In 2016, human remains were inadvertently discovered during construction andremodeling of the George Thomas Building (GTB), one of eight historic buildings located onPresidents Circle at the University of Utah (Lechert et al. 2017; Kopp 2017). Upon discovery,work was halted and the remains were confirmed to be human and archaeological innature by the Antiquities Section of the Utah Division of State History. During on-siteexamination of the remains, it was observed that a skull had the calotte (skull-cap)removed in a manner consistent with a craniotomy - a procedure associated withdissection where the calotte is sawn off to expose the brain for examination. Evidence ofcraniotomies, discovered artifacts (medical laboratory glassware, ca. 1900 to 1930), andhistorical research led to the conclusion that the remains were likely historic anatomicalspecimens associated with the University of Utah’s School of Medicine (UUSM) (Lechert etal. 2017; Kopp 2017). Most likely, the remains were buried at this location between theschool’s establishment (1905) and completed construction of the GTB (1935) (Kopp 2017). Itwas realized this assemblage provided a unique opportunity to gain insight into earlytwentieth-century medical school practices and, more specifically, the early practices ofthe UUMS. As such, research was undertaken to determine how perimortem alterationsobserved in the skeletal remains compared to documentation of early twentieth-centurydissection standards, as well as the UUSM.

INTRODUCTION

Early twentieth-century dissection methods: A case study from the early years of the University of Utah’s School of Medicine.

Meghan Banton Derinna Kopp

Standard osteological methods of recording and analysis were applied to the GTB skeletalassemblage (Kopp 2017). The results of this analysis were then compared to historic (latenineteenth and early twentieth century) documentation relevant to dissection and theUUSM. Such documentation included anatomical dissection manuals and archivedUniversity of Utah course catalogues.

MATERIALS & METHODS

In total, nearly 14% of present bones and bone fragments exhibited cut marks and 15%exhibited saw marks (Kopp 2017). The frequency of these marks in each bone type can beviewed in Table 1 and Table 2. Of the bones with marks, some alterations were noted to beconsistent in their patterning. For example:

— Present are three calottes and a cranium missing the calvarium. These bones showevidence of being removed via a saw (evidenced by cutmarks) and chisel (evidenced byrugged break-away points) (see Fig. 1).

— All but one of the eight clavicles in the assemblage are sectioned (see Fig. 2) and twoscapula fragments have the acromion process sawn off (see Fig. 3).

— One complete spinal column is present, which displays sawing through all the posteriorvertebral arches at the laminae (see Fig. 4).

The processing of the remains was selective, with some bones/areas of bones beinghighly modified and others unaltered. This suggests the remains did not have all softtissues removed prior to burial. Instead, only particular tissues were removed. Thispattern was probably produced by removal of specific tissues for the purpose ofvisualizing underlying anatomical tissues, organs, and structures.

It was also noted that the number of skeletal elements representing particular bodyregions varied greatly. For example, there were more identifiable lower limb bones(femur, tibia, fibula, foot bones) (30.69%) than upper limb bones (humerus, radius, ulna,hand bones) (11.48%) (Kopp 2017). This pattern suggests the remains were buried as bodilyportions as opposed to whole cadavers.

RESULTS

REFERENCESElizondo-Omaña, R. E., Guzmán-López, S., & De Los Angeles García-Rodríguez, M. (2005). Dissection as a teaching tool: Past, present, and future. Anatomical Record , 285(1), 11–15. https://doi.org/10.1002/ar.b.20070Holden, L., Langton, J., & Hewson, A. (1901a). Holden’s Anatomy: A Manual of the Dissection of the Human Body; Vol.1. Philadelphia: P. Blakiston’s son.Holden, L., Langton, J., & Hewson, A. (1901b). Holden’s Anatomy: A Manual of the Dissection of the Human Body; Vol.2. Philadelphia: P. Blakiston’s son.Kopp, D. (2017). Human Skeletal Report GTB (unpublished report).Lechert, S., Hovanes, K., & Stelte, K. (2017). Cultural Resources Discovery, Monitoring, and Data Recovery Investigations at the George Thomas Building/Crocker Science Center at the University of Utah, Salt Lake City, Salt Lake County, Utah. Salt Lake City. SWCA Environmental Consultants.Moxham, B. J., & Plaisant, O. (2014). The history of the teaching of gross anatomy how we got to where we are! European Journal of Anatomy, 18(3), 219–244.University of Utah (1906). Catalogue of the University of Utah Including the School of Arts and Sciences, State School of Mines, and the State Normal School. Salt Lake City. https://catalog.utah.edu/#/content/5c1bbd228dae44001a0fb3c0University of Utah (1907). Catalogue of the University of Utah Including the School of Arts and Sciences, State School of Mines, and the State Normal School. Salt Lake City. https://catalog.utah.edu/#/content/5c1bbd228dae44001a0fb3c0University of Utah (1918). Catalogue of the University of Utah Including the School of Arts and Sciences, State School of Mines, and the State Normal School. Salt Lake City. https://catalog.utah.edu/#/content/5c1bbd228dae44001a0fb3c0

Table 3: Descriptions of the ‘descriptive anatomy’ course and sections taught by the UUSM in the 1906-1907academic year. The courses are designed around learning the anatomy of specific body regions. Most ofthese courses mention utilization of dissection. Future catalogs of anatomy course sections continue theirfocus on dissection of body regions with only minor adjustments, such as having two separate sections forthe study of the abdomen and throax (University of Utah 1918, p.146-149).

Figure 1: “To examine the brain and its membranes, the skull-cap must beremoved about half an inch above the supraorbital ridges in front, and on a levelwith the occipital protuberance behind... It is better to saw only through the outertable of the skull, and to break through the inner with a chisel. In this way thedura and the brain are less likely to be injured” (Holden, 1901a, p.26).

The image above is an example of a craniotomy from the GTB assemblage. As described in Holden (1901a),the top of the skull has been removed via sawing (red arrows) and chiseling (the breakaway point is insidered brackets).

Figure 4: “To examine, in situ, the spinal cord covered with its membranes, the arches of the vertebrae must be sawn through andremoved” (Holden, 1901b, p 758).

What Holden (1901b) is describing is a Laminectomy, a procedure where the posterior (back) portion of one or more vertebra is remove to give access to thespinal cord. This done by cutting through the left and right lamina. The photo above is from the GTB assemblage and displays marks consistent with thisprocedure as described by Holden. Incomplete (red arrows on photo) and complete saw marks (rough location shown by red lines on the anatomicaldrawing) are present through the laminae of the entire spinal column. The yellow arrow shows where the posterior aspects of the neural arch (made by thelaminae and spinous processes) were successfully removed via sawing. The transverse processes have also been removed from some vertebrae.

Figure 3: “To see its insertion (supra spinatus), theacromion should be sawn off near the neck of thescapula.” (Holden, 1901a, p. 382).

One of two scapula in the GTB assemblage that have the acromionprocess sawn off (red line) as it would have neared the neck ofthe scapula. Based on Holden (1901a), this may have been forexamination of the scapular musculature.

‘DESCRIPTIVE ANATOMY’ COURSE AS DESCRIBED IN THE CATALOGUE OF THE UNIVERSITY OF UTAH (1906-1907)

DESCRIPTION:

“The study of anatomy extends through two years. The work consists of lectures,demonstrations, recitations, and laboratory dissections. Four half-days per week throughoutthe first year and three throughout the second, are devoted to the practical work in thelaboratory” p. 143.

COURSE SECTIONS

Introduction to Anatomy & Osteology. Lecture & demonstrations on general organization of thebody.

The Upper Extremity. Course on the anatomy of the arm; utilized dissections, lectures andsection recitation.

The Lower Extremity. Course on the anatomy of the leg; utilized dissections, lectures andsection recitation.

The Thorax and Abdomen. Course on the anatomy of the body wall and of the thoracic,abdominal, and pelvic viscera; utilized dissections, lectures and section recitation.

Head, Neck and Spinal Column. Course on the anatomy of the axial body; utilized dissections,lectures and section recitation.

Neurology. Course on the gross structure of the brain, spinal cord and organs of special sense;utilized lectures, readings, and laboratory work.

Topographic and Regional Anatomy. Course on topographical anatomy and surgical landmarks;utilized dissections, lectures, demonstrations, and laboratory work.

DISCUSSION & CONCLUSION

Figure 2: “…remove the arm by sawing through themiddle of the clavicle” (Holden, 1901a, p. 377).

Three of seven clavicles in the GTB assemblage that displaycomplete sectioning (via saw) near the mid-clavicle point (redline). Based on Holden (1901a), this may have been part of thedissection process used to removing the arm from the torso.

Table 1: prevalence of cut marks by bone element (Kopp 2017).

Table 2: prevalence of saw marks by bone element (Kopp 2017).

While dissection of cadavers has long been considered important to the teaching of humananatomy (at least as far back as ancient Greece), by the early twentieth century, it wasconsidered an essential part of a well-rounded medical school education in the UnitedStates and elsewhere (Elizondo-Oman et al. 2005; Moxham & Plaisant 2014). As such,along with the establishment of the UUMS (1905), there was requisite establishment of ahuman anatomy program. Since archaeology suggests the GTB remains date to the earlydays of the UUMS, this is where the present study targeted its research into medical andUUSM documentation (Lechert et al. 2017; Kopp 2017).

During the early twentieth century, dissection manuals provided medical students withstep-by-step instructions on how cadavers should be dissected to view particularstructures. One such manual discovered while researching this project was Holden’sAnatomy: A Manual For The Dissection Of The Human Body (1901). This two volume textprovides instructions that aligned well (perfectly in many cases) with the skeletalalterations observed in the GTB assemblage. Several examples are presented andexplained in Figures 1, 2, 3, and 4. Interestingly, these techniques are still employed today.The current manager of the University of Utah Body Donor Program, Kerry Don Petersonindicated, “…the cuts on the bones are consistent with cuts we use today to gain access todeeper anatomic structures; e.g.: the calvaria is removed to gain access to the brain andcranial cavity, a laminectomy is performed to gain access to the spinal cord, clavicles arecut to study the great vessels-trachea-esophagus & associated structures exiting andentering the thoracic inlet” (Kopp 2017, p.7-8). It appears that medical students roughly 100years ago had a similar practical anatomical education to those of modern day students atthe University of Utah.

Course catalogs (University of Utah, 1906; University of Utah, 1907; University of Utah, 1918)indicate the UUSM taught six or seven anatomy courses, with the majority being focusedon dissection of particular body regions (see Table 3), such as the upper extremity, lowerextremity, thorax/abdomen, and head/neck/spine. Given this regional focus, it would havebeen logical to use sections of remains as deemed necessary for specific courses; whyuse a whole cadaver simply for the purpose of studying the arm? This suspicion appearsto be confirmed by the burial context of the GTB assemblage, as remains seem to havebeen buried as bodily portions rather than whole cadavers. Therefore, the findings of theskeletal analysis of the GTB assemblage affirms the regional anatomy pedagogyexpressed in the early course catalogs for the UUMS. Furthermore, this type of regionalfocus would likely cause differing demand for particular body parts at specific times, asnecessitated by the number of students enrolled and the number of ‘body parts’ deemedappropriate by the instructor to be used per student. Such factors could explain whybodily portions appeared disproportionately represented in the GTB assemblage.

While skeletal assemblages can often provide information that leave puzzlement whenexamining primary resources, this has not proven to be the case for the GTB assemblage.Instead we find great consistency between general medical school dissection practices,UUMS practices, and the skeletal data. This makes the GTB assemblage a valuable andreliable resource for research into early twentieth century medical school practices in theUnited States.