From Dissections to Death Masks: The Anatomical Museum, The University of Edinburgh

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk


Last weekend I was finally able to satisfy my curiosity of what lay behind the 19
th century doors of The University of Edinburgh’s School of Medicine and Anatomical Museum.

Located on Teviot Place, The Anatomical Museum at the University has not long been open to the public. Now welcoming visitors through its grand gates on the last Saturday of every month, it instantly absorbs you into its stony walls of history and heritage. The museum, which opened as part of the new Medical School in 1884, was founded by the renowned Monro dynasty; 3 generations of Alexander Monro’s whose teaching spanned 126 years occupying the Chair of Anatomy at the University, one after the other through the 18th and 19th century. The grand lobby looms over you with two enormous elephant skeletons from either side. As an eager anatomist, your eyes don’t know where to settle first; the enormous jaw bones of a whale, the huge replica of Rembrandt’s ‘The Anatomy Lesson of Dr. Nicolaes Tulp’ or the many portraits and busts of famous anatomists from days gone by.

Dissection Theatre

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk

As a former student of anatomy and as somebody who is fascinated by its teaching from days gone by, I was completely awestruck as I entered the dissection theatre which is still in use as a lecture theatre today. The beautiful rounded room is centred by a relatively small space that once was host to the magnificent spectical that medical students would flock to see; a human body. It’s tightly packed rows of seats are incredibly steep providing views of the cadaver to even those less-than-eager students in the back row. Sitting in one of the leather-like fold down chairs three quarters of the way to the back, I looked down upon the anatomical demonstration videos of Acland Anatomy that were projected onto the wall below. It was quite overwhelming to think that I was sitting in the very seats that would have looked upon the teaching of the famous Monro dynasty and the many cadavers that graced their dissection tables.

Death Masks

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk

The museum has a fascinating collection of 40 life and death masks on display which eerily look out onto the museum and its curious visitors from the far wall that they occupy. Originally belonging to the Edinburgh Phrenological Society, the collection which is now owned by the William Ramsey Henderson Trust shows some well known faces from scientists and politicians to criminals and historical figures. To literally come face to face with pioneering Scottish anatomist and surgeon John Hunter and buyer of Burke and Hare’s bodies Robert Knox alongside notorious figures such as William Shakespeare and Julius Caesar is an experience that can only be personified by the true anatomical cast of the individual’s face.

Burke and Hare

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk

Photograph by Hugh Pastoll via www.anatomy.mvm.ed.ac.uk

The notorious Westport Murderers are well known historical characters in Edinburgh. Known across the world as the ruthless bodysnatchers who took the lives of at least 16 Edinburgh residents from 1827 to 1828 to capitalise from the high demand for cadavers in the the dissecting rooms of Edinburgh’s Medical School. Once their crimes were discovered and they were both detained, Hare was offered immunity from prosecution if he would confess and agree to testify against Burke. His testimony set him free and committed Burke to execution by hanging in Edinburgh on January 28, 1829. His body was dissected at The University of Edinburgh and his skeleton preserved, articulated and displayed. Now on view at the museum (minus the two phalanges from the 3rd toe on his right foot…), visitors can come face to face with this shady character from Edinburgh’s past, a vivid reminder of how far anatomy and its teaching have come since those dark days in the early 1800s.

To find out more about the Anatomical Museum, visit their website at www.anatomy.mvm.ed.ac.uk

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Book Review: From Bodysnatchers to Lifesavers: Three Centuries of Medicine in Edinburgh by by Dorothy H. Crawford and Tara Womersley

From Bodysnatchers to Lifesavers: Three Centuries of Medicine in Edinburgh by Dorothy H. Crawford

My rating: 5 of 5 stars

I don’t give 5 stars lightly, this book is fantastic! Those of you interested in the history of medicine know that the facts themselves are an interesting read, but the authors of this book wrote it in such a way that you really get to know the key figures from Edinburgh’s medical history and their fascinating careers. Don’t know Edinburgh? Don’t be put off. You will learn the history of some of the world most celebrated discoveries and professionals; from Charles Darwin to Arthur Conan Doyle, from bodysnatchers Burke and Hare to Dolly the Sheep. Reading this gripping book really made me proud, not only to live in a city steeped in such pioneering medical history, but to be working for a Royal College so involved in the advancement of medicine through the centuries to the present day.

View all my reviews

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Hydrocephalus: Cerebrospinal Fluid and a Curious Condition

Prof. Jas. Mundie
Copyright: Prof Jas. Mundie

Although I have previously posted about hydrocephalus on the Facebook page’s ‘Fact of the Day’, I was inspired to discover more about this distinctive condition after a recent visit to Surgeon’s Hall Museum, Edinburgh. Full of fascinating pathological specimens, the congenital hydrocephalic infant skulls on display are hard to miss with their domed craniums, characteristic of bodies more alien than our own.

The term hydrocephalus comes from the Greek words ‘hydro’ meaning water  and ‘cephalus’ meaning head. Translated literally, it means ‘water on the brain’. Hydrocephalus is in fact a build up of cerebrospinal fluid within the brain.

10 Facts About Cerebrospinal Fluid

  • Cerebrospinal fluid (CSF) is a clear, colourless liquid that fills and surrounds the brain and the spinal cord, acting as a lubricator against bone and a shock absorber against trauma to our body’s most important system
  • It is formed primarily in the ventricles of the brain and circulates via a series of chambers
  • It helps to maintain a constant pressure within the cranium by decreasing in levels as the volume of blood or brain tissue increases and vice versa
  • When cerebrospinal fluid is in excess, it is moved away from the brain by absorption into the bloodstream by a specialised tissue called the arachnoid villi which act as a one way valve
  • It transports metabolic waste products, antibodies, chemicals, and products of disease away from the brain and spinal cord into the bloodstream
  • It has a slightly alkaline pH
  • It is about 99% water.
  • There are approximately 100-150ml of CSF in the average adult human body
  • It is produced continuously, and it is completely replaced every six to eight hours
  • Analysis of CSF can diagnose a number of diseases. Samples can be obtained by lumbar puncture or spinal tap by inserting a needle into the lumbar region of the lower back

Hydrocephalus
Hydrocephalus can develop where there is a blockage in one of the ventricles, preventing excess CSF from moving out of the brain, where the arachnoid villi aren’t functioning properly and CSF is unable to filter into the blood vessels or, in some rare cases,  when the brain produces too much CSF.

Joakim BlockstromCopyright: Joakim Blockstrom

Congenital hydrocephalus can occur due to the restriction of flow of CSF caused by brain defects in the developing baby which can be due to certain health conditions like the most serious type of spina bifida. It can also occur in premature babies which experience bleeding in their brain, blocking the flow of CSF and causing hydrocephalus. Other potential causes include X-linked hydrocephalus where the condition occurs as a result of a genetic mutation, rare genetic disorders such as Dandy Walker malformation and arachnoid cysts between the brain or spinal cord and the arachnoid membrane.

Acquired hydrocephalus which develops in adults or children is most often occurs by injury or illness that results in a blockage between the ventricles of the brain. Possible causes include bleeding inside the brain, blood clots inside the blood vessels of the brain, meningitis, tumours, head trauma and stroke.

Anatomical abnormalities
The physical symptoms of hydrocephalus are distinctive, but can vary with age, tolerance and progression of the disease. The characteristic, unusually large cranium is caused by the infant skull’s ability to expand to accommodate the build up of excess CSF. The sutures of the skull, which are not yet closed, provide the flexibility in the cranium to ‘grow’ with the expanding volume. The scalp may be thin with visible veins and the fontanelle (soft spot on the top of a baby’s head) may be tense or bulging. The eyes can also appear to be looking downwards due to nerve damage which can affect the muscles of the eye.

skull-of-a-newbornCopyright: A.D.A.M

Treatment
Without treatment, it is thought that up to 6 in 10 people with hydrocephalus would die. However, most children with hydrocephalus that survive past the age of one will have a fairly normal life span. Patients usually require prompt treatment to reduce the pressure on their brain either by neuroendoscopy or shunt surgery which involves implanting a thin tube into the brain to run the excess cerebrospinal fluid to another part of the body, usually the abdomen, where it can be absorbed into the blood stream.

hydroassoc.orgCopyright:  Hydrocephalus Association

Resources & further reading:

www.hcrn.org
www.hydroassoc.org
www.shinecharity.org.uk
www.nhs.uk/conditions/Hydrocephalus
www.hydroresearchfund.org/learn-about-hydrocephalus
www.childrenshospital.org/az/Site1116/mainpageS1116P1.html
www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm
www.britannica.com/EBchecked/topic/103430/cerebrospinal-fluid-CSF

Virtual Autopsy: The Decline of Forensic Dissection?

severed spineThe body of a 50-year-old man run over by a train. Via The Guardian

Gone are the days of forensic autopsy whereby the only means for determining cause of death were by cutting into the cadaver of the victim. Swiss researchers at the Institute of Forensic Medicine at the University of Zurich have developed a powerful and pioneering method of virtual imaging, never used in post mortem before; Virtopsy. Prof. Richard Dirnhofer initiated the Virtopsy project several years ago and now, along with operative head of the group Prof. Michael Thali, runs the applied research team which has been operating from the University in Switzerland since 2011.

Combining the uses of optical 3D surface scanning, 3D-photogrammetry, computed tomography (CT), and magnetic resonance (MR) imaging, virtual autopsy is a technique that could not be further from traditional methods of the historical figures of medicine. Virtopsy allows the indefinite storage of collected images and data from the subject which can be re-examined, replicated and distributed at any time, allowing greater accessibility other experts in the field across disciplines and indeed locations. These techniques can be used in living patients to avoid invasive procedures, but the ground breaking aspects of Dirnhofer and Thali’s work lies in the forensic mortuary. Biological tissues, their decomposition and sometimes lack of reliability cannot compete with the ‘snapshot’ evidence taken by these methods, allowing findings to be shared in legal and court cases in a much more modern and interactive way.

The technology allows for the preservation of the deceased in a digital form, escaping the destruction of tissues caused during investigation and decomposition and allows access to areas of a cadaver which may not always prove accessible or appropriate to dissection. For example, the distribution of gas throughout the body is not often observed by the naked eye in traditional autopsy, but with this new technique, gaseous pockets and bubbles can be located quite clearly. It is also of great benefit to forensic autopsy when determining injury from attack by weapons. Scrolling through the layered depths of the victim allows for calculation of weapon length in stab wounds much easier than by traditional methods.

Understandably, virtual autopsy is warmly welcomed by certain religious communities and the families of the deceased who favour this non-invasive method. For the relatives, it allows peace of mind for the dignity and state bodies of their loved ones who have in most circumstances already been through a traumatising and unsettling ordeal.

Given that a deal of technological retraining would be required by investigators if virtual autopsy was rolled out and became a more common means of exploration, would this modern day approach favour the younger generation of forensic professionals? Will virtual autopsies replace traditional forensic examination over time? It is a welcome addition complementary to current investigation, but should we rely completely on such detached methods? Can anything substitute real, hands on exploration of the human body, no matter how advanced the technology and results may be?

Further reading:
www.virtopsy.com
www.guardian.co.uk/science/2013/feb/23/virtual-autopsy-virtopsy-forensic-science
www.independent.co.uk/news/science/body-of-evidence-a-radical-new-approach-to-forensic-pathology-1987389.html
www.spiegel.de/international/europe/new-virtual-autopsy-procedure-is-changing-forensics-a-8756

Tabulae Anatomicae: The Lost Plates of Italy’s Eustachi

Eustachi_title crop
Title plate, Tabulae Anatomicae, Bartolomeo Eustachi.

Considered the most meticulous and thorough anatomist of his time, physician and anatomist Bartolomeo Eustachi (d.1574) not only had a career embellished with anatomical discoveries and pioneering practices, but was author to one of the discipline’s most influential texts; Tabulae Anatomicae.

Thought to have studied medicine in Rome and Padua, Italy, Eustachi served as physician to the Duke of Urbino and Cadinal Giulio Della Rovere in Rome where, as a lecturer in anatomy, he is said to have introduced the practice of hospital post-mortem examinations.  He is credited with many significant findings of the human body including the discovery of the thoracic duct and adrenal glands as well as providing the first accurate descriptions of the uterus, laryngeal muscles and origin of the optic nerve. Perhaps most famously, he is celebrated for the discovery of the passage linking the middle ear to the nasopharynx; the Eustachian tube.

Ear diagramCopyright: Tangient LLC

Eustachi published Opuscula Anatomica in 1564 which featured eight anatomical plates, mainly detailing the kidneys and vascular system. There were an additional thirty eight copperplates that he had prepared with illustrator Pietro Matteo Pini and engraver Giulio de’ Musi which went unused up until Eustachi’s death in 1574. These remaining plates were forgotten until they were discovered in the Vatican Library by the Pope’s physicist Giovanni Maria Lancisi who published the plates in 1714 under the title Tabulae Anatomicae (Anatomical Tables). It illustrated the human body in a way that had rarely been seen before. The use of copper-plates provided greater detail and precision than the wooden-plates of previous works such as Versalius’ De Humunai Corporis Fabrica, 1543 could produce. Omitting the numbered and lettered labelling which were the favoured annotation methods of the time, Eustachi had used an inventive coordinate system created by rulers that bordered his images. He had pioneered an uncluttered and clear representation of the human form which, coupled with immaculate hand colouring, created the most vivid, vibrant and rousing anatomical illustrations up unto their time.

Eustachi_t09Eustachi_t26Eustachi_t30

Dancing Skeletons: Characters of Cham Dance

Dancing Skeleton Facec.1919 Dancing Skeleton costume on display at the National Museum of Scotland, Edinburgh

This bank holiday weekend brought a meandering stroll through the inspiring National Museum of Scotland, Edinburgh. Located on Chamber Street, between South Bridge and the Grassmarket, the National Museum of Scotland is still one of my favourite places to visit after this 4th or 5th trip. There were some fascinating anatomy-related finds that I came across for the first time on Monday; one of which was the costume of the Dancing Skeleton. (Level 3, World Cultures, Performance And Lives)

Tibetan Cham Dance is a lively costumed dance associated with some sects of Buddhism, often performed at Buddhist festivals. With monks providing the accompanying music with traditional Tibetan instruments, the dances are considered a form of meditation and an offering to the gods.

Dancing Skeleton Fullc.1919 Dancing Skeleton costume on display at the National Museum of Scotland, Edinburgh

One character from the Cham Dance is the Citipati, or ‘Dancing Skeleton’. Cheerfully dressed, their costumes are made from cotton and are decorated to show the bones of the skeleton in bright and illustrative way.  Their somewhat intimidating eye-less skull mask is fashioned from papier-mâché and sheet tin, showcasing a crested headdress of smaller skulls. Despite their daunting presence, their intention is not to frighten but to remind and inspire the audience of the transience of human life and the fleeting presence of the organic body.

The Home Doctor: Homage to a Vintage Classic, 1931

Books (C)

Yesterday saw one of my favourite weekend adventures in the historic city of Edinburgh; a trawl through the town for vintage and antique medical texts.

One find from this yielding trip was ‘Home Doctor’ by Edinburgh physician and lecturer John D. Comrie, published by George Newnes Ltd, 1931.

Comrie held a long list of prestigious positions including Physician at the Royal Infirmary of Edinburgh, Consulting Physician at Deaconess Hospital, Edinburgh, Lecturer on Practice of Medicine at The School Of  The Royal Colleges At Edinburgh and Late Consulting Physician To The Forces in North Russia.

His best known work is perhaps Black’s Medical Dictionary, for which he was editor from the 1st edition in 1906 to the 17th in 1942. Black’s is still sold today and is currently in its 42nd edition.

Comrie opens Home Doctor with the following:

Preface
This volume is designed for those who, without having any medical knowledge, desire advice of a practical character, especially in matters affecting the preservation or restoration of health. Such a book is continually needed in every household, and this book has been prepared specially for use in the home.

J.D.C
Edinburgh, March 1931

A large 391 yellowed and dusty pages, the book boasts ‘two full-page illustrations in colour, with key to the same’:

Home Doctor John D Comrie George Newnes Ltd 1931
‘Organs of the body from before, with the soft parts removed’

Home Doctor John D Comrie George Newnes Ltd 1931 back
‘Organs of the body from behind, with the soft parts removed’

The beauty of antique and vintage books is the insight they give you into the way the world was at the time of writing. This 1930’s household staple has some gems in the ‘S’ section alone:

Page 324,  Snoring: is a form of noisy breathing due to sleeping with the mouth open.  It can be checked by tying up the jaw and breathing only through the nose, or by turning on the side.

Page 324,  Smallpox, Symptoms: The period of incubation is from about ten to fourteen (usually twelve) days. The invasion is sudden, with shivering, high fever, headache, and often vomiting. On the third day the characteristic eruption begins to make its appearance, and spreads all over the face, trunk, and extremities in the course of a few hours. On the second or third day after its appearance the eruption undergoes a change – the pimples becoming vesicles filled with a clear fluid. The clear content of these vesicles gradually become turbid, and by the eighth or ninth day of the disease they are changed into ‘pustules’ containing yellow matter, with an increase of the fever. The eyes may also be involved in the eruption, to the danger of permanent impairment of sight. On the eleventh or twelfth day the pustules show signs of drying up, and along with the fever abates. Great itching of the skin attends this stage. The scabs produced by the dried pustules gradually fall off and reddish brown spots remain, which according to the depth of skin involved in the disease, leave a permanent, white depressed scar – this ‘pitting’, so characteristic of smallpox, being specially marked on the face.

Page 338,  Suicide: See under ‘Insanity’

Happy bedtime reading.

I Heart Anatomy: A Lifelong Craving For A Curious Science

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Firstly, thank you for stopping by. I guess the best introduction is an introduction

I was very lucky to begin my degree in Anatomical Sciences in 2003 at the University of Dundee; Scotland’s only remaining university to use whole class full human cadavers for dissection. Throughout my degree the legendary Dr David L. Dawson, (who never wore gloves for dissection) led the class through the amazing anatomy-lab journey of the human body, from breaking the ice with bum-cheeks on the first day to brains, eyeballs and everything else. Yes. Everything.

Upon graduating, I worked for the university as a post-graduate demonstrator for a year. I then moved to Edinburgh, the home of Burke and Hare, in hope of wider opportunities and a future in the anatomy lab. With the recession deepening as time went on, this didn’t turn out to be the case. After working in business development and administration, I am now happily settled in the events industry, based in Leith, Edinburgh. However, not a day goes by when I don’t miss dearly the wonder that anatomy and the honour that dissection brought to the ‘working week’.

I felt the time had come to record my thoughts, favourite findings and curiosities which some of you may have already come across through The Irregular Anatomist’s Twitter and Facebook page, established earlier this month.

Join me here to delve into the wonderful world of anatomy, cadavers, body snatching and the history of medicine as well as an insight into the trends, fashion and designs that continue to draw inspiration from this fascinating and curious science.