Bodyworlds

Iain Bamforth

In 1997, in the space of four months, more than three-quarters of a million people – the highest attendance for any postwar exhibition in Germany – queued to be admitted to the Bodyworlds (Körperwelten) exhibition at the Technical and Industrial Museum in Mannheim. The show produced similar attendance figures when it moved to Japan and to the traditional European capitals of death, Vienna and Basel, where I caught up with it. It is now showing in Cologne; here, too, it is bringing in the crowds. This is no ordinary exhibition, and not the display of fossilised machine tools from Germany’s long and unfinished history of industrial achievement that might have been expected from the museum’s name. What is on show, in fact, is a collection of about two hundred human anatomical specimens including the usual kinds of body sections, slides of diseased and healthy tissue, organs in glass cases. These are standard objects in an exhibition of this kind. More controversial, and certainly more spectacular, are the 18 ‘plastinated’ cadavers – Ganzkörperpräparate or ‘whole body preparations’.

Anatomy exhibitions have gone on the road before, though you might have to go a long way back, to the freak shows of the Victorian circus era, to find one which has aroused so much curiosity and controversy. Many of the anatomy museums in Europe’s famous medical schools have always been open to tourists, or can be visited by appointment: I recall spending an afternoon a few years ago in the mote-filled hall of the University of Montpellier’s junk room, examining one of the famous series of wax impressions of syphilitic buboes and chancres from the 19th century. Montpellier’s anatomy tradition goes back to 1315, when the body would be opened for inspection by two barbers under the instruction of a magister reciting the appropriate Galenic text. That tradition – or much of it – has been revived in books by Frank Gonzalez-Crussi, a professor of pathology in the Children’s Memorial Hospital at Northwestern University, who has created a subgenre of his own: portrayals of the usual and the monstrous drawn from his own professional life, with a bookish veneer that places them somewhere between Borges and Sir Thomas Browne. In one of his essays, ‘Bologna, the Learned’ (in Suspended Animation, 1995), he reminds us of the popularity from the 14th century onwards of public dissections, which were advertised in Latin on the columns of the Archiginnasio days before the event. The cutting, rending and division of a body was a chance for the demonstrators to show the ‘image of the universe’ to the audience, and for learned members of the audience to engage in heated disputatio; it was, above all, an event in the social calendar. As always, the poor were likely to be held up for scrutiny by their social betters.

Anatomists had to work fast to avoid the deliquescence of the body. The French surgeon Ambroise Paré (1510-90) was already aware of the use of alcohol to preserve tissue, but the more reliable method was ceroplasty, or wax modelling, as developed in northern Italy – especially Florence – in the 17th century. Gaetano Zummo was the pioneer of this technique; it was brought to a fine art under Abbot Felice Fontana (1730-1805), who was able to convince artists and anatomists to work together on his waxes. Ceroplasty was a highly skilled procedure requiring an intermixture of purified beeswax and spermaceti, as hardener, which was then pigmented to the desired hue; special techniques which required silk threads to be dipped in hot wax were used to achieve the effect of fine structures such as the lymphatics. Fontana’s waxes were shown to great acclaim in 1780, when he was commissioned to prepare a series of obstetrical specimens for the Emperor Joseph II: these can still be seen in glass cases, as a permanent exhibit, in the palatial Josephinum in Vienna. It was hoped that they would educate Viennese doctors in the use of forceps as advocated by the two pioneering Scots Hunter and Smellie. Tristram Shandy, written at about the same time, descants knowingly on the optimum fulcrum placement of this new technology for use by man-midwives. Along with gross anatomy, wax models were an important means of advancing the evidence of things seen, when so many concepts in medicine had hitherto been deductive. To understand the body, the body was enough – a modern thought. A Thomist would never have considered saying, ‘whose body is it anyway?’ as I heard someone exclaim on television as if clinching the argument for donating her body to the Institute for Plastination, an independent anatomy lab in Heidelberg. Indeed, to say ‘I have a body’ would have been a novel and disturbing heresy five centuries ago. But the epistemological strain is clear enough: on the one hand, an anchorite contempt for the flesh seems to ally itself with the Cartesian doubt that dominates modern analytical medicine; on the other, the body loses its place in a purposive, hierarchical, meaningful cosmos, and the very idea that it could incarnate the divine comes to seem self-evidently absurd. Not that anything in human affairs is ever self-evident.

Ceroplasty and the vascular injection of fixatives and dyes remained mainstays for teaching anatomical structure into the 20th century. There is clearly a difference between these two methods: the first is an imitation of nature, a distancing technique, the other an attempt to preserve the corruptible body and protect the anatomist from the dangers of putrefaction. The lifelikeness of prepared wax specimens can be such as to acquire a ‘terrorising’ quality (Gonzalez-Crussi), although the technique met with Goethe’s approval (his youthful enthusiasm for anatomy classes in Strasbourg in 1770 gave way to a suspicion that anatomists were rather contemptible people). On the other hand, it is probably more accurate to say that what most medical students remember of their dissection classes is not a feeling of horror at having to cut up a body, but a sense of how undramatically grey and shrunken the fixed cadaver is.

The illustrations from Vesalius’ De humani corporis fabrica ranged in the museum outside the dissection room at Glasgow University were more disturbing: even when subject to terrible violence – flensed like Marsyas or hanging by a cord to keep their jaws shut – his studies insist on comporting themselves in unmistakably lifelike ways: outrage is made complete, Baudelaire suggests in his poem ‘Le Squelette Laboureur’, by their being ‘tricked out to look like hired hands’. Tool, image, grave: the three artefacts that take the measure of and transcend the human condition are assembled in the poem, yet Baudelaire’s slave labourer goes on digging even after he has dug his grave, refusing to move into the immaterial. Concerning Vesalius’ series, Roger Caillois remarked in his essay ‘Au coeur du Fantastique’ that ‘more genuine mystery crops up in such documents, in which precision is of the essence, than in the wildest inventions of Hieronymus Bosch.’ In the dissection groups, imagination was stilled by the gossip of group work and the pedagogic imperative: learn, learn, learn. It’s an odd business: even surgeons don’t need to know all the grooves, tuberosities and foramina of every bone, nor every pulley and conduit of the softer parts. What isn’t clinically important gets forgotten. My enduring memory of the anatomy class is the pungent smell of formalin; it penetrated clothes and gloves and lingered in the hair, a kind of olfactory ectoplasm from a cold place in which people no longer matter.

Enter Professor Günther von Hagens, who describes himself as ‘inventor, anatomist, physician and synthetic chemist’. In the mid-1970s, at the University of Heidelberg, he developed a new technique for preserving biological tissue. It had taken him 15 years of experimentation with industrial solvents. ‘Plastination’, as the technique is known, is now under patent but available for use by medical schools across the world. It requires tissue, or whole bodies, to be fixed in the standard way with formaldehyde or some other preservative. Specimens are then dehydrated, a process in which fluid in the tissue is replaced with a chilled organic solvent such as acetone. The next, and central, step of the process is forced impregnation: the solvent is replaced under vacuum with a polymer, silicone or epoxy resin. The corpse can then be manipulated in ways that were quite impossible with previous preservation techniques. The final stage involves hardening the polymer. Tissue can be rendered pliable or hard, and with a high degree of realism. The essential architecture of the body is preserved. In all, the process takes between five hundred and a thousand working hours. It is undoubtedly an elegant plastic technique, and produces specimens which are much more resistant to oxidation and general wear and tear than the old formalin-phenol injected bodies. Plastination can give a body five hundred years of post-mortem standing.

It also allows the skeleton to be shucked out, leaving the rest of the body, once the muscles have been hardened, as a self-supporting ‘shell’. Hagens has exploited this feature in one of his dissections, where a menacing figure, the Muscleman, is displayed a step ahead of his skeleton. The entire muscle apparatus of the body is displayed intact, free-standing and bloated, the distortion caused no doubt by the difficulty of extricating the cranium, ribcage and long bones of the inside. It is a virtuoso piece of dissection work, though the raised left arm and the flailing triceps conjure up the image of Boris Karloff as Frankenstein’s monster. Several other of the whole body preparations are similarly ‘exploded’ to show the arterial system, or relationships between the internal organs. The ‘Orthopaedic Body’ is decorated with 12 different prosthetic devices, and sponsored by Johnson and Johnson.

Another preparation suggests that the association between the Muscleman and Frankenstein was not fanciful: one figure is defrocked of his skin which he holds up in his right hand, intact, with an imploring gesture. It is a direct quotation of the famous flayed man published by the Spanish anatomist Juan Valverde in Rome, in 1560. Other dissections have ‘windows’ at various standard levels indicating structures which have to be located or avoided during surgery. There is a young woman with a five-month-old foetus in her uterus, the overlying rectus abdominis muscle opened in the midline to reveal the dome of the uterus pressing upwards on the intestines. Another figure, posed like a chess-player, has been pared to the ribs to show the central and peripheral nerves as they exit in pairs from the spinal column and innervate the skeletal muscles, a feat beyond the means of the traditional anatomist. The organs of a ‘longitudinally expanded’ figure, which has been made to squat, shoot upwards out of the body, and are held in space by threads. ‘I create space for the viewer to see the parts clearly,’ Hagens says, ‘so that he can close the space up in his imagination.’ One preparation is dissected in bands, like a Dalí drawing; another is caught in the act of running, all the muscles freed from their insertions and splayed outwards. It is a dramatic portrayal of a body in motion, but it nods at the pioneering artists of the early 20th century, for whom the Anatomical Angel, a woman with her trapezius cut and suspended like wings, in Jacques Gautier d’Agoty’s Myologie complète en couleurs, of 1746, was a fetish image.

Hagens is unflustered about blurring the distinction between art and dissection. He seems to thrive on it, never being seen in public without his Joseph Beuys hat. His method of personal self-promotion stands in sharp contrast to the impersonality of his exhibits. The Plastinator is quick to point out that some of the best early anatomists were artists, like Leonardo, who is thought to have dissected 30 corpses; nor is he the first anatomist to model his dissections on works of art. Fragonard’s famous dissection of a rider on his horse, both stripped to the bone, recapitulates Dürer’s Tod und der Reiter, and can still be seen in all its lacquered glory at the National Veterinary School at Alfort, near Paris. Frederik Ruysch (1638-1731), professor of anatomy in Amsterdam and celebrated for his vascular injection technique (he used a secret combination of wax, resin, talc and cinnabar, which had to permeate the entire vascular system before it hardened), had five rooms in his town house at the Niewe Zijds Achterburgwal converted into a Wunderkammer for the display of his meticulously prepared specimens and mummies. They were baroquely adorned and placed in allegorical scenes: playing a violin with a bow made of a dried artery, weeping into handkerchiefs made of mesentery or meninges, or abandoned to bewail their fate on a stage constructed out of gallstones and other body casts. Peter the Great bought the lot for the huge sum of 30,000 Dutch guilders in 1717, and had them shipped to Russia.

Both Fragonard and Ruysch were decidedly odd characters, brooders who took their discipline to a pitch well beyond the necessary degree of scientific precision or desired illusion. In the exhibition catalogue, however, Hagens attempts to play down the aesthetic, suggesting that ‘the art is in the beholder’s eye.’ Yet the subtitle of the exhibition – ‘Die Faszination des Echten’ – spells out the nature of the confusion: what status do these exhibits have? What does ‘real’ mean in this context, and why should it be so fascinating? Organs and body sections on their own (images of which can be downloaded from the Internet) aren’t really that interesting unless you know what you’re looking at: without the whole body preparations, the exhibition would not be a succès de scandale. Heated television debates accompanied the show when it was first seen. Hagens was arraigned for bad taste and lack of respect for human dignity; the Mannheim theologian Johannes Reiter said: ‘the person who styles human corpses as works of art no longer respects the importance of death.’ Protests about tastelessness were made by the heads of both main Churches to the minister president of Baden-Württemberg, though a cool-headed 16-year-old pointed out in the visitors’ book that the Church has a long tradition of putting its own holy mummies on display. Hagens has recruited Luther as his alias: everyone should have a chance to see the plastinated body, just as everyone should be able to read the Bible without mediation. He is ‘democratising’ anatomy. ‘We are not putting dead human beings on public show. The whole body preparations on display have been anonymised and are no longer dead human beings because they are no longer the object of piety and mourning.’ Article 168 of the German Penal Code, Disturbing the Peace of the Dead, has no legal force since all these former persons donated their bodies to the Institute for Plastination – a process which required them to relinquish their right to be buried.

True enough: we don’t know who these people are. We won’t know their names, or their stories. Even their features have been smoothed out by anatomical preparation. The glass eyes make them look vacuous. We may be able to guess their age, within a margin of error. Their sex will be apparent. Some organ deformation may give a clue to the cause of death. That’s about all that can be guessed of them in their singularity as social beings. They are empty testaments. But how can we address them except as social beings? Hagens believes that his exhibition satisfies a great human longing for what he calls ‘unadulterated originality’ (‘unverfälschte Originalität’) – a clumsy expression which might translate as ‘authenticity’. What does he mean? A plastinate isn’t a mimetic object like one of those glossy wax models of the 17th century which, by virtue of being a representation, keeps its distance. In the exhibition catalogue, a whole body plastinate is defined as a structural model of the cadaver (it lacks most of the water that makes up four-fifths of the human body). But an artefact can’t be authentic, since an artefact is always the view of a thing, not the thing itself; nor does a cadaver have inherent structural aptitude for self-display. Hagens has to give it form by plastinating and then modelling it before hardening, a procedure ethically comparable to the partial intrusion on autonomy when a plastic surgeon reconstructs a face or body. A plastinate ends up pretending to be its original self.

It is playing to the gallery to insinuate, as Hagens does, that visitors to the exhibition can, in a day’s viewing, locate the meaningful turnings of the very tradition which has made it possible to strip a body: a medical education is an apprenticeship in which the discipline is itself reappropriated, precept by precept. It is participatory, not a viewing experience. Twenty years ago, I spent a cold year dissecting a body as part of my medical training. It was a chore, and it seemed odd that we had to acquire a sense of medicine’s embodied realism by destroying the evidence. The six of us around the table were dimly aware of the ambivalence of what we were doing: the body was no longer a human subject but neither was it wholly in the realm of the senseless (the same cleavage attends the removal of organs from cadavers for transplantation: the sense of a ‘material’ being cannibalised sits uncomfortably with the prospect of the ‘harvested’ organs entering another, living individual). It was a knowledge which had already been informed by allied disciplines, and was broadened by twice-weekly lectures on form and function. It was hard to appreciate in anatomy classes that being a good doctor would entail getting beyond the old Indo-European notion of knowing as seeing: knowing in medicine is just as much listening and touching. (Sniffing patients is not popular these days, though diabetes can sometimes be diagnosed in a patient who smells of acetone; urine-tasting has fortunately become obsolete.) What can a ‘laterally expanded’ whole body preparation convey to an observer whose only previous sense impressions of lateral expansion have been in a gore movie?

The difference between Hagens’s hard plastic bodies and a simple skeleton, bereft of the conceptually rich body it supports, is obvious: imagination is at work here, as Hagens knows it is bound to be; which is why it is disingenuous of him to pretend that the aesthetic aspects of his preparations are institutional and second-order, not intentional – ‘in the beholder’s eye’. Or perhaps crafty, if he does think he’s Beuys. Art is surely the exclusion of death, which obliterates the aesthetic. The only art form I can think of which meaningfully includes it – which turns on doing an animal to death – is the bullfight. There the danger of exposure to the ‘bull’s keen horn’ is a mortal risk, as that restrained masochist Michel Leiris notes in L’Age d’homme, thereby saving the torero from an art of vain affectation. Again the argument turns on authenticity and performance: the same strategists of liberation who had applauded the Anatomical Angel made tauromachy a vitally theatrical form of self-discovery. Leiris’s autobiography became a lifelong mortification.

The exhibition in Cologne offers no new scientific discoveries: gross anatomy’s heyday was long ago. The number of autopsies performed annually in hospitals has been declining for years. Teachers of anatomy may not be anatomists at all, but molecular biologists or biochemists. It is ironic, too, that the state of the art perception of the body is airier and less solid even than that of the medieval medici: it is a composite representation made up of vector forces, atomic energy and sound waves. The body is as permeable as it is resonant. The more refined our techniques, the more our substance eludes us. It is a progression that would no doubt have appealed to medieval philosophers who believed the material body was accidental to our true essence. Hagens’s exhibition seems peculiarly of our times in its materiality and unwillingness to sacrifice immediacy, its literal disbelief in art as substantiating community. Reality alone counts, and reality knows nothing of representation: it is a definition of animal consciousness. Besides, if the body is a symbol of society, as Mary Douglas says it is, then society itself must be laterally exploding. We can’t expect to lay the world bare, cognitively speaking, and not feel the draught: one of the uncomfortable things about knowledge since Bacon’s time is having to feel threatened by an anatomist.

Most visitors to the body show actually seem to applaud the idea behind it. ‘It’s better than being eaten by worms,’ one visitor commented. No moral objections were raised by the Churches in Vienna and Basel, both of which have a long tradition of socialising their own exquisite dead. Hagens now claims to have a waiting list of a thousand ‘donors’, for some of whom plastination will provide an ultimate face to meet the world. Perhaps they’re down at the gym already, preparing for the new symbolic order. Michel Leiris would have blanched at a form of autobiography that contrives to be perfectly sculptural but is bereft of anything to say about the bull’s keen horn. But the dead never did tell tales.