Anatomie Nederlands
Ling Baus
It has often been argued that the subjects of dissections were criminals. Ending up under the anatomist's knife was seen as a post mortem punishment.9 This was often the case, but the corpses of poor and destitute people without friends and relatives who had died in the city hospital also found their way to the dissection table. This way at least the costs of coffin, grave and a decent burial were covered. Moreover, as human corpses were scarce, anatomists also dissected and vivisected animals, particularly dogs, calves and pigs. Their anatomies were considered similar to human anatomy, which meant that investigating the insides of an animal would automatically lead to a better understanding of the human interior body.
The knowledge and objects presented in the anatomical theatre relied on these same commercial values. They were objective in both the increasingly standardized processes of preservation as well as in the moral economy which made them meaningful objects. And they were dealt with in lectures and guided tours in which refreshing stories, credibility and the use of plain language were of key importance.13 So, students and visitors visiting the Leiden anatomical theatre returned to their home countries with a specific Dutch (i.e. based on commercial values) view of anatomy and the world.
The collection activities had started under Paauw, but it was thanks to Otto Heurnius that the theatre's collections were significantly expanded. To the initial purchases of Paauw, Heurnius added not only anatomical objects, but also a collection of Egyptian objects, such as mummies, funerary statues and vessels decorated with hieroglyphs. Heurnius' fascination with ancient Egypt was not only medically motivated, but was also triggered by his interest in the hermetic writings. Like so many of his contemporaries, Heurnius hoped to catch a glimpse of the pre-lapsarian wisdom of Adam, as handed down and recorded (in hieroglyphs) by the Egyptian priest Hermes Trismegistus.14
Most importantly, Heurnius decided to admit visitors to the theatre when no anatomical dissections were taking place. In so doing he enhanced the status of the theatre's collections, not only attracting physicians, but also lending status to the city of Leiden as protagonist of the arts and sciences. Quickly, the anatomical theatre was considered an attraction not to be missed. Travel guides praised the collections extensively, and upon arrival in Leiden visitors were immediately confronted with signs on the quayside (since all important Dutch towns were connected by rivers and canals, the usual and most convenient way of travelling was by canal boat) indicating the way towards the theatre. Catalogues were printed and translated into several languages, and it was said that "even if one had a thousand eyes, a full day would not suffice to see all the mysterious and curious objects".15
In particular the stories attached to many objects made the theatre worth a visit. For instance, skeletons were a normal sight in an anatomical collection, but stories turned them into an attraction. Even the catalogue hinted at the stories, so tourists stood eyeball to eyeball with:
Van Horne's association with de Bils was significant. Notwithstanding the frauds with which de Bils was later associated, de Bils was generally considered the anatomist of bloodless dissections and life-like anatomical preparations. Association with his work meant the promotion of Leiden anatomy as the place of cutting-edge anatomical research. Apparently it worked: not only did students flock to Leiden, the Leiden anatomists also became part of international networks of natural philosophers discussing new discoveries in anatomy.
It has been suggested by historians of the Leiden anatomical theatre that van Horne considered his private activities more important than his duties in the anatomical theatre. Yet, although much anatomical work was done in the professorial quarters, student rooms and even the post-mortem room of the city hospital, van Horne enhanced the theatre's international renown as a place of learning. After all, the theatre served as an entrepreneurial advertisement of his anatomical business. To this end van Horne performed as many public dissections as the number of corpses allowed. So, although the character of a theatrical dissection was completely different from the collaborative work done in private rooms, the theatre nevertheless served as a public signboard advertising the new Leiden anatomy performed in smaller circles.
Bidloo was probably not the best person to look after the anatomical theatre. The curators of the university had to reprimand him on several occasions for his neglect of lecturing duties, in particular when he went off to England as physician to the Stadtholder. The anatomy servant also complained that Bidloo regularly took preparations home without returning them to the theatre.
However this may be, Bidloo started his career in the anatomical theatre with enthusiasm. At the time Bidloo was one of the most promising anatomists in the Netherlands. A decade earlier he had published his Anatomia humani corporis (1685), a beautiful and "realistic" anatomical atlas which was meant to replace all contemporary anatomical atlases to date. Within a month of his appointment Bidloo wrote to the curators that the theatre urgently needed to be refitted with items (such as linen, the black cloth for covering the cadaver, dishes, instruments etc.) that had gone missing over the years. He also set out to replace damaged and decayed anatomical preparations, and requested that the windows be covered with curtains or shutters, presumably because the sunlight damaged organic preparations.
Three years later students started complaining about Bidloo's haphazard teaching in the city hospital. This was due to his frequent attendance at the sickbed of the Stadtholder and the latter's family. This happened most often during the winter months, and therefore also interrupted Bidloo's anatomical demonstrations. Bidloo's anatomical teaching was further jeopardised by a severe lack of corpses. The problem was even more urgent than before because the Amsterdam city magistrates and bailiff refused to hand over the corpses of executed criminals. Eventually the excellent anatomical teaching which had given Leiden such a good name was in such a bad state that the university curators happily accepted the proposal of the Amsterdam city lithotomist Johan Jacob Rau to perform anatomical demonstrations (for free) in the Leiden theatre.
Bidloo, even though he was neglecting his duties, was not happy with the way things went. He quarrelled with Rau as well as with the well-known Amsterdam anatomist Frederik Ruysch, although according to contemporaries, Ruysch was as much to blame. The quarrels between Bidloo and Ruysch nicely demonstrate how controversies were battled out in the anatomical theatre. It shows that a demonstration was far from being a quiet affair, with anatomists respectfully gazing at and working on a corpse. On the contrary: anatomists shouted at each other, they held organs in each other's faces, and were incredibly rude in calling each other names. It would happen that in the heat of the debate they waved organs, bones and tissues about. At some point Ruysch was so angry that he compared the anatomical theatre to a battleground. He argued: "soldiers, when they hear the approach of the enemy, shout, To arms, To arms! I say here likewise, Ad visum, Ad visum! To looking, To looking!"22
The controversy between Bidloo and Ruysch illustrates the fact that the visual evidence gained during an anatomical dissection was hardly ever conclusive. Of course, it was notoriously difficult to make out any anatomical detail in the bloody mess on the table, so anatomists primarily saw whatever they thought they should see. Controversies were inevitable, and the academic mores (being completely different from today's courteous attitude in solving professional differences) allowed anatomists to rudely battle it out in front of big audiences. Again, the anatomical theatre was used to promote one's own anatomical views, and vulgarly slagging off others was seen as a legitimate and effective way of doing so.
The Leiden medical curriculum was also famous for its bedside teaching. As early as 1575 the theology professor Wilhelm Feungueraeus recommended to medical faculties that students should perform "fewer disputations and speeches", and instead pursue "the inspection, dissection, dissolution, and transmutation of living plants, bodies and metals". This practice was derived from Padua, where reformers had advocated a return to the ancients, with their emphasis on anatomical dissections and bedside teaching. Feungueraeus stated that it was indispensable for students to "follow a very experienced and learned physician, to see, admire and imitate under his guidance the treatment of the disease according to the directives of Hippocrates and Galen".23
Despite the advice of Feungueraeus from the 1570s, it took another seventy years before the University Curators decided to assign twelve beds, divided into a male and female ward with six beds each, to the university medical teacher. Their action was prompted by the introduction of clinical teaching at the University of Utrecht, which threatened to overtake Leiden as the Dutch centre of medical excellence. Two professors in charge of clinical teaching were to lecture in the hospital twice a week. The day-to-day care of the patients was left to two city doctors. They were obliged to refer interesting cases to the professors and keep written reports of selected cases. Students had unlimited access to the reports as well as to the patients. In this way students could learn about the signs and symptoms of internal diseases, particularly from the urine and the pulse, as well as about medication and the prescription of cures. For fear of losing students (either to the disease itself or from fear of catching the disease) contagious diseases were excluded from the practical curriculum. Should the patient die, the hospital had a special post-mortem room and a surgeon on stand-by for dissection purposes. The surgeon performing the dissection had to master Latin, so that foreign students were able to follow the proceedings.