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Dissection has always been a rite of passage, whether it involves a pig fetus in high school or watching your first episode of CSI.

The same and more, of course, goes for medical students, who have to not only survive their first close encounter with a dead body but also then disassemble it into its component parts. Dissection of human cadavers is considered by many to be the moment that students are transformed into doctors.

In modern times, dissection has been criticized as a desensitizing event that leads too many MDs to see patients as slabs of meat on a table. These days, when medical students enter the dissection room and stand over a lifeless body, scalpel and saw in hand, they are encouraged to view the subject lying there as their “first patient,” according to the authors of Dissection: Photographs of a Rite of Passage in American Medicine: 1880-1930.

• Dissection: Photographs of a Rite of Passage in American Medicine: 1880-1930, by John Harley Warner and James M. Edmonson, Blast Books, 208 pages, $56.50

This respect for the dead was decidedly not present in American medical schools in the late 19th century and early 20th century, as the authors of Dissection thoroughly demonstrate. Back then, cadavers were treated with as much courtesy as a bone-in ham at an overcrowded Easter buffet.

The proof of this is indisputable, thanks to a singular historical circumstance: The rise of dissection as the focus of human anatomy studies in American medical schools in the late 1800s coincided with the beginnings of photography. As a result, what was to some extent an illicit act because of the dubious provenance of the cadavers was routinely and gleefully captured on film to a high degree of gruesome detail.

The authors have discovered hundreds of photos of medical students posed around a cadaver, usually in groups that symbolized the bonding nature of the undertaking. For young men and (the few) women going into medicine at the time, cutting into a human body had the same transformative effect that it has today but, instead of humanizing the students, it served to harden them.

“ Body parts are strewn about carelessly or used as props in many of the photos”

Students wrote letters home about how the practice desensitized them to the fact they were cutting into human tissue, and of how it made them callous – a fact that is plain to see in the black humour and general indifference to human life expressed, deliberately or by accident, in dissection room photos.

Body parts are strewn about carelessly or used as props in many of the photos; other photos are composed with handwritten signs propped up around the dissecting table that contain crude jokes like “Rest in Pieces” and “She lived for others but died for us.”

While the photos in the book can be hard to look at, the real horror story behind early medical dissections is revealed in the text. The unspoken truth of the practice, one about which students were sworn to secrecy, was that most of the cadavers were stolen – ripped out of graves by “resurrectionists” and sold for a tidy profit to establishment beacons like Harvard and Yale.

As has been their particular gift throughout history, the rich were okay with that, just as long as the resurrectionists avoided better burial grounds and raided the cemeteries of society’s marginalized peoples: the poor (Harvard med students relied on a steady influx of sickly Irish immigrants for fresh cadavers), criminals and, especially, the country’s newly freed black population.

Just as African-Americans had been stolen and sold live as a commodity, now the remains of their law-abiding descendants were suffering the same fate. In some respected schools, as many as 50 per cent or more of the cadavers were those of African-Americans.

For the authors, the practice was just another way of oppressing black Americans after the Civil War was over. Like lynchings, the theft and mutilation of their loved ones’ remains was a deliberate signal to African Americans that they were still a lower order of being, even if Abolition said otherwise. The authors note somewhat menacingly that a similar photographic trend of the day – snapshots of lynching victims that were swapped like trading cards – were some times the work of the same photographers handling the camera in dissection laboratories.

Dissection

See the images from the book

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It took reporters in Philadelphia to bring about a beginning to the end of the resurrectionists; in 1882 they exposed the systematic robbing of the city’s main African-American cemetery. That, and the occasional midnight disinterment of a child of the wealthy that caused the ruling classes to suddenly rediscover their moral compass (in 1878, the body of the son of president William Henry Harrison was found hanging by the neck from the ceiling of an Ohio medical school dissecting room). Laws began to be passed in various states outlawing the trade in cadavers, and by 1930 legislation had all but eliminated it.

Changes in attitude about dissection itself occurred at the same time. Many doctors were appalled that “inexpert boys hack away at a cadaver until it is reduced to shreds,” and they pushed for a more objective, professional and detached approach to students’ first encounter with a scalpel and a body. The future doctors of the 1920s and ’30s were pushed to overcome their emotional reactions and focus on the science and precision of their roles, a necessary evolution that had the downside of churning out several generations of MDs who seemed to forget they were in the business of treating people, not bodies.

Today, dissection is still a fact of life for medical students, but the cadavers come mostly from people who will their remains to science. Students are known to refer to a cadaver as the “donor” and hold “services of gratitude” at the end of their anatomy courses.

Their teachers, meanwhile, hope the rite of passage will help them deal with, not abnegate, their human feelings about an experience they describe as “an activity that feels simultaneously wrong and very right, a taboo and yet a privilege.”