyburn Riot Against the Surgeons’, in Douglas Hay et al. eds.) Albion's Fatal Tree. Crime and Society in Eighteenth-Century England (London, 1975) p.73. *' Ruth Richardson Death, Dissection and the Destitute (London, 1987) pp. 36-7. ® Linebaugh The Tyburn Riot’ pp.77-78. *° Steven Shapin and Simon Schaffer Leviathan and the Air-Pump. Hobbes. Boyle and the Experimental Life (Princeton UP 1985) pp.38-40, 55-65, 112- 14, 283-331. “ Victor Robinson ‘Anatomical Dissection in the 18th Century’ Ciba Symposia Vol.3 (1941). 2, pp.826-845, 849; Linebaugh The Tyburn Riot p.73. * Robert Hughes The Fatal Shore. A History of the Transportation of Convicts to Australia 1787-1868 (London: Pan Books, 1987) pp.34-5. °° Richardson Death pp.28-9. “ Linebaugh ‘The Tyburn Riot’ pp.74-5, 79. * Linebaugh ‘The Tyburn Riot’ p.103. “° Linebaugh ‘The Tyburn Riot’ p.72. © Richardson Death p.58. *! Linebaugh ‘The Tyburn Riot’ p.110.60 Jan C.C. Rupp ® Toby Gelfand ‘The “Paris Manner” of dissection: student anatomical dissection in early eighteenth-century Paris’ Bulletin of The History of Medicine Vol.46 (1972). pp.99- 130; and Professionalizing Modern Medicine. Paris Surgeons and Medical Science and Institutions in the 18th Century (Westport: Greenwood Press, 1980); Christopher Lawrence “Alexander Monroe Primus and the Edinburgh Manner of Anatomy’ Bulletin of the History of Medicine Vol. 62 (1988). pp. 193-214. ® Gelfand ‘The Paris Manner’ pp.109 and 116. 9% Gelfand ‘The Paris Manner’ p.107. % Gelfand ‘The Paris Manner’ pp. 111-12. % Gelfand The Paris Manner’ p. 115. Gelfand ‘The Paris Manner’ pp. 105-6 and 188. %8 Gelfand ‘The Paris Manner’ p. 117. %® Gelfand ‘The Paris Manner’ pp. 128-9. 100 Gelfand ‘The Paris Manner’ pp. 129-30. 11 N, Elias Civilizing Process: the History of Manners (O: Blackwell, 1978).Copyright © 2003 EBSCO Publishing