Cadaver

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The Anatomy Lesson of Dr. Nicolaes Tulp by Rembrandt shows an anatomy lesson taking place in Amsterdam in 1632.

A cadaver, also referred to as a corpse (singular) in medical, literary, and legal usage, or when intended for dissection, is a deceased body.[1]

Human Decay[edit]

Cadaver in Refrigerator in the Forensic Medicine at the Charité Berlin

Observation of the various stages of decomposition can help determine how long a body has been dead.

Stages of decomposition[edit]

  1. The first stage is autolysis, more commonly known as self-digestion, during which the body's cells are destroyed through the action of their own digestive enzymes. However, these enzymes are released into the cells because of active processes ceasing in the cells, not as an active process. In other words, though autolysis resembles the active process of digestion of nutrients by live cells, the dead cells are not actively digesting themselves as is often claimed in popular literature and as the synonym of autolysis - self-digestion - seems to imply. As a result of autolysis liquid is created that seeps between the layers of skin and results in peeling of the skin. During this stage, flies (when present) begin to lay eggs in the openings of the body: eyes, nostrils, mouth, ears, open wounds, and other orifices. Hatched larvae (maggots) of blowflies subsequently get under the skin and begin to consume the body.
  2. The second stage of decomposition is bloating. Bacteria in the gut begin to break down the tissues of the body, releasing gas that accumulates in the intestines, which becomes trapped because of the early collapse of the small intestine. This bloating occurs largely in the abdomen, and sometimes in the mouth, tongue, and genitals. This usually happens around the second week of decomposition. Gas accumulation and bloating will continue until the body is decomposed sufficiently for the gas to escape.
  3. The third stage is putrefaction. It is the final and longest stage. Putrefaction is where the larger structures of the body break down, and tissues liquefy. The digestive organs, brain, and lungs are the first to disintegrate. Under normal conditions, the organs are unidentifiable after three weeks. The muscles may be eaten by bacteria or devoured by animals. Eventually, sometimes after several years, all that remains is the skeleton. In acid-rich soils, the skeleton will eventually dissolve into its base chemicals.

The rate of decomposition depends on many factors including temperature and the environment. The warmer and more humid the environment, the faster the body is broken down.[2] The presence of carrion-consuming animals will also result in exposure of the skeleton as they consume parts of the decomposing body.

History[edit]

The history of the use of cadavers is one that is filled with controversy, scientific advancements, and new discoveries. It all started in 3rd century ancient Greece with two physicians by the name of Herophilus of Chalcedon and Erasistratus of Ceos.[3] They practiced the dissection of cadavers in Alexandria, and it was the dominant means of learning anatomy.(20) After both of these men died the popularity of anatomical dissection decreased until it wasn’t used at all. It wasn’t revived until the 12th century and it became increasingly popular in the 17th century and has been used ever since. (21)

Even though both Herophilus and Erasistratus had permission to use cadavers for dissection there was still a lot of taboo surrounding the use of cadavers for anatomical purposes, and these feelings continued for hundreds of years. From the time that anatomical dissection gained its roots in the 3rd century to around the 18th century it was associated with dishonor, immorality, and unethical behavior. Many of these notions were because of religious beliefs and esthetic taboos (20) and were deeply entrenched in the beliefs of the public and the church. As mentioned above, the dissection of cadavers began to once again take hold around the 12th century. At this time dissection was still seen as dishonorable, however it was not outright banned. Instead, the church put forth certain edicts for banning and allowing certain practices. One that was monumental for scientific advancement was issued by the Holy Roman emperor Frederick II in 1231. (20) This decree stated that a human body will be dissected once every five years for anatomical studies, and attendance was required for all who was training to or currently practicing medicine or surgery. (20) These events are what led to the first sanctioned human dissection since 300 B.C. and was performed publicly by Mondino de Liuzzi. (20) This time period created a great deal of enthusiasm in what human dissection could do for science and attracted students from all over Europe to begin studying medicine.

In light of the new discoveries and advancements that were being made religious moderation of dissection relaxed significantly, however the public perception of it was still negative. Because of this perception, the only legal source of cadavers was the corpses of criminals who were executed, usually by hanging. (21) Many of the offenders whose crimes “warranted” dissection and their families even considered dissection to be more terrifying and demeaning than the crime or death penalty itself. (21) There were many fights and sometimes even riots when relatives and friends of the deceased and soon to be dissected tried to stop the delivery of corpses from the place of hanging to the anatomists. (22) The government at the time (17th century) took advantage of these qualms by using dissection as a threat against committing serious crimes. They even increased the number of crimes that were punished by hanging to over 200 offenses. (22) Nevertheless as dissection of cadavers became even more popular, anatomists were forced to find other ways to obtain cadavers.

As demand increased for cadavers from universities across the world, people began grave-robbing. These corpses were transported and put on sale for local anatomy professors to take back to their students. (21) The public tended to look the other way when it came to grave-robbing because the affected was usually poor or a part of a marginalized society. (21) There was more out-cry if the affluent or prominent members of society were affected, and this led to a riot in New York most commonly referred to as the Resurrection Riot of 1788. It all started when a doctor waved the arm of a cadaver at a young boy looking through the window, who then went home and told his father. Worrying that his recently deceased wife’s grave had been robbed, he went to check on it and realized that it had been. (21) This story spread and people accused local physicians and anatomists. The riot grew to 5,000 people and by the end medical students and doctors were beaten and six people were killed. (21) This led to many legal adjustments such as the Anatomy Acts put forth by the U.S. government. These acts opened up other avenues to obtaining corpses for scientific purposes with Massachusetts being the first to do so. In 1830 and 1833 they allowed unclaimed bodies to be used for dissection. (21) Laws in almost every state were subsequently passed and grave-robbing was essentially eradicated.

Although dissection became increasingly accepted throughout the years, it was still very much disapproved by the American public in the beginning of the 20th century. The disapproval mostly came from religious objections and dissection being associated with unclaimed bodies and therefore a mark of poverty. (21) There were many people that attempted to display dissection in a positive light, for example 200 prominent New York physicians publicly said they would donate their bodies after their death. (21) This and other efforts only helped in minor ways, and public opinion was much more affected by the exposure of the corrupt funeral industry. (21) It was found that the cost of dying was incredibly high and a large amount of funeral homes were scamming people into paying more than they had to. (21) These exposures didn’t necessarily remove stigma but created fear that a person and their families would be victimized by scheming funeral directors, therefore making people reconsider body donation.(21) Currently, body donation isn’t surrounded by stigma but can be considered as celebrated. Body donation has not only led to scientific advancements and discoveries, it has also led to lives being saved. If one donates their body after death, their organs can be used as transplants to save another’s life. The study of cadavers has led to incredible discoveries and saved millions of lives, even though it hit a few roadblocks along the way!

Cadavers in Art[edit]

The study of the human body was not isolated to only medical doctors and students, as many artists reflected their expertise through masterful drawings and paintings. The detailed study of human and animal anatomy, as well as the dissection of corpses, was utilized by early Italian renaissance man Leonardo da Vinci in an effort to more accurately depict the human figure through his work. He studied the anatomy from an exterior perspective as an apprentice under Andrea del Verrocchio that started in 1466.[4] During his apprenticeship, Leonardo mastered drawing detailed versions of anatomical structures such as muscles and tendons by 1472.[4]

His approach to the depiction of the human body was much like that of the study of architecture, providing multiple views and three-dimensional perspectives of what he witnessed in person. One of the first examples of this is using the three dimensional perspectives to draw a skull in 1489.[5] Further study under Verrocchio, some of Leonardo da Vinci’s anatomical work was published in his book A Treatise on Painting.[6] A few years later, in 1516, he partnered with professor and anatomist Marcantonio della Torre in Florence, Italy to take his study further. The two began to conduct dissections on human corpses at the Hospital of Santa Maria Nuova and later at hospitals in Milan and Rome.[7] Through his study, da Vinci was perhaps the first to accurately draw the natural position of the human fetus in the womb, via cadaver of a late mother and her unborn child.[7] It is speculated that he conducted approximately 30 dissections total.[8] His work with cadavers allowed him to portray the first drawings of the umbilical cord, uterus, cervix and vagina and ultimately dispute beliefs that the uterus had multiple chambers in the case of multiple births.[7] Da Vinci gained an understanding of what was happening mechanically under the skin to better portray the body through art.[8]  For example, he removed the facial skin of the cadaver to more closely observe and draw the detailed muscles that move the lips to obtain a holistic understanding of that system.[9] He also conducted a thorough study of the foot and ankle that continues to be consistent with current clinical theories and practice.[8] His work with the shoulder also mirrors modern understanding of its movement and functions, utilizing a mechanical description likening it to ropes and pulleys.[8] He also was one of the first to study neuroanatomy and made great advances regarding the understanding of the anatomy of the eye, optic nerves and the spine but unfortunately his later discovered notes were disorganized and difficult to decipher due to his practice of reverse script writing (mirror writing).[10]

Cadavers in Science[edit]

Cadavers have contributed to body science and medical students often use cadavers to study anatomy. Cadavers are often used to verify surgical techniques before moving on to living patients.[11] While many schools have moved to using technology and surgical models to teach students, cadavers are still needed for hands on learning. However, the expense of maintaining cadaveric dissection facilities has limited the time and resources available for gross anatomy teaching in many medical schools, with some adopting alternative prosection-based or simulated teaching.[12] This, coupled with decreasing time dedicated to gross anatomical courses within the growing greater medical school curriculum, has caused controversy surrounding the sufficiency of anatomical teaching with nearly half of newly qualified doctors believing they received insufficient anatomy teaching.[13]

Appendectomies, the removal of the appendix, are performed 28,000 times a year in the United States and are still practiced on human cadavers and not with technology simulations.[14] Gross anatomy, a common course in medical school studying the visual structures of the body, gives students the opportunity to have a hands-on learning environment. The need for cadavers has also grown outside of academic programs for research. Organizations like Science Care and the Anatomy Gifts Registry help send bodies where they are needed most.[14]

Preserving Cadavers for Use in Dissection[edit]

Once a person has deceased, the body is injected with embalming fluid through the arterial system. The embalming fluid contains a multitude of different chemicals: Cells conditioners, Cavity Fluid, Dyes, Preservative chemical, Water, Humectants, etc. The embalming fluid is a mixture of roughly nine chemicals; three of these chemicals are methanol, formaldehyde, and glutaraldehyde. These chemicals are extremely toxic to living people, and precautions must be taken. Additionally, diseases present in the cadaver may be transmitted to the living, although rare; diseases like HIV, Tuberculosis, and Hepatitis A and B can still be a threat. When handling cadavers, protective gloves must be on at all times. A mask is suggested to be worn, as the chemicals such as formaldehyde can evaporate quickly into the air as well as fungal spores and aerosols.[15] Another precaution is to have the cadaver in a well ventilated area and to make sure fresh air is available. Eye protection is also needed, given the possibility of liquids, splashes, and/or fumes entering the eye.[15]

Although taking precautions and being in a ventilated area is needed, it also subjects the cadaver to drying out quicker. Standard precautions to slow this process down are important for both students and instructors. Precautions include plastic wrap and a body bag to help keep the cadaver moist for longer when the body is not being used for scientific learning purposes.[15] Other steps require an antifungal and moistening fluid. When, or if, mold starts to grow on the cadaver, it is suggested to use an antifungal solution and remove all plastic covering, wrappings, and sheets covering the cadaver. Phenol has been used to wipe away the fungus. (WARNING: only trained personnel should handle phenol) (WARNING: never touch phenol with or without gloves, use another object to handle phenol cloth) Wear gloves and use forceps to handle cloth, when wiping away fungus.[16] All areas that appear to still be affected by the mold after being wiped are encouraged to be cut away and disposed of properly. Mold is rare, but should be taken seriously as well as the chemicals used to get rid of the mold.[16]

To prevent any sort of growth (e.g. fungus), the use of a moistening solution is recommended.[16] Nebanol is a non-hazardous solution, as per OSHA approval. Using a Moistening Solution regularly and often, prevents mold from ever-growing and is safer than the alternative of chemicals like phenol.[16]

Body Snatching[edit]

While the term "grave robber" was technically used for individuals who stole jewelry from the deceased, some respected anatomy instructors exhumed bodies themselves. Famous anatomist Thomas Sewall, who later became the personal physician for three U.S. presidents, was convicted in 1818 of digging up a corpse for dissection.

There are cases in which some anatomists would even dissect members of their own family. William Harvey, the man famous for discovering the circulatory system, was so dedicated to his study that he even went as far to dissect his father and sister. From 1827 to 1828 in Scotland, a number of murders were carried out, so that the bodies could be sold to medical schools for research purposes. These became known as the West Port murders. The Anatomy Act of 1832 was formed and passed because of the murders. H. H. Holmes, a noted serial killer in Chicago, Illinois, USA, sold the skeletons of some of his victims to medical schools.

By 1828 some anatomists were paying others to perform the exhumation. At that time, some London anatomy schools employed ten full-time body snatchers and about 200 part-time workers during the dissection season. This period ran from October to May, when the winter cold slowed down the decomposition of the bodies. At the time, a crew of six or seven could dig up about 310 bodies.[citation needed]

Disposing of the dissected body was difficult, and over the years, rumors have appeared about how anatomists might have managed to do so. One possibility was secretly burying the remains behind their school, whilst another rumored possibility was that they gave the bodies to zoo keepers, as feed for carnivorous animals or burial beneath elephant grazing pens, or fed the bodies to vultures kept specifically for this purpose.

Stories appeared of people murdering for the money they could make off cadaver sales. Two of the most famous are that of Burke and Hare, and that of Bishop, May, and Williams.

  • Burke and Hare — Burke and Hare ran a boarding house. When one of their tenants died, they brought him to Robert Knox's anatomy classroom in Edinburgh where they were paid seven pounds for the body. Realizing the possible profit, they murdered 16 people by asphyxiation over the next year and sold their bodies to Knox. They were eventually caught when a tenant returned to her bed only to encounter a corpse. Hare testified against Burke in exchange for amnesty and Burke was found guilty, hanged, and publicly dissected.
  • London Burkers, Bishop, May and Williams — These body snatchers also killed three boys, ages ten, 11 and 14 years old. The anatomist that they sold the cadavers to was suspicious. To delay their departure the anatomist said he needed to break a 50-pound note. He sent for the police who arrested the men. In Bishop's confession he stated, "I have followed the course of obtaining a livelihood as a body snatcher for 12 years, and have obtained and sold, I think from 500 to 1,000 bodies.

Body snatching, an act of the past, is said to be the initial controversy amongst medical ethics. Medical practice is viewed by the public as a source of treatment and healing, making the learning process overshadowed. This caused past physicians to resort to unlawful ways to fulfill their passion for knowledge.[17]

Making Cars Safer[edit]

Since the 1930s cadavers have been essential in making vehicles safer. Cadavers have helped set guidelines on the safety features of vehicles ranging from laminated windshields to seat belt airbags. After the crash tests, the cadavers are taken in to get x-rayed and autopsied to examine the damage. Cadavers have helped Ford promote inflatable rear seat belts in the 2011 Explorer.[18] Cadavers can indicate how seat belts will create soft tissue damage, which is something a crash test dummy cannot do. An example that occurred in an experiment in Europe was that scientists were testing a new seat belt and thought it was unflawed. Then, after testing it on a dummy, they brought in a cadaver. They later found out that the seat belt protected the sternum, but not the pelvis. They were unable to find this out in the dummy because it did not have working parts located in the pelvic area, like the human cadaver.[19]

See also[edit]

References[edit]

  1. ^ New Oxford Dictionary of English, 1999. cadaver Medicine: or poetic/literary: a cait.
  2. ^ "Decomposition – The Forensics Library". aboutforensics.co.uk. Retrieved 2017-02-06.
  3. ^ [21]
  4. ^ a b "Leonardo Da Vinci - The Complete Works - Biography - leonardoda-vinci.org". www.leonardoda-vinci.org. Retrieved 2018-11-19.
  5. ^ "https://www.metmuseum.org/toah/hd/anat/hd_anat.htm". www.metmuseum.org. Retrieved 2018-11-19. External link in |title= (help)
  6. ^ Vinci, Leonardo Da (1967). The Notebooks of Leonardo Da Vinci. Lulu.com. ISBN 9781105310164.
  7. ^ a b c Wilkins, David G. (2001). "Review of The Writings and Drawings of : Order and Chaos in Early Modern Thought". The Sixteenth Century Journal. 32 (2): 509–511. doi:10.2307/2671780.
  8. ^ a b c d Jastifer, James R.; Toledo-Pereyra, Luis H. (2012-09-25). "Leonardo da Vinci's Foot: Historical Evidence of Concept". Journal of Investigative Surgery. 25 (5): 281–285. doi:10.3109/08941939.2012.725011. ISSN 0894-1939.
  9. ^ Pater, Walter, "LEONARDO DA VINCI", The Works of Walter Pater, Cambridge University Press, pp. 98–129, ISBN 9781139062213, retrieved 2018-11-19
  10. ^ "Renaissance Neurosurgery: Italy's Iconic Contributions". World Neurosurgery. 87: 647–655. 2016-03-01. doi:10.1016/j.wneu.2015.11.016. ISSN 1878-8750.
  11. ^ Eizenberg, Norman (December 30, 2017). "Anatomy and its impact on medicine: Will it continue?". The Australasian Medical Journal. 8: 373–7. doi:10.4066/AMJ.2015.2550. PMC 4701898. PMID 26759611.
  12. ^ Older, J (2004). "Anatomy: a must for teaching the next generation". Surgeon J R Coll Surg Edinb Irel. 2: 79–90. doi:10.1002/ca.20662.
  13. ^ Fitzgerald, J.; White, M; Tang, S; CMaxwell-Armstrong, C; James, D (2008). "Are we teaching sufficient anatomy at medical school? The opinions of newly qualified doctors". Clinical Anatomy. 21: 718–724. doi:10.1002/ca.20662.
  14. ^ a b McCall, Matt (July 29, 2016). "The Secret Lives of Cadavers". National Geographic.
  15. ^ a b c Demiryürek, Deniz; Bayramoǧlu, Alp; Ustaçelebi, Şemsettin (26 December 2002). "Infective agents in fixed human cadavers: A brief review and suggested guidelines". The Anatomical Record. John Wiley & Sons, Inc. doi:10.1002/ar.10143.
  16. ^ a b c d Druecker, Jay (25 January 2000). "Cadaver Care HAPP-L". Chadron State College and Imperial Valley College. Retrieved 2 October 2018.
  17. ^ Frank, Julia Bess (1976). "Body snatching: a grave medical problem". The Yale Journal of Biology and Medicine. 49: 409–410.
  18. ^ Hyde, Justin (August 21, 2010). "How Cadavers Made Your Car Safer". WIRED. Archived from the original on April 20, 2015. Retrieved April 13, 2017.
  19. ^ Hadden, Gerry (February 10, 2014). "Europe takes a cue from US and decides to use cadavers to make cars safer". PRI's The World. Archived from the original on April 13, 2017. Retrieved April 13, 2017.

20.[1] 21.[2] 22.[3]

Further reading[edit]

  • Jones, D. Gareth (2000). Speaking for the Dead: Cadavers in Biology and Medicine. Aldershot: Ashgate. ISBN 0-7546-2073-5.
  • Roach, Mary (2003). Stiff: The Curious Lives of Human Cadavers. New York, NY: W. W. Norton and Company Inc.
  • Shultz, Suzanne (1992). Body Snatching: the Robbing of Graves for the Education of Physicians. Jefferson, North Carolina: McFarland & Company Inc.
  • Wright-St. Clair, R. E. (February 1961). "Murder For Anatomy". New Zealand Medical Journal. 60: 64–69.

External Links[edit]

  1. ^ Ghosh, Sanjib Kumar (September 22, 2015) "Human cadaveric dissection: a historical account from ancient Greece to the modern era" NCBI. Retrieved November 18th, 2018.
  2. ^ Hulkower, Raphael (2011) "From sacrilege to privilege: "the tale of body procurement for anatomical dissection in the united states" Albert Einstein College of Medicine. Retrieved November 19th, 2018.
  3. ^ Mitchell, Piers et al. (April 2018, 2011) "The study of anatomy in England from 1700 to the early 20th century" Journal of Anatomy. Retrieved November 19, 2018.