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The Victorian Medico-Legal Autopsy Part II: The Whitechapel Murders -Autopsies and Surgeons
By KARYO MAGELLAN

I have examined the standards of forensic medical examination that prevailed in Victorian England at the time of the Whitechapel murders, from 1888 to 1891, and found them to be rather more impressive than is generally believed.(1) The post-mortem examination of a corpse discovered under suspicious circumstances was thorough and followed a well-established protocol for what was both a medical and a legal process.(2) (3) Every police surgeon involved in the examination of the Whitechapel murder victims would have been aware of the protocol for medico-legal examination and would have followed it closely, even more so when it was suspected that a serial killer was at work.

By the end of the nineteenth century, forensic pathology was an acknowledged specialisation, as Forensic Medicine and Toxicology, a book published in 1893 by Professor J Dixon Mann, shows. Training, knowledge and experience in medico-legal science, however, would have varied considerably between different surgeons, and expertise was dependent on experience. Professor Mann wrote:

This work has been written chiefly as a text book for Students of Medicine; it is hoped that it may also prove useful to Practitioners and others who are interested in the subject of Forensic Medicine. Since Medical Practitioners in general acquire much of their expert medico-legal knowledge from the study of reported cases...(4)

Formal training in forensic medicine did exist at the time. Mann was an Examiner in Forensic Medicine at the University of London, and books on the subject written during several previous decades were a source of learning for many surgeons. For instance, the first edition of A Manual of Medical Jurisprudence by Alfred Swaine Taylor appeared in 1844, and by the time of its seventh edition, seventeen years later, it had sold 150,750 copies. Even at this early stage, the author regarded the book's sales as 'satisfactory proof of its practical utility to those members of the medical and legal professions for whose assistance it has been especially intended'.(5) (6) After Taylor's death in 1880, his work continued to be revised and published. Thomas Stevenson edited volumes of Taylor's work which were available from the 1880s until the turn of the century.(7) Several other medico-legal texts were also published in the 1880s, so that education in forensic medicine was easily available to those who sought it.

Regardless of whether surgeons availed themselves of such learning, they all had a responsibility to give evidence at inquests. Yet, even as late as the 1890s, many surgeons still held this formality in low regard and did not take medical contributions to inquests seriously. This was largely because of the circumstances under which inquests were held, in public house parlours where the 'fumes of bad tobacco and stale beer were not calculated to impress the public with the majesty of the law' and in the presence of the 'ignorant and uneducated class of persons who often constitute the jury'.(8) (9) This may have been a common perception among general surgeons, who became involved in an inquest only when they were the first medical men called to tend to the victim. Police surgeons, on the other hand, would have had a rather different approach, since they were aware that their evidence might become crucial should matters progress to the prosecution of a suspect, during which they would have to testify in a far more adversarial environment. So there can be little doubt that a Divisional Police Surgeon would have adhered closely to the medico-legal guidelines for the post-mortem examination of a murder victim. Such diligence, however, may not have extended to all medical men involved in the Whitechapel murders, especially early on, before there were indications that a serial killer may have been at work.

Not all medico-legal necropsies were undertaken by the Divisional Police Surgeon or his assistants. Medical men other than police surgeons were often involved on the grounds of expediency, bearing in mind that time was of the essence in providing medical assistance and that not all bodies discovered were necessarily dead ones. However obvious death may have appeared, it was not for the police constables to make that particular assumption.

Even when the Divisional Police Surgeon had responsibility for the post-mortem examination, he need not have conducted the dissection himself. An assistant frequently performed that duty when assigned to do so by, or in the absence of, his superior. He would probably have been also present when the Divisional Police Surgeon conducted an autopsy, usually to take notes. This was much in keeping with Mann's suggestion that more than one surgeon should be present. It is worth mentioning here the advice given by Mann regarding the conduct of necropsies:

It is convenient and advisable that two practitioners should conjointly make the post mortem examination. In case of doubtful or of obscure indications, the advice and countenance of a colleague is advantageous, and the division of labour one practitioner making the section, and the other recording the results adds to the completeness of the investigation and to the facility with which it is made. Every step should be accurately recorded at the time, or in event of the examination being made by one medical man only, immediately after its completion. If the notes are made by a colleague they should be read over on the spot by the operator, and then signed by both medical men. No other persons than those concerned in making the necropsy should be present. If a medical man is implicated, he must not be permitted to be present; he may depute another medical practitioner to represent him at the necropsy, but his representative must not take any active part in the proceedings. In all cases in which a legal inquiry is likely to take place, the medical practitioner in charge should refrain from making an examination until he receives an order from the coroner to do so. When an inquest is going to be held, the dead body is technically in the possession of coroner until he has issued his order for the burial, and, consequently, it may not be interfered with without his permission.(10)

Any other interested party could be present only with the agreement of the Divisional Police Surgeon. There seems to have been some confusion over the interpretation of the coroner's authority regarding who could be present at autopsies. Such confusion was illustrated by Wynne Baxter's attitude during the inquest into the death of Rose Mylett, when he commented upon the procession of medical men who viewed the corpse. The coroner always had responsibility for the body until it was discharged to the relatives, and it was he who requested the post-mortem examination and appointed a responsible surgeon to conduct it. Yet it is doubtful whether he actually had any power to limit the number of surgeons or assistants involved in the process.

The procedures for dealing with an unexplained death were likely to be the same for every police division. In the case of a death by violent means, police constables were instructed to remain by the body until properly relieved; to send a messenger for an Inspector and Divisional Surgeon; not to allow the body to be moved; not to interfere with the room or place or anything about the body; and to exclude the public and give no information to the public except by permission of a superior officer.(11)

It is reasonable to assume that a Divisional Police Surgeon took personal responsibility for the more demanding or politically sensitive cases and was less involved with routine autopsies. For the murders of Emma Smith, Martha Tabram and Mary Nichols, neither the Divisional Police Surgeon for the police district nor an assistant gave evidence at the inquest. But these were the first three murders in the Whitechapel series, following which a different approach was required as standardisation and accountability became more prominent factors. Only in the murder of Annie Chapman did the Divisional Police Surgeon for the Whitechapel police district become involved.

Before looking at the post-mortem examinations of the individual Whitechapel murder victims, there are some relevant points to be borne in mind. First, none of the original post-mortem notes from the examination of the corpse of any of the Whitechapel murder victims have been discovered, if indeed they have survived. These would be in the form of rough but detailed notes including the weight of major organs and other measurements. Such notes would form the basis for the subsequent post-mortem report written either immediately after the necropsy or later that same day by the surgeon responsible or by a competent assistant. One imagines that they would have been filed for future reference and it seems likely that the surgeon would have retained his own copy of his summary report, always bearing in mind the potential for criminal proceedings at a later date.

Secondly, little significance should be attached to the handwriting or to the signature in reports, since neither confirms that the person who wrote or signed the report actually performed the dissection or was responsible for the necropsy. Examination of the handwriting of authors of reports has given rise to misinterpretation as to who did what, but, as a general rule, whoever performed the dissection was unlikely to have made the original notes.(12) This would be impracticable. A medically qualified assistant to the Divisional Police Surgeon, or even to a Divisional Police Surgeon from another district, would usually have taken notes. In most cases, the surgeon responsible, who need not have been the surgeon performing the dissection, dictated the findings. Only in rare instances, when a surgeon performed an autopsy alone, would he have been forced to take notes as well. Whatever the circumstances, the notes recorded were the basis for the post-mortem report which might be edited or summarised for inquest testimony. Others present at the necropsy were entitled to make their own notes, but the notes recorded would have been taken down from the original dictation by the surgeon responsible and not from anyone else. More than one surgeon dictating on the findings would have caused chaos. This will be of significance when looking at the procedures for the autopsy of Mary Jane Kelly.

Observations and Comments on the Individual Necropsies

Based upon documentation by way of police reports and inquest testimony, either as official transcripts or detailed newspaper reports, and occasionally upon other sources, it is possible to gauge the quality and extent of the investigation generally, and of the necropsy specifically, for each of the Whitechapel murder victims. For the purposes of this exercise I am concerned more with the post-mortem examination of the corpse at the mortuary than with the findings recorded at the crime scene. Details of those present at the autopsies can also be gleaned from reliable sources and, additionally, from newspaper reports, but care must always be taken with any aspect of newspaper reporting that cannot be substantiated from other sources. Newspapers are notoriously unreliable, especially when reporting or commenting upon forensic and medical details. However, it must be conceded that much of the detail we have from the inquests comes from proceedings reported in the newspapers. Other officials were undoubtedly present at some of the autopsies in addition to the medical men, but such individuals are not considered here unless they had relevant input during the process.

Full and detailed summaries of the necropsy findings are only available for the autopsies on Alice McKenzie and the unidentified female torso discovered on 10 September 1889. Phillips wrote the summaries for McKenzie, and Phillips, Hebbert and Clark, those for the torso murder. Information on the remaining post-mortem examinations comes from police reports, official inquest statements and transcripts, and newspaper reports of inquests. As a last resort, and only in the case of the murder of Emma Smith, was it necessary to rely partially upon a newspaper editorial in the absence of a more reliable source. The level of detail of the post-mortem examination given at the inquest varied appreciably from a brief summary of the fatal injuries to a more extensive summary including other findings.

Emma Elizabeth Smith (murdered on 3 April 1888)

Evidence relating to the internal injuries suffered by Emma Smith was given to the inquest by George Haslip, the London Hospital House Surgeon who attended Smith during her brief stay in hospital.(13) Haslip was not a police surgeon and there is no direct evidence that he undertook the autopsy. It is quite likely, however, that he did, since he gave evidence to the inquest and no other surgeon appears to have been involved. Police and newspaper reports also imply that the House Surgeon performed the autopsy. From the scant police reports available it is not possible to determine the extent of the necropsy; the abdomen must have been opened to determine that peritonitis was the cause of death, but whether or not the thorax and cranium were also opened is not known. Newspaper reports mention or imply that an autopsy was undertaken and that Smith's internal organs were generally in a normal condition.(14)

Martha Tabram (murdered on 7 August 1888)

The autopsy of Martha Tabram's corpse was undertaken by Dr Timothy Killeen, who also gave evidence at her inquest. There is no documented evidence that Killeen was a police surgeon. The post-mortem examination included Tabram's thorax and abdomen, both of which had suffered extensive stab wounds. There is no indication that the brain was examined and it is impossible to gauge the full extent and detail of the autopsy from the inquest testimony. Examination and reporting of the multiple stab wounds seem comprehensive enough. Some reliance can thus be placed on the surgeon's assertion that two knives were used in the killing, suggesting that two perpetrators were responsible for it.

Mary Ann Nichols (murdered on 31 August 1888)

This is probably the most contentious of the post-mortem examinations on any of the Whitechapel murder victims. The autopsy of Mary Nichols was undertaken by Dr Rees Ralph Llewellyn. There is no evidence of a contribution from any other surgeon. Nichols was murdered within the Bethnal Green jurisdiction, which is why the Whitechapel Divisional Police Surgeon was not in attendance. The Bethnal Green Division was not formed until 1886 and information is elusive concerning the identity of the police surgeon for that division. Llewellyn is documented as being a Medical Officer, but this post is unrelated to that of Divisional Police Surgeon. Furthermore, at no time is he clearly identified as Divisional Police Surgeon. That he was called to the scene of Nichols's murder is evidence of nothing other than the efforts of the police to secure medical assistance for the victim as soon as possible. Considering the confusion prevalent throughout Llewellyn's medical evidence to the inquest, his experience in medico-legal necropsies and the interpretation of forensic evidence is questionable.

Llewellyn did not adequately assess the amount of blood at the scene, causing speculation that Nichols might have been attacked elsewhere. He also erroneously suggested that the abdominal wounds were inflicted before the throat wounds. These assertions were overruled by the coroner in his summing up. Llewellyn also thought that the murderer was left-handed when all the evidence suggests that he was right-handed. Indeed, Chief Inspector Swanson's report of 19 October 1888 revealed that the surgeon subsequently had doubts about this point.(15) Llewellyn undertook only a superficial examination of the body at the crime scene and had to be called to the mortuary an hour later to examine the abdominal wounds discovered by the police.

Llewellyn's testimony at the inquest is concerned entirely with the external appearance of Nichols's corpse, including the condition of the neck and abdominal wounds. There is no indication from what he said that he actually opened any of the body cavities. The wounds were further described by Spratling in his Special Report of 31 August 1888, but the omentum and outer surface of the stomach as described could all have been visualised through the existing wounds to the abdomen. Indeed, even the description of the external wounds was not without confusion.(16) (17) (18) It is possible that Spratling took notes on behalf of Llewellyn, which is why he was so well-informed as to the wounds. Llewellyn was recalled to the inquest on 17 September after a two-week adjournment. On this occasion, he confirmed, after a further examination of the corpse, that 'no part of the viscera was missing'. This statement arose in relation to the murder and extensive mutilation of Annie Chapman during the period of adjournment of the Nichols inquest.

But did Llewellyn know this or did he assume it to be the case from the limited extent of the wounds to her abdomen? Unfortunately for Llewellyn, Mary Nichols was buried on 6 September, two days before the murder of Annie Chapman, so he must have re-examined Nichols's corpse before 6 September, and for some reason other than to establish, in the light of Chapman's murder, whether any organs were missing. On the basis of our interpretation of the wounds inflicted, it seems unlikely that any organs had been removed from Nichols's body, but there is no way of knowing for sure if Llewellyn did undertake a comprehensive necropsy, and there is no evidence whatsoever to suggest that he did. Llewellyn was also convinced that Nichols received the fatal wound to her neck from a frontal attack.

Annie Chapman (murdered on 8 September 1888)

The medical investigation into the death of Annie Chapman appears to have been far more searching than that undertaken for Mary Nichols. Police Surgeon to the Whitechapel Division George Bagster Phillips examined the body and the surroundings at the crime scene and conducted a thorough necropsy at the mortuary, hindered though he was by inadequate staff and facilities. It is evident from inquest testimony that Phillips opened all body cavities during the post-mortem examination of Annie Chapman. Her abdomen was, of course, already open, and Phillips's comments on the lungs and meninges confirm that the thorax and cranium were also opened. In terms of general health, Chapman was 'far advanced in disease of the lungs and membranes of the brain, but they had nothing to do with the cause of death'. Furthermore, she was poorly nourished with 'signs of great deprivation'. The only controversial aspect of this autopsy was Phillips's reluctance to reveal which organs were missing from Chapman's body. The coroner eventually managed to persuade him to give details to the inquest and, although reporting was limited, an authoritative account was given in the Lancet.(19) It was a dispute not repeated at Wynne Baxter's inquests, and at the Kelly inquest the coroner didn't even ask the question. No other surgeon appears to have played a significant role in the necropsy of Annie Chapman.

There is an indication from Phillips's testimony as to how long he took over medico-legal necropsies. When recalled to the inquest, and in response to a question from the coroner as to how long he thought the killer might have taken to mutilate Chapman, Philips said:

I think I can guide you by saying that I myself could not have performed all the injuries I saw on that woman, and effect them, even without a struggle, under a quarter of an hour. If I had done it in a deliberate way, such as would fall to the duties of a surgeon, it would probably have taken me the best part of an hour. (20)

By 'duties of a surgeon' Philips did not mean the removal of almost the entire abdominal contents as a surgical procedure but their removal as part of the detailed necropsy procedure undertaken in his capacity as a police surgeon. Thus he would have taken the best part of an hour to attend to the abdominal organs and perhaps another couple of hours for the external and internal examination of cranial and thoracic cavities - pretty much in keeping with Virchow's maximum estimate of three hours for a comprehensive autopsy. (21)

Elizabeth Stride (murdered on 30 September 1888)

Phillips once again had responsibility for the autopsy and presentation of findings to the inquest on Elizabeth Stride. On this occasion, he was assisted by William Blackwell, who was the second medical man to arrive at the scene of her murder and certified her death. Philips and Blackwell undertook the necropsy of Stride at St George's mortuary in the presence of doctors Rygate and Johnson. According to Phillips, 'Dr Blackwell kindly consented to make the dissection.' Once again the autopsy was comprehensive, with evidence that all body cavities were opened. In terms of general health Stride was 'fairly nourished'. She had adhesions of both lungs to the chest wall, deformity in the bones of the right leg and healing sores.

Phillips visited the mortuary on at least two further occasions in order to assess the development of marks upon the body Bruising occurring about the time of death can further develop, and that is what Phillips wished to monitor. On one of these additional visits he was accompanied by doctors Brown and Blackwell.

Edward Johnson, who was Blackwell's assistant, also gave evidence to the inquest, but only in relation to his involvement as the first surgeon to tend to Stride. Likewise, Blackwell's inquest testimony did not extend beyond his observations at the scene of the murder, and the post-mortem findings were left to Phillips, even though Blackwell had actually performed much of the autopsy.

Catharine Eddowes (murdered on 30 September 1888)

Since Catharine Eddowes was murdered within the City boundary, responsibility for her post-mortem examination fell to the City Police Surgeon, Frederick Gordon Brown. Sedgwick Saunders the City Analyst, George Sequeira and Phillips were all present at the post-mortem examination and all, except Phillips, gave evidence at the inquest.

In his inquest testimony, Brown described the body and the crime scene and his post-mortem examination of Eddowes's corpse. Although his testimony was lengthy, it did not constitute a full post-mortem report but was only a detailed summary of relevant findings. Brown restricted his descriptions to external marks, the fatal neck wounds, and the mutilations, and he dealt with other organs in a single sentence stating that 'The other organs were healthy'. It is likely that Brown followed the conventional medico-legal autopsy protocol with a full external examination followed by details of the neck wounds, then the abdominal wounds and organs. There is no direct evidence from testimony that the thorax or cranial cavities were opened, although it is reasonable to assume that they were.

Sequeira was present at the post-mortem because he had been the first medical man at the scene and Saunders attended to take charge of the stomach contents for toxicological analysis. At the inquest, Saunders confirmed that the stomach was tied at both ends but its contents were undisturbed and the container was carefully sealed with Brown's private seal. Phillips was understandably present, having been responsible for the necropsy of victims Chapman and Stride.

Mary Jane Kelly (murdered on 9 November 1888)

The murder of Mary Jane Kelly fell within the jurisdiction of Divisional Police Surgeon Phillips. Both Bond and Brown attended her autopsy, possibly together with Drs Dukes, Hebbert and Clarke.

Phillips's brief inquest testimony and Bond's notes are the only records relating to the autopsy of Kelly. Phillips's testimony gives no insight into the extent of the post-mortem examination of the corpse. In that regard, Bond's notes are far more valuable. There is, however, a misunderstanding as to who did what with regard to Kelly's necropsy which will be discussed later.

According to Bond's notes, it appears that a full routine post-mortem procedure was followed, this being subdivided into external examination recorded at Miller's Court and at the mortuary and a necropsy at the mortuary. Bond's notes on the post-mortem examination progress logically from head through neck, thorax, abdomen, upper leg, lower leg, forearms, hands and fingers. Comments on the neck wounds provide some detail but there is very little on the remaining organs apart from the lungs and stomach contents. The cranium would have been opened, the brain examined and all organs minutely examined, so we are entitled to assume that, apart from some evidence of chronic but apparently not debilitating lung disease, there were no other significant pathological lesions in any of the remaining tissues.

In Bond's report to Anderson he mentioned that the heart was 'absent'. In detailing this, he meant that it was absent from the body and from the room. There's not much more he could have said, and pathology reporting has a history of terseness. This observation was later confirmed by Hebbert.(22) Further support for Bond's assertion comes from what was not included in his report; had the heart been examined there would certainly have been comment on it with respect to contraction of the ventricles or absence of blood. Every other major organ was accounted for in Bond's report with the exception of the heart. I think there should be no further ambiguity about this.

Rose Mylett (murdered on 20 December 1888)

The autopsy of Rose Mylett is noteworthy as much for its political aspects as for the controversy surrounding the cause of her death. Mylett's body was discovered in Poplar, which was within the Bow Metropolitan Police District. Divisional Police Surgeon Matthew Brownfield was sent for, but it was his assistant, Mr Harris, who attended and certified death. The autopsy on Rose Mylett was undertaken the following morning by Brownfield with the assistance of Harris. That afternoon Brownfield gave testimony to the inquest that it was a case of murder, a conclusion that came as a surprise to the police. Police Commissioner James Monro did not agree with what the surgeon said and instructed Assistant Police Commissioner Robert Anderson to ask Thomas Bond to look into the death. Since Bond was otherwise engaged, Monro asked Chief Police Surgeon Mackellar to look at the body. Meanwhile Bond's assistant, Charles Hebbert, opened the note from Anderson and took it upon himself to act on Bond's behalf. Hebbert arrived at the mortuary the day after Brownfield had conducted the first post-mortem examination and after Anderson had left. Hebbert made the second post-mortem examination of the body in the company of Brownfield and Harris. Just after Hebbert had left, Mackellar appeared. Two days later, Bond visited the mortuary to verify Hebbert's notes and the body was opened for a third time. All the doctors concluded that death had resulted from strangulation, but in a subsequent meeting with Bond and Hebbert, Anderson pressed his 'difficulties and objections' to such a conclusion so Bond went again to the mortuary, made a 'more careful examination of [Mylett's] neck' and 'entirely altered his view'. Such an astounding volte-face suggests that his opinion may have been influenced by pressure from Anderson. On that basis alone, Bond's contribution would be significantly discredited. Anderson 'undertook the distasteful task of going to the mortuary and examining the body' himself at some point prior to Bond seeing the corpse and reached the conclusion that 'the death had not been caused by homicidal violence',(23) thus showing that there was little need for police surgeons in the Metropolitan Police Force at that time. This was all the more astounding because Anderson was a Doctor of Law, not a surgeon.

The procession of 'doctor after doctor' through the mortuary to view Mylett's corpse was much to the consternation of coroner Wynne Baxter, whose concerns were certainly valid if additional dissections had been performed without his permission. Baxter rightly dismissed Bond's input because the Westminster Police Surgeon had not seen the body until five days after death, by which time it had already been dissected twice. Anderson regarded as it as 'unfortunate' that Hebbert had acted of his own volition by opening Anderson's note to Bond and conducting a second post-mortem examination.(24)

Neither post-mortem report nor inquest testimony exist other than that reported in the newspapers. In his testimony, Brownfield makes reference to abdominal organs, lungs, heart and brain, meaning that all cavities were opened in the course of a thorough post-mortem examination. It seems that Mylett was in reasonable health before she was murdered. Brownfield smelled the stomach contents and suggested that she had not taken significant amount of alcohol prior to her death nor, he concluded from the appearance of the remaining organs, was she a heavy drinker.

Alice McKenzie (murdered on 17 July 1889)

Since Alice McKenzie was murdered in Whitechapel, responsibility for the post-mortem examination and inquest testimony fell again to the Divisional Police Surgeon, Phillips. His inquest testimony was relatively brief, although it was based upon a very detailed autopsy. Together with several colleagues, Phillips undertook the autopsy in a shed used as a mortuary in the Pavilion Yard. The use of such facilities inevitably drew a protest from the surgeon.

Surgeon in Chief Alexander MacKellar and Frederick Brown attended the post-mortem examination, as did Phillips's assistant Percy Clark (together with a Mr Boswick who was apparently there for a short time without Phillips's permission). Thomas Bond was not among the 'several colleagues,' although he later inspected the body and generated a lengthy assessment of the findings and his own opinion on them in another report to Robert Anderson. Bond examined the corpse in the company of Phillips and they differed in one or two respects. Most significantly, Bond thought that McKenzie was a victim of the Whitechapel serial killer whereas Phillips did not.

Phillips's post-mortem report as it appears in the public records is of particular interest among the medical records of the Whitechapel murders since it represents a full and original post-mortem report as one might expect after a comprehensive necropsy. That said, the report is signed and dated 22 July 1889, some five days after the necropsy, which was conducted on the afternoon of McKenzie's death on 17 July.(25) Phillips's report, in his own hand, must have been compiled from other notes which formed the basis of his evidence to the inquest later on the day of McKenzie's death. There is nothing wrong with this in principle, although from a legal point of view it means that there is scope for the report to be changed from the original notes of observations when re-writing, assuming that those notes were not also filed with the rewritten report. Nonetheless, Phillips's report reveals his proper systematic approach to the necropsy broadly following Virchow's protocol: starting with his observations at the crime scene; then an external examination with the body clothed at the mortuary; examination of stripped body for external lesions; detailed assessment and internal dissection of the wounds; followed by dissection and assessment of the brain, thoracic, and abdominal organs, in that order. Apart from some old lung adhesions and localised syphilitic lesions, McKenzie was in good general health prior to her death.

Phillips examined McKenzie's body on two further occasions, once with Thomas Bond and again with Frederick Brown.

Unidentified Female Torso (discovered 10 September 1889)

Phillips had overall responsibility for the autopsy and inquest testimony concerning the torso of a woman which was discovered in the Whitechapel police district. Because he had to return from Bournemouth, the post-mortem examination was delayed. The coroner had requested that Phillips conduct the examination on 10 September, but Phillips elected to undertake it the following morning at 10.00am instead. Once again, Anderson called upon Thomas Bond to submit to him a report independently of that supplied by Phillips. Bond, however, did not attend the autopsy and Hebbert appeared in his stead. Present at the autopsy were Phillips and his assistant Percy Clark, Charles Hebbert and Frederick Brown. On this occasion there are three post-mortem summaries, all of them consequential to just one post-mortem examination and dissection.

Hebbert prepared a report on the autopsy of the torso to be sent to Anderson. It should not be inferred from this that Hebbert conducted any form of independent post-mortem examination, because he did not do so. Either Phillips or Clarke conducted the autopsy and the other took notes. Indeed, Hebbert says quite clearly in his report that he was 'present' at the post-mortem examination, not that he conducted the dissection, but he was quite at liberty to place his own interpretation on what he saw.(26) Although it has been suggested that Hebbert had significant involvement in this necropsy, he actually had no specific responsibility and attended as either observer or note-taker.

Clark examined the torso at the scene of discovery and re-examined it at St George's mortuary. His post-mortem report was essentially the same as that produced by Phillips. Details of the post-mortem findings as reported by Hebbert are rather more comprehensive than those reported at the inquest by the Divisional Police Surgeon.

Taking into consideration all sources of information, there is little doubt that Phillips followed the standard medico-legal protocol with a thorough necropsy of the remains, although it obviously did not include the cranial cavity. There was a detailed external examination followed by an internal examination of the thoracic and the abdominal organs. Besides the presence of some lung adhesions, the victim had, according to Phillips, a fatty and diseased liver. Hebbert, on the other hand, thought the liver was 'fairly healthy'.

Frances Coles (murdered on 13 February 1891)

The necropsy of Frances Coles's corpse was undertaken by Phillips as Divisional Police Surgeon, but Dr Frederick Oxley, who was the first medical man on the scene, gave brief evidence to the inquest, which was followed by the post-mortem evidence from Phillips. Phillips's testimony was limited to the wounds to Coles's neck and there were no details of lesions in any other organs. It is reasonable to assume that Phillips undertook his usual thorough post-mortem examination of the corpse.

The inquest and investigation into Coles's murder were skewed by the determination of the police to have Thomas Sadler stand trial for her murder - an objective in which they failed miserably, for the most part because he was probably not her killer.

Thomas Bond's Report on Mary Jane Kelly

The discovery of Kelly's corpse marked the high point of public and media interest in the murders, fuelled in no small way by the manner in which she had been killed and mutilated. It is my personal belief that Kelly was not a victim of Jack the Ripper because of several significant factors that are inconsistent with murders in the series. Surprisingly, although Kelly's murder came under close examination by police and surgeons, later evaluation is hampered by the paucity of information given at the inquest into her death. While this is irritating for researchers, coroner Dr Roderick MacDonald followed generally the correct procedure by not prolonging proceedings beyond establishing the cause of death. It could indeed be perceived, in contrast to the inquests conducted by Wynne Baxter, that MacDonald deliberately conducted a truncated enquiry. That there was a political dimension to the inquest on Kelly is in little doubt, and the fact that her body was removed to Shoreditch Mortuary - outside the jurisdiction of Wynne Baxter - gives a strong indication of this. It is also possible that MacDonald may have been influenced by instructions from a higher level that on this occasion only the information necessary for the central purpose of the inquest should be available in the public domain. As a consequence, evidence from medical experts related only to establishing the cause of death.

Phillips, giving evidence as Divisional Police Surgeon, was unusually succinct and very little can be gleaned from his testimony. In fact, he only reported on what he found at the crime scene examination of the body and made no mention of the post-mortem findings. Much more information became available when Dr Bond's handwritten report to Anderson revealing details of the post-mortem examination of the crime scene and Kelly's corpse turned up in 1987. However, Bond's report is not altogether what it appears to be and does not constitute a post-mortem report in the conventional sense.

Depending upon the source, and presumably also upon the ability of the newspaper reporters to recognise and name the various surgeons, the doctors attending the crime scene and post-mortem examination of Kelly included some or all of the following: George Phillips (Whitechapel Divisional Police Surgeon), Thomas Bond (Westminster Divisional Police Surgeon), Frederick Brown (City Police Surgeon), William Dukes (surgeon), John Gabe (gynaecologist and paediatrician), and Charles Hebbert (assistant to the Westminster Divisional Police Surgeon) were all mentioned.(27) Although Percy Clark was not mentioned by name, the presence of an assistant to Phillips, who in all probability was Clark, was reported. But there may have been some confusion between Dukes and Clark. Speculation as to whether Hebbert attended either crime scene or necropsy remains in spite of the assertions that he did so.(28)

There is misunderstanding over Bond's involvement with the examination of Kelly's corpse which stems directly from the fact that the only notes available are those presented to Anderson by Bond. There is thus an automatic assumption that Bond conducted the necropsy on Mary Jane Kelly, but he did not do so. The coroner would have instructed Phillips to conduct the necropsy on Kelly and the Whitechapel Police Surgeon would have been responsible for the post-mortem report and for giving evidence at the inquest. No other surgeon had any unique input and none would be required to contribute to the proceedings.

The Shoreditch Mortuary was certainly a busy place at 7.30am on Saturday 10 November 1888, occupied as it was by several surgeons and the corpse of Mary Jane Kelly. Brown would reasonably have been invited by Phillips in view of his autopsy of Eddowes and the need for comparison, and Dukes and Clark (if both were present) were in attendance as assistants to Phillips. Bond was only involved at the request of Anderson and would have had no authority to view Kelly's autopsy or the scene of her murder without the agreement of Phillips. The presence of Hebbert makes little sense other than to take notes for Bond. Phillips and Brown were sufficient in expertise and number to provide an agreed version of necropsy findings, but it is also likely that Phillips preferred to have the security of other opinions in case Bond reported anything likely to be controversial. Indeed, such was precisely the case with the murder of Rose Mylett several weeks later.

There is no way of knowing exactly who undertook the dissection and reassembly of Kelly's remains, who recorded the observations and who was merely a bystander, but we can reasonably speculate that the practical aspect was a combined effort by Phillips, Brown and Bond, with the Whitechapel Divisional Police Surgeon in overall charge and either Dukes or Clark taking notes on Phillips's behalf. If Hebbert were present he would have made notes on behalf of Bond. It is inconceivable that Bond would have dictated observations to Hebbert at the same time as Phillips did the same to Dukes or Clark; to do so would have been pointless and unnecessarily confusing. One man gave commentary and Bond or Hebbert made their own notes.

Interestingly, if the notes supplied to Anderson by Bond were the only documentation of the post-mortem examination of Kelly's corpse, they would be a pretty sparse record and Phillips undoubtedly had his own record of findings of crime scene and necropsy which would have been far more extensive than those made by anyone else in attendance.

Although S G Ryan nicely demonstrated that Bond's notes to Anderson were in fact written by Hebbert, and this indeed appears to be the case, this is no great surprise and is not proof that Hebbert attended either the crime scene or the autopsy.(29) Indeed, had Hebbert not been present at the mortuary, it is quite conceivable that Bond gave his notes made separately at the crime scene and the autopsy to Hebbert in order that he rewrite them in a presentable and coherent manner for presentation to the Assistant Chief Commissioner. In any event, Bond's report, written by Hebbert, is unlikely to be an original version recorded at the crime scene and autopsy because it is far too uniform in presentation. Ryan also suggests that there may be pages missing from Bond's report but it was no more than a summary of the salient points that he or Hebbert noted down and as such his report covers pretty well every aspect of the crime scene and autopsy and there is nothing left to include. There was also no need to sign or date the document since it had no particular authority. Although Bond's post-mortem notes to Anderson are not dated, the likelihood is that they were written on 10 November, the day of the autopsy, and accompanied Bond's profile of the killer, which he wrote on the same day and sent to Anderson.

Matters Arising from the Murder at Miller's Court

It is useful to reproduce the text of Hebbert's contribution on the murder of Mary Jane Kelly to A System of Legal Medicine. In addition to providing post-mortem reports for each of four 'torso murders', Hebbert referred to the murder of Kelly in a chapter dealing with the determination of the sex of mutilated or decomposed bodies when it is not immediately obvious. The text is as follows:

In the particular illustrative instance, the woman was murdered in a bedroom. The body was naked when found. The eyebrows, eyelids, ears, nose lips, and chin had been cut off, and the face gashed by numerous knife-cuts. The breasts had been cut off and the whole abdominal parietes, together with the external organs of generation, had been removed. The skin and much of the muscular tissue, not, however, exposing the bone, had been slashed away from the anterior aspect of the thighs as far as the knees. The abdominal viscera and pelvic viscera, including bladder, vagina, and uterus with appendages, had been torn from their cavities, and in fact there was no sign of [the] sex [of the victim] except the long hair upon the head, and, as is well known, that alone is not a positive sign as in some nations hair is worn long by men. The fact that the whole bladder had been removed did away with the help that might have been afforded by the presence of the prostate gland. In this case, to be sure, all organs except the heart were found scattered about the room, and showed the sex without doubt.(30)

Hebbert could have recalled everything that he reported with regard to Mary Jane Kelly from having recorded or transcribed the original notes. Given the absence of any detail, there is no evidence that he had in his possession any formal documentation relating to Kelly's murder or autopsy. This contribution from Hebbert remains of dubious significance and certainly isn't proof that he attended either the crime scene or Kelly's autopsy. However, Hebbert's contribution on the torso murders is rather more detailed and the in extension post-mortem findings appear remarkably like verbatim transcripts of the original post-mortem reports, although these could of course have been provided with all the necessary permissions. Hebbert's findings for the torso murder of 11 September 1889, discussed above and reproduced in A System of Legal Medicine, are identical to his report held in the National Archives.(31) (32)

It is interesting to note that Hebbert mentions in the record of Kelly's autopsy that the thigh bone was not exposed. This does not contradict what is stated in the report to Anderson that 'the right thigh was denuded in front to the bone' and is consistent with my assertion that the longitudinal white strip visible on the ventral surface of Kelly's right thigh in the photograph of her corpse is, contrary to popular belief, a flap of skin and not femur.(33)

Bond asserted that the serial killer of the canonical victims had no scientific or anatomical skill whatsoever, by which he contradicted the opinions of other medical men on previous cases.(34) Bond's conclusion was perhaps a little overconfident, given that the only body that he personally saw was that of Kelly. He only read the notes concerning the previous victims, so it is difficult to see how he could have reached such a conclusion. I suspect that he assumed all five were killed by the same man who killed Kelly, ergo the standard of mutilation must have been the same as that for Kelly, which clearly displayed no skill whatsoever! We have to be very careful about Bond's interpretations.

Another discrepancy is the matter of the chemise. Kelly was 'naked' according to Bond and Hebbert, but wearing a linen under-garment or chemise according to Phillips. I am more inclined to follow Phillips's description at the inquest, which should be more reliable.(35) Thus, the killer must have cut or torn the chemise - commonly a smock type of under garment - in order to expose the abdomen and thorax for mutilation. This is one of several factors that is inconsistent with other murders attributable to the serial killer, because on no occasion did Jack the Ripper tear or cut the clothing of any victim. The differences between the murder of Mary Jane Kelly and murders in the series are not merely a consequence of the amount of time available to the killer. They are qualitative and not quantitative differences.

The Death of a Victim

Descriptions of death by wounds to the throat are documented in contemporaneous text books. Syncope was the mode of death reported for each of the cutthroat victims. Although this is a word little used today, except perhaps as a synonym for fainting, it was frequently referred to in the 1880s and for several decades afterwards. An 1894 dictionary definition of syncope is given as:

A sudden suspension of the heart's action, accompanied by cessation of the functions of the organs of respiration, internal and external sensation, and voluntary motion.(36)

Stevenson elaborates and describes the symptoms of haemorrhage leading to death:

In order that the action of the heart should be maintained, it is necessary, first that the blood supplied to it should be of sufficient quantity, and secondly, that this blood should be of proper quality. In death from haemorrhage we have an instance of deficiency..

. One of the most striking of the phenomena which attend this mode of dying (death from haemorrhage or anaemia), is an extreme pallor of the face, hands, and lips, and, indeed, of the body generally. The patient is very restless, tossing the limbs about in all directions. Giddiness and nausea are often complained of, and actual vomiting may occur. In many cases vision is extinguished, everything appearing black. There is transient delirium, which soon passes into insensibility. The pulse becomes more and more weak and irregular, until at length it is imperceptible. The respiratory movements are repeated at uncertain intervals, and have a sighing or gasping character. Towards the last there are general convulsions. In these cases the heart is found empty and contracted at the autopsy.(37)

A victim with a wound to the neck which severed a carotid artery would die from haemorrhage. The speed of that death would depend upon whether vessels on one or on both sides of the neck were severed and upon whether the vessels were cut through completely or partially. Death from haemorrhage, even by this means, would not be instantaneous, and victims would experience at least some of the above symptoms in the moments before they lost consciousness. It is of course the absence of an adequate flow of blood to the brain that causes unconsciousness and death. This flow is instantly interrupted by severance of the common or internal carotid arteries that supply the brain with oxygenated arterial blood. In much the same way that the brain ceases to function within seconds of cardio-respiratory arrest, it would cease to function with the collapse of cerebral blood pressure following the opening of a major artery. Unconsciousness would occur in a few seconds where the carotid arteries on both sides were completely severed, but sentience would be prolonged if blood loss were less rapid.

Death from haemorrhage is covered at some length in contemporaneous medico-legal texts, where the general consensus is that the rate of blood loss is more significant in determining the speed of death of the victim than the actual quantity of blood lost:

A sudden loss of blood has a much more serious effect than the same quantity lost slowly. A person may fall into a fatal syncope from a quantity of blood lost in a few seconds, which he would have been able to bear without sinking had it escaped slowly. This is the reason why the wound to an artery proves so much more rapidly fatal than that to a vein. Death speedily follows the wound of a large artery like the carotid; but it takes place with equal certainty, although more slowly, from wounds of smaller arteries

. It is difficult to say what quantity of blood should be lost, in order that the wound may prove fatal. The whole quantity contained in the body of an adult is calculated at about one-thirteenth of its weight - i.e. about twelve pounds. According to Watson, the loss of from five to eight pounds is sufficient to prove fatal to adults. But while this may be near the truth, many persons will die from a much smaller quantity; the rapidity with which the effusion takes place having a considerable influence.(38)

Phillips determined that Alice McKenzie had lost only 1½ to 1¾ pounds of blood, equivalent to no more than 2 pints, in the course of bleeding to death from a severed left common carotid artery. This firmly supports the suggestion that death can ensue from the loss of relatively little blood if such loss occurs rapidly.(39)

Wounds to the throat are also covered quite comprehensively in medico-legal texts of the latter decades of the nineteenth century and the distinction between suicidal and homicidal wounds was of obvious importance. By examining prevailing knowledge we can gain further insight into the nature of such wounds - perhaps more so than by examining present day forensic medical texts. In particular, contemporaneous texts illustrate the criteria that police surgeons employed when arriving at conclusions as to the direction of cut and nature of the knife used. Stevenson covers these topics:

In examining a wound on a dead body, it is proper to observe its situation, extent, length, breadth, depth, and direction: whether there is about it effused blood, either liquid or coagulated; whether there is ecchymosis, i.e. a livid discolouration of the skin from the effused blood; whether the surrounding parts are swollen, whether adhesive matter or pus is effused, and whether the edges of the wound are gangrenous, or any foreign substances are present in it. In the dissection every muscle, vessel, nerve, or organ involved in the injury, should be traced and described.(40)

In incised wounds, the sharpness of the instrument may be inferred from the cleanness and regularity with which the edges are cut.(41)

Wounds of the throat, when inflicted by suicides are commonly at the upper part, involving the hyoid bone and the thyroid or cricoid cartilages; the large vessels often escape, but the larynx is opened. The wound does not always cause death by haemorrhage. It has been somewhat hastily laid down as a general rule, that an extensive wound of the throat, involving all the vessels and soft parts of the neck to the spine, could not be inflicted by a suicide. Although in general suicidal wounds of this part of the body do not reach far back, or involve the vessels of more than one side, yet we find occasionally that all the soft parts are thus completely divided. These are cases in which, perhaps with a firm hand, there is a most determined purpose of self-destruction.

Unless the person attacked be asleep or intoxicated, resistance may be offered - evidence of which may be obtained by the presence of great irregularity in the wound, or the marks of other wounds on the hands or on the person of the deceased. In some instances, however, it is extremely difficult to say whether the wound is homicidal or suicidal - the medical facts being equally explicable on either hypothesis.

Homicidal incisions, especially in the throat, are often prolonged below and behind the skin forming the angles of a wound, deeply into the soft parts. Those which are suicidal rarely possess this character; they terminate gradually in a sharp angle, and the skin itself is the furthest point wounded, the weapon is not carried either behind, below, or beneath it.

The end of an incised wound in the throat is often digitated, owing to the skin being dragged forward in folds by the cutting instrument; and when recent the minute saw-like serrations of the skin point towards the commencement of the wound.(42)

Llewellyn, who suggested that Nichols had been attacked and wounded from the front, would have been interested to read the following paragraphs from Stevenson and from Mann:

A murderer, by surprising his victim from behind; by having others at hand to assist him; or by directing his attack against one who is asleep, intoxicated, or from age or infirmity incapable of offering resistance, may easily produce a regular and clean incision in the throat.

The direction of a wound has been considered to afford presumptive evidence sufficiently strong to guide a medical jurist in this enquiry. It has been remarked that in most suicidal wounds which affect the throat, the direction of the cut is commonly from left to right, either transversely or more often passing obliquely from above downwards. In left-handed persons, the direction would, of course, be in the opposite direction. It is obvious that if a murderer makes an incised wound in the front of the throat from behind, the direction may be the same as that commonly observed in cases of suicide.(43)

Homicidal incised wounds of the throat, when inflicted by a right-handed man facing his victim, are from right to left, and are usually more horizontal than suicide throat wounds. If the assailant stands behind the victim the wound may closely resemble one of suicidal origin, the position and movement of the hand and arm being very like that of a person who inflicts a wound on his own throat. In such a case the incision will be from left to right, and will probably sever the whole of the soft structures down to the vertebrae, one of which may be nicked.(44)

It is virtually impossible for a right-handed assailant standing in front of a victim, or even over a victim lying on her back on the ground, to make an instantaneous single continuous cut six to eight inches long round the throat from left to right with the greatest depth on the left side and reaching down to the vertebrae. Such a cut is more easily inflicted from behind by a right-handed assailant.

There can be no doubt that the Whitechapel murder victims who received fatal wounds to the throat would have been unconscious within seconds as arterial blood pressure collapsed. Merciful though this may seem, considering what mutilation followed in some instances, the women would have been sentient for those frightening few seconds and some for longer than others. There is, moreover, no certainty that the victims were unconscious by the time further mutilation commenced, such was the speed with which Jack the Ripper worked.

Given the considerable amount of medical evidence that we are fortunate enough to have available, I am puzzled that there is continued popular support for the suggestion that Jack the Ripper, as part of his killing routine, partially throttled his victims before wounding them and that the initial neck wound was inflicted with the victim on the ground. I hope to visit these aspects of Ripper folklore at a later date.

Notes

1. Magellan K, (2006) The Victorian Medico-Legal Autopsy Part I - Dissection in Pursuit of the Cause of Death, Ripperologist 71, 23-43
2. Virchow R, (1887) Post-Mortem Examination. Translated by TP Smith, Blakiston & Son, Philadelphia.
3. Mann JD, (1893) Forensic Medicine and Toxicology. Charles Griffin, London, 17-21
4. Mann, Preface
5. Taylor AS, (1844) A Manual of Medical Jurisprudence, Churchill, London
6. Taylor AS, (1861) Medical Jurisprudence, Churchill, London
7. Thomas Stevenson conducted the post-mortem examination of Maud Marsh, one of George Chapman's victims, and gave evidence at Chapman's murder trial.
8. Municipal Journal and London, January, 1899
9. Stevenson T, (1894) Taylor's Principles and Practice of Medical Jurisprudence. Volume I Fourth Edition, Churchill, London, 10
10. Mann, 20
11. Childs H, (1903) Police Duty; Catechism and Reports
12. Regardless as to whether or not surgeon pathologists at this time wore rubber gloves, and probably they did not, their hands would have been covered in tissue and body fluids to such an extent that they would hardly have been in a position to write as they dissected. Indeed there is a good example in the case of the Stride autopsy when Blackwell 'kindly consented to make the dissection' presumably while Phillips, the surgeon responsible for the autopsy, took notes. It is inconceivable that a pathologist would turn away from the dissection every few minutes, his hands covered in blood and tissue, to make notes with pen and ink, and not leave tell-tale marks all over the paper, or changes in handwriting and structure.
13. There is confusion as to the name of the House Surgeon; Haslip was the name recorded in official reports by Inspector Reid and Inspector West (St. BG/Wh123/19); Hellier was reported in Lloyds Weekly News, 8 April 1888; and Hillier in Morning Advertiser 9 April 1888.
14. Lloyds Weekly News, 8 April 1888; Morning Advertiser, 9 April 1888.
15. HO 144/221/A49301C, ff 129-34
16. MEPO 3/140, ff 239-41
17. Magellan K, (2005) By Ear and Eyes, Longshot Publishing, Derby, 34
18. Wescott T, (2006) Old Wounds: Re-examining the Buck's Row Murder, Ripper Notes 26, 53-66
19. The Lancet, 29 September 1888, 637
20. Daily Telegraph, 20 September 1888
21. Virchow, vi
22. Hamilton AM and L Godkin (1894) A System of Legal Medicine, EB Treat New York Volume I, 61.
23. MEPO 3/143, ff. E-J
24. Ibid
25. MEPO 3/140, ff. 263-71
26. MEPO 3/140, ff. 141-7
27. The Times, 12 November 1888; 'As early as half past 7 on Saturday morning, Dr. Phillips, assisted by Dr. Bond (Westminster), Dr. Gordon Brown (City), Dr. Duke [sic] (Spitalfields) and his (Dr. Phillips's) assistant, made an exhaustive post-mortem examination of the body at the mortuary adjoining Whitechapel Church.' According to The Echo, 10 November 1888, cited by S G Ryan: 'the post-mortem examination-in-chief was only commenced this morning at the early hour of half-past seven, when Dr. Phillips, Dr. Bond, Dr. Hibbert [sic], and other experts attended.'
28. Ryan SG, (2006) Another Look at Mary Kelly's Heart - Part 2: Further Revelations, New Criminologist, 23 April
29. Ibid
30. Hamilton, p 61. This contribution is assumed to originate from Hebbert although it is not directly attributed to him. However, since Francis Harris, the author of the chapter in which it appears, acknowledges Hebbert's contribution and refers to the Whitechapel murders, it is unlikely to have been derived from any other source.
31. Ibid, 85-87
32. MEPO 3/140, ff. 141-7 and MEPO 3/140, ff. 146-7
33. Magellan, (2005), 146
34. HO 144/221/A49301C, ff. 220-3
35. It is possible that what is visible across Kelly's left shoulder in the image of the crime scene are the remains of a garment, but there is an alternative interpretation by Christopher Scott that the cloth visible may be sheeting. This does not contradict Phillips's observation. Scott C (2005) Will the Real Mary Kelly. Publish and be damned, 72.
36. Price JAP, (1899) Hoblyn's Dictionary of Medical Terms. Thirteenth Edition, Whittaker: London, 730
37. Stevenson, 165
38. Ibid, 609-10
39. MEPO 3/140, ff. 263-71
40. Stevenson, 509
41. Ibid, 522
42. Ibid, 536-9
43. Ibid, 537-8
44. Mann, 291