What does poet Walt Whitman have to do with an autopsy manual?

Here’s a post about a curious book, and a mystery that lasted more than a century.

THE BOOK

A few days ago I added to my library a book I had been looking for for some time: a 1903 first edition of Post Mortem Pathology by Dr. Henry Ware Cattell.

It is a well-known, thoroughly-illustrated autoptic manual detailing the methods used to carry out post-mortem examinations at the end of the 19th century.

On the title page one can find a tasty quote in Italian from the Divine Comedy:

These verses come from Chant XXVIII of Dante’s Inferno, describing the punishment inflicted on Muhammad (translation: “Rent from the chin to where one breaketh wind. / Between his legs were hanging down his entrails; / His heart was visible, and the dismal sack / That maketh excrement of what is eaten“), and they are quoted here as a clear allusion to autopsies, which offer a similar macabre spectacle.

Post Mortem Pathology is an interesting book for at least two historical reasons.

First, it contains some “advice” on how to obtain consent from the dead person’s relatives in order to perform an autopsy; but it would be more correct to say that Cattell gives indications on how to deceive the deceased’s family members, obtaining consent for example from someone “connected with the household, though not necessarily from the nearest relative“, taking care not to specify which anatomical parts are to be preserved, etc. Dr. Cattell also complains about the absence of a law allowing autopsies on all those who die in hospitals, without distinction.

As James R. Wright writes, these are “unique and important insights into local autopsy consent “practice” in Philadelphia in the 1880s which allowed […] pathologists to get away with performing autopsies at Blockley Hospital without legal consent. […] these questionable and highly paternalistic approaches to autopsy consent, although morally incomprehensible now, permitted outstanding clinicopathological correlations which made Blockley an excellent teaching environment.” ⁽¹⁾James R. Wright Jr., Henry Ware Cattell and Walt Whitman’s Brain, in Clinical Anatomy, 31:988–996 (2018)

Second, Cattell’s book describes the procedure, originally developed by the gynecologist Howard Kelly, to perform the removal of the internal organs per vaginam, per rectum, and per perineum. ⁽²⁾Julius P. Bonello, George E. Tsourdinis, Howard Kelly’s avant-garde autopsy method, Hektoen International Journal of Medical Humanities (2020) .

The method consisted of incising the vagina in women, or the anus in men; by inserting the arm up to his shoulder inside the body, the anatomist proceeded to pierce the diaphragm and remove the heart, lungs, liver, kidneys and the rest of the organs through that single cut.

Why all this effort? One might ask.

The answer is unfortunately linked to what we said above: it was a trick to perform an autopsy in the absence of legal consent; the organs were removed without disturbing the external appearance of the body, so that the relatives would not notice anything unusual.

But the real curiosity linked to this book is the fact that its author was implicated in a very peculiar incident.

THE MYSTERY OF THE MISSING BRAIN

In 1892 one of the most famous and celebrated American poets, Walt Whitman, died.

By the end of the 19th century, phrenology had already been discredited, yet it was still believed that the brains of “geniuses” could show some difference compared to those of normal people; this was the reason why in Philadelphia, as in other cities, there existed a Brain Club, a nickname for the Anthropometric Society, a — more or less secret — lodge  of doctors and pathologists who took care of preserving the brains of illustrious men. (Clearly just male brains, not women’s, but that’s OK.)

Famous pathologist William Osler, a member of the “Brain Club”, performing a brain autopsy ath the Bockley morgue in Philadelphia.

A reunion of anatomists in Philadelphia.

Henry Cattell was part of it, and at the time of Whitman’s death he held the position of prosector, that is, the one who did the “dirty work” by opening and dissecting the body.
He was therefore the one who dealt with the poet’s corpse during the autopsy that took place at Whitman’s house in Mickle Street on March 27, 1892, under the supervision of prof. Francis Dercum.

The brain of the immortal cantor of the “electric body” was removed and entrusted to Cattell to join those of the other important intellectuals preserved in liquid by the Anthropometric Society.

At this point, though, something went horribly wrong, and the precious organ disappeared into thin air.

This enigmatic incident changed Cattell’s life forever, making him doubt his talents as a pathologist so much that he decided to increasingly rarefy his commitments in the autopsy room, and to devote himself to scientific publications. Post Mortem Pathology represents, in fact, the first release of his publishing house.

But what had really happened?

The first testimony about it was published in 1907 in a paper by Dr. Edward Spitzka, which was apparently based on Cattell’s confidences to some members of the Society. Spitzka wrote that “the brain of Walt Whitman, together with the jar in which it had been placed, was said to have been dropped on the floor by a careless assistant. Unfortunately, not even the pieces were saved.” ⁽³⁾Edward Spitzka, A study of the brains of six eminent scientists and scholars belonging to the American Anthropometric Society, together with a description of the skull of Professor E. D. Cope, in Trans Am Philos Soc 21:175–308 (1907)

The news caused quite a sensation, so much so that it evidently entered the common imagination: this episode was likely the inspiration for the Frankenstein (1931) scene in which the Doctor’s assistant, who breaks into the university in search of a brain for the Creature, drops the jar with the “normal” brain and steals the “abnormal” one.

But, as James R. Wright writes, “what could not be understood is why the fragments had been discarded as there still would have been some value in examining these. Less clear was whether it was an assistant or Cattell who destroyed Walt Whitman’s brain.”

Be that as it may, in the absence of further clues, for more than a century this remained the official version. Then, in 2012, Cattell’s secret diary appeared on an eBay auction.

Henry W. Cattell during WWI.

The diary does not directly mention the autopsy, but from when it was performed in March 1892 until October of the same year Cattell’s notes have an optimistic tone — it had been a positive and finacially rewarding period of work. Then, starting from October 14, the entries in the diary become much more dark and worried: Cattell seems to suddenly doubt his own abilities, even coming as far as to have suicidal thoughts.

Here is the chronology of his entries, outlining a very different story from that of the assistant dropping the preparation on the ground:

13 ottobre 1892 — “Prepare specimens for path. soc. [Pathological Society of Philadelphia].”

14 ottobre 1892 — “I am a fool.”

16 ottobre 1892 — “I wish that I knew of the best way of keeping an account of my work. It often seems to me that I am so forgetful and yet I remember certain things which others might not be able to mind.”

13 aprile 1893 — “I am a peculiar man in many ways. Why did I get rid of Edwards—in all probability because I was jealous of him.”

15 maggio 1893 — “I am a fool, a damnable fool, with no conscious memory, or fitness for any learned position. I left Walt Whitman’s brain spoil by not having the jar properly covered. Discovered it in the morning. This ruins me with the Anthropometric Society, and Allen, perhaps with Pepper, Kerlin &c. How I ever got in such financial straights [I] do [not] know. When I broke with Edwards I should have told him to go to thunder. Borrowed over $500 more from P & M [Pa and Ma]. They are too good & kind. I would have killed my self before this a dozen times over if it had not been for them.”

18 settembre 1893 — “I should be happy and I suppose in my way I am. Except for my parents I could go to Africa or die and I w[ou]ld be in no way missed.”

30 settembe 1893 — “I look back on my confidence and self possession of last year as somehow wonderful. I now know that I do not know enough pathology for the position which I occupy.”

So here’s the truth: Cattell had badly sealed the jar containing Whitman’s brain; the liquid had probably evaporated, and the organ had dried out, decomposed or been attacked and damaged by some mold. Cattell blamed his assistant Edwards, who had probably started to blackmail him, threatening to tell the truth; this extortion, in addition to Cattell’s financial problems, had forced him to borrow money from his parents, throwing Cattell into a state of depression and mistrust in his abilities.

By publishing Cattell’s diary excerpts for the first time in 2014, Sheldon Lee Gosline wrote:

“Then, too, why put this incriminating evidence down on paper at all, risking public exposure? Clearly Cattell wanted to leave a confession that one day would become public—which now, 120 years later, has finally happened.” ⁽⁴⁾Gosline, Sheldon Lee. “I am a fool”: Dr. Henry Cattell’s Private Confession about What Happened to Whitman’s Brain. Walt Whitman Quarterly Review 31 (2014), 158-162.

EPILOGO

June 9, 1924.

Cattell was now 61 years old, and 32 years had passed since Whitman’s unfortunate autopsy.

At the time, as Gosline points out, Cattell “not only had his university staff income, but also charged assistants to privately assist him, provided post-mortems and expert testimony for a fee, ran a medical journal for a profit, and was a successful and lauded author. All of this was possible because he had evaded disgrace from the Whitman incident. “

His luck came from having kept silent regarding his incompetence in preserving the brain of a poet, and it is with a poem that, in a very proper way, the pathologist ends his diaries. These verses sound like a sort of balance sheet of his whole life. And the image that emerges is that of a guilt-ridden soul, convinced that his entire honored career has been earned through fraud; a man divided between a pleasant economic security, which he cannot give up, and the need to confess his imposture.

Perhaps the only one who could have smiled at this whole matter would have been Walt Whitman himself, aware that the individual body (container of “multitudes“) is nothing more than a mere transitory expression of the universal: “For every atom belonging to me as good belongs to you.” ⁽⁵⁾Walt Whitman, ‘Song of Myself’, Leaves of Grass (1855)