The Hunterian and RCSE

The collections of various body parts in jars at the Hunterian Museum and the Royal College of Surgeons Edinburgh create an interesting comparison between the work of those working completely within the medical establishment and those without it. Our tour guide at the Hunterian described John Hunter as a man who did not have a formal education in medicine or science but who instead wanted to learn via experience and observation. He learned technique from his brother who had been a surgeon and teacher, eventually becoming good enough to open a school of his own. Hunter also collected a variety of body parts and pieces from animals and creatures of all sorts and in all forms. It was through studying what could go wrong with the body that he hoped to determine how to fix it; the theory of animal economy, demonstrating an analogous body plan across far reaching species, was the reason behind the extreme variance in creatures. John’s collection was certainly meant to be studied, both by himself and later by his students, but simultaneously it was meant to be seen. He displayed the pieces publicly, with days when people could come off the street to see the wonders that he had within his combined home-museum-school and whom he impressed with details of either the intellectual value or the actual price of most pieces. It was only after his death that the collection was sold to the Royal College of Surgeons London, where it was placed in display cases behind glass, arranged to emphasize the sheer volume of the collection.

While the collection at the Royal College of Surgeons Edinburgh at first may seem extremely similar, the differences quickly become apparent. This collection was never meant for public consumption but rather to teach exclusively. Even the physical placement of the collection within the building is telling—the upper level balcony which would physically give way were too many people to tread across it houses shelves of jars which can be seen by the public below but not touched. Importantly, the jars arranged on the shelves all contain diseased or abnormal human specimens and are all able to be held and examined closer by the medical student who might be researching. In general, one must pass inspection to be allowed up among the specimens. Further, while each jar in the Hunterian Collection is clearly labeled and explained, often with the names of those who were the prior owners, the jars among the teaching collection are anonymous. The prize piece in London was the Irish giant who was displayed in the center, well lit, and next to a small person wasting away of bone disease for comparison. Meanwhile, the centerpiece of the Edinburgh collection is less clear and certainly less prominent. It could be argued to be the case of Livingston’s broken arm, as this is the only piece with a name associated and certainly the only one with a 2 foot wide poster explaining its significance.

I am not sure what to make of this contrast in methodologies or reasons for presenting these valuable and informative collections in such differing manners. Yet, the difference between the newcomer and the professionalized, the public and the institutional, and the prized and the educational is marked in the comparison of the two collections.

TB today

In the Wohl reading, in addition to the emergence of techniques to control cholera, he discusses the ways that people brought down the number of tuberculosis cases. He mentions such simple changes as improved housing and more nutritious diet, which certainly did a fair part in improving the living conditions in general as well as with regards to TB. The developments were discussed almost as a side note and I found the tone of the writing to be nearly dismissive. Yet, just because food and housing which is good enough to evade TB may have been discovered over a hundred years ago and seem to be a simple thing to do, it has yet to become standard practice in many places around the world. Despite our ability to consider TB in the developed world as a nineteenth century problem, and one which was fairly straightforward (if not exactly simple) to resolve, the disease is still a major problem in many parts of the world. Wohl’s tone did not convey that not only are these still problems faced today, but they still have the same solutions as they did then. Although TB cannot be cured by better living conditions, it can be avoided through them. Still this has not happened in many parts of the world. The lack of these basic things is aggravated by the sometime-assumption that the disease is something of the past. Such thinking will only lead to a continued ignorance of the problem. While the changes that must be made to avoid TB are not simple, they are clear and, importantly, relevant today.

Blood, Sawdust, and Vampires

The medical walking tour featured many amazing things but I was most struck by the operating room. While other places certainly had a lot of history behind them and were full of remarkable remnants of bizarre medical practices, it was only in the operating room that they became real. Seeing a bone saw in a glass compartment is one thing, but holding it up to someone’s leg is quite another. Having learned and read about 19^th century surgical practices in the past, I knew the general gist of the process—no anesthetic, no antiseptic, and not great odds of survival. It was a sign in the corner of the attic-operating room which I found most interesting and considered an aspect which I had never thought of: how to deal with both blood lost and blood loss. The sign read:

The floor boards of the operating area form a false floor, being laid upon joists which rest upon the true floor: the 3 inch (7.5cm) space between is packed with sawdust. This would ensure that any blood which reached the floor was absorbed before it could pass into the church below. A mop and bucket in the corner would be used to clean up after the operation.

The image of blood-soaked sawdust is pretty horrible to thing about, but worse is the image of blood dripping onto people in the church downstairs. Blood loss must have been excessive during these operations, which though speedy were radical. I am currently about half-way through reading Bram Stoker’s Dracula, in which there are several scenes featuring blood transfusions. The fictional tale makes it seem to be a highly personal and threatening procedure, even referring to it as an operation. Further, there is no mention made of the blood clots and other problems that we now know to be issues when non-compatible blood types are mixed. With all the blood loss that was apparently a part of operations during the time, I am curious to learn more about transfusion possibilities, procedures, and problems.

Survival of the Fittest: Darwin and Wallace

The tour through the Natural History Museum rare books collection was really amazing—I am always slightly embarrassed by how much I enjoy seeing a book that was annotated by so-and-so or printed in such-and-such a year, and this was a veritable treasure trove. Who knew there was a copy of On the Origin of Species printed in Braille? What I found most interesting, however, (and what this post is really focused on) was the presentation of Wallace to the group. He was discussed as a man who was unfairly treated by historians and one who constantly was left in the shadow of Darwin. Taking into account the facts that I am a product of those same historians (could I even say one of them?) and that I have never taken a course exclusively on Wallace but have taken a few concerning Darwin, I don’t think that Wallace has been treated quite as unjustly as it was made to seem the other day. Surely, Wallace should have every claim to co-discoverer, or even discoverer, of the theory of natural selection. He did publish the article first and Darwin’s somewhat questionable tactics to get around this fact are often skimmed over or ignored. Yet, what is said is just as important as what is not said and it was the latter that I was thinking of during our talk.

Yes, Wallace’s paper was published in 1858 and Darwin’s book in 1859, but what happened after that? Wallace remained on the outskirts of society, at times even of the world, and to my knowledge did not publish again on the subject. What Wallace did do, however, was become involved in some strange and mystical aspects of 19^th century science, including spiritualism, mesmerism, and phrenology. These might have been seen as scientific at the time, but they were certainly a far cry from his work in evolution. Meanwhile, Darwin spent the remaining years of his life publishing work after work delving deeper into various aspects of natural selection only touched upon in Origin. For all intents and purposes, Darwin was branding himself, if you’ll forgive the 20^th century language. He found a niche in the scientific realm and was able to thrive and specialize in it. Darwin has become the great figure in the field not because he founded it (although this should not be totally taken from him when crediting Wallace), but because he made himself into the expert on the subject. In not discussing the period of Wallace’s life between 1858 and his death in 1913, much was left out of our presentation which would help explain the one-sided history that we know now.