Dying for Victorian Medicine: English Anatomy and Its Trade in the Dead Poor, c. 1834-1929 by Elizabeth T. Hurren (review)

"Hurren takes up where Ruth Richardson left off," writes Keir Waddington in his back cover endorsement. Indeed, in the more than two decades since the publication of Ruth Richardson's seminal Death, Dissection and the Destitute (1987)—a study of the making of the 1832 Anatomy Act—social history of anatomy in the West has received much attention. Yet no one has explored how the legal access to bodies "unclaimed" after death—without provisions for burial, without family, or without families who could afford the expense—played out upon the supply of bodies in post-1832 Britain. Drawing on diverse sources (workhouse and burial records, parliamentary papers, police files, census records, medical school archives) and using the demanding yet richly rewarding method of record linkage, Hurren explores the period up to the abolishment of the system of the Poor Law Unions in 1929. She weaves together stories of paupers across England with hard data on the fluctuating numbers of medical students, workhouse inmates, and bodies supplied to anatomy departments; poor law union incomes and pauper burial costs; as well as distances that the bodies traveled along newly built railway tracks.

The book consists of two parts organized in seven chapters and a short conclusion. The first three chapters set out the general framework: legislation, changes in medical education, and cultures of death among the poor. In addition to the Anatomy Act and the Poor Law Amendment Act of 1834 (the latter decreeing that workhouses should hand over "abandoned" corpses to be studied), the Medical Act of 1858 with its two-year practical anatomical instruction requirement for medical license kicked supply networks into gear. But it is the discussion of the performance of the Anatomy Act in the early Victorian oral and literacy culture and of the culture of "decent burial" that I found especially strong and enlightening. Even sick and out-of-work poor did not make the decision to give up bodies of their kin lightly and wanted assurances of a burial that conformed to their cultural expectations.

The four chapters in the second part all examine the supply of pauper bodies to anatomists in one of the four very different English medical schools. The well-established St. Bartholomew's in the city of London drew on the humanity at its doorsteps—homeless, suicides, jilted girls, and prostitutes dying at childbirth—to feed its growing appetite. The up-and-coming Cambridge school could count on few local "resources," but its Professor Alexander Macalister smartly utilized the growing railway network to recruit workhouses in the Midlands. At the small Oxford medical school, the ambitious Arthur Thompson struggled against a meager local supply and opposition from the town coroner. By contrast, in the industrial north, the newly established Manchester medical school profited from the fast demographic growth and high mortality of the urban poor.

The most illuminating part of Hurren's book is her skillful mapping of the fluctuations in body supply onto vagaries of poverty politics, showing, for instance, how the attack on outdoor relief around 1870 immediately increased the number of bodies supplied, while the 1908 Old Age Pension Act was a major contributor to the drop of the available corpses (see, e.g., graphs on pp. 132, 191). The book is at its weakest when it comes to a longue durée and comparative perspective. Hurren writes that it was the supply of pauper bodies to anatomists that was "the origin of the tradition of a 'wake'" (p. 5)—yet the tradition of the wake is much older than the nineteenth century and extends beyond England, or indeed any of the Western countries that practiced human dissection. Hurren also writes that "[i]n France, the poor were used to train doctors because dissection and accurate diagnosis was held to be in the national interest" (p. 82), but...