The kidney removal of Catherine Eddowes.

[Herlock Sholmes]

Why all this talk of surgical techniques? In Victorian times, what we now think of as basic surgery didn't even exist, or was in its absolute infancy. In 1887 the first successful appendectomy was performed to treat acute appendicitis in which the patient survived! However, butcher/slaughterers in 1888 could kill and eviscerate pigs and sheep at the rate of four or five an hour, day after day. They must have developed their own techniques and found out the quickest and easiest ways to remove organs. By this time they had developed and mastered their necessary techniques for each task, and who is to say that some of these techniques were not similar to, or even more or less identical to more modern surgical techniques. They were doing these things first, for a long long time, and by the thousand.

I wouldn't dream of asking a butcher/slaughterer about advanced surgical techniques, as that would be ludicrous, but for some reason modern surgeons and pathologists are regarded as experts on what an experienced butcher/slaughterer could do.

Once again, I repeat a letter from an experienced butcher, R. Hull of Bow, written to the police on 8th October 1888.

"From the age of 14 years till past 30, I was a butcher so that I can speak with some authority. Doctors, I think, but little know how terribly dextrous a good slaughterman is with his knife. There has been nothing done yet to any of these poor women that an expert butcher could not do almost in the dark. It is not known perhaps to the medical fraternity that a slaughterman is a dexter handed man. Consequently doctors are misled. And as to the time taken by the murderer to do the most difficult deed done as yet, I think it would be reduced to about one third of the time stated by them if done by a practical man, which according to their own evidence it must be, or someone connected to their own craft. I cannot think that inexperienced men could do it. I have never seen the inside of a human being, but I presume there is little difference between such and a sheep or a pig. I could when in the trade kill and dress 4 or 5 sheep in one hour. Then as to the blood, do not be misled, if done by a butcher he will not have any or very little blood on his person. I have many a time gone into the slaughterhouse and killed several sheep or lambs and scarcely soiled my clothes, that is when the weather has been fine and the skins have been dry. It likewise occurs to me, that if done by a butcher he would know his work too well to attempt to cut the throat of his victim while standing up, but when they have laid down for immoral purpose, then with one hand over the mouth, and the thumb under the chin, then with what is known in the trade as a Sticking knife, which is a terrible weapon in the hands of a strong butcher, in the twinkling of an eye he has cut the throat, then turning the head on one side, like he would a sheep, the body would bleed out whilst he did the rest of his work, from which the blood would flow. The only fear of making a mess would be the breaking of a gut or intestine and that would not be done by one knowing his business. The slaughterman's knives consist of a set of three ..."

He then concludes by describing the knives, the significant one being the sticking knife, "6 or 8 inches long in the blade", which corresponds with the known murder weapon.

That letter makes several points very clear. Firstly, a butcher/slaughterer reckons that JtR was one of his kind. It takes one to know one, they say! But it also makes other points too. Poor light would not be a problem, he could use both left and right hands, the time taken would be far less than the doctors' estimates, there would probably have been little or no blood on his person, the description of the modus opperandi is convincing, and he would know how to avoid making a mess etc.

Although we can never be certain, this is the best guide I have seen to who JtR probably was.

Good post Doc.

These people focused on speed and they would have removed more kidneys in their lives than any surgeon would have had to.

[Doctored Whatsit]

Why all this talk of surgical techniques? In Victorian times, what we now think of as basic surgery didn't even exist, or was in its absolute infancy. In 1887 the first successful appendectomy was performed to treat acute appendicitis in which the patient survived! However, butcher/slaughterers in 1888 could kill and eviscerate pigs and sheep at the rate of four or five an hour, day after day. They must have developed their own techniques and found out the quickest and easiest ways to remove organs. By this time they had developed and mastered their necessary techniques for each task, and who is to say that some of these techniques were not similar to, or even more or less identical to more modern surgical techniques. They were doing these things first, for a long long time, and by the thousand.

I wouldn't dream of asking a butcher/slaughterer about advanced surgical techniques, as that would be ludicrous, but for some reason modern surgeons and pathologists are regarded as experts on what an experienced butcher/slaughterer could do.

Once again, I repeat a letter from an experienced butcher, R. Hull of Bow, written to the police on 8th October 1888.

"From the age of 14 years till past 30, I was a butcher so that I can speak with some authority. Doctors, I think, but little know how terribly dextrous a good slaughterman is with his knife. There has been nothing done yet to any of these poor women that an expert butcher could not do almost in the dark. It is not known perhaps to the medical fraternity that a slaughterman is a dexter handed man. Consequently doctors are misled. And as to the time taken by the murderer to do the most difficult deed done as yet, I think it would be reduced to about one third of the time stated by them if done by a practical man, which according to their own evidence it must be, or someone connected to their own craft. I cannot think that inexperienced men could do it. I have never seen the inside of a human being, but I presume there is little difference between such and a sheep or a pig. I could when in the trade kill and dress 4 or 5 sheep in one hour. Then as to the blood, do not be misled, if done by a butcher he will not have any or very little blood on his person. I have many a time gone into the slaughterhouse and killed several sheep or lambs and scarcely soiled my clothes, that is when the weather has been fine and the skins have been dry. It likewise occurs to me, that if done by a butcher he would know his work too well to attempt to cut the throat of his victim while standing up, but when they have laid down for immoral purpose, then with one hand over the mouth, and the thumb under the chin, then with what is known in the trade as a Sticking knife, which is a terrible weapon in the hands of a strong butcher, in the twinkling of an eye he has cut the throat, then turning the head on one side, like he would a sheep, the body would bleed out whilst he did the rest of his work, from which the blood would flow. The only fear of making a mess would be the breaking of a gut or intestine and that would not be done by one knowing his business. The slaughterman's knives consist of a set of three ..."

He then concludes by describing the knives, the significant one being the sticking knife, "6 or 8 inches long in the blade", which corresponds with the known murder weapon.

That letter makes several points very clear. Firstly, a butcher/slaughterer reckons that JtR was one of his kind. It takes one to know one, they say! But it also makes other points too. Poor light would not be a problem, he could use both left and right hands, the time taken would be far less than the doctors' estimates, there would probably have been little or no blood on his person, the description of the modus opperandi is convincing, and he would know how to avoid making a mess etc.

Although we can never be certain, this is the best guide I have seen to who JtR probably was.

[GBinOz]

Hi George,

While Trevor may have a point there, it doesn't mean that the uterus in these cases were cut out by different persons. If we assume that the Ripper did it, then there's no reason to think he needed the specimen to be excised in the same way as he wasn't, as far as we can tell, interested in selling the specimen; he was just interested in cutting them out & taking a souvenir. Furthermore, different circumstances may have further contributed to different modes of excising the organ.

Cheers,
Frank

Hi Frank,

I quite agree. but with so many unknowns and so many contradictions, can we justify dismissing any theories addressed at providing possible solutions? There may have been more than one perpetrator, and Trevor provides a theory that relieves the ripper from having to possess advanced dissection techniques. I don't know that we are so amply provided with hard facts as to enable us to dismiss theories out of hand.

Cheers, George

[FrankO]

Trevor has a point when he observes that the techniques used on Chapman and Eddowes were quite different, ...

Hi George,

While Trevor may have a point there, it doesn't mean that the uterus in these cases were cut out by different persons. If we assume that the Ripper did it, then there's no reason to think he needed the specimen to be excised in the same way as he wasn't, as far as we can tell, interested in selling the specimen; he was just interested in cutting them out & taking a souvenir. Furthermore, different circumstances may have further contributed to different modes of excising the organ.

Cheers,
Frank

[Herlock Sholmes]

That is the issue that Lewis suggested, and I would concur with your elimination list with the possible exception of Kosminski who I suspect may have been responsible for Stride only.

With regard to the son of the surgeon, I dare say that the fact of his being a practising barrister and cricket tragic, he may have had some theoretical knowledge but little time for repetitive practical experience in a dissecting room. An interesting suspect, never the less.

Hi George,

This might be a frustrating situation for us because we might have here a genuine way of narrowing down the suspect list massively but we can only take it as far as ‘we have no evidence that x had any such knowledge/experience.’

[GBinOz]

One of the issues that we would have to consider though George is that we couldn’t always be certain who might or might not have acquired that knowledge. We could only really say that there are many suspect that we have no evidence of having medical knowledge….which is the majority (Kosminski, Druitt, Bury, Kelly etc) Then we would talk of those who ‘might’ have acquired such knowledge/skill and you would get someone like me suggesting the son of a surgeon.

That is the issue that Lewis suggested, and I would concur with your elimination list with the possible exception of Kosminski who I suspect may have been responsible for Stride only.

With regard to the son of the surgeon, I dare say that the fact of his being a practising barrister and cricket tragic, he may have had some theoretical knowledge but little time for repetitive practical experience in a dissecting room. An interesting suspect, never the less.

[GBinOz]

[Bolding added.]

Hi George,

I suggest that a person could have had the skills or knowledge that the Ripper needed to have without us knowing that he had those skills, and that a person could have had the skills/knowledge even if his occupation didn't require it. If we were to eliminate all named suspects that weren't butchers or trained as surgeons and aren't ridiculous for other reasons, I think that would mean eliminating all named suspects except Levy, Chapman, and Thompson.

Hi Lewis,

While I do agree, I think that such a person would also need the experience provided by repetition. The three names you put forward are good candidates.

Cheers. George

[Herlock Sholmes]

.
The Time Conundrum is a focal point of this mystery. If some of the popular suspects with no butchering or dissection room experience are to retain their positions on the suspect list, then an alternative theory, such as that presented by Trevor, is required. If the killer(s) took the organs, then the suspects without said skills need to be eliminated.

JMO.

One of the issues that we would have to consider though George is that we couldn’t always be certain who might or might not have acquired that knowledge. We could only really say that there are many suspect that we have no evidence of having medical knowledge….which is the majority (Kosminski, Druitt, Bury, Kelly etc) Then we would talk of those who ‘might’ have acquired such knowledge/skill and you would get someone like me suggesting the son of a surgeon.

[Herlock Sholmes]

I agree. It was known at the time that Watkins said that he walked through the square at about 1:30 and discovered the body at about 1:44. If that wouldn't have allowed the killer enough time to remove the organs, that wouldn't have gone unnoticed.

If anyone were able to prove that it would have required more than 20 minutes to remove the organs (and do everything else the killer did in the square), I would consider it far more likely that Watkins lied or was mistaken about his 1:30 walk through the square than that the organs were removed in the mortuary prior to the post-mortem.

So would I Lewis. Look at PC Harvey. He supposedly went to the end of Church Passage and looked into Mitre Square at 1.40 and saw nothing. Does it seem likely that he could have missed seeing a body lying up ahead? After all, it can hardly be likely that the body wasn’t there at 1.40 then the killer and victim enter with the ensuing murder and mutilation to be found by Watkins just 4 minutes later. Ten months later Harvey was dismissed from the Force for unknown reasons.

So can we be totally certain that Watkin searched the square properly at 1.30? Is it possible that he could have walked up to Kearney and Tonge and just waved his bullseye in the direction of the corner where Eddowes was lying? From memory, isn’t it the case that those lamps weren’t very bright. From Bishopsgate Station to Mitre Square is around 7 minutes I believe; let’s say 10. Is it impossible that the ripper murdered her at around 1.10 and both Harvey and Watkins, through a mixture of cutting corners/expediency and a not very bright lamp missed her body lying in the shadows? I’m not making that claim but far stranger things have happened.

[Lewis C]

With all due respect my friend, your logical progression does not conform to scientific principles. You pose your questions, answer them yourself and ascribe a 100% outcome based entirely on your opinions.

To ascribe some alternatives:

1. My research suggests a minimum time required of 15 minutes. Phillips (who was there and was the most experience police surgeon of his time) quoted this time in the Chapman case, and there was more done to Eddowes than to Chapman. Bond's "expert" came up with a time of 5 minutes, but it was not stipulated whether he was talking about just the organ extractions or the whole procedure, or under what conditions he conducted his experiment. Was it conducted in a theatre with full lighting? Bear in mind that he still managed to nick the bladder. The experiment would have been conducted on a cadaver so the blood in the abdominal cavity would not have been comparable.

2. There is no need to involve Lawende and friends to deduce a time available of 14 minutes, +/- 2 minutes. Police beat time was considered more reliable that that of casual observers. Of course, this excludes the possibility of Watkins skiving.

3. The killer(s) exhibited both butchering and dissection room knowledge and experience, the latter more so in the case of Eddowes (and Kelly). This is obvious from the injuries and techniques recorded at the autopsies. To say that the killer(s) had time to visit these injuries upon their victims because that is what happened is a logical fallacy.

The Time Conundrum is a focal point of this mystery. If some of the popular suspects with no butchering or dissection room experience are to retain their positions on the suspect list, then an alternative theory, such as that presented by Trevor, is required. If the killer(s) took the organs, then the suspects without said skills need to be eliminated.

JMO.

[Bolding added.]

Hi George,

I suggest that a person could have had the skills or knowledge that the Ripper needed to have without us knowing that he had those skills, and that a person could have had the skills/knowledge even if his occupation didn't require it. If we were to eliminate all named suspects that weren't butchers or trained as surgeons and aren't ridiculous for other reasons, I think that would mean eliminating all named suspects except Levy, Chapman, and Thompson.

[Lewis C]

I'd suggest that the Ripper spent no more than 5 minutes with any of his victims (excluding MJK)

He clearly wasn't stupid and so spending more than 5 minutes outside and exposed to potential capture, would be highly unlikely.

The killer knew how to use a knife, had previous experience of cutting things open, and knew with a degree of certainly his potential escape routes, and the duration and rotation of the regulated police beats.

Hi RD,

I'd suggest that the Ripper took considerable risks in any case, and we can't know exactly how much risk he was willing to take. If he was willing to be risky enough to do these killings, he might have also been willing to take the risk of taking a few more minutes to do the mutilations, especially of the experience seemed incomplete without that.

[Lewis C]

Hi Lewis,

I certainly think that we can get pretty close. In the past I made the mistake of allowing for added time at one passing without considering that it would have been the same at the other. Although we can’t be certain of the accuracy of Lawende’s time. At the end of the day though we know that the killer took organs so he certainly had time to do what he did; no matter how difficult. The doctors at the time had no doubts on the matter.

I agree. It was known at the time that Watkins said that he walked through the square at about 1:30 and discovered the body at about 1:44. If that wouldn't have allowed the killer enough time to remove the organs, that wouldn't have gone unnoticed.

If anyone were able to prove that it would have required more than 20 minutes to remove the organs (and do everything else the killer did in the square), I would consider it far more likely that Watkins lied or was mistaken about his 1:30 walk through the square than that the organs were removed in the mortuary prior to the post-mortem.

[Herlock Sholmes]

I am going to conclude this fiasco you have instigated and post 3 reports from modern day medical experts in their field on dealing with evisceration of bodies starting with Phillip Harrison a mortuary manager whose roll it is to prepare bodies for post morttems and assist with the post mortems he has over 25 years experience

So a Mortuary Manager. Whilst I certainly don’t intend to doubt Mr Harrison’s knowledge or experience he prepared bodies for PM’s and assisted with PM’s. Hardly compares to a surgeon in terms of knowledge and experience does he? How many people, when looking into a question related to the extraction of internal organs, would favour a mortuary manager over a surgeon?

You, apparently.

I will firstly comment on the murder of Annie Chapman. She was described in the post-mortem report as showing signs of great deprivation. I mention this as in my opinion evisceration is more difficult in a person with a poor covering of body fat. When a person is very thin the skin at autopsy loses its elasticity. It is more difficult to carefully remove organs when the opening cannot be stretched. Surgeons use a retractor to make the opening as big as possible. Surgeons need as much room as possible but would work internally in what would seem to the layperson as an impossibly small opening. The skin is very elastic and a small incision can be stretched to make it quite large.

Chapman’s abdomen was laid open. For someone with anatomical knowledge and experience, the small intestines are the easiest to remove from the mesenteric attachments. I would imagine the original pathologist is referring to the small intestines. With great skill and practice, it is easy to remove the small intestine from its mesenteric attachments with one cut if speed was of an essence. But it does take skill and many years of practice.

I am right-handed and I would suggest the perpetrator to have been right-handed as the neck wound indicates that and the fact that the organs removed from the abdominal cavity were placed at the head of the body.
A piece of the stomach was found on the left shoulder. This could have been cut and removed accidentally during the frenzied attack as the intestines, and in particular, the large intestine was removed and placed to one side.
An interesting point is the removal of the pelvic organs. The report states that the uterus and its appendages and the upper portion of the vagina, and parts of the bladder had been entirely removed. To remove the appendages, the uterus, the fallopian tubes and ovaries in one frenzied attack and one slice of a blade would be almost impossible. It is a very difficult and quite a skilled undertaking to remove these organs carefully even by today’s methods especially as the comment is that they were cleanly cut and the cut missed the rectum. These specific organs are in very close proximity to each other and at post-mortem are removed by a mixture of blunt dissection and a sharp knife. Even doing this carefully it is still possible to damage some of the surrounding organs and tissues. There would have been no need for the killer to remove the intestines to facilitate the removal of the uterus.

It is stated that a knife of at least five to six inches long was used. It may be possible under normal modern-day hospital conditions but would have been almost impossible given the number of mutilations and the fact that it was dark.

It wasn’t dark. Annie Chapman was killed at around 5.30. It wasn’t fully light but it certainly wasn’t dark.

This brings me back to the signs of great deprivation. I would imagine that the deceased was very emaciated. This could have made the abdominal opening much tighter to work in to delicately remove the pelvic organs. The organs would have been covered in blood and probably faeces and make it difficult to see where to cut and handle the organs. The organs do not bleed but they ooze blood, and faeces would also have come out of the cut sections of the bowels. I also note that the original reports show that when the body was discovered both her legs were drawn up, indicating this is how the killer left the body. With the legs in those positions, it would have been a hindrance to the killer in attempting to remove the organs. The normal position would be to have both legs flat and open to give free and unrestricted access to the abdomen.

The second report I will comment on relates to the murder of Catherine Eddowes. The injuries inflicted on the face and neck has been well documented and most of the other injuries to the face, neck and lower body occurred after death. There is no doubt she was subjected to a frenzied attack. The report states that the abdomen was opened from the xiphoid process to the pubic bone. This seems to be a much smaller incision to the one made at post-mortem allowing access to the abdominal organs.

There is difficulty in ascertaining how much elasticity remained in the deceased’s tissues for the kidney and uterus to be removed. As I have previously stated deceased persons who have very little body fat covering tend to have very tight skin coverage especially over the abdomen thus making it difficult to enter the abdominal space. In Eddowes’ case looking at Picture (3) taken before the post-mortem. This clearly shows a much smaller jagged incision than is described in the post-mortem report. An interesting side point about the abdominal wound is how it circled the umbilicus. The umbilicus or belly button is cartilaginous in nature and is not cut through during the initial post-mortem incision today. An experienced anatomist would have known this.

In my experience, this would have made it extremely difficult for the killer to investigate the abdominal cavity and to remove any organ easily especially in almost total darkness especially if the killer was in a rush and trying to work quickly.

For the left kidney to be easily removed a person would need to be on the right side of the body as this gives easier access to the left kidney. What cannot be underestimated as briefly mentioned in the post-mortem report is the amount of blood and faecal matter that would have been present around and in the abdominal cavity. The liver was stabbed and almost cut through; this would have undoubtedly let a lot of blood into the abdominal cavity. A newly deceased does not bleed in the normal sense of the word but there is a lot of seepage of blood from the tissues and organs.
This makes it even more difficult to remove organs carefully. Standard post-mortem procedures involve wearing gloves that give more of a grip when dealing with blood and body fluids. It would have been difficult for a person to grip warm and very messy organs to remove them carefully so soon after death.

The kidneys are situated at the back of the abdominal cavity surrounded by their own protective covering and the renal capsule and surrounding fat. The post-mortem report states that about 2 feet of the colon was removed. If the colon was removed from the left-hand side of the transverse colon and the descending colon, access to the kidney is somewhat easier. To remove the kidney from its membrane as is documented shows a high level of skill and anatomical knowledge.

The uterus was also removed without damaging any underlying tissue. This is also very difficult especially as the report says that the sigmoid colon was invaginated into the rectum very tightly. It would be difficult with a six-inch knife to carefully remove the uterus. I use surgical scalpels and have also become quite adept with a very sharp knife with a 4” blade. We have in the post-mortem room “daylight lighting”. Given the levels of light available and the time available it would have made it more difficult to remove the organs carefully, especially given the crime scene location and the level of light required. As I have stated previously if the killer was targeting specific organs for removal, as with the murder of Chapman the killer would not have needed to remove the intestines to remove the uterus.
I also note that the original reports show that when the body was found one leg was drawn up. I again refer to my previous comments with regards to the position of the body of Chapman and the hindrance having a leg drawn up when trying to access and remove organs from the abdominal cavity.

To work in such an intricate manner and to remove the kidney carefully and the uterus without damaging the surrounding tissue with a six-inch knife would be very difficult. In the time the perpetrator had with their heightened levels of awareness and the prospect of being caught makes this even more difficult. The emphasis is on carefully because only a person with expert knowledge of anatomy would be able to remove the organs in the manner described and would find it very difficult if not impossible in almost total darkness

And yet Dr Sequiera, who was actually there said: “Where the murder was committed was probably the darkest part of the square, but there was sufficient light to enable the miscreant to perpetrate the deed.”

In my opinion, I do not believe that the killer of Chapman and Eddowes was responsible for removing their organs at the crime scene. Even for a highly skilled medical man given all the circumstances, it would have been a daunting task which given the level of expertise of surgeons in Victorian times would also make it a lengthy process for such a person in any event. In my opinion, the killer could not have removed those organs in the time known to have been available to him

We have been here before Trevor. How much time did Mr Harrison believe the killer had available to him?

Dr Calder-Pathologist
I am a Fully Registered Medical Practitioner and Consultant Pathologist. I have the basic qualifications of Bachelor of Medicine and Bachelor of Surgery from the University of St. Andrews. I have the additional qualifications of Doctor of Medicine, Doctor of Science, Membership of the Royal College of Physicians, Fellowship of the Royal College of Pathologists, Fellowship of the College of Pathologist of Hong Kong, Fellowship of the Faculty of Occupational Medicine of the Royal College of Physicians, Diploma in Medical Jurisprudence and Diploma in Medical Disability Assessment. I have approximately twenty-eight years of investigating sudden and unnatural deaths. I have also been involved in basic research in pathology. I have no idea as to the number of autopsies I have carried out but it must be in the tens of thousands.

I have been asked to express my opinion relating to the evisceration and mutilation of the bodies of Annie Chapman and Catherine Eddowes. Evisceration requires considerable experience and overall awareness of anatomy, especially human anatomy. In my opinion experience in eviscerating animals requires an entirely different technique, so as a basic premise it is mercenary to consider a person with practical experience in human anatomy and/or surgery. Even in those experienced in evisceration it is not a technique, which can be done ‘blind’, and would have to be carried out under direct visual observation. Organs at autopsy and in fact surgery are slippery, which can cause technical problems unless gloves are used.

In considering Catherine Eddowes, from the autopsy report it does appear she was subjected to a “frenzied attack”, with injuries both post-mortem and ante-mortem distributed over the body.
The autopsy report states that the abdomen had been opened from the bottom of the sternum as far as the pubis. It is interesting to observe that this incision appeared to be irregular, which could suggest the use of a slightly blunt knife. However the incision had avoided the umbilicus (which is more difficult to incise), and this would perhaps be supportive evidence that the assailant knew of this from past experience.

The kidneys are in the upper posterior of the abdomen and are not easy to locate as they are behind major organs. Given this, the usual surgical approach is by an incision in the loin. To remove the left kidney an approach from the right side would be ergonomically easier. Technically it would be easier with visceral organs removed. However, to carry this out in the dark would be almost impossible without producing damage to other organs. This lends support to the fact that to achieve such there needed to be not only knowledge of anatomy, but experience in applying it.

To remove the uterus without adjacent damage is technically very difficult, even with a sweeping motion of a knife, even when pulling the uterus out of the bowl of the pelvis. An anatomist would not need to remove the intestines to facilitate the removal of a uterus.

It is difficult to explain the piece of cloth, which was part of an apron, which had faecal staining and blood spotting. There have been put forward three possible uses for this - cleaning the assailant’s hands, wiping a knife or as wrapping material for a kidney. A kidney removed from a fresh cadaver would have a considerable amount of blood.

In the case of Annie Chapman, she was a sparse female and would suggest that the abdominal wall was without much fat and possibly lean. To remove the bowels would require expertise and experience.
The pelvic organs appear to have been removed skillfully without damage to adjacent tissues.

This would be technically very difficult, as the organs are down in the bowl of the pelvis, and would require continuous observation, to avoid the complicated local anatomy.

Conclusion

From the evidence considered if the assailant did remove the organs from Eddowes and Chapman, he would not only have known about anatomy but experience in using it. Even in the experienced, such evisceration would have to be carried out by observation in a well-lit area. Therefore there has to be a doubt about the removal of these organs at the crime scenes. I also suggest that there is a doubt about when and where all the abdominal injuries to the victims occurred. In my opinion, the killer could not have removed the uterus and kidney within the time frame suggested available to him at the crime scene.

I have also looked at the reports relating to the removal of the organs from Mary Kelly. In my opinion, these removals do not appear to have been made by someone with specific medical anatomical knowledge.

So she said that ‘if’ the killer removed organs he had practical anatomical knowledge and skill. She only said that it couldn’t have been done when the time available is considered. Which, knowing you, would have been reduced to the bare minimum to encourage that conclusion.



Edmond Neale-Gynaecologist

I am Edmund Neale; I have been a consultant Obstetrician and Gynaecologist for over 25 years. I am a Fellow of the Royal College of Obstetricians and Gynaecologists, and a senior examiner for them.
I have viewed the post mortem reports of the victims, Annie Chapman and Catherine Eddowes. I have looked at them from the perspective of a modern-day gynaecologist, but have tried to extrapolate back to practice in 1888.

In both cases I note the severity and depth of the fatal neck wounds, suggesting an extremely sharp blade was used, as it marked the anterior surface of the vertebrae.

Catherine Eddowes

In addition to the post mortem report, I have also seen a drawing and a photograph of the body before the post mortem. I am first struck by the jagged appearance of the abdominal wound. This does not look like a surgical incision. The irregular nature of it and some of the minor wounds to underlying organs suggests to me that possibly the knife (the pathologists at the time conjectured a thin blade of 6-8 inches) entered probably the upper portion of the abdomen which was then opened by pulling the knife upwards, possibly with a sawing motion, as opposed to a surgical incision where one would press down with the blade on the skin. In other words, the irregular line suggests the abdomen was opened from inside out rather than outside in. I believe this approach would allow maximum pressure to be exerted on the abdominal wall whilst minimizing the damage to the internal organs.

“Someone with anatomical knowledge” could accomplish the removal of the uterus quite quickly once access has been obtained. Traction on the organ would allow division of the tissues on either side with one sweep of the knife. The only task that would then remain would be to cut horizontally to remove the organ. In the case of Catherine Eddowes, I note the cervix of the uterus was left behind.
Today this would be termed a subtotal hysterectomy as the cervix is seen as an integral part of the uterus. The obstetricians and midwives of the 19th century were aware of the importance of the cervix in childbirth, but I have no knowledge of Victorian anatomist’s gynaecological view of the cervix. I would, however, have expected it to be removed as well if the organ was required for experimentation.

I agree with the suggestion at the time that to have removed a kidney would require a degree of knowledge, but, interestingly, it is the left kidney that was removed rather than the right, which would probably be more difficult to access because of the liver, thereby making the task of removal more difficult to accomplish, and a longer time frame needed.

In respect of the piece of the apron and whether it was used as a sanitary towel or not, it is quite possible that even in Victorian times women in their late forties would still be menstruating and may well have used a piece of rag as a sanitary towel. Blood spotting is a part of the female menstrual cycle. I have not been shown a photograph of the original apron piece showing the blood spotting, so I, therefore, cannot give a definitive answer as to whether the blood spotting described on the apron piece is consistent with the menstrual cycle

I have provided a photograph of a surgical swab showing the effect of wrapping a recently removed normal-sized uterus from a live donor. Picture 8. This clearly shows a heavy concentration of oxygenated deep red blood, which has heavily stained the swab. Annie Chapman

My comments above on the removal of the uterus will again apply. I note that in this case it is reported that the appendages were removed. Also, the uterus and cervix were removed, the transverse incision cutting through the vagina. However, in this case, a portion of the bladder was also removed.

Anatomically the bladder is loosely attached in front of the cervix and must be reflected out of the way when performing a hysterectomy, (removing the uterus). In patients who have had a pelvic infection (as a prostitute may well have done), this attachment may be quite dense and tough. The removal of a portion of the bladder suggests to me that speed was important, but does not help determine where or when it was done. However, I note that in this case, it seems to have been important to remove the female pelvic organs intact (i.e. uterus, cervix, ovaries and fallopian tubes), which could, in conjunction with a nephrectomy suggest removal for experimentation.

Conclusions

As to the time and feasibility of undertaking these procedures in semi- or almost total darkness, the Doctors assessment at the time of the inquest was probably around about right. To my mind, the various stab wounds noted in the livers would again support my theory that the blade was stabbed in through the abdominal wall and cutting down the sides and across the bottom. It would require more medical knowledge to understand the need to severe the mesentery of the gut to identify the kidney and remove it. It should also be noted that an anatomist would know drawing upwards rather than a surgical type incision from the outside the uterus would be fairly easy to remove with a modicum of knowledge by pulling up hard and that there would be no need to take out the intestines to remove a uterus.
It is difficult to accurately estimate the time required to perform such a procedure. It In modern-day practice with an anaesthetic and attempting to preserve the tissue layers and anatomy to reduce morbidity one would take 10-15 minutes to make such an incision and removal in a planned non-urgent case, but it could be achieved in around 3 minutes in an emergency situation, however, one would also have to also consider the time needed to perform the removal of the kidney, which I would estimate would have taken at least two more minutes, and the time taken to carry out the other mutilations (apart from the murder itself).

Once the abdomen has been laid open there is the question of access. In modern-day practice with a live patient, there remains a tension in the abdominal wall and retractors are used to display the surgical site fully. In this case, there would be no such tension in the abdominal muscles (the pathologist states rigor mortis had not yet begun) so the abdominal wall could be expected to “fall open” to a greater extent allowing better access.

In order to remove the uterus, it could simply be felt and pulled upon. It would usually be reasonably mobile, but if these women had borne children it is likely to be more so. There are four sets of ligaments attached to a normal uterus. The round ligament arises from the top, the broad ligament from the side (and has the fallopian tube at its top and the ovary right behind) and the cardinal and uterosacral ligaments which are attached in the region of the cervix. Victorian anatomists were usually quite precise, that’s supposing it was the killer who removed them. So I am surprised that there is not greater detail of which of these ligaments were removed and which were not, however, suffice to say that the round and broad ligaments would have to be cut or removed in part even to perform a subtotal hysterectomy.

It is my professional opinion that once the abdomen is open, the killer or whoever, had merely to take the uterus in his hand (it has a unique shape and texture in the pelvis and so could easily be identified even in the dark (if one had some prior knowledge of it), pull hard and cut either side of one’s hand to separate the round and broad ligaments. A horizontal cut across the base of his hand would then separate the uterus from the body. The lower the cut, the more likely the organ remover is to remove the cervix and damage the bladder, the higher the cut the more likely he is to leave the cervix behind.
I note that the hysterectomies performed on the two victims were different, but there is not enough information available to me to say whether or not they were carried out by the same person, or different persons. I am not able to say where or when the organs were removed.

They could have been removed at the crime scenes had the perpetrator had sufficient anatomical knowledge to be able to locate the specific organs and had the time available to him to do so, or equally I cannot dismiss the suggestion that they could have been removed at the mortuary before the post mortems by someone with sufficient anatomical knowledge.

Finally one should consider the nephrectomy, but I make these conclusions from my anatomical and gynaecological knowledge. I have not worked in urology for 32 years.
If the killer is on the patient’s right, it would be easier and more natural to remove the left kidney. The kidneys lay either side of the spine protected by fat and the peritoneal membrane in all mammals. Again they have a particular feel and consistency unique for their position. I am unable to comment on the amount of fat there is likely to have been in Victorian times, but the less there is, the easier it would be to find once the bowels have been moved to one side (whether detached or not). If the killer knew of the position of a mammalian kidney (whether human or animal) they would also be aware that the only “attachment” is the vessels and urethra which lie between the kidney and the spine. If one was not concerned with preserving life a simple longitudinal cut parallel to the spine would create an opening in the peritoneum into which a finger and then a hand could be placed and the kidney “shelled out”. I estimate this could be done in 1-2 minutes as a minimum working at speed under modern-day theatre conditions.

In concluding and with regards to the removal of the organs from Eddowes and the time needed for them to have been removed at the crime scene. In my opinion, it would not be the skill that would be needed, but the level of anatomical knowledge, which would determine the time needed at the crime scene to effect these removals. If the killer did remove the organs then he must have had sufficient anatomical knowledge otherwise he would not have had the time to search for the organs, and work out how to remove them within that “at least five-minute window” as stated by Dr Brown.

So he estimates around 3 minutes for the removal the uterus and 1 or 2 minutes for the kidney. Plus the time to kill and perform the other mutilations.

Dr Neale expresses no doubt that this could have been achieved if the killer had sufficient knowledge and skill - which we can’t doubt as none of us know who the killer was.


www.trevormarriott.co.uk

So, two (a mortuary manager and a pathologist) don’t think that it could have been achieved in the time available but we don’t know what time they believed was available. The third (a gynaecologist) felt it was possible as long as the killer had the correct knowledge and skills.

…….

Conclusion


Prosector…(an actual surgeon), who has to trump the three experts above…accepts that the killer removed organs. (I seem to recall Nick Warren (another actual surgeon) believing that the killer took organs.

Add to this the fact that we have ZERO evidence of the existence of ‘organ thieves.’ Professor Hurren certainly doesn’t mention them and, despite claiming on here that he had evidence that she had mentioned them, Trevor is yet to provide it. Quite simply, he invented it. There were body dealers who profited from corpses (and who would also take amputated limbs if they were available)

Not one single Doctor or police officer who were there at the time suggested, suspected or hinted at the killer not taking organs.

Trevor’s point about the ‘different techniques’ has been refuted by Prosector (an actual surgeon) who trumps an ex-police officer on these matters.

I could produce a longer list but the above is enough to show how this theory really does need to be kicked well and truly into the long grass. Trevor, of course, will do what he always does and defend it at any cost of credibility. I did a poll and not one person stood up to agree with Trevor. The same discussion took place over on JtRForums (so you don’t even have to consider my opinions if you don’t want to) but people like Chris Phillips, Paul Begg, Neil Bell and others repeatedly pointed out why this theory was a non-starter, but, as ever, the whole world is wrong and Trevor is right.

I’m sorry but that’s not the case. However difficult it was (and I’m not discounting the difficulty) the killer undoubtedly took organs away. If Trevor thinks his surgical knowledge is better than two surgeons then there’s nothing that I or anyone can do or say to change his mind.

That the killer took away organs is a fact.

[GBinOz]

Hi George,

What are you saying or trying to say here? It's a bit confusing, because if the placing of the intestines, the incision around the navel and the removal of the heart are medical procedures (and I don't doubt they were), then aren't Chapman, Eddowes and Kelly connected? Yet, in the second part you seem to be suggesting that Chapman was eviscerated by a butcher rather than someone with knowledge of medical procedures, while Eddowes and Kelly were eviscerated by someone with such knowledge.

Cheers,
Frank

Hi Frank,

Yeah, I'm a bit confused as well. Trevor has a point when he observes that the techniques used on Chapman and Eddowes were quite different, but had the mobilisation of the small bowel in common.

Cheers, George

[GBinOz]

Some more quotes from Prosector:

"For the benefit of anyone that hasn't had both hands inside a human abdomen before, simply getting at either the kidney or the uterus is incredibly difficult. You might know roughly where they are but the problem is you have a mass of slippery, writhing intestines in the way and as much as you try to push them aside, the more they flop back into the middle and down into the pelvis which is where you need to be if you wish to get at the uterus.

What you have to do is a manoeuvre known to surgeons, anatomists and pathologists as mobilisation of the small bowel. This involves making a slit in the root of the mesentery which lies behind the bowels and this then enables you to lift the small intestines out of the abdomen and gives you a clearer field. Jack did this in the case of Chapman and Eddowes (hence the bowels being draped over the right shoulders). Dividing the root of the mesentery single handed is very difficult since you are operating one handed and blind. Usually an assistant wound be using both hands to retract the guts so that the operator can get a clearer view of it."

"Anyone just hacking away in order to find either a kidney or a uterus, especially using a long bladed, sharp pointed knife, would very quickly perforate the small bowel. That would instantly cause the abdominal cavity to fill with liquid small bowel content and make further progress impossible.

As far as I am aware he never accidentally perforated the small intestine (and few surgeons even today could say that). The only time that he cut into the bowel was when he deliberately removed a section of Eddowes’s descending colon in order to get direct access to the left kidney. The descending colon however contains semi-solid faeces so although there was a little contamination it was nothing like what would have happened if he had perforated the small intestine.

He needed anatomical knowledge to know that the left kidney lay behind the descending colon (did you know that?) and even then it would have been difficult to find and excise because it is completely covered by the posterior peritoneum (the ‘membrane’ that Dr Frederick Brown talked about at her inquest).

No, JTR was no butcher."

"In November 1888 the first appendicectomy in Britain was yet to be performed. Very, very few surgeons had much experience of abdominal surgery. An average surgeon would probably only do a few hysterectomies in their entire career (and most of those by the vaginal rather than the abdominal route).

It's all very well to talk about the best way of taking out a kidney - from the front or the back. In 1888 no-one took out kidneys from living patients. It was only done in the dissecting room or the mortuary."

"The 'reach in and grab' method that you describe doesn't really work when it comes to mobilising the small intestine which he did in both the Chapman and the Eddowes cases. As I mentioned in a previous post, he used the method that is used by medical students in dissecting the human body and by surgeons and pathologists, namely dividing the root of the mesentery."