Michael Sappol, A traffic of dead bodies: anatomy and embodied social identity in nineteenth-century America, Princeton University Press, 2002, pp. xiv, 430, illus., US$35.00 (hardback 0-691-05925-X).

Abstract

Michael Sappol's A traffic of dead bodies examines the critical role played by anatomy in two intersecting nineteenth-century projects: the making of an American medical profession, and the making of a modern, “bourgeois” self. Anatomy, in Sappol's account, was power for American medical men. It was a means of producing and demonstrating knowledge of the body, but also a potent symbolic resource, confirming practitioners as secular priests endowed with a capacity to transgress fundamental rules about life and death. For a fractious medical world, a common commitment to the anatomical project served as the potential touchstone for a collective professional consciousness. For the burgeoning nineteenth-century medical schools, dissecting rooms and anatomical museums advertised their scientific credentials, while for medical students themselves the rituals surrounding dissection constituted their initiation into a “homosocial” professional confraternity. Even the humblest country practitioner, through a display of its iconic emblems in his office (a skeleton in the closet, a pickled organ on the desk) sought to associate himself with the charisma that anatomy conferred. Re-reading the history of American medical professionalization through the lens of anatomy leads Sappol to question scholarship that has stressed medicine's low status for much of the nineteenth century, and to argue instead for its considerable social authority grounded primarily in the epistemological, therapeutic, and cultural prestige derived from anatomical science. Anatomy, then, was social power, but to what end? For Sappol, the answer lies not in a simple medicalization thesis. In his analysis, medical power serves not so much to impose subject positions as to provide resources for acts of individual and collective “self-making”. Anatomy played to a receptive audience, aspirants to a particular type of social distinction that Sappol denotes as “bourgeois”. This is a capacious, at times unwieldy category, defined not by socio-economic position but in relation to an ethos of modernizing self-improvement that captivated a broad swathe of Americans (farmers, artisans, clerks, emancipated slaves, as well as dominant elites) in the context of dynamic and unstable nineteenth-century America. A modern, bourgeois self was respectable, refined, cultivated, disciplined, a subject that—in contrast to cruder “others”—embodied self-mastery. It is the fundamental shift constitutive of modern anatomy—designated variously as the rise of the “anatomico-clinical method” and of “hospital medicine” by historians of medicine—that connects it in Sappol's analysis to this project of self-making. In the new anatomy, bodies ceased to be understood as fluid, contextualized and holistic entities and became instead analytical sites characterized by taxonomic fixity and intricate (and visually representable) internal differentiation of parts. This provided a model for, and an exemplary practical instance of, becoming an embodied bourgeois self. By performing on themselves the anatomical procedure of penetrating, dividing, and naming, individuals enacted the kind of objective, knowledge-based self-discipline expected of modern subjects. Sappol's favoured metaphor for this process is territorial: anatomical knowledge of the self confers a control akin to political powers who “know and control the world, by cutting it apart into clearly named, bounded, and regulated regions, and by enforcing local, regional and super-regional laws conducive to social and hygienic utility” (p. 258). The anatomically conscious individual who continuously inventories the operations of his own body is engaged in an act of (self) conquest. Sappol describes the dynamic relationship between professional- and self-making in terms of “overflow.” Anatomy overflowed the boundaries of medical professional discourse and performance, and through the medium of “popular anatomy”—an amalgam of lectures, demonstrations, pamphlets and books—tapped into a mass audience for anatomical knowledge. Purveyors of this knowledge, coming from different backgrounds and pursuing different agendas, translated anatomy into the terms of modern selfhood, providing a set of performative and cognitive tools for those seeking to embody this bourgeois self. In turn, popular anatomy's own purposeful banks overflowed. Its “joyless insistence on physiological propriety” (p. 213) belied other forms of bodily knowledge (especially those linked to sexual desire), which were irrelevant or even counter to its explicit purposes, and which found their expression in sensational fiction and in late-century popular anatomical museums. It is a credit to Sappol's imaginative approach to an eclectic range of textual and visual sources that he manages to connect these disparate anatomical worlds into a compelling analytical whole. There are elements of his ambitious and innovative study that are not entirely satisfying. The self-understanding required of modern subjecthood, for instance, seems to rest as much on physiology as anatomy, and despite his rich account of anti-anatomical rioters, too much is made of anatomy's public and medical appeal. Nevertheless, this is a work of keen intelligence and creativity, rich in detail, bold in its claims—a stimulating and innovative contribution to the cultural history of medicine.