Not too long ago I wrote a post about corpse medicine; the use of parts of the dead body in medicines. This could take the form of Stroking lumps and bumps with the hand of a hanged man, or including mummified flesh in a remedy. But dead bodies weren’t only used as remedies, they were used to experiment and develop new cures.
This week I have been reading the 1683 English translation of François Tolet’s Treatise on Lithotomy – the operation to remove bladder stones (we have previously explored Samuel Harlib’s search for a cure for this disease). Tolet was lithotomist at Hôpital de la Charité in Paris. His book includes detailed descriptions of how to cut for the stone and remove it from the body, and, in case you needed them, provides illustrations of the tools used and the procedures as well.1 (see here for a video about how images of lithotomy changed over the early modern period)
At several points in the book Tolet mentions the use of dead bodies. He explains that because these procedures are very complex, and surgeons can easily damage the surrounding organs, they should practice on corpses before they try their hand on living patients.
In order to establish whether a patient had a stone lodged at the top of the urethra surgeons would pass a catheter or a medicated candle into the passageway. If it hit an obstruction the surgeon would know what was causing the problems and where about they would need to cut. Many patients were very reluctant to experience this particular diagnostic test. a patient of Sir Hans Sloane in the early eighteenth century was described as having ‘A great prejudice to being search for the stone, and so much that I believe he will never submit to it.’2
Perhaps it is little wonder then that Tolet recommended practising – the chances to perform on a living patient were perhaps limited and it was important to get it right to avoid unnecessary pain and suffering. He explained that in order to practice properly the dead body would need to be slightly modified.
It is very necessary to make an Experiment of this in dead Bodies, by opening the Bladder, and putting Stones therein; and then having stitched up the Parts, to introduce the Catheter by the Yard
He noted later in the text that if surgeons wanted to try performing the ‘High Operation’ for cutting the stone – so called because of where on the body the surgeon made his incision – then it ‘would be necessary to try many Experiments on dead Bodyes’. He likewise claimed that ‘It is good to practise such kind of Operations upon dead Bodies’, when discussing using a trocar (a small tool designed for use in these operations) to relieve patients who suffered from a suppression of urine; this operation was very similar to cutting for stone. Again Tolet provided instructions for how to prepare the cadaver:
for that end, one must with a Syringe Squirt as much matter as possibly he can, into the Bladder, then tie a Ligature about the Yard, and make the Puncton as he hath been described, and then make a dissection of the Bladder, to observe what hath been done, that so he make take his measure for another time
Tolet clearly believed that making cadavers simulate particular conditions would allow surgeons to practice making them better practitioners. This was important as the flow of urine could complicate recovery from these types of operations. For example, Tolet noted that urine dissolved many, medicines making them ineffectual. Other surgeons recorded the life-long difficulties some patients whose incisions did not fully heal or were made in the wrong place, experienced, explaining that such men no longer urinated through their penis but through the holes that remained in their perineum. Tolet does not though make any suggestion about how easy it was for surgeons to acquire corpses to practice on, and this was probably not an option for every surgical trainee.
- Tolet, François, A treatise of lithotomy, or, Of the extraction of the stone out of the bladder … translated by A. Lovell (London, 1683).
- British Library London, Sloane MS 4076, 49.