Charles Bell and the Anatomy of Reform by Carin Berkowitz (review)

During the heyday of London’s private anatomy schools, Charles Bell (1774–1842) was one of the most successful teachers, and one of the few surgeons to be knighted, but he is best known for his priority dispute in the 1820s with French physiologist François Magendie. Carin Berkowitz’s book, based on her 2010 Ph.D. dissertation, successfully situates Bell in the world of London anatomy during the age of reform and affirms his contemporary reputation as an exceptional anatomist and teacher.

Berkowitz organizes her material thematically; Bell acts, she writes, “as a sampling device to uncover a strain of what I term ‘conservative reform’ in early nineteenth-century British medical education” (p. 3). She covers much the same era as Adrian Desmond’s Politics of Evolution¹ but from a vastly different perspective, to give due credit to those who did not wholeheartedly adopt “reform.” Bell’s first thirty years in Edinburgh, before he moved to London in 1804, are dealt with briefly—perhaps too briefly, given the importance later accorded to this background—in the introduction. There appear to be few sources for Bell’s life, and Berkowitz relies heavily on his letters to his brother George. The reader could sometimes use a bit more guidance through the period—what does it mean to be a Whig in 1820? How much is 5 guineas worth? What does it mean to be “religious”?

London medical education in the early nineteenth century was a hodgepodge of independent instructors and hospital training, which only began to change with the founding of London University in the mid-1820s. With assiduous courting of patrons and real talent as an instructor, the fiercely ambitious Bell climbed to near the top of the London anatomy scene by 1812, when he purchased a controlling share of William Hunter’s famous Great Windmill Street School.

Not the least of Bell’s talents was as an artist, and his instruction emphasized the ability to draw as well as to dissect. Berkowitz’s excellent chapter on Bell’s pedagogy notes the coordination of seeing and doing, based not only on dissection but also on viewing and making models, drawing, and verbal description. Such instruction required not only dead bodies but also a museum of models, preserved specimens, books, and pictures. Her account complements the broader picture of London instruction up to 1815 offered in Susan Lawrence’s Charitable Knowledge.²

Although Bell strongly believed in the value of books and illustration, he published little in the critical middle years of his career. Books served to make his early reputation, but he adapted awkwardly to the new medical journals of the 1820s. The Lancet in particular espoused radical reform of medical training, with central institutions and standardized curricula, while Bell argued for retention, with some modifications, of a model he believed to be pedagogically and therapeutically superior. Berkowitz fully explains the arguments for and against reform and the politics behind the founding of London University. But Bell often disappears in these discussions, and it is not made clear until later in the book why anatomy is at the center of conservative reform; the politics surrounding the Anatomy Act of 1832 get short shrift. While Berkowitz connects disdain for French research-based instruction with political disdain for French “radicalism,” it is simplistic to claim that French science was by definition politically radical.

Berkowitz’s final chapter explores the Bell-Magendie debate on the discovery of the localized function of the nerves in this context of debates and changes in British medical culture, and thus offers a new perspective. Her focus is not on priority but on Bell’s methodological differences with Magendie and other experimentalists. Although Bell’s original discovery was based in part on vivisection (and he continued to work on living but “stunned” animals, a fact that Berkowitz omits), he continued to value dissection over experimentation. His failure to publish anything on his discovery other than...