History of Medicine in Vienna – A Travelogue, 10. -14. February 2013

Stephanie Eichberg

1FINAL

No doubt, Vienna is a beautiful city and one doesn’t really need a specific reason to go and spend a few days in the vicinity of world-famous coffee houses (marvellous cakes, too!); brilliant art (Klimt, Kubin, Stifter…); architecture (the Martinellis, Otto Wagner, Hundertwasser…) or opera houses.
But the reason why we chose it as the destination for this year’s History of Medicine Field Trip is because a number of individuals discussed in our modules had made their first appearance in Vienna: the late eighteenth-century physician Anton Mesmer whose unconventional treatment influenced the history of hypnosis; the phrenologists Franz Joseph Gall and Johann Spurzheim; Sigmund Freud; Ignaz Semmelweis, the pioneer of antiseptic procedures – just to name a few. As it turned out, the richness of Vienna’s medical heritage exceeded our expectations by far.

What follows is a synopsis of things we learned and things we looked at, including some unofficial titbits of information that our wonderful museum and tour guides shared with us over the course of our visit.

MONDAY, 11th FEBRUARY
Our first point of contact with Vienna’s medical history was the Josephinum, a beautiful building specifically designed to house Vienna’s new faculty for surgery and medicine, which was commissioned by the Habsburg Emperor Joseph II in 1785.

Prof. Sonia Horn, who is in charge of the historical collections at Vienna’s Medical University, gave us an overview of this unique institution and its historical development, which was followed by a tour of the History of Medicine Museum. The Josephinum’s history provides fascinating testimony to a once close connection between medicine, society and the state, due to Joseph II’s keen interest in medical reforms. Another outcome of the Emperor’s involvement in Vienna’s medical matters is the world’s second-largest collection of wax anatomical models held at the Josephinum. Only four of such collections have survived in Europe, the largest being La Specola in Florence, home to the creator of the models, the Italian wax sculptor Clemente Susini (1754-1814). Joseph II himself had visited Florence in the 1780s, his personal surgeon in tow, and after seeing the spectacular creations of Susini, he immediately ordered a large number of anatomical models for Vienna’s medical faculty.  Interestingly, when the wax models arrived in Vienna (a total of 1192 specimens, delivered over two years ‘on the backs of mules and men’[1]), the medical establishment was markedly less impressed than their Emperor. In a recent article of the subject, Anna Maerker concludes that, rather than being hailed as useful models for teaching anatomy to medical students, they actually sparked debates on their utility, resulting in conflicts between surgeons and physicians. Overall, they were mostly perceived as ‘toys’ to entertain the public.

We certainly found them entertaining. The wax figures are so eerily beautiful that they alone would have been worth the visit to Vienna. Apart from stunningly detailed wax preparations for individual organs, including the vascular, muscular and nervous system, and manifestations of diseases with varying levels of grossness, the stars of the show are the life-sized anatomical figures lying or standing in their original caskets made of rosewood and Venetian glass. With their classical postures inspired by early modern anatomical textbooks, the male wax figures in particular appear to have stepped directly off the pages of Vesalius’ De humani corporis fabrica, only to freeze again in their respective poses.

3FINAL

Anatomical wax figures in classical poses.

The most famous one, however, is the Anatomical Venus, the wax figure of a female lying in a glass casket like in a coffin, almost lasciviously splaying out her viscera to the observer. She is often compared to Snow White or Sleeping Beauty because of her princess-like pose (though I don’t know about that, unless I’ve been missing out on the original Grimm’s version in which the heroines are dismembered at the end of the fairy tale…). Her waving hair and eyelashes are made from real human hair, and one of the most interesting titbits of information we were fed by our guides was that cultural preferences in female beauty appeared to have been well catered for: while her Florentine counterparts are all brunettes, the Viennese waxen Venus is blond. It made us wonder whether all Venuses made for the north of Europe would have been furnished with blond hair, while those heading for the south were brunettes, or whether Joseph II requested this particular detail when he placed his order (no cultural differences or preferences are discernible in the male figures whose bodies are all flayed to reveal the vessels, muscles and nerves).  One of our helpful guides further speculated that the pearls round her neck and/or the gold band in her hair might have been added by 19th–century medical students for a joke. We could well imagine the impact this naked and revealing beauty had on a bunch of unruly male students…. Our (well-behaved) IBSc students at least marvelled at the anatomical detail and accuracy, and one of them remarked that he would have welcomed the use of such models in his own anatomy courses at UCL. Images in books, computer models and even real corpses were, to his mind, not able to convey the rich detail and intricate beauty of the human body in the same way as these models did. One can only agree.

4FINAL

Viennese Anatomical Venus.

Viewing afterwards the beautiful library and an extensive medical instrument collection, we all felt a little dizzy when we left the Josephinum. So much to see and take in! I’m not sure our brains could have handled another two or three hours of information overload; as it was, our planned tour to the Museum for Forensic Medicine fell flat, due to illness of our tour guide….so we went instead to the nearby campus of the medical university, indulging in a hearty Austrian meal and beer from a monastery brewery. 

5FINAL1

 

TUESDAY, 12th FEBRUARY

6FINAL

Figure 1: A model painting of the Old Hospital Campus in the 1780s. The layout is not accurately presented, due to the addition of several yards over time. Figure 2: The ‘Narrenturm’ (Fools Tower). Figure 3: Inside the Fools Tower. The former cells are now used as storage space for additional specimen from the anatomical-pathological collection.
http://www.viennadirect.com/sights/hospital.php

For Tuesday, we had booked a tour of the Fools Tower, which is situated next to the grounds of Vienna’s old General Hospital (today’s university campus) and which now houses a large anatomical-pathological collection. Stomping through the snow, our guide led us first through the vast labyrinth of the old hospital campus. The hospital buildings are organised around several yards which are connected via gate passes. It is hard to believe that this amazingly organised hospital structure with its several yards for different diseases dates back to the 18th century (the first hospital building was erected in 1693). It is easy to get lost in these grounds, but the underlying idea of separate, yet connected yards is genius: functioning like wards in a modern hospital, there would have been a yard for lung diseases, say, one for skin diseases, one acting as an obstetrics hospital with an adjacent orphanage (to discourage infanticide, women could enter through a separate gate, the ‘Schwangerentor’, give birth anonymously and leave their children at the orphanage), etc. What we found especially interesting was that the porter, sitting at the main entrance to the hospital, would assess incoming patients’ symptoms and then send them off to specific yards, implying that 18th-century hospital porters, although not members of the medical personnel, were the first link in the chain of medical diagnostics.

In the 19th century, the old hospital took on important research functions; illustrious names like Ignaz Semmelweis, Theodor Billroth (founder of modern abdominal surgery), Karl Landsteiner (discovery of blood groups and the Rhesus factor), all made an appearance. We greatly appreciated that our enthusiastic guide would not simply rattle through the names of great men and their great discoveries but also mentioned the darker side of Viennese medicine, such as incidents of experiments on patients and the influence of Nazi ideology on some scientists whose statues still decorate the hospital grounds.

Eventually (being sufficiently frozen), we entered the Fools Tower, the first ever building on continental Europe to house and treat mental patients, courtesy once more of Joseph II who had the Tower built in 1784. Historians claim that the Emperor’s personal interest in the healing of the insane was based on his membership of the Knights Templar or Rose Crusaders. The latters’ alchemist and mystic numerology seems indeed written all over the Fools Tower: the round building has 5 floors and has a circumference of 66 ‘Klafter’ (old Viennese measuring unit). Each floor contains 28 cells and the roof additionally houses an octagon which Joseph II is said to have visited on a weekly basis. Our guide also told us that an atmospheric-electric or magnetic field exists at the site of the Tower which might have been identified and used in the treatment of patients at the time (the Tower also features the world’s oldest lightning rod). It is still debated whether the Fools Tower’s round-shape architecture is based on or inspired by the Benthamite idea of surveillance; yet, apart from the fact that there was no central observation point, the building probably just made it easier for doctors and nurses to do their ‘rounds’ (though it is also said that the round shape was a deliberate way of enabling non-violent inmates to walk endless turns without encountering a hindrance). Patients suffering from raging madness were on the top floor, those with the lightest symptoms, such as melancholics, were housed on the ground floor.

Overall, considering its importance in the history of mental asylums, Carole and I were a bit disappointed that hardly any exhibition space was devoted to this initial purpose of the building. An exception was one cell that still contained its original door with spy hole, and a tiny model of an 18th-century cell. All floors were otherwise devoted to a vast anatomical-pathological collection, including phrenological skulls and the collection of the Viennese physician and electro-pathologist Stefan Jellinek (1871-1968) who began to collect specimens and reports about lightning strokes and accidents with electricity in the 1890s. The specimens – waxen and otherwise – even made our medical students feel a bit queasy….

7FINAL

Figures 1-3. Specimen of the anatomical-pathological collection at the Fools Tower, 19th-20th century. Figure 4: Gents – be careful where you take a leak…Electrical Protection in 132 Pictures; ca. 1930s by the Viennese physician Stefan Jellinek.

Our guide was a passionate storyteller who threw in an extra hour for us – the 3 ½ hour tour was only once interrupted for a much appreciated serving of coffee and homemade (!) cake. The students loved every second of it!

On WEDNESDAY, 13th FEBRUARY – a bitterly cold day with harsh winds and lots of snow – we ventured on a guided history of medicine tour through Vienna’s city centre. Such is the rich medical heritage of Vienna that one can book a variety of medically-themed tours set up and organised by a cultural historian. (http://www.wienfuehrung.com/Medicine_Vienna.html) We had booked a mixture of ‘Barber-Surgeons, Physicians and Quack-Doctors in Old Vienna’ and ‘From the Plague Hospitals to the Modern Clinics’. Our tour guide was another passionate storyteller who appeared unfazed by the blizzard and dropping temperatures (though she kindly led us to a café midway through the tour to enable us to thaw…). She was brilliant, in that she did not focus exclusively on history of medicine topics but weaved in other cultural highlights of Vienna. Thus it was that we once stood opposite the still operating Knights Templars’ headquarters and we also caught glimpses of the beautiful Lipizzaner horses at the stables of the Spanish Riding School (first named in 1572, it is the oldest of its kind). At the Plague memorial, erected 1693, we heard entertaining folk tales about drunkards who woke up in plague pits, the constant ringing of church bells at plague times to keep the air circulating to expel the miasma from the town; the use of theriac, this most elusive and mysterious universal remedy containing all sorts of ingredients, including the fat of executed criminals (this we learned standing in front of Vienna’s old court pharmacy which still displays the original layout and interior). We were told that the early modern and slightly unorthodox physician and alchemist Paracelsus had completed part of his medical studies in Vienna (there is even a beer bearing his name and the Paracelsian inscription “Beer is a truly divine medicine”); that the Hofbibliothek, the former court and now national library, contains some of the oldest medical manuscripts, such as the 6th-century illuminated Materia Medica by Dioscorides and…. I could go on and on.

Vienna is so infused with medical history that a whole travel guide has been published on the subject – written by doctors for doctors (W. Regal, M. Nanut, Vienna. A Doctor’s Guide, 2007).

8FINAL

Figure 1: The Plague Column (1693) at the heart of Vienna’s city centre. Figure 2: Early modern physician in plague-protection attire. . Figure 3: The old Bürgerspital which became the first teaching clinic for medical students under Anton de Haen. Figure 4: Vienna – A Doctor’s Guide, a travel guide written by doctors for doctors.
http://www.wienfuehrung.com/Medicine_Vienna.html

On the same day – to make the most of this last afternoon in Vienna – some of us went to another eye-opening museum which is probably the only one of its kind worldwide: the Museum for Contraception and Abortion. Since related debates tend to focus mostly on the life and death of the unborn, this museum extends the focus by looking at the historical, political, international, cultural, and domestic contexts in which contraception and abortion have taken place; what women throughout history have done to their bodies to end unwanted pregnancies, and what happens in societies in which abortion is made legal or illegal (a whole map, for example, featured the development of so-called ‘abortion tourism’). The museum also provides an interesting historical overview on the use of contraception, from the earliest recorded in ancient Egypt to the introduction of the pill in the 1960s, and beyond. One can browse through abstracts of hundreds of novels that mention contraception or abortion since the 18th century, and short films from the 1920s until today are used to illustrate the development of attitudes towards sexuality and procreation (interestingly, the 1920s appear more progressive in this respect than some of the modern debates).
The most harrowing part of the museum was a corner set up as a domestic kitchen scene, containing the tell-tale kitchen table on which many illegal abortions took (or still take) place. Next to this table was a strange-looking electrical device which turned out to be the latest invention by the household company Bosch in the 1950s: a precursor of the modern washing machine, called ‘Schallwäscher’, its electrical vibrations were meant to help housewives do the laundry more easily….Bosch, however, was eventually forced to take this device off the market when it turned out that desperate pregnant women would apply what was lovingly called the ‘Waschbär’ to their bellies, causing internal bleeding. What sent an additional chill through our bones was an original 1950’s advertising brochure for the Schallwäscher, casually placed on the kitchen table, which depicted a husband carrying the device and other wrapped-up Christmas presents – the caption saying “This will make her happy”…
Visiting this museum was certainly a highlight, albeit a chilling one. It is unique in tackling a subject heads on that at best divides opinions, at worst sparks violence; a subject that is otherwise politically instrumentalised as, for example, shown in the recent book by Mara Hvistendahl (Unnatural selection, 2011) on birth control programmes in the developing world, including forced abortion and gender selection. However, in this museum, contraception and abortion are elevated to topics that infuse the historical and cultural matrix of countries worldwide and which make the visitor see more than one side of concurrent debates.            

  

SchallwaescherFINAL

Figure 1: A domestic scene from the museum with tell-tale kitchen table. Figure 2: An advertisement for the ‘Schallwäscher’, a precursor of washing machines invented by Bosch; it was taken off the market when it was found out that women applied the electrical device to their pregnant bellies in order to abort. The caption reads ‘Useful in every household’… . Figure 3: Another advertisement with the caption ‘This will make her happy’.

PilleFINAL

Figure 4: The Frog Test, a biological indicator for pregnancy used until the 1970s. Figure 5: The pill that changed the world. (Images courtesy of MUVS, Vienna)
http://en.muvs.org/
https://www.facebook.com/eMUVS

On Thursday, 14th February, all too soon, it was time to say goodbye to Vienna. Although we had an amazing time, it felt like we left too much unfinished business behind – there was still so much more to see and do! Apart from history of medicine–related museums (some of which are listed below for those interested), one could spend a month in Vienna and visit a different museum each day, or else go to dozens of art galleries, not to forget the world-famous opera houses … Have a look at http://en.wikipedia.org/wiki/List_of_museums_in_Vienna

Anyone planning a visit to Vienna with a special interest in the history of medicine might also want to check out the following:

Sigmund Freud Museum

Vienna Central Cemetery (hosting eminent figures in the history of medicine)

 

History of Nursing and Medical Care Museum

 

Museum for Forensic Medicine 

Dental Museum, including a replica of a 19th-century dentist’s office .


History of Drugs and Pharmacy Museum

——————————————————————————————————

The unofficial blog for the History of Medicine Field Trip to Vienna.

The group is standing somewhere in Vienna’s city centre, gaping open-mouthed at the beautiful buildings surrounding them (the students are actually panting because Carole is still on inner-city-London-pace).

Carole: This is wonderful. Being here is such an immersive experience. I can’t wait to get to all of the medical history museums, following the path of Mesmer, Lister, Semmelweis….

Student 1: Semmelweis….I’ve heard of that guy!

Carole: …. and seeing the Old Hospital Campus of the late 18th century.

Stephanie: I’m hungry.

Student 2: Is Lister the chap who invented the mouthwash?

Student 3: They had hospitals in the 18th century??

Carole: We must immerse ourselves in the medical history and culture of this place!

Stephanie: Did you know that Vienna is also the ‘Capital of Cake’?

Student 4: It’s snowing; we shouldn’t be out in this weather.

Student 5 (hungover from last night’s visit to the hostel bar): I don’t feel so good.

Carole: Just look at this amazing memorial. It’s huge. I wonder what it’s for. (Shouts) STEPH – what does the guidebook say?

Student 5 edges closer to the memorial.

Stephanie: (reaches for the book and recites): The Plague Column is the best known memorial of Vienna’s city centre. It was erected to commemorate the death of countless plague victims in the last outbreak in 1679. It is said that the plague hit Vienna so hard that the stench of rotting corpses hung over the city for weeks…..

Vomiting noises from behind the memorial.

Carole: Come on folks, we mustn’t be late for our next museum tour. (Runs off with accelerating speed).

Student 4: I can’t move; my feet are frozen to the ground.

Student 6: Where are Carole and Stephanie?

Everybody turns in the direction of a fleeting dust cloud in the far distance. Heads turn in the other direction. Stephanie has spotted a bakery and made a run for it.

 


[1] Anna Maerker, ‘Florentine anatomical models and the challenge of medical authority in late-eighteenth-century Vienna’, Studies in History and Philosophy of Biological and Biomedical Sciences 43 (2012), 730-740.

Stephanie Eichberg is a Teaching Fellow at the UCL Centre for the History of Medicine.

The Object of Writing History in the of Age of Biomedicine

Roger Cooter

Dustjacket2

I’m delighted to announce this book’s soon publication by Yale University Press. I’m thrilled, too, that we were able to get permission from the Munich artist, Stefan Birkel, to reproduce (albeit only in black and white – for the original colour image see below) his ‘Das Rad der Ziet läuft gut geschmiert’ (‘The Wheel of Time Runs Well Greased’) – an appropriate, if enigmatic, metaphor for Writing History in the Age of Biomedicine.

Although eight of its ten chapters have been seen before, Writing History in the Age of Biomedicine was not conceived as a ‘best of’ book. In mind, rather, was a volume that would deal explicitly with a subject that historians tend to shy away from: the politics and epistemology of historical writing. Writing History in the Age of Biomedicine (four of its chapters co-authored with Claudia Stein) uses previously published work to illustrate and critically comment on this. Each chapter therefore has a substantial preface in which I lay out not only the personal and intellectual circumstances for its writing, but also the wider and deeper epistemic conditions of possibility for its existence in the first place. Through its engagement with different ‘turns’ in recent history writing — from the pre-somatic, through the cultural, the corporeal, the visual, the spatial, on to the fashionable ‘neuro’ and ‘material’ ones of today — the book comprises, in effect, a history of academic history’s own historicity. It argues the case for acknowledging and even celebrating the fact that history writing is never conducted outside of theory, methodology, and epistemology, but is always inside them.

The hitherto unpublished first and final chapters wrestle more particularly with the ‘so-what?’ and ‘why bother?’ of writing history today – a time when its academic pursuit (and that of the humanities in general) has become like salmon fishing in the Yemen, impossible and increasingly disdained culturally. This occurs, I argue, not simply because we live in ‘the age of biomedicine’ in which the natural sciences have acquired cultural pride of place, and have come to define what we are, what problems we should address, and the terrain on which we should address them.  Rather, it is because what is fashioned as ‘the age of biomedicine’ lies deep within the episteme of neoliberalism. Neoliberalism is more than just a political and economic project, which also happens, non-coincidentally, to be much beholden to biocapital (and, incidentally, to have gained a great deal of intellectual capital from the poststructuralist turn in the academy).  It is also an approach to, and understanding of the world, in which history has no place, at least outside the profit-making entertainment industry and the propaganda departments of politicians. It fosters ahistoricity, or the inability to see things as always in history and shaped by it. It does so by celebrating a particular temporal frame, that of newness or novelty, which draws a line under the past in the interest of the present and the future. Present-centricity is its hallmark; future growth (above all in stocks and shares) is its global promise. The weight of history — the past – just stands in its way. However critical history writing, I contend, has the potential to expose and refute this present-centricity, but it can only do so by confronting itself — confronting its own ahistoricity in thinking that the present is somehow a neutral space in which ‘objectively’ to write the past. Writing History in the Age of Biomedicine is therefore at one and same time a chronicle of historical critique, a retrospective reflection on the shifting nature of its conduct, a personal statement of my core belief in the function of history writing as a form of critical politics for addressing the present, and a call to arms.

OLYMPUS DIGITAL CAMERA

Roger Cooter is a Professor at the UCL Centre for the History of Medicine.

The Tubes and Flaps of Modern Medicine

Louise Crane

I’m reading James Le Fanu’s account of “The Rise and Fall of Modern Medicine”. It’s a gripping whistle-stop tour of how medicine changed dramatically from the era of the Second World War onwards. Le Fanu pulls out such glorious gems of whimsy in these tales of triumph, I just had to share one here:

In 1973, reports of the first “free skin flap transfer” gave hope that the old style “tube pedicle” transfer – whereby a portion of skin is removed from a healthy part of the body and conjoined to skin near an area that has been damaged (namely from burns) where this skin tube naturally gains a blood supply from the new site, is then removed entirely from the original area and finally sewn as a flap of healthy skin over the damaged area – could become a technique of the past.

The first of the new microsurgical free skin flap transfers involved the complete removal of healthy tissue from an Australian patient’s groin area and subsequent transfer to the area of damaged skin on the ankle. This technique made use of the newly-invented operating microscope to enable grafting of miniscule blood vessels between the skin surrounding the damaged site and the healthy skin graft. The tension lay in the skill of the surgeon connecting these pin-head sized vessels, and the question of whether they would immediately carry blood through to the grafted skin.

In this case, they did. And here is the gem:

“After 17 days the sutures were removed and a few luxuriant pubic hairs were noted growing on the ankle.”

Le Fanu mined this quote from the original paper in Plastic and Reconstructive Surgery*. It is the appearance of the word “luxuriant” more than “pubic hairs” that really makes me smile. I like to imagine authors Daniel Rollin and Ian Taylor enjoyed inserting that into an otherwise standard technical account of an extraordinary technique that transformed the treatment of skin burns.

*Available to subscribers only, sorry.

Louise Crane is an MA candidate at the Centre.

Roger Cooter’s “Writing History in the Age of Biomedicine” – Coming Soon!

Some great reviews coming in for Writing History in the Age of Biomedicine by Roger Cooter (with Claudia Stein) to be published by Yale University Press. You can see some of them below. It’ll be out in June and we’ll be publishing a review of Prof. Cooter’s work a little later in the year.

“….an intellectual tour de force wresting with Marc Bloch’s original quest to interrogate the purpose, meaning, and methodology of the historian’s craft….this will be a ‘must have’ book for introducing students to the study of history, especially at the graduate level.”—Dorothy Porter, Professor in the History of Health Sciences, University of California, San Francisco

“I can think of no really comparable recent book…Writing History in the Age of Biomedicine may turn out to be quite significant as a touchstone for the internal critique of historical scholarship in the first decade of the current century.”—William Summers, Yale University

“In the 21st century there is no arena of history more contested than that of biomedicine. Roger Cooter’s Writing History in the Age of Biomedicine (written with Claudia Stein) is the first serious attempt to look at the historiography of medicine as an index of the debates about meaning and its generation within these debates. Whether examining questions of biopower in biomedical science, the new materialism and its claims at truth, or looking at the analysis of specific themes, such as the history of HIV/AIDS and its representation, Cooter and Stein provide detailed and critical looks at the shifting assumptions within the history of biomedicine. This is more than an important book from two seminal thinkers: it is a call to examine the shifts in the writing of bio-history and their underlying political assumptions.”—Sander Gilman, author of Difference and Pathology

“In this gnarly and very personal meta-historiography, scholar-provocateur Roger Cooter dishes the political epistemological dirt. Essay by essay, Cooter’s pilgrim progress goes through a dizzying spin cycle of social, literary, cultural, pictorial, neuroscientific, material turns.”—Michael Sappol, author of A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in 19th-Century America

“I am a fool” Dr Henry Cattell’s Private Confession – 14 October 1892

Sheldon Lee Gosline

      Much speculation has been written about what really happened to Walt Whitman’s (1819-1892) brain, and the degree of responsibility for its destruction has been variously assigned.[1] Probably the most comprehensive study is by Brian Burrell in “The Strange Fate of Whitman’s Brain.”[2] Cynthia Haven speculated that the narrative of how Whitman’s brain was destroyed even inspired a vivid scene the 1931 film Frankenstein.[3]

Image courtesy of Dr. Geoffrey Sill, Rutgers University.

Walt Whitman (Image courtesy of Dr. Geoffrey Sill, Rutgers University.)

The narrative of how a clumsy lab assistant dropped the bottle containing Whitman’s brain, after which it was discarded, is still told at the Walt Whitman House in Camden, NJ.[4] This was historical fiction to protect the reputation of the guilty party.  The head of the lab, Dr Henry Ware Cattell (1862-1936), perhaps best known for his Post-Mortem Pathology, has received his share of accusations, but until now there has been no proof.  Whitman’s brain was supposed to join those of other prominent Americans at the University of Pennsylvania’s Wistar Institute, famous for its collection of nineteenth-century elite brains donated in pre-mortem agreements by members of The American Antropometric Society, informally called the “Brain Club,” established in 1889. [5] A believer in phrenology, Whitman made regular references to it in his writings, [6] so it is no surprise that he was interested in having his brain studied after his death.

Cattell’s diary, covering parts of 1891-1893, sheds some light on what actually happened.  This is an unpublished handwritten ledger with a cover page entitled “Diseases of Children”. The bulk of the text consists of his diary for 1892 – the fateful year when the poet Walt Whitman died, had an autopsy performed by Cattell, removing his brain for scientific research.  The ledger was sold on Ebay in December 2012, and I am very thankful to Jason Cacioppo, its current owner, for sharing the unpublished data with me.[7]

i am a fool

Unfortunately, Cattell’s diary is silent about the Whitman autopsy, with no entry for the day in question, 27 March 1892.  It is, however, revelatory about how the poet’s brain was destroyed.  There are sporadic diary entries for 1891 (2 March to 14 September 1891, pp 50-60), then a gap during the time of the Whitman autopsy.  Dated entries resume with daily entries beginning 23 May 1892 (p 61).  At first optimistic, the diary entries are sporadic.  Many day-pages have little or no data.  Having recently received the post of anatomical demonstrator for the University of Pennsylvania, 1892 started out as a great year for Cattell.  He notes seeing his first professional baseball game on 20 July 1892 (p 96), that he got new glasses, even recording his lens correction, on 30 September 1892 (p 130), and the passing of his 30th birthday on 7 October (p 137).

But after 14 October 1892 diary entries are increasingly dark and self deprecating, expressing financial concerns, doubts, and even confessions of suicidal thoughts.  The pivotal moment concerns an unexplained confession on 14 October 1892, “I am a fool.”(p 144)  This begs the obvious question, why does Cattell call himself a fool?  The prior day his notes include “Prepare specimens for path. soc.”(p 143)  Hypothetically, among those specimens was the brain of Walt Whitman, as yet undamaged.  Is a nearly blank page with a teasing confession the closest we will ever come to learning what actually happened?  By itself, “I am a fool” could relate to anything, and even if it does concern Whitman’s brain it does not by itself tell us why Cattell wrote it.

Two days later, on Sunday, 16 October 1892, Cattell made a more specific confession, “I wish that I knew of the best way of keeping an account of my work.  It often seems to me that I am so forgetful and yet I remember certain things which others might not be able to mind.”(p 146)  Are the two confessions somehow related?  Are we any closer to solving the mystery of Whitman’s brain?  Historical research is filled with such tantalizing back alleys and dead-ends, and at first this seems like another one.  However foolish Cattell may have felt on the 14th, by 31 October he was excited, noting “Pay day at the University [of Pennsylvania] to-morrow.  I will get the largest sum which I have ever received at once clear viz. $183 1/3, the first annual check being the only one larger than this, but over $100 having to be directly paid out for work done.”(p 161)

Cattell was sometimes more candid and reflective, although still cryptic.  Skipping ahead to an entry on 13 April 1893, he wrote, “I am a peculiar man in many ways.  Why did I get rid of Edwards – in all probability because I was jealous of him.”(p 167)  Money concerns about over-spending are also evident, but the biggest confession was yet to come.

fool whitman 2

In the privacy of his journal, about a month after his confession to being peculiar, Cattell fully confessed to the Whitman brain disaster, reflecting: “I am a fool, a damnable fool, with no conscious memory, or fitness for any learned position.  I left Walt Whitman’s brain spoil by not having the jar properly covered.  Discovered it in the morning.  This ruins me with the [American] Antropometric Society, and [Harrison] Allen, perhaps with [William] Pepper [Jr], [Isaac Newton] Kerlin &c.  How I ever got in such financial straights [I] do [not] know.  When I broke with Edwards I should have told him to go to thunder.  Borrowed over $500 more from P & M [Pa and Ma].  They are too good & kind.  I would have killed my self before this a dozen times over if it had not been for them.”(p 179)  This reflection, on Monday 15 May 1893, most likely relates to the briefer confession of 14 October 1892, and links with the Edwards dismissal, who seems to have taken the official blame until now.  Self-doubt continued to plague Cattell.  On 18 September 1893 he wrote, “I should be happy and I suppose in my way I am.  Except for my parents I could go to Africa or die and I w[ou]ld be in no way missed.” (p 197)  On 30 September 1893 he wrote, “I look back on my confidence and self possession of last year as somehow wonderful.  I now know that I do not know enough pathology for the position which I occupy.” (p 203)  Financial woes continued to plague Cattell for some time, but his diary entries were not all doom and gloom.  On 17 October 1893, Cattell wrote: “My finances were never in so flourishing a condition and I felt like writing the other day that I was happier than I have ever been.” (p 215)sepiawhitman

So, there it is, as clear as can be.  Sometimes the facts do finally emerge, but (as in this case) it would always be welcome to learn more details.  Who threw away Whitman’s brain?  What exactly does it mean that it was spoiled by not having the jar properly covered?  Was it knocked over by the cleaners?  Did something strange get into the jar that contaminated it?  Was Edwards at all involved or only a convenient scapegoat?  Reading between the lines, Cattell appears to be the victim of extortion, perhaps by the disgraced assistant.  Then, too, why put this incriminating evidence down on paper at all, risking public exposure?  Clearly Cattell wanted to leave a confession that one day would become public – which now, 120 years later, has finally happened.  At the end of this ledger there is a poem Cattell wrote on 9 June 1924.  Perhaps it best summarises how he viewed his life, disregarding many honours as fraudulently gained, and the last lines allude to a lifetime of guilt concerning Whitman’s brain.

A Thoughts on glancing over the back pages of this book

A lovely life he had / No wife to warm his bed / No childish voice to hear / Or baby prattles dear / No loving arms entwined outlined / Around his neck outlined entwined.

Those many worldly things / Which lots of money brings / He had, too true, galore. / And honors many more / Than fall to better men / Were won with learned pen.

Now envy not his lot / For happy was he not / His sense of justice fair / Was found not longer there / A hell in every nook / For God he had forsook.

Even though the details may never be more certain, we at least have part of the answer to the mystery of what happened to Whitman’s brain and the lifetime of guilt by the responsible party.

Sheldon Gosline is researching the role of the physician as entrepreneur for his PhD thesis at University College London.  It focuses on the the physician as entrepreneur through the life and career of S Andral Kilmer, MD.


[1] Ron Avery “Philadelphia Oddities” http://www.ushistory.org/oddities/brain.htm; Thomas Lux “Walt Whitman’s Brain Dropped on Laboratory Floor” http://www.bu.edu/agni/poetry/print/2002/56-lux.html; Kim Roberts “Walt Whitman’s Brain” micklestreet.rutgers.edu/Scholarship/poems/Walt%20Whitmans%20Brain.pdf

[2] Brian Burrell, “The Strange Fate of Whitman’s Brain” Walt Whitman Quarterly Review 20 (Winter 2003): 107-133.  ir.uiowa.edu/wwqr/vol20/iss3/2/

[3] Cynthia Haven, “Frankenstein and Walt Whitman’s brain: ‘This is a grewsome story!’” bookhaven.stanford.edu/2012/06/frankenstein-and-walt-whitmans-brain-this-is-a-grewsome-story/

[4] “The True Story of Whitman’s Brain”  www.youtube.com/watch?v=claBmga4ruc

[5] Edward Anthony Spitzka, “A Study of the Brains of Six Eminent Scientists and Scholars Belonging to the American Anthropometric Society together with a Description of the Skull of Professor E D Cope,” Transactions of the American Philosophical Society, New Series 21:4(1907):175-308.

[6] Nathan Mackay “ Phrenological Whitman”  www.conjunctions.com/archives/c29-nm.htm

How To Make a Victorian Villain (or the Tale of Isaac Baker Brown) Part 2

Sally Frampton

Isaac Baker Brown and the Clitoridectomy Operation

It was around the time of Brown’s break with the world of general hospitals that he began to be heavily influenced by ideas of nervous physiology, particularly those of Charles Brown-Séquard (1817-1894). Hysteria had long been associated with the female generative organs but Brown now started to suspect that irritation of peripheral nerves in that area was the specific cause of such afflictions. It was from this theoretical basis he took the controversial step of asserting that excitement of these nerves through masturbation could trigger mental disturbances of all kinds in women – not just hysteria, but epilepsy and mania too – and that extirpation of the clitoris in chronic masturbators was a potential means of cure. Here Brown, perhaps keen to claim credit for what he felt was a significant and novel surgical innovation, quickly put idea into practice with the verve he would become famous for. His account of his first clitoridectomy, on a 26 year old dressmaker form Yorkshire makes for uneasy reading. In keeping with Victorian etiquette Baker Brown’s language was rather veiled when it came to the matter of masturbation – he often avoided the word itself although in other cases referenced “excitation of the pudic nerve”, the meaning of which would have been clear enough to fellow doctors. In this first case however Baker Brown only rather cryptically mentioned that “her physiognomy at once told me the nature of the case” before noting her rather vague symptoms of weight loss, irregular menstruation and melancholia. Disconcertingly, what singled her out for his surgical experiment appeared to be timing rather than the specifics of the case, Brown writing that she was “the first case that came under my notice after I had satisfied myself of the correctness of my views on the subject.”[1]

While it was known that Brown had been performing clitoridectomy since the early 1860s it was only with the publication of his monograph On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy and Hysteria in Females (1866) that the extent of his practice was revealed. Aside from the dubiousness of Brown’s claims that a permanent cure could be achieved this way, for many of his surgical colleagues it was the flagrant attempt to use surgery to treat nervous conditions which irked. The professional standing of medicine remained shaky and the boundaries of what it was appropriate for different types of doctor to do had an increasing influence over mid-century medicine; Brown’s expansion of surgery into the realm of mental disease did not sit well with this. Still more objected to the assumption that masturbation was occurring with frequency among women and some even challenged Brown to consider whether such actions would be acceptable if the patient was a man; “we have scarcely more right to remove a woman’s clitoris than we have to deprive a man of his penis” noted one opponent.”[2] As criticism mounted the Council of the influential Obstetrical Society took the unusual step of proposing the expulsion of Brown. The ensuing debate, which was published in The Lancet on April 6th 1867, makes for fascinating reading as Society members packed in to the crowded hall to cast their vote. It seems likely however, that the die was cast before Brown even walked into the room, for his supporters were few and far between by this point. Brown was barely given a chance to speak and jeers broke out whenever he attempted to do so. He was expelled with 194 votes for and 38 against.

Extract from “The Baker Brown Fund.”The Lancet, Volume 99, Issue 2535, 30 March 1872, Page 453.

Extract from “The Baker Brown Fund.”
The Lancet, Volume 99, Issue 2535, 30 March 1872, Page 453.

The expulsion effectively ended Brown’s career, with the Surgical Home folding soon after. By the end of the following year Brown was registered bankrupt, a wretched example of how quickly financial fortune could turn in medicine and the peculiar risks of specialising in diseases of women. An appeal in the medical press in the early 1870s for financial support for the destitute and by now critically ill Brown – reports hint at a nervous breakdown of some kind – attracted big medical names such as William Withey Gull and James Paget. But it was too little too late and Brown died 3 February 1873, his death attributed to apoplexy and a softening of the brain.[3] Soon after his son and assistant, also once known as Isaac Baker Brown, changed his name to Lennox Browne in attempt to disassociate himself from his father, a final sadness to the story. Brown’s apparent excommunication from the profession seems to have extended into surgeons’ own personal archives. It was not uncommon for Victorians to request sensitive parts of their correspondence to be destroyed once they died and hence not that surprising that there is no collection of Baker Brown’s papers. But I have always found it striking that in my years of research into Victorian surgery I have never once stumbled upon any letter to or from him. He was, perhaps, a bad dream that London surgeons wanted to forget.

What then can we learn from the story of Isaac Baker Brown? Firstly of course, that it’s a story that involved many people; not least the dozens of women who were operated on in circumstances of dubious consent, robbed of a fundamental part of their sexuality and all for a treatment that few believed worked. One disturbing example leapt out at me when reading Brown’s cases; a 57 year old woman who came under his care in 1861 suffering from “homicidal mania”. The woman was subject to the usual treatment at the Surgical Home; however on completing the operation the woman did not exhibit the usual expected compliance. Rather Brown reported that “she complained to my son that I had unsexed her. He answered that nothing of the sort had been done, but that the operation had prevented her from making herself ill.”[4] This one case speaks volumes, not only of the arrogance that had come to dominate Brown’s practice, but of the quiet resistance of the nameless patient.

But Isaac Baker Brown also tells us something about the way we do history and how controversial medical practices become easy emblems in a broader narrative of Victorian social mores. Brown is a quick and easy Victorian villain; one only has to Google him to see how many times he features in a paragraph or two in any number of works on the history of gender or madness. He earned this place with extreme treatments practised upon vulnerable women which were almost as controversial in his own time as they are now. But it’s important to remember too that he was the product of other contexts as well; not least a professional culture where specialist institutions and procedures had increasing social and economic value and where improvements in surgery meant that the self-identity of surgeons was fundamentally changing. Isaac Baker Brown was just a man after all, made of flesh and blood, whose convictions and talents became overpowered by arrogance. And perhaps that is the saddest thing of all.


[1] Isaac Baker Brown On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy and Hysteria in Females (London: Robert Hardwicke, 1866) 20-21.

[2] Moore, Harry Gage “Clitoridectomy” (The Lancet, V.87, no.2234) June 23 1866. 699.

[3] “Obituary” (The Lancet, V.101, no.2580) February 8th 1873, 222-223.

[4] Brown (1866), 79.

How To Make a Victorian Villain (or the Tale of Isaac Baker Brown) Part 1

Sally Frampton

                                                   Portrait of Isaac Baker Brown from the Medical Circular (1852)    Portrait of Isaac Baker Brown from the Medical Circular (1852).

Isaac Baker Brown is something of a legend in the history of medicine. A shorthand for the unhappy excesses of Victorian surgeons, he was the brute who mutilated vulnerable women; the clitoris cutter of West London carried away by his talent for operating; the surgeon who took his knife to those who committed the heinous act of masturbation; an embarrassment to the profession who was eventually exiled by his colleagues, had a nervous breakdown and died a broken man.

…well that’s the tabloid version anyway. And a fascinating tale it is too. But of course like so much of history, the story of Isaac Baker Brown is one easily compacted, compartmentalized and extricated from context.  It’s easier to think of Brown this way perhaps, as more monster than man, rather than consider the many factors that led to him towards performing clitoridectomy, one of the most shocking surgical experiments of the nineteenth century. This I hope to do here in a blog of two parts.

Isaac Baker Brown – The Early Years

Like all good stories Brown’s was one of twists and turns which reflected the rapid changes occurring in medical culture in the mid-nineteenth century.  His beginnings however, were inconspicuous enough. Born in 1812, the second son to a respectable farming family in Essex, he was apprenticed at a young age to a local surgeon. Brown was fairly typical of the type of young man entering surgery in the early decades of the nineteenth century, which was increasingly considered a worthy profession for middle-class men. Hospitals were slowly beginning break free from the nepotism that had previously dominated selection of staff, allowing a more meritocratic environment for young surgeons to distinguish themselves in. Judith Roy has speculated that Brown’s relatively modest background may have played a part in propelling him towards a practice in treating diseases of women, which had a reputation for being lucrative;[1] this seems plausible, but it was probably as much to do with his stint as a student at Guy’s that followed his apprenticeship, where he quickly began to make a name for himself as a young surgeon of some talent. It was here his interest in ovarian disease was formed in the buzzing atmosphere of London’s hospital wards and medical societies and where in 1830, at the tender age if eighteen, he read a paper on the topic to contemporaries. It is perhaps not surprising that an intelligent young man like Brown was drawn to this testing branch of medicine. Ovarian disease was notoriously hard to treat. Medicine seemed to be ineffective in curing or even palliating ovarian tumours, which often grew to huge sizes, and some radical thinking doctors had begun to tentatively suggest the use of major abdominal surgery to remove the disease, despite the risks of haemorrhage and post-operative disease that such a procedure entailed. The operation had been performed a number of times with success in Scotland and America and the justifiability of performing it would become one of the most controversial and debated topics in Victorian medicine. Brown’s mentor at Guy’s, James Blundell (1791-1878), was one of the most avid proponents of the operation and probably played a large part in influencing the professional choices of his young colleague.

Ironically, for someone who would go down in history for his surgical excesses, Brown’s forays into abdominal surgery were initially rather restrained. While other surgeons began to attempt the operation on patients with advanced cases of the disease, Brown held back, believing that ‘ovariotomy’, as the procedure was increasingly known, was not justifiable. Convinced that other less risky therapeutics such as mercurial tonics and pressure bandages could be adequate in treating the disease, only at the end of the 1840s did he begin to cautiously advocate opening the abdomen. His first attempt came in 1852. Sadly his results were not good; the first three of his ovariotomy patients all died. Famously his fourth case was his own sister, who did survive and went on to live a long and healthy life. It might be tempting to see his performance of such a risky operation on his sister as an early clue to his tendency to put convictions before the patient’s safety or welfare. What kind of man after all, would perform ovariotomy on his own sister after such terrible results? But I’m not sure if this would be quite accurate. Ovarian disease was a humiliating and painful condition and Baker Brown was probably cognisant that radical surgery was his sister’s only chance of survival. Given his history of surgical restraint, it seems he was no more audacious than other young ovariotomists. Bad luck? Definitely. Bad operating? Quite possibly. Rashness? Probably not. Nor should we assume that he was emotionally detached from the experience. Historians of medicine have often cited the importance of surgeons and anatomists’ dispassion;[2] certainly harbouring some emotional detachment from one’s grim and bloody work was a useful tool in protecting both professional reputation as well as one’s own sanity. But even with the bountiful advantages of anaesthesia (and indeed even after the integration of antiseptic techniques), surgery remained hugely risky. The tense and heated atmosphere of the operation made for a veritable myriad of emotions and throughout the nineteenth century surgeons performing ovariotomy were often open about the trauma they experienced in performing the operation on their vulnerable and terrified patients, writing emotion into their reports of cases and eliciting emotional responses; “in 1883, 1881 and 1882….my ovariotomies died right off as fast as I could operate upon them. It made me so sick, that I could scarcely bear to hear of a case of ovariotomy” wrote one American surgeon with remarkable candour in 1884[3]. Many of these men gave up permanently after a bad experience.

Due to his increasing success, Brown was not one of these men. By the mid-decades he one of Britain’s most well-known and successful ovariotomists. However his colleagues at St. Mary’s disliked him performing the controversial operation within its walls and in 1858 he left to form his own specialist hospital, the London Surgical Home. Not by any means the first specialist hospital for women, it was however the first in the city to have at its heart the surgical treatment of the diseases of women.  The Home employed a system where women paid only what they could afford and it enjoyed great success over the following years; most specialist hospitals relied on the patronage of the wealthy and well-known to support their work but by 1865 the Surgical Home’s list of supporters was one of the most extensive, as Earls and Bishops, Lords and Ladies queued up to put their name to Brown’s endeavours. His star was on the rise.

Part 2 of How To Make a Victorian Villain (or the Tale of Isaac Baker Brown) coming next week!

Sally Frampton is a research student at the Centre working on the history of ovarian surgery,


[1] Judith M. Roy, ‘Brown, Isaac Baker (1811–1873)’, Oxford Dictionary of National Biography, Oxford University Press, 2004 [http://www.oxforddnb.com/view/article/50268, accessed 16 Jan 2013]

[2] For instance see Lynda Payne on medical dispassion in the early modern period: With Words and Knives : Learning Medical Dispassion in Early Modern England (Aldershot: Ashgate, 2007).

[3] Essay on Desperate Surgery in its Relation to Women: The Proper Place for it; Who Should and Who Should not Attempt it. Journal of the American Medical Association, v.3, no. 12. September 20, 1884. 322.