Surgical knowledge?

[Ben]

Hi Errata,

So what does it mean that he went for the kidney through the front?

When considered alongside Eddowes' other injuries, it tells us that he was an unskilled mutilator slashing and grabbing at anything that felt interesting, and this was the majority verdict amongst the 1888 doctors. There's no good reason to think he knew where the kidney was in the body. More likely he was fumbling around and found something firm.

[Wickerman]

Surgical EXPERIENCE is what would tell him to flip the corpse over and take the kidneys out from the back. That he apparently did not have. So he wasn't a practicing surgeon. But anyone who has paid attention to a butcher or a couple of autopsies could take out the kidneys from the front.

And that is pretty consistent with the opinions of Brown, Saunders & Sequeira, and a handful of us on the boards.
More than the average layperson but less than a professional, and only in the field of anatomical knowledge, although clearly handy with a knife, yet no surgical experience.

[Errata]

So what does it mean that he went for the kidney through the front? He still would have had to get the uterus from the front, so it's not like he would have had to sacrifice one presentation for the other. We are sort of juggling several ideas as though they were the same thing, but they aren't. Anatomical knowledge tell him where the kidney is in the body. Evidently he had that. But that can be gained through observation. Surgical knowledge tells him how to extract the kidney from the encasement without having to take out everything else. This can also be Butcher's knowledge, both of which can still be had through observation, or exceptional spatial sense. Surgical EXPERIENCE is what would tell him to flip the corpse over and take the kidneys out from the back. That he apparently did not have. So he wasn't a practicing surgeon. But anyone who has paid attention to a butcher or a couple of autopsies could take out the kidneys from the front.

[Wickerman]

Saunders was only 'sent' the stomach contents, he was not present at the autopsy - three doctors only.

Ok, I apologise for that, yes Saunders was according to Inquest testimony, also present at the autopsy.

However, this same paragraph from Saunders himself also makes it clear that Saunders agreed with Gordon-Brown and Sequeira contrary to the opinion of Dr. Phillips who thought there was less expertise.
I took your earlier post to suggest Gordon-Brown stood alone, the Inquest testimony makes it clear that Saunders & Sequeira were actually in agreement with him.

"Having ample opportunity of seeing the wounds inflicted, he agreed with Dr. Brown and Sequeira that they were not inflicted by a person of great anatomical skill...".
(my emphasis)

Regards, Jon S.

[Wickerman]

Hi Jon,
Exactly, which is why anyone possessed of actual anatomical knowledge would have flipped the body over and accessed the kidneys from the back.

Yes Ben, I have heard that opinion before, but such a methodical assumption does not allow for the shock value that a disemboweled body presents when laid out prostrate on its back.
This argument also assumes the killer intended to take a kidney from the outset. His decision to take the kidney may have been made while he was in the process of mutilation, intending to take the uterus certainly, but for added mystique, "I'll remove a kidney too, this'll give the buggers something to talk about".

Nope. Four.

Brown, Phillips, Sequeira and William Sedgwick Saunders.

Saunders was only 'sent' the stomach contents, he was not present at the autopsy - three doctors only.

As for Dr. Bond, there seems to be a persistent, weird misconception that his observations are undermined because he only looked at the notes.

They were.
Warren chose to have Anderson hire Bond in October, in order to determine the nature of the wounds. It was pure fortune or misfortune, that another murder took place in early November which enabled him to actually be present at one of the autopsies, but that was never the intention.

Any modern surgeon will tell you that it is very difficult to determine the degree of skill used in mutilations unless you are able to see the body first hand, as much of your opinion is based on visual evidence.

It is perfectly clear from other sources (real ones!) that Phillips believed the Eddowes murder to have been committed by an unskilled copycat of the Chapman murder. In this respect, he once again influenced Baxter's theorizing.

Phillips did not talk to the press, he was above all that. Therefore, unless his opinion was given at an Inquest, or as hearsay, from his assistant Mr Clark, I am suspicious about anyone offering opinions from Dr. Phillips.

The two bodies which were in the worst condition with respect to any absence of skill were the two who were mutilated in the dark, Polly Nichols and Kate Eddowes.
Both Chapman and Kelly were mutilated under better lighting conditions, therefore, we should quite reasonably expect to see less evidence of ability displayed with the two mutilated in the dark.

Regards, Jon S.

[Ben]

Hi Jon,

it is the lowest organ to reach for when the body is laying on its back

Exactly, which is why anyone possessed of actual anatomical knowledge would have flipped the body over and accessed the kidneys from the back. It really doesn't matter whether the organs could be seen or not. If he was fumbling around for anything that might be interest, the chances of him alighting on a kidney were hardly very slim considering that he was operating within the confines of a small woman's abdominal cavity. It's not as though he had a whole array of visceral options or places to explore.

Ok, well your numbers do not add up, there were only three doctors who examined the body.

Nope. Four.

Brown, Phillips, Sequeira and William Sedgwick Saunders. The last mentioned did not believe that the perpetrator possessed any anatomical skill, basically echoing Sequeira. As for Dr. Bond, there seems to be a persistent, weird misconception that his observations are undermined because he only looked at the notes. This is, of course, complete nonsense. Unless the other doctors either deliberately withheld details of Eddowes' injuries or didn't file a full report for some reason (incompetence?), the notes were just as good as a first-hand viewing.

Commenting on Stride & Eddowes (unsourced):
"Dr. Phillips has stated that the injuries inflicted upon these women have been apparently performed by a person possessing some anatomical knowledge.

"Unsourced" - there's your clue.

It's nonsense.

It is perfectly clear from other sources (real ones!) that Phillips believed the Eddowes murder to have been committed by an unskilled copycat of the Chapman murder. In this respect, he once again influenced Baxter's theorizing.

"I think that the murderer had no design on any particular organ of the body. He was not possessed of any great anatomical skill." does not in any way detract from the words of Gordon Brown, who made no allusion to "great" skill or "specific" design on any organ.

If you describe an actor as having "no great talent", you're basically saying he's crap, and the same is true of Sequeira's assessment of the perpetrator's anatomical knowledge. He was passing an irrefutably negative opinion on the level of "skill" evinced by the mutilations, and had he wished to convey the impression that he thought the killer had "some" skill, he would have said so explicitly. When he referred to no "design on any particular" organ, he meant that no particular organ was targeted for extraction - the implication being that the killer stumbled upon the kidney without knowing where it's located or even what it was.

He certainly wasn't commenting on any future plans the killer might have had for the kidney thereafter. The issue of what might be done with the targeted organ thereafter was quite simply not his area of expertise to venture an opinion on. That was a matter for the coroner and for the police, and had Sequeria offered an opinion as to what financial or specimen-related plans the killer might have had for the organ, it would have been interesting but completely irrelevant to the autopsy he was being specifically queried about. Hence, I think we can be fairly sure that notwithstanding Baxter's funny ideas from the Chapman inquest, Sequeira was saying that in his opinion, the killer did not appear to be in pursuit of any particular organ. This would certainly tally with his view that the mutilations took three minutes.

"We don't have to believe the killer was a doctor to accept what Gordon Brown & Phillips have deduced."

No, no, there's no "Gordon Brown & Phillips". This creates the very misleading impression that they shared the same opinion. They did not. Phillips believed that Chapman and Eddowes were killed by different people. Brown - outnumbered four to one - believed that Eddowes' killer had anatomical skill. Phillips did not. These two doctors are at odds, as as such, they do not "join forces" to create imaginary evidence that Jack the Ripper had medical knowledge.

It is impossible to arrive at the conclusion that the Whitechapel murderer had anatomical skill without deliberately cherry-picking the minority-endorsed opinions as correct whilst discarding the bulk that argues otherwise. It just can't be done.

All the best,
Ben

[Wickerman]

We might be reminded by the words of Doctor Phillips concerning Chapman's mutilations:

Coroner:Was any anatomical knowledge displayed?
Phillips: I think there was; there were indications of it. I think the anatomical knowledge was only less displayed or indicated by being hindered in consequence of haste.

When Eddowes was mutilated it was much darker at 1:40 am that it was between 5-6:00 am, just breaking dawn.
Any reason to think he may not have operated in haste at Mitre Sq., and with the added hinderence of darkness? He probably risked loosing a finger...
And you complain about nicks and scratches?

You might want to read up on the collateral damage caused by battlefield surgeons in the Civil War, ...and they were experienced.

[Michael W Richards]

Not really, Jon.

Anyone fumbling around in the dark with their hands and a knife could easily find it by accident without knowing what it was, as Dr. Sequeira's evidence implies. Remember that only one of the four doctors who examined the body thought the kidney extraction indicated expertise or even knowledge, and an additional fifth doctor - Thomas Bond - studied the autopsy notes and came to the same conclusion as the three doctors who didn't detect any anatomical knowledge.

Since the kidney was never found, it cannot be stated that he did not "injure it in any way". His knife may have made a complete mess of it during its excision for all we know.

As for his preference for a kidney over a liver, Errata's suggestion is just as good as any. He might also have considered it too large to transport.

The preponderance of evidence indisputably supports the contention that the killer did not have "abilities above the ordinary layperson".

All the best,
Ben

Well put Ben. Since we have a killer who also sliced Kate's colon in sections, (perhaps in error one imagines.....and wonders aloud about the need for a section of cloth from the victim)...and the sloppy upward cut he made, we must lean toward a fortuitous acquisition rather than a targeted one.

Even the nicks on Kates face may have been just collateral damage when he cut her nose,....another faux pas for the skill and knowledgeable.

Cheers mate

[Bridewell]

Liver Was Healthy

If Eddowes was an alcoholic, my guess is that her liver was in pretty rough shape. I don't know if you've ever seen the liver of an alcoholic, but it looks like a normal liver shrunken and covered in corn smut. And there's no way anyone looks at that and thinks it's safe to eat, even if for some unfathomable reason they thought it looked tasty. I'm thinking he cut her open, was going to take liver and kidneys, but the liver grossed him out so he just took a kidney.

Dr Frederick Gordon Brown:

"There was a cut from the upper part of the slit on the under surface of the liver to the left side and another cut at right angles to this which was about an inch and a half deep and 2 1/2 inches long. Liver itself was healthy"

I think, as it was not easy to get at, that the killer wanted the kidney specifically.

Regards, Bridewell.

[Errata]

Sorry Errata, but it almost seems like you are saying this killer analyzed her liver while it was still in her body, and in the dark too.

I submit that it doesn't require analysis, merely placing a hand on the organ would have caused some serious doubts as to it's wholesomeness.

[Wickerman]

Not really, Jon.

Anyone fumbling around in the dark with their hands and a knife could easily find it by accident without knowing what it was,

Ben, the kidney is covered by every other organ in the abdomen, because it is attached to the spine (effectively), it is the lowest organ to reach for when the body is laying on its back.
It is not an organ that can be seen from the killers point of view. This does not mean he could not have blindly reached down to grab anything hard (firm), which he could have. But equally, given that it is out of sight, and the abdomen swimming in blood and soft organs, it is difficult to remove that which you cannot see.

Remember that only one of the four doctors who examined the body thought the kidney extraction indicated expertise or even knowledge, and an additional fifth doctor - Thomas Bond - studied the autopsy notes and came to the same conclusion as the three doctors who didn't detect any anatomical knowledge.

Ok, well your numbers do not add up, there were only three doctors who examined the body.

"The post-mortem examination of the body, which took place at the Mortuary, Golden-lane, and was conducted by Dr. Phillips, Dr. Gordon Brown, and Mr. G.W. Sequeira, occupied nearly four hours, but as to the results the doctors declined to speak."

(perhaps you confused "four hours" with "four doctors"?)

Doctor Bond only worked from the same notes that were compiled by these three doctors (more likely only those of Gordon Brown & Phillips). You cannot determine experience from notes, so Bond is only commenting on that which was written down by his colleagues.

Commenting on Stride & Eddowes (unsourced):
"Dr. Phillips has stated that the injuries inflicted upon these women have been apparently performed by a person possessing some anatomical knowledge."

That pretty much leaves us with the exchange between Gordon Brown and the Coroner:

[Coroner] Would the removal of the kidney, for example, require special knowledge? - It would require a good deal of knowledge as to its position, because it is apt to be overlooked, being covered by a membrane.

The fact Sequeira made this comment:
"I think that the murderer had no design on any particular organ of the body. He was not possessed of any great anatomical skill." does not in any way detract from the words of Gordon Brown, who made no allusion to "great" skill or "specific" design on any organ.

Once an organ has been removed, how can anyone claim to determine whether the killer intended to take that organ, or not? - the statement has no value.
Sequeira is apparently trying to calm any public suspicions that this killer had a market for the uterus - that is all his comment was intended to convey.

Since the kidney was never found, it cannot be stated that he did not "injure it in any way".

By not leaving any small slices of kidney within the membrane, it was removed complete?

The preponderance of evidence indisputably supports the contention that the killer did not have "abilities above the ordinary layperson".

Gordon Brown & Phillips together imply that there is a position below the surgeon, but above the layperson, who may hold sufficient experience.

We don't have to believe the killer was a doctor to accept what Gordon Brown & Phillips have deduced.
Phillips also thought there was less experience shown with the mutilations of Eddowes when compared to Chapman, but, Chapman was killed in the early morning dawn, Eddowes was killed in the darkest corner in the middle of the night. Of course there was still sufficient light to conduct the mutilations, but apparently not sufficient light to make every cut as clean as he previously did.

All the best...

Jon S.

[Ben]

Because the kidney is inside a fatty membrane, only someone with knowledge would be able to find it.

Not really, Jon.

Anyone fumbling around in the dark with their hands and a knife could easily find it by accident without knowing what it was, as Dr. Sequeira's evidence implies. Remember that only one of the four doctors who examined the body thought the kidney extraction indicated expertise or even knowledge, and an additional fifth doctor - Thomas Bond - studied the autopsy notes and came to the same conclusion as the three doctors who didn't detect any anatomical knowledge.

Since the kidney was never found, it cannot be stated that he did not "injure it in any way". His knife may have made a complete mess of it during its excision for all we know.

As for his preference for a kidney over a liver, Errata's suggestion is just as good as any. He might also have considered it too large to transport.

The preponderance of evidence indisputably supports the contention that the killer did not have "abilities above the ordinary layperson".

All the best,
Ben

[Wickerman]

If Eddowes was an alcoholic, my guess is that her liver was in pretty rough shape. I don't know if you've ever seen the liver of an alcoholic, but it looks like a normal liver shrunken and covered in corn smut. And there's no way anyone looks at that and thinks it's safe to eat, even if for some unfathomable reason they thought it looked tasty.

Sorry Errata, but it almost seems like you are saying this killer analyzed her liver while it was still in her body, and in the dark too.

[Errata]

Why did the killer not go for the liver rather than the kidney? As you say, the kidney was much the harder organ to access. It obviously had a significance to the killer. I wish we knew why.

Regards, Bridewell.

Well, my personal bet is that he took it to eat. My guess is that your average person of that day knew what livers and kidneys looked like (and generally where they were located in say, a sheep), since they were something of a food staple. And there isn't a lot of variance in shape between animals and humans. If Eddowes was an alcoholic, my guess is that her liver was in pretty rough shape. I don't know if you've ever seen the liver of an alcoholic, but it looks like a normal liver shrunken and covered in corn smut. And there's no way anyone looks at that and thinks it's safe to eat, even if for some unfathomable reason they thought it looked tasty. I'm thinking he cut her open, was going to take liver and kidneys, but the liver grossed him out so he just took a kidney. And that process was difficult enough that he didn't bother going after the other one. If so, whatever message he was intending to send got very very garbled.

[Wickerman]

Why did the killer not go for the liver rather than the kidney? As you say, the kidney was much the harder organ to access. It obviously had a significance to the killer. I wish we knew why.
.

Because the kidney is inside a fatty membrane, only someone with knowledge would be able to find it. And, the suggestion the kidney was removed with care(?), might suggests he had abilities above the ordinary layperson.

Corny as it might sound, I wondered if the killer was sending a message to the doctors who do the autopsy. Its nothing that the ordinary public, or maybe even the police might appreciate, but to remove a kidney from inside the membrane (assuming that is what was meant), and not injure it in any way might speak volumes to a doctor.

On the one hand he carves up Eddowes like the lunatic he is said to be, yet also removes a kidney in a professional manner as if to say, lunatic, I am not!

A pause for thought issue.

Regards, Jon S.