The Autopsy Elegies
Paragraph One follows: 1:
On Wednesday, July 15, 1868, Mary Lynch was admitted to Philadelphia’s almshouse, suffering from tuberculosis.[See Endnote 1A]
Adjacent to the University of Pennsylvania, the almshouse operated under the auspices of Philadelphia General Hospital, a charity facility. Then, as now, American medicine was a private, for-profit system. A closed system. Charity hospitals are still the last resort for patients who cannot afford to pay for treatment.
The women’s receiving register recorded precious little information on Mary. She was 28 years old, an Irish widow of ‘temperate habits’ (she did not drink to excess). That is all we know of her private life. Her medical afterlife tells another story entirely. One that blurs the boundaries between body and book, doctor and patient, author and subject, ghost and host.
I write elegies for women. I can’t seem to stop. It started with my sister, but that’s another, longer story. A story for another day, as my sister would say. The women I love, whose blood I share, often die young. I have no illusions that this is extraordinary outside of the relatively privileged milieu I find myself occupying, these days. It’s a far cry from where I grew up, but that too is another story for another day. Every elegy needs an author. And then, an autopsy. Mary’s autopsy rendered her first a medical curiosity, then a bibliophilic oddity, then a museum artefact. Her elegy has been an long time coming.
Mary spent six months in the almshouse prior to her death. She was admitted to Ward 27, where one of the attending physicians was John Stockton Hough, a recent graduate of the University of Pennsylvania, five years Mary’s junior, with a research interest in intestinal parasites. By a strange convergence of fate, while convalescing Mary contracted trichinosis, a parasite that passes from host to host via ingestion. [See Endnote 1B]
Perhaps, if you have a the sort of imagination I do, you may think that it was not, after all, a coincidence. Nineteenth-century medical archives abound with tales of doctors in so-called charity hospitals experimenting on patients, or hastening their deaths in order to obtain their corpses for anatomy demonstrations.[See Endnote 1] Almshouses and their adjacent cemeteries were the primary source of cadavers, fuelling the black market that supplied medical colleges in constant shortage of “anatomical material”. [See Endnote 2]
Due to the wasting nature of both tuberculosis and trichinosis, Mary, who was 5 feet 2 inches tall, weighed only 60 pounds (27.2 kg) at the time of her death. [See Endnote 3] She was buried in an unmarked grave in the almshouse cemetery. Hough autopsied Mary’s corpse sometime before her burial (the exact date is unknown). To say that he discovered a parasitic infestation would be putting it mildly. But the parasites Mary hosted were not only internal. The medical appropriation of her body had only just begun.
Hough’s graphic account of Mary’s case history was published in the American Journal of Medical Sciences (1869). The article marked his debut appearance in medical literature. Hough bestowed upon Mary a more lasting textual fame. Sometime during the autopsy, he excised a piece of skin from her thigh. After removing this specimen, he went down to the almshouse basement and tanned it in a chamber pot. Hough held onto this macabre souvenir for thirty years, during which time he became a wealthy bibliophile. In 1870, Hough entered private practice, drawing his patients from Philadelphia’s most elite circles. He travelled throughout Europe and America seeking artefacts for the fledgling book collection that became his lifelong obsession and posthumous legacy. In the following decades, Hough published widely and diversely in the arenas of hygiene, biology, gynaecology, speculative physiology, social science, vital statistics, population and political economy. He was regarded as an authority on “human monsters”, the unfortunate term then used to describe severe foetal abnormalities. Hough also attained notoriety for his invention of a dual-use vaginal / rectal speculum. 
In January 1874, Hough married Philadelphia heiress Sarah M. Wetherill, who died less than a year after their wedding, following complications in childbirth.  As a wealthy widower, Hough ceased practicing medicine and devoted himself to three main passions: expanding his collection of rare manuscripts, authoring a history of pre-modern medical literature, and meticulously curating his own autobiographical archive. Following his second marriage in 1887 to Edith Reilly of New York City, Hough became a “gentleman farmer”, ran for political office, and relentlessly pursued acquisitions for his library.  His books and papers now reside in Philadelphia’s Mütter Museum and Historical Medical Library, where I encountered them during a research fellowship.
In 1887, almost 20 years after he initially collected the specimen, Hough used Mary’s preserved skin to bind three medical texts on the subject of female reproduction: Robert Couper’s Speculations on the Mode and Appearances of Impregnation in the Human Female (1789); Louis Barles’s Le Nouvelles Decouvertes sur Toutes les Parties Principales de L’Homme et de la Femme (1680); and Louise Bourgeois’s Recueil des Secrets de Louyse Bourgeois (1650). This was not an isolated, macabre fetish. Nineteenth-century medical bibliophiles often collected books bound in human skin, a technique known as anthropodermic bibliopegy. Like Hough, the creators of such volumes were usually doctors who obtained human leather from the autopsied bodies of their most vulnerable patients, often women. Outwardly, these books keep their secrets well; human leatherwork does not immediately betray its origins to the naked eye. Handwritten inscriptions reveal their sources. The front flyleaf Hough’s copy of Couper’s Speculations contains a note on the binding’s origins, including its preservation in a ‘pot de chambre’ by his own hand. The book assumes the body’s protective sheath, binding this anatomical treatise to one specific cadaver. Opposite the inscription, Hough pasted his article from American Journal of Medical Sciences detailing Mary’s case history.
As Carolyn Marvin’s history of human-leather books establishes, like the cadavers used for medical dissection, skin bindings were almost always sourced from marginal bodies:
The human hide-bound book was situated in the scholar’s library and the museum, entitled private places… What made it morally defensible to use the poor in this fashion… was the social construction of the indigent and outcast as surplus people… useful at least for medical science, or, in the case of the bound book, for indulging the esoteric intellectual interests of medical practitioners… Like medical body snatching, it made of the poor a resource for the production of physicians.
Throughout the nineteenth century, when anatomical specimens were in high demand but notoriously difficult to acquire, a black market trafficked in human remains. Medical body snatching was rampant in antebellum America. The bodies of African Americans, immigrants, prostitutes, Native Americans, and the poor, who crowded almshouses in life and potter’s fields in death, were ideal targets. A disproportionate number of immigrants fuelled the illicit cadaver trade. By 1880, only one eighth of the US population was foreign-born, yet immigrants (like Mary) made up one third of the patients in almshouses. Their bodies were buried anonymously in ‘potter’s fields’the name historically given to cemeteries for the indigent and unknown. ‘Those in charge of morgues, the dead rooms of hospitals, and potter’s fields, could tell some startling things about how bodies disappear from those places,’ a whistle-blowing doctor asserted in an 1879 issue of Penn Monthly. ‘The number of bodies that are allowed to go into the potter’s fields throughout the country is very small, and the majority of those that reach them are not allowed to rest in them many hours.’ In 1880, the anatomy demonstrator at the University of Michigan promised the university trustees that ‘better people’ could rest assured. Although the legal supply of corpses fell drastically short, he sourced additional cadavers from the ‘paupers and friendless dead’ of the ‘county houses and asylums.’ Antebellum decedents were as segregated as the living: those whose disenfranchisement rendered them commodities, and those protected by power and privilege that extended beyond the grave.
Couper’s treatise opens with a compellingly opaque declaration: ‘There is frequently ambiguity in words.’ He goes on to describe the female body from the perspective of an ‘ancient’ anatomist, who has ‘rise[n] from his grave’ to dissect her cadaver. Significantly, neither party is alive. The scalpel is wielded by a ghost, resurrected from his tomb for the purposes of conducting this dissection. His haunted autopsy uncannily foreshadows the professional title adopted by nineteenth-century medical grave robbers, who called themselves ‘resurrectionists.’ The phantom’s post-mortem includes vivid descriptions of the female reproductive organs during copulation. In this sense, the medical treatise doubles as a necrophilia fantasy (although the taboo is at least partially subverted by the fact that both parties are dead). As the anatomist’s scalpel pierces blood and bone, he describes the woman’s organs in various states of sexual flux:
[A]natomists generally favour us with accurate measurements of the uterine system, as an antiquarian does of a piece of nice architecture. Before coition has disturbed its proportions, the canal of the uterus may be about five or six inches long… and when its walls are thrown into violent distension… its diameter may be about a sixth a part of its length… After frequent coition, the vagina becomes considerably shorter, but at the same time its diameter is more than proportionally increased… We shall pass on with the physiologist to his examination of the uterus, which meets with more of his respect, as he considers every aspect of the female genital system chiefly subservient to it.
Throughout Couper’s treatise, readers ‘follow’ the ‘ancient’ narrator as he ‘establishes communication’ with each of the sexual organs. In his hands, the female body is reduced to ‘a piece of nice architecture,’ in which the genitals are ‘subservient’ to the womb. The vagina is merely ornamental, while the uterus is functionally ‘respect[ed]’ for its role in procreation. Yet, despite his dismissals, it is not only pregnancy that fascinates this surgeon-spectre, but also the catalytic sex act that precedes it. Although the vagina does not command the anatomist’s ‘respect,’ he dwells at length on its ‘coalescence’:
From its structure, its sides surely coalesce in its natural state; though from its texture and elasticity, these sides may be thrown into such a figure as may constitute a cavity. In coition, with all its uncommon phænomena, what charm have we now left to overcome this coalescence?… Though females may entertain sanguine ideas of these things, we must suppose the physiologist, toiling through the unalarming and chilly organs of the dead, can furnish us with more substantial reasons.
Couper dismisses whatever ‘sanguine ideas’ women hold about their own anatomies, endorsing as superior the physiologist’s conclusions, based on experiments conducted on the ‘unalarming and chilly’ cadaver. By inversion, we conclude that the living woman is not only warm-bodied and red-blooded (an alternate meaning of ‘sanguine’ is the colour blood-red), she is also alarming, unlike her passively inert doppelganger.
Such erotic anatomy demonstrations were far from unique. Couper was part of a medical culture that unified anatomical investigation and sexual fetishization of the female body. It was a condition of theoretical enquiry that the woman about to be dissected must first be seen as beautiful. Consider Couper’s Speculations alongside another medical fetish object, created less than a decade before his text was published. in 1782, Italian sculptor Clemente Susini unveiled his Anatomical Venus, a life-sized wax mannequin designed as a medical teaching tool. Cadavers were in short supply due to the widespread belief that the body must be buried intact in order for resurrection to occur. ‘The Demountable Venus,’ as she was also called, was made to be dismembered. Each organ was removed in a prescribed order until the final reveal: a tiny foetus resting in her womb. From the moment of her debut, the Venus and her subsequent sisters — a series of anatomical models commissioned under Susini’s supervision — embodied the somnambulant allure of necrophilia: a wounded icon whose dissection was eerily presided over by her own ecstatic face. Collectively called the ‘Slashed Beauties’ and the ‘Dissected Graces,’ they fused religious iconography, erotic pathos, aesthetic symmetry and anatomical precision. Their modern descendants are the scream queens of the horror genre (who remain beautiful despite their bloodbaths), and the uncanny valley girls of the flourishing erotic doll industry. The 18th-century medical equivalent of Stepford Wives, these beauty queens are unfazed by their own bloodless dissections. The original Venus wears a string of pearls. One of her younger sisters is crowned with a golden tiara. Another wears a silk ribbon looped in a bow around her own entrails. All are adorned with glass eyes and real human hair. Inert in their glass and rosewood coffins, they smile demurely with downcast, unseeing eyes.
Female aesthetic beauty was vital to anatomical illustrations for centuries before the arrival of the ‘dissected graces.’ As though, before investigating the biological workings of the female body, medical men must first be attracted to it. Yet, unlike the gruesome realities of the autopsy theatre, students of the Venus and her sisters both invoked and overturned the necrophilia taboo. A key element of the Venus’s charm is that, unlike her human counterparts, she can be reconstructed. Even her autopsy is ephemeral. Like Prometheus, she must endure her own dismemberment, eternally (and silently).
Viewing the ‘Slashed Beauties’ through the lens of our current reckoning with systemic gender violence, two questions linger and will not leave me:
1) What does it mean to desire a body that remains supine and lovely even as she is torn apart?
2) What drives this form posthumous desire, where beauty is seen as a prerequisite to wounding? Is it attraction to the corpse’s inertia, or rejection of the living woman’s alterity?
During my residency at the Museum, the country of my birth inaugurated a man as President of the United States of America, who, by his own (involuntary) admission, has a long history of genital violence. My time in the archive was punctuated by protests. First, the Women’s March. Then, the Republican Party held a convention in Philadelphia. The city erupted. Everywhere the delegates went, hundreds of protesters followed, streaming a virtual map of their movements as politicians were sighted. While I examined Hough’s sketches of specula designs, Planned Parenthood reported an escalating demand for IUDs as women sought a form of birth control that could outlast this administration’s assaults on their bodies and their psyches.
In the year that followed, I too became a case study. I spent hours inside Magnetic Resonance Imaging tunnels, listening to the whirling dervish of machinery mapping my insides, while I lay strapped to a pool of cold water to avoid radiation contact burns. I thought of Mary, whose face I’ve never seen, though I’ve touched her skin a thousand times. Whose interior I imagine I know as well as I now know the shapes of my own organs. In words and pictures, if not in flesh. I filled out many forms soliciting my consent. I thought about the unspoken debt modern medicine owes to women like Mary, to countless experiments conducted on dispossessed bodies. I thought about consent and its absence. Does human agency end when we take our last breath, leaving behind only anatomical material, as John Stockton Hough and his contemporaries presumed? Or is such appropriation a form of posthumous violence, of corporeal theft? How do we reckon with the legacies we owe to the anonymous beings whose autopsies created our current understanding of the human body, in all its fragile resilience, its hewn grace?
One day, as I walked home from the clinic, I saw an advertisement for some kind of lavish face serum: ‘leave behind a ‘beautiful corpse.’ I recalled Poe’s conviction that ‘the death of a beautiful woman is, unquestionably, the most poetical topic in the world.’ I don’t want it to be true, but here we are. I thought of all the beautiful cadavers in my own ossuary of ghosts. And of Mary, the bookbound Anatomical Venus.
The following poems are my articulated elegies not only for Mary, but also for an infinite chorus of unnamed women, past and present: fragmented specimens that play host to a haunted palimpsest — a dialogue between male and female, body and soul, doctor and patient — that slips between their century and ours. Their ending is unwritten. A story for another day.
There is often ambiguity in wounds.
Her cursive history guards
against whatever lies
he affixed to its conception,
that unkempt state from which
we date material origins.
General laws of the animal economy
fail us, even now.
Once again, we cease to fathom
the progress of a vein.
A specimen, lavished in enquiry,
tortured by every effort of ingenuity.
Her train of peculiar symptoms
bestowed manifold gifts under the knife.
All were encysted.
Let this medium be what it is.
Leave her room to evade
the diagnosis, where nothing coheres.
A tragic stranger, treading on bacteria,
triaged in the mouths of absorbents.
All that is left is a name I can’t recognize;
Disorderly capillaries in an otherwise poised face.
Fugitive anatomical sheets,
male and female, superimposed.
A seriality nested in fascia
her spectral limbs, unmoored.
Even in death,
she belonged to the house.
A wife is the worst historian.
Her eyes could not abide, awake,
husbands in the mouths of every man.
With her skirts awry
and a distaste for shipboard games,
widowed, but not yet bookish.
The kind of woman who causes suicides.
Limned in green,
glasses heavy on her cheek
unmarked by either tar or creosote.
Deemed worthy, but only just.
Tunic-sleeved, the taste of dust
still narrow in her mouth.
She belonged to that class of women
he called ‘floaters’
who drift through hospitals (as in debris)
Later, there will be horses
and old-fashioned pornography.
Silver-fissured celluloids atop
crimson overlays of collagen.
The binding gives out
in manifold kinships.
No one is safe, here.
angry as asphodels,
we rebel against the whims
of some minor god.
The sort with a line for every occasion
who never learns not to look back.
Always pillaging in the garden.
His wife hiding, just shy of peripheral.
She likes to watch from afar.
It is never banal to see someone unfurl.
As in the agonies of pressed flowers
or birds nailed to wooden doors.
She never was attracted to severance
but desire is a pre-existing condition.
Consent is not.
Written in breastbones. Not written at all.
Her story now bound between her own thighs.
Curatorial skin gold-vellumed
and embossed with his name.
Sleep comes not in the grave
but the stacks.
At first, she ate ravenously.
Nothing strange but the subject.
A widow of temperate habits
confined to disjointed reveries.
The anatomist, long content
to number human bones,
traced with edifying precision
the decline of evanescent arteries.
Eminent men have long decorated
the usual maladies with scalpeled cadence.
Many whims have been treated
meeting the lifted sword with a glove.
In her almanac of thrift store
couture and anime organs,
mementos light wounds.
Open cavities host
shelved in gilt.
Sieged glands unmothered,
mouths portals to carrion.
Our teeth gave us cause to tear
the flesh of living creatures.
Still, there are rules
to which we must abide.
Misery requires conditions.
Cleaving to suburban biologies,
the beleaguered fortunes
of anatomical loveliness.
An unblemished specimen, aglow
Her well-heeled symptoms
burnished in gauze.
Diet her fever
as you might tend an heirloom.
Only strangers arrive by the front door.
Sterile belles hold rallies for twilight sleep.
The future belongs to obsolescent devices,
a looselimbed cabal of drugstore blondes.
Where launderette submissives wait to assume
some other, less brutal, pastoral.
The final girl will always prevail.
With violence bouqueted in her hair,
bedroomy combs fastened at the temple.
Her skull is a dream.
The anonymous ones cut their teeth
on plastic diadems and hourglasses.
It’s safer this way,
though still fraught with the usual maladies.
The road home
is littered with wooden limbs.
Shape the eye in silt irises
that tiny organ rendered in glass and glow.
After a cavalcade of scandals, his
rodeo girls blush into lissom pinups.
Under waning florescence the taxidermist
clothes mouths in perpetual desire.
Cadence scalpeled, tracing
ghost on faceless ghost.
False idols are fetish proof,
but telegrams arrive faster.
In case you need anything
don’t hesitate to reverse the charges.
Leave her clothing dishevelled;
photograph only flattering angles.
Catalogue the location of scars and sunburns.
These will enter the permanent collection.
There’s always a spare room in our elastic house
while we cloak relics in half-morocco quarto,
waiting for the day her wound will become a womb.
Drunken ghosts downpour maledictions.
When will we put an end to mourning?
When we hunt machines of our own creation,
make cathedrals of our bitten selves.
Just imagine the bruises the fall must have caused.
That afternoon I saw another doctor
to milk a wound for all it’s worth.
No pretty utterances on the couch
only gutter glass and all my best vintage
the clothes that guard against your eyes.
A girl’s got to eat. Or not. Alterity is underwhelming.
Sometimes ‘no’ is the only word a mouth can shape.
My criminal record includes truancy
which is simply a refusal to remain in the designated place.
Always this compulsion to run until the femur cracks.
When I was thirteen I lived in the woods for four nights.
When hunger was a bloom on animal husbandry
When we slept on beds of needles
ribs curled into barren limbs.
Before the bridal elegy began.
This project has been generously supported by a series of grants from the Mütter Museum and College of Physicians of Philadelphia, home to the largest collection of confirmed anthropodermic books in the world. My poems include numerous quotes altered from Hough’s papers and from Couper’s Speculations.
Endnote [1A] During the nineteenth century, tuberculosis (TB) was the leading cause of death in the United States. Also termed “consumption,” primary symptoms include fatigue, night sweats, and a general “wasting away” of the victim. “Typically but not exclusively a disease of the lungs, TB is also marked by a persistent coughing-up of thick white phlegm, sometimes blood.” Prior to 1943, when Selman Waksman discovered the antibiotic streptomycin, there was no reliable treatment for TB. Physicians sometimes prescribed bleedings and purgings, but most commonly, doctors simply advised their patients to rest, eat well, and exercise outdoors. Very few patients recovered. “Tuberculosis was primarily a disease of the city, where crowded and often filthy living conditions provided an ideal environment for the spread of the disease. The urban poor represented the vast majority of TB victims.” “Early Research and Treatment of Tuberculosis in the Nineteenth Century,” Historical Collections at the Claude Moore Health Sciences Library, University of Virginia, 2007, Web, March 17, 2018.
Endnote [1B] Mary consumed meat tainted with Trichinella spiralis, a parasitic roundworm often found in pigs. Trichinella is transmited from host to host via “ingestion of muscle tissue that has been infected with the encysted larval stage of the parasite.” Inside the new host’s small intestine, larvae progress into their adult stage. Then, after mating and reproduction, newborn larvae exit the intestine and “migrate through the circulatory system to muscles throughout the body. The total time for this cycle to occur is 17 to 21 days.” Beth Lander, “The Skin She Lived In: Anthropodermic Books in the Historical Medical Library,” Fugitive Leaves: A Blog from the Historical Medical Library of the College of Physicians of Philadelphia, October 1, 2015, Web, March 17, 2018.
 There is no direct evidence to support this supposition. In his article on Mary’s case in American Journal of Medical Science, Hough asserted that the contaminated meat came from visiting family and friends who ‘invariably brought her ham and Bologna sausage, of which she ate ravenously.’ ‘Two Cases of Trichinosis observed at the Philadelphia Hospital, Blockley,’ The American Journal of the Medical Sciences 57 (April 1869): 565-566.
 Hough, ‘Two Cases of Trichinosis’ 565.
 ‘From the data, counting the number in 1 gram of muscle, the whole number of cysts were estimated to be about 8 million.’ Hough, ‘Two Cases of Trichinosis’ 565.
 Fred B. Rogers and Thomas A. Horrocks, ‘John Stockton Hough: Medical Bibliophile and Bibliographer,’ Transactions and Studies of the College of Physicians of Philadelphia Ser. 5 Vol. 11. No. 4 (1989): 355-361.
 Rogers and Horrocks 356; John W. Jordan, Colonial Families of Philadelphia vol. 1 (New York: Lewis Publishing, 1911) 1006.
 Rogers and Horrocks 357.
 Carolyn Marvin, ‘The Body of the Text: Literacy’s Corporeal Constant,’ The Quarterly Journal of Speech 80.2 (1994): 129-149.
 Marvin 142.
 Michael Sappol, A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in Nineteenth-Century America (Princeton: Princeton University Press, 2002) 2.
 Sappol 2-5
 David C. Humphrey, ‘Dissection and Discrimination: The Social Origins of Cadavers in America, 1760-1915,’ Bulletin of the New York Academy of Medicine 49.9 (1973): 822.
 The legend of the name dates back to Judas Iscariot, who as an act of repentance returned to the temple the thirty pieces of silver he was paid for the betrayal of Christ. The priests decreed that the blood money could not enter the treasury, and instead used it to purchase a plot for the burial of strangers who died in the city of Jerusalem. They acquired an abandoned field, formerly the site of a pottery, which was known locally as the potter’s field. Frederick C.Waite, ‘Grave Robbing in New England,’ Bulletin of the Medical Library Association 33.3 (1945) 279-281.
 Thomas S. Sozinsky, ‘Grave Robbing and Dissection,’ Penn Monthly 10 (1879) 217.
 Humphrey 822.
 Robert Couper’s Speculations on the Mode and Appearances of Impregnation in the Human Female (Edinburgh: Elliot and Kay, 1789) 10-11, emphasis mine.
 Tuggle 31.
 Couper 11.
 Couper 16-17.
 Couper 11, 20.
 Couper 16-21.
 Couper 33-34.
 In practice, medical cadavers were a rare commodity and physical beauty was not necessary. However, when creating models or textbooks aesthetic conventions were paramount. See Joanna Ebenstein, ‘Ode to an Anatomical Venus’, WSQ: Women’s Studies Quarterly 40, nos. 3 and 4 (2012): 349.
 Ebenstein, ‘Ode to an Anatomical Venus’ 348-50.
 Joanna Ebenstein, The Anatomical Venus (London: Thames and Hudson, 2016) 14-20.
 Joanna Ebenstein, The Anatomical Venus 15-16.
 Erin Ross, ‘Women Rush To Get Long-Acting Birth Control After Trump Wins,’ NPR, November 11, 2016, Web, March 1, 2018.
 The origin of this quote is the 1949 film Knock on Any Door, directed by Nicholas Ray and starring Humphrey Bogart.
 ‘The Philosophy of Composition’ (1846), The Poetry Foundation, Web, March 1, 2018.