Did he have anatomical knowledge?

[Prosector]

OK

Just to take a general point first. The killings (except the last) were done in semi-darkness, on the ground, in just a few minutes. To do complex things like extracting a kidney or a uterus in that time and under those circumstances takes exceptional skill and anatomical knowledge. Even George Bagster Phillips said that he doubted that he could have extracted Annie Chapman’s uterus in less than quarter of an hour and that a surgeon might have taken ‘the best part of an hour.’ The point that he could do it faster than most surgeons no doubt reflected the fact that he had nearly 30 years’ experience of carrying out autopsies.

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.

That's probably enough for one post - see what I mean about needing a few hours?

Prosector

[DVV]

Thanks for sharing your views, Prosector, but Phillips was wrong : Eddowes has been butchered and mutilated in less than 10 minutes.

Cheers

[C. F. Leon]

OK

Just to take a general point first. The killings (except the last) were done in semi-darkness, on the ground, in just a few minutes. To do complex things like extracting a kidney or a uterus in that time and under those circumstances takes exceptional skill and anatomical knowledge. Even George Bagster Phillips said that he doubted that he could have extracted Annie Chapman’s uterus in less than quarter of an hour and that a surgeon might have taken ‘the best part of an hour.’ The point that he could do it faster than most surgeons no doubt reflected the fact that he had nearly 30 years’ experience of carrying out autopsies.

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.

That's probably enough for one post - see what I mean about needing a few hours?

Prosector

You are assuming that the 'surgeon' is planning in advance to excise a particular organ. That is his goal from the start, so he is careful and methodical to achieve it. That means TAKING HIS TIME. By ALL accounts, that is NOT how Jack worked.

I'll lay odds that your example (and whatever experience YOU have had, however much it may be) involved a team of surgeons/nurses working in a overlit room, with whatever MODERN equiptment you needed/wanted. (And probably billing by the hour.) Jack didn't have any of that- even if you accept the Royal Conspiracy.

[Prosector]

That is precisely my point (and Phillips’s). To do it in 10 minutes took an enormous amount of anatomical knowledge and skill. And you’re wrong about the women being butchered. 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.

Prosector

[Simon Wood]

Hi Prosector,

Thank you for your informative and eminently sensible post. Nocturnal kerbside surgery sure ain't easy.

However, I regret to tell you that your apparent knowledge in these matters will not shine a light in the dark corridors of Ripperology, for you may have noticed that all arguments regarding the Whitechapel murders inevitably return to the mystery's default settings, which over the years have almost become an article of faith: namely that a person known as Jack the Ripper [variously and authoritatively identified as a suicidal schoolteacher, an insane Polish Jew, a quack doctor and a hanged poisoner] actually possessed the dazzling kerbside surgical skills which contradict your post.

Faith is resistant to logic and reason. Which is why the mystery persists. For some bizarre reason, people insist on believing in Jack.

Regards,

Simon

[Ben]

Hi Prosecutor,

I'm always rather surprised to see darkness and speed of the butchery being cited as indicators of anatomical skill. I've never heard of any non-murderous surgical operations where speed is considered an indication of ability, or even encouraged for that matter. Similarly, I don't know of many surgical procedures - then or now - that are conducted in darkness and rely on touch only. You argue that whoever was responsible for these mutilations must have had 30 years worth of "experience", but how much of this experience consisted of speedy eviscerations conducted in darkness and using touch only?

Regarding your point about the intestines. I'm putting myself in the role of a completely unskilled mutilator with little or anatomical knowledge, and I'm confronted with an abdominal cavity and a load of intestines. If I tugged at these and realised, in so doing, that they still adhered to the body, surely all I need to do is cut this adherent (or these adherents)? I didn't need any prior knowledge of its location, and I didn't need to know it was called a "mesentery". I just need to go; "Oh look, it's still attached at that bit - chop!".

Note Brown's observation that the intestines had been detached "to a large extent" from the mesentary. In other words - and significantly - not completely.

There is no evidence that he "deliberately" removed a section of Eddowes descending colon. This is far more commonly attributed to clumsiness on the part of the killer. It is doubtful in the extreme that he "deliberately" allowed his hands to become soiled with faeces purely to gain access to the kidneys. It is my understanding that the kidneys are more easily accessed from the back anyway. Of course, if the killer had no design on any specific organ - as argued by Dr. Sequeira - and was simply rummaging around for anything of interest, it's not as if it was unlikely that he'd alight on a kidney. We're talking about the small frame of a woman, and it's not as if there were viscera options aplenty.

Finally, it's worth remembering that the "surgical skill" theory was a minority-endorsed medical opinion at the time. Three out of the four doctors who examined Eddowes' body detected little or no skill from her mutilations, and Dr. Bond, who examined the notes, agreed.

All the best,
Ben

[Hunter]

Hi Prosector,

Thanks for statring this thread and for the initial input. I would like to see some more input from you before I offer any criticism for I'm sure you have more that might be rather enlightening.

Were you aware of the experiment conducted by Dr. Brown regarding the organ removals?

And I would like your input on how the victim's bladder was left unharmed when the uterus was extracted. Brown's professional was apparently able to do this in 3 1/2 minutes but damaged the bladder.

Thanks again.

[DVV]

To do it in 10 minutes took an enormous amount of anatomical knowledge and skill.

The Mozart of surgery, therefore.

And you’re wrong about the women being butchered.

Am I ? -They were butchered. Like pigs in the market, according to Dr Watkins. And contrary to your theory, the more he had time and light, the more messy the crime scene was. See the pics of MJK.

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).

Nothing new. The Ripper didn't have to know where exactly was the left kidney. He knew there were organs here or there. He cut, he felt, he took away.

No, JTR was no butcher.

Agreed.

[Simon Wood]

Hi Prosector,

I rest my case.

People insist on believing in Jack.

Faith is resistant to knowledge, logic and reason.

Regards,

Simon

[Prosector]

Hi Ben

Your reply begs too many questions to attempt to answer them all in one go. However, to take one or two: I didn't say or imply that Jack had 30 years of experience, just that Phillips had, through autopsies, which was why he was more adept at this sort of thing than most surgeons. 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.

As far as how he mobilised the intestines, I dare say that to some extent he did do it piecemeal but there are more than 20 feet of small intestine - that's a lot of cutting if you are doing it your way. It also requires dividing all of the many major blood vessels and, although the blood would be starting to clot it would still be liquid for twenty minutes or so after death. There are no accounts of very large amounts of blood being present in the abdominal cavities (except in MJK but that's another story).

Of all the doctors involved, the one I respect least is Dr Sequeira. He had only been qualified for two years with the lowest practicing qualification possible (LSA - although he later got the MRCS), he was not a police surgeon (and therefore had little or no autopsy experience and, as far as I know, he only turned up to confirm death and was not present at the autopsy so how would he have known how much skill had been displayed?) Phillips was by far the most experienced doctor involved in the Ripper cases (and I include Bond in that) and Brown was the next. They both thought that JTR had both anatomical knowledge and some degree of surgical skill.

I've got a lot more reasons for saying that (ever wondered why he deviated around Kate Eddowes's navel to the right rather than going straight through it?) but I'll save those for another time.

Prosector

[Abby Normal]

OK

Just to take a general point first. The killings (except the last) were done in semi-darkness, on the ground, in just a few minutes. To do complex things like extracting a kidney or a uterus in that time and under those circumstances takes exceptional skill and anatomical knowledge. Even George Bagster Phillips said that he doubted that he could have extracted Annie Chapman’s uterus in less than quarter of an hour and that a surgeon might have taken ‘the best part of an hour.’ The point that he could do it faster than most surgeons no doubt reflected the fact that he had nearly 30 years’ experience of carrying out autopsies.

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.

That's probably enough for one post - see what I mean about needing a few hours?

Prosector

Hi prosector
Thanks for this. It's good to see a post on this subject from an expert. So, your argument is that he was an expert surgeon.

So Where do we go from here then?
What does it mean in terms of known suspects. It would rule everyone out except I Beleive perhaps chapman?
Is it Puckridge, tumblety, royal conspiracy?
What's your idea then who it was specifically?

What does this have to do with the witnesses and the suspects they described?
Most describe suspects dressed not or perhaps not as old as someone with 30 years surgical experience.
Would not someone with this background be dressed in a wealthy appearance?
Has this expert surgeon taken a turn for the worse mentally or financially?
Is he dressing down, in disguise?
Is he actually after all the classic image of a ripper with top hat and Gladstone bag?


how does it fit in with peripheral evidence like the dear boss letters
"they say I'm a doctor now haha"?

Or the story of the American doctor looking for uteri for sale from London's medical establishments?

if you Beleive the ripper was an expert surgeon please follow up and give us your ideas on how it fits in with everything else.

[Abby Normal]

Hi Prosector,

I rest my case.

People insist on believing in Jack.

Faith is resistant to knowledge, logic and reason.

Regards,

Simon

Ok Simon
So there is a problem. What's your solution?

[Hunter]

Not for this thread. Let's keep it focused.

Prosecutor, Sequeira was at the post- mortem.

[Simon Wood]

Hi Abby,

What's my solution?

A healthy and much-needed dose of disbelief in Jack.

Regards,

Simon

[Errata]

A lot of different terms are flying around, and I think some distinction is in order.

Was Jack a butcher (in style if not by occupation)? Absolutely. Butchers are as neat and precise as surgeons. A butcher's shop does not look like a meat grinder exploded. Animals are rendered into their component parts with very little waste. Not dissimilar to Jack.

Did he have anatomical knowledge? Was he familiar with the structure of the human body? He was. I could do what he did. I'm not a doctor, not a surgeon, I have a wicked tremor, but I certainly know enough to do what he did. Not because I've studied it or seen it, but my dad's an OB/GYN. I myself have a uterus, and I figured it was only fair to know where it is. I've also seen all the little charts and models in the doctor's office. I took basic anatomy in High School. I could do this easy. And I'm only perhaps slightly more educated than any random group of people. If Jack had no knowledge at all, he would have taken bladders. The bladder is in generally the right place, and looks like a balloon, so why wouldn't it hold a baby?

Does he have anatomical experience? Has he rooted around in innards before as a profession or hobby? Probably not. Not many people have that kind of access to bodies without actually being a medical professional. I also don't think he would have removed the uterus in blocks if he had experience. He would have known where the connections were and could have taken it out without other bits.

Did he have surgical (or butcher) experience? Did he cut open bodies for a living, did he manipulate organs or render them on a regular basis? No he didn't. He did not open the abdomen in the most efficient way. Not by a long shot. He cut up the liver trying to get the kidney out, And I actually think he severed the colon while removing the uterus, which is kind of a rookie mistake. A surgeon could not do what Jack did because surgeons are trained to preserve surrounding tissue. It's in their muscle memory. A surgeon would have simply performed a hysterectomy on a corpse. A surgeon could easily remove the uterus without taking chunks of the bladder. As it happens, a uterus is a fairly unique organ. It is dense, it is curved backward, it's connected to a bunch of different things, it's like nothing else in the body. Once you get your hands on it, stripping the connections and removing should be easy for a surgeon.

When pressed, when stressed, we do what we've always done. A surgeon freaking out and trying to rush doesn't turn into a yeti with a blade. His cuts may be less precise, but he doesn't suddenly try to get in a body in some new and exciting way with maybe 10 minutes in which to work. He makes surgeons cuts. Sloppy surgeons cuts, but a surgeon would never open someone in such a way as to make it look like the corpse has hacked open by a woodsman after a grandmother. A butcher makes butchers cuts. Butchers do make that long abdominal cut, but they are very used to dealing with the organs inside in a neat and precise manner. Frankly, a butcher would simply remove the intestines, not loosen them enough to toss them out of the way. It's not faster to throw the guts over the shoulder. To be blunt, once you get a good cut in they tear out pretty easily. The only people who made that kind of cut, and it's still not exactly the same, are sport hunters. Hunters open a carcass and just evacuate everything in the cavity. They general can only identify two or three organs because generally the don't use the organs. But the knife style used on say, a deer carcass is actually pretty similar to what was done to these women. Butcher don't rip down like that. Surgeons certainly don't. But hunters do, and I think the anatomical knowledge of a trophy hunter is what we are looking at. Not an actual trophy hunter, but someone with that knowledge.

But Jack wasn't a surgeon, and he wasn't a butcher. If he was practiced in getting into a body, it's because he had done it enough times previously that he had a method that worked for him. Where he got that practice is up for debate, but the skill upgrade between Nichols and Chapman was meteoric. There have to be other bodies. There have to be.