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Archive through January 10, 2000
Casebook Message Boards: General Discussion: Medical / Forensic Discussions:
JTR's Hysterectomies:
Archive through January 10, 2000
Author: Thomas Ind
Saturday, 08 January 2000 - 05:34 pm |        | Some questions and comments concerning the JTR’s Hysterectomies
I have some questions concerning JTR’s hysterectomies. If you’ll forgive me for a long verbose e-mail, a little explanation about my interest may prompt contribution to the discussion.
I am the Senior Registrar in Gynaecological Oncology Surgery at the Royal Hospitals Trust in London (Barts & the Royal London Hospitals). I have had a varying interest in JTR for many years. As a medical student I was interested in the text concerning Freemasonry and the Royals. This even led me to spend a day in the Barts Hospital archives looking through the admissions books and case logs of 1888. Not surprisingly, my less than thorough search revealed nothing.
My interest was rekindled during the Maybrick publications. However, my then quite extensive library was thrown away when I went to work in Australia. I returned from Australia in February of 1999 and moved back to Barts in September of the same year.
For the first time, I now regularly travel between both Barts and the Royal London Hospitals. My different routes take me past almost every JTR site of interest. I am often on duty at the London Hospital at night. To escape the boredom of the hospital canteen I regularly cross the road to MacDonalds next to the tube station. The Whitechapel tube (adjacent to an inquest site) is opposite the hospital. While facing the tube there is a small alleyway to the right. The alleyway (Woods buildings) is an unrenovated Victorian pathway that brings to life the squalor of the late 1880s. I find the alleyway cold and even today have a slight tingle of fear when I walk down it. It leads over the train track into Durward Street (Bucks Row). I’m sure readers will understand when I say that my interest has been rekindled. However, I’m familiar with the story and basic facts but am sparse on detail. I have only three books now (one new and two I have purchased for a second time). They are the The Mammoth Book...., The JTR A-Z & The Complete...... .
Two weeks ago I was performing a hysterectomy with a colorectal surgeon for a woman with extensive cancer involving the womb and the bowel. During the operation two things crossed my mind. Firstly, as my colorectal colleague felt it necessary to expose the left kidney and secondly as the screw on the operating light had to be tightened as I had difficulty directing it to expose the pelvic cavity.
Comment 1
Many authors state that anatomical knowledge was required to perform the mutilations. Most use the excision of the kidney as evidence. Other excisions could have been undertaken with little anatomical knowledge. Eddowes had her left kidney removed in spite of little to no light.
Once an abdomen is open the small intestines easily lift out of a wound. Due to the attachments of the mesentery the bowel has a tendency to lie to the right of the patient. It is therefore unsurprising the intestine was placed over the right shoulder not the left. That would be the natural position for it to lie after a frenzied attack not a careful and determined positioning.
Once the small intestine is out and stretched on it’s pedicle of the mesentery the peritoneum of the left paracolic gutter is exposed. In a thin woman a simple excision into the peritoneum of the left paracolic gutter will expose the left kidney. (In a fat woman it is normally partially obscured by perinephric fat). Just removing the bowel from it’s mesentery (as in the case of Eddowes) may reveal the left kidney. So JTR found the left kidney fortuitously. This may explain why (according to what I gather from the Mammoth Book) no other case involved a nephrectomy.
Please correct me if my facts about the murders are incorrect.
Removing a right kidney would be a different matter altogether. The caecum and ascending colon are partially attached to the peritoneum. These would have had to be mobilised to locate the right kidney and such an excision would have probably required considerable anatomical knowledge and skill.
Comment 2
My real interest as a gynaecologist who performs many hysterectomies is in the uterine excisions. The uterus is not difficult to locate but on the one occasion when I had difficulty with the light during an operation something occurred to me. Even in a well lit operating theatre, the contents of the pelvis are almost totally dark unless a strong light is directing down towards it. JTR must have performed his hysterectomies guided by touch & feel rather than sight. I now have three questions;
Question 1
Were the uteri removed carefully or by a random ‘slash’?
Question 2
Were the uteri removed by a knife placed into the pelvis and sawing them out or did JTR grab the uterus with one hand lifting it out of the pelvis to assist excision with his knife?
Question 3
JTR’s victims were prostitutes. Many of my patients who are sexually promiscuous have pathology consistent with previous venereal disease. What pathology was present?
Possible answers to question 1
Although JTR managed to precisely remove a kidney he completely failed to perform an adequate hysterectomy. In Chapman’s case he excised part of the bladder and in Eddowes case he only performed a subtotal hysterectomy (leaving the cervix behind).
According to the Mammoth book Kelly had her uterus placed under her head. There is no comment as to what was attached to the uterus and whether it included the cervix. Does anyone know the answer to this?
In my opinion there was nothing careful nor informative concerning the uterine excisions.
Comment 3
Most hysterectomies involve removing the corpus (main body) and the cervix (neck). Although I must add that there is a small current trend for women to request that their cervix is left behind in the unfounded theory that it contributes to orgasms. Some involve removing the ovaries as well and others do not.
The danger in performing a hysterectomy include damaging the vessels of the pelvic side wall and the ureters (tube connecting the kidneys to the bladder). In most non-cancerous cases this is avoided by keeping the excision close to the uterus as well as identifying the above structures. Do we know from the post mortems if there was any damage to the ureters during the uterine excisions or damage to the other structures on the pelvic side wall? These structures are the external iliac vein and artery, the internal iliac vein and artery, the obturator nerve and vessels, the psoas muscle and the genitofemoral nerve.
To remove the cervix you need to mobilise the bladder caudally. If you do not it is almost inevitable that you will also remove part of the bladder. This is what JTR did during Chapman’s hysterectomy.
Possible answers to question 2
I asked this question to myself before I read the details. If the JTR performed an aimless sweep of his knife I think he would almost certainly end up performing a subtotal hysterectomy (leaving the cervix). If he tried to lift the uterus out of the pelvis what was excised would depend on the mobility of the uterus. A woman who has had no children would have a uterus with little mobility and difficult to lift out of the pelvis. That would result probably in a subtotal hysterectomy. In a woman who has born children the uterus would be more mobile and a total hysterectomy would be more likely. The later would involve excision of part of the bladder if the bladder was not displaced as a surgeon would. The only confounding factor is if there was any disease of the pelvis such as adhesions from severe pelvic infection or endometriosis. In the presence of severe disease the uterus is likely not to be mobile.
Chapman had three children. This would probably result in a mobile uterus with a hysterectomy involving removal of the cervix if JTR grabbed the uterus with one hand and excised it with his knife in the other. I understand that this was the case with Chapman but please correct me if I am wrong.
Eddowes I understand had only one child. Is this correct? This is a difficult case as it is difficult to know how mobile the uterus is likely to be. It could be very mobile or not mobile at all. I understand that she had a subtotal hysterectomy. Is that correct? If so, little can be concluded from this case.
Did Kelly have any children? I think not. This case will support or dispute but not prove or disprove my theory. If so and according to my hypothesis, she would have had a subtotal hysterectomy with the cervix detached from the corpus. Does anyone know the answer to this question?
The Mammoth Book states that Chapman had the uterus and appendages removed. What do they mean by appendages? Today that would mean that the ovaries were removed as well. This I find more difficult to comprehend. If the ovaries were normal and not diseased then a frenzied attack would be more likely to result in them being left behind. This would not be the case if there was disease in the pelvis such as pelvic inflammatory disease, endometriosis or even fibroids. Assuming that she had no such disease then certain questions need to be answered.
If the ovaries were removed in the same single excision of the uterus then they would have to have been mobilised medially to prevent damage to the structures to the pelvic side walls. Again, were the structures of the pelvic side wall damaged? If not we have to ask if the ovaries were removed with a different movement of the knife or if the ovaries were adherent to the uterus from disease. I doubt the former as if that was the case then why didn’t he remove the ovaries in the case of Eddowes? Does anyone know how many incisions were made to remove the uterus in Kelly’s case? I understand that this was the only case where the specimen was left behind. It would be easier to answer this question with a specimen rather than pelvis consisting of other mutilations.
Probable answers to question 3.
The uteri were available for analysis in Kelly’s & Nichols’ cases. Are there any comments about pre-existing disease of the Fallopian tubes, ovaries or adhesions? Does anyone have the actual PM report with comments on the normality or abnormality of the uteri? If so, we may help unravel this submystery and help us understand the MO used for the hysterectomy.
Two final comments.
When I perform a hysterectomy I often have to change the blade of my knife during the operation (surgeon’s use knives not scalpels). Especially in Kelly’s case a very sharp knife would be required. As blood and debris deposited on the knife if would become less sharp and more difficult to use. Did JTR use more than one knife? A butcher lurking on this site may be able answer this question. For example, how often would a butcher have to sharpen his knife while preparing a carcass?
Thinking of Eddowes. If I was surgically removing a left kidney and uterus is would take me a few hours. However, If I was to open an abdomen, lift the small bowel off the mesentry and place it over the right shoulder with no regard for haemostasis; excise the left kidney and remove the uterus I could do it very quickly and could achieve this in minutes. It would be easier for me as a right handed person to stand on the woman’s right. With my right hand I could make the abdominal incision with one manouvre. Lifting out the small bowel would be slippery and to lift it off the mesentery would be made much easier by incising it rather than riping it off. In a thin woman the kidney would then be easily located and excised as long as the adrenal gland was attached. I would grasp the uterus with my left hand and be able to excise the uterus with one sweep of the knife from left to right. JTR could have performed these excisions in minutes without any surgical knowledge.
Thank you in advance for answering my questions.
Thomas Ind |
Author: Diana
Saturday, 08 January 2000 - 06:08 pm | | | Oh Dr., where have you been all our lives? All I know is that one of them had the uterus removed with "one sweep of the knife". In your opinion how much expertise was involved? Are we dealing with a butcher? a hunter? a medical student? a Dr.? a surgeon? somebody with no background at all? Is the right kidney hidden behind the liver? There were slashes and stabs on Eddowes liver and I wondered if he was trying to get at the other kidney? In looking at the mutilations as a progression from Nichols to Kelly, do you see a growth in "expertise"? Was he learning as he went along? |
Author: D. Radka
Saturday, 08 January 2000 - 10:14 pm | | Dr. Ind,
In the case of Eddowes, do you feel it was necessary for him to re-enter the abdomen to remove the right kidney separately from the great wound he cut right through the middle, or could he have obtained that kidney by reaching his hands toward the kidney from the inside of that main wound?
Eddowes had multiple children, three I believe, but this matter will certainly be commented on by others.
A previous poster, a Dr. Villon, often flatly stated here that it would be impossible for someone without human anatomical training and experience to remove the uteri ventrally under the dark conditions of the murders. The uterus is simply embedded too deeply in the pelvis to permit this--it would just be totally unthinkable for anyone other than a skilled, experienced person to accomplish it. I once suggested to him as a counterpoint that perhaps the murderer proceeded by locating the position of the uterus by feel, by pushing the middle finger of his right hand as far up the vagina as possible, and then feeling around inside the pelvis with his left hand right opposite the pressure point made by his right. By this he would locate the uterus, which lies right behind the vagina; he would, in effect, be pointing out the uterus with the finger of his right hand. He would then lift up the uterus roughly with his left hand, and slice it off with his sharp knife. We would much appreciate your comment on this possibility.
Great to have you on the boards, sir.
David |
Author: Jon
Sunday, 09 January 2000 - 12:54 am | | Thomas Ind
Extremely interesting poste Sir, this is the kind of professional input we all appreciate.
If you have a copy of The Mammoth book of Jack.....coupled with the JtR, A-Z then you have read the autopsy reports, and although I have scanned over them lightly I see no obvious omitions when comparing them to the copies of the original reports that have survived, nor those that only exist in newspapers.
It would appear that you have as much as there is to go on, as we have.
I hope you will re-read the autopsy details and see if you can draw any further conclusions, the accuracy of the info presented in the Mammoth and the A-Z is reasonably good and I think your assessment from those reports is most valuable.
It was a pleasure to read such a detailed & thoughtfull poste.
You do realize, your experience will require you to answer lots and lots of questions.. :-)
Welcome to the Casebook, Thomas
Regards, Jon |
Author: Diana
Sunday, 09 January 2000 - 08:04 am | | Those autopsy reports are found on page 69 of the Mammoth Book. We have those. We have some of the inquest testimony, I believe, and of course contemporaneous press reports but the latter are corrupted by 1)distortion due to sensationalism 2) suppression of certain specifics due to delicacy 3)distortion due to reporters ineptitude and carelessness. An exception to this would be the contemporaneous Lancet report of the inquest testimony on (I believe) Chapman. As far as the Royal theory goes, court records and many eyewitnesses indicate that Prince Albert Victor was in Scotland at the time of at least some of the killings. With regard to Maybrick, the ink in the diary has been analyzed and been shown to be of later manufacture than 1888 and I believe the man who produced the diary has confessed to forging it. I must bow to your superior anatomical knowledge. I for one am afraid that I will be asking you more questions than giving you answers. But then maybe you will tell one of us something that will jog our memories and make us realize that something we thought was trivial is really very important. I have been studying pictures and it appears that the stomach and liver would have to be displaced to get at the kidneys? Or would one be able to reach up and under? You stated that the colon (I assume you mean the transverse colon) would be in the way, so maybe the pictures I saw led me to believe the kidneys were a little higher than they are. Could you please explain the terms: pedicle, peritoneum, gutter, caecum paracolic (Wait! para=alongside and colic is related to colon and babies have colic [colon problems?]the gutter alongside the colon, right?). You state that "in a thin woman a simple excision into the peritoneum of the left paracolic gutter will expose the left kidney. Just removing the bowel from its mesentery . . . may reveal the left kidney." You, as a highly trained and skilled professional know that. As a layperson I do not. Assuming for the moment that JTR knew next to nothing, he is reasoning something like this: I got her open now! I'm gonna pull out her guts. Aha! Whatta we got here. There's something purple hiding behind this membrane back here. I'm gonna get that too. This was done in dim light. Is this scenario possible? Or are we dealing with someone with a degree of knowledge.
A look at Eddowes mortuary photo seems to indicate that she was not overly endowed with fat.
(I believe the photos may be found on this site. Tabram and Chapman look heavier, and of course he didn't get to eviscerate Stride. Nichols looks slightly chunky to me but not so much as Tabram and Chapman. You said that the uterus is not difficult to locate. We had a Dr. on these boards last summer who said it would be very difficult to find. However your specialty is Gynecology. I'm sure its not hard for you to locate. How about a person who knew nothing? A hunter who dressed out his kill? A slaughterhouse worker? A butcher? A mortuary attendant? A first year medical student? A veterinerian? How much help would it be to cut up animals in whatever context? The other Dr. said not much help. My veterinerian told me that you learn the basic mammalian structure and then you go on to master the variations for the various species. My sister, who is also a veterinerian told me that cat and dog uteri have little projections on them which make them a little easier to find than a human uterus, but her opinion was that finding the uterus was no simple task. I'm not arguing with you. You're obviously the expert. I'm just trying to fit all these things I've been told together. You need a strong light to operate. You stated that the contents of the pelvis are almost totally dark unless a strong light is directing down towards it. Would JTR's removal of the uterus in very dim light, using feel instead of sight argue for expertise and how much? Would it be absurd to suggest that JTR had been struck off the register due to blindness? As far as whether Kelly's cervix was taken or not I know of nothing written that would say. It is perhaps possible that if you look at the crime scene photo your trained eye may pick up something where the rest of us see nothing but a carved up mess of tissue. How much expertise is indicated by the removal of the appendages to Chapman's uterus? Finally, there has been much debate about why the killings suddenly stopped, and a long discussion on this site of the dubious safety of mucking around inside dead bodies with a knife in hand. In your opinion, if JTR accidentally cut himself or had an open sore on his hand, is it possible that he picked up some kind of fatal infection while mutilating his victims? Thank you for your kind attention and I'm sure everyone is excited about your arrival on these boards as I am. If I seemed to be questioning some of your expert opinions it was only that I was trying to integrate what you said with what other experts have said. |
Author: Bob Hinton
Sunday, 09 January 2000 - 12:44 pm | | Dear Thomas Ind,
Welcome to the boards. Your experience and knowledge of anatomy make you a rare find, I do hope you will remain with us for a very long time.
I think the first thing to do is to build up your library again, Loretta Lay Books, Greyhouse Books and the bring and buy pages should help you here.
As I understand it you say that it would be possible to remove Eddowes left kidney without any particular knowledge and with very little light, using what I term 'slash and grab'.
Have I read you correctly?
I cannot overemphasise how valuable your contributions are going to be, as long as you can put up with having your brain picked on a regular basis. |
Author: Villon
Sunday, 09 January 2000 - 03:27 pm | | Dr. Ind,
I am the other doctor who has been mentioned a few times to you here. Hello. Hi everyone, I am just back from a stint with Medecine Sans Frontieres.
I'm not a surgeon, though I did a year of obstetrics/gynaecology in Zimbabwe where the strangest thing I had to do was assist at an emergency hysterectomy, involving multiple fibroids and bifurcation, with a twelve week pregnancy as a further complication.
I have every junior doctor's natural dread of questioning the judgement of a senior reg, and in fact I have absolutely no quarrel with any of your analysis, except to suggest that the general poor health of the women concerned, plus their known promiscuity would make it very likely that infection and concomitant adhesions were present in the pelvic organs, thus making Jack's job even more problematic and challenging. You know better than I do the twisted mess that can be made of a woman's reproductive system by chronic inflammations. Teasing them apart could be like trying to unravel a knotted ball of wool.
But with respect sir, I think Diana is right. Your experience is in a way acting against you. You are forgetting the great gulf there is between your knowledge and that of the average layman.
I am sure you could do the procedure in minutes, because you know exactly where to go and what to look for.
A brickie can build a wall in half a day, but that doesn't mean you or I could do the same.
What about a man who had never opened an abdomen in his life? Who has five minutes to do this procedure - in the dark?
What chance would he have of removing the small bowel in a clean sweep?
How would he know that the adrenal gland sits on top of the kidney, and that this would lead him to it?
How would he even know what an adrenal gland looks like?
Why not just take a chunk of liver which is sitting there right under his hands?
You see my point?
Try and recall your first dissection; the despair of realising that those neat diagrams look nothing like the real mess of an opened abdomen. Remember fumbling to find an ovary,or anything you could easily identify, mind blank about every last thing you'd been taught.
Okay, well, sir, imagine doing that first dissection in the dark, with a timer set for five minutes or less.
I think our Jack had to have been at least a second year student, with a bit of anatomy knowledge and hands-on experience behind him.
Mike Villon |
Author: Thomas Ind
Sunday, 09 January 2000 - 06:19 pm | | I'm going to have to answer all of these questions at the same time. Mike Villon's comments are interesting and I would welcome his opinion with respect to my theory. However strong a light you have present, unless it is directed down into the pelvis the uterus is difficult to see. I am sure that the uterus was removed through touch and feel. With respect to what anatomical knowledge is required, my feeling is that unless you are someone like me who accesses the pelvis every day, then the knowledge of other doctors, butchers etc on the most efficient way to remove a uterus would be so small and offer no additional advantage over a lay person in the dark. I think that JTR put his left hand into the pelvis, felt something round and hard and removed it with his right hand. Anyone who placed their hand deep into the pelvis could feel this lump (the uterus) and by feel remove it. However, they would damage the bladder and rectum which JTR did. The only thing against this argument is the photo of Kelly. There is little room to her right for someone to stand and work and the small intestine appeares to be placed on the table to her left. If JTR approached Kelly from the left, then it would be easier to grap the uterus with the right hand and excise with the left (perhaps he was left handed). Otherwise grabbing it with the left hand would involve an aukward excision with the right if standing on her left side.
PLEASE EXCUSE SPELLING, I AM JUST CHURNING THIS E-MAIL OUT WITHOUT CORRECTION.
I can see no mention of the uterus in the Kelly case other than where it was found. Is there any other mention of it? I know standards have changed today but the autopsy reports do appear very inadequate. Mike's comments about disease are very important. For a surgeon, removing a diseased uterus is more difficult. However, I think docotrs must forget about the difficulties they pose in surgery when damage to other organs has to be prevented. JTR just slashed them out. I don't even think you need to know where the uterus is. You could just feel it in the pelvis.
When I perform a hysterectomy, I would make my incision, place the patient head down to help displace the bowel upwards, place a retractor and then packs in the abdomen to help keep the bowel away from my operating site. I would then adjust the light and only then would I get a good view of the pelvis. So I would have;
1: The bowel out of the way.
2: The head down.
3: The light angled.
Only then would I get a good view. This clearly didn't happen in JTRs case. However, like most surgeons I am impatient to find out what I am going to be dealing with during the operation. Am I going to have a nice easy uterus to remove or one similar to that Mike described? I normally put my hand into the pelvis once I have entered the abdomen and have a feel first.
When I want to perform a radicle hysterectomy for cancer. I would place the legs into something called the LLoyd-Davis position (quite similar to the position Kelly's legs are in) and place something in the vagina to push it upwards to assit my access.
The kidney story is interesting. My levels of expertise here are not as great as those concerning the uterus and I am tempted to speak to my urology colleague (although I am not quite out of the closet when it comes to being a JTRologist!). If I need to access the kidney during an operation I would have another surgeon present with those expertise to help me. During an operation, a midline incision would be improved by retractors. In Kelly's case access was improved by a upside down Y I think. Even if you were an expert surgeon, you would struggle to get the kidney out without someone assisting you and without good light and retraction if you were looking for it and wanting to dissect it out. However, once the bowel is out the way you could feel the left kidey easily. So if standing on the patient's right, then cutting the bowel out, you would feel the left kidney easily. You might not know it was a kidney you were feeling but you would feel it. Was the adrenal gland attached to it?
In summary, I think JTR could have done all the mutilations with no expert knowledge at all. I think he was a lay person anatomically. That he opened his victims abdomen; had a feel around; and removed what he could feel.
TO SPLIT THINGS UP I WILL POST THIS NOW AND CARRY ON WITH ANOTHER POST IMMEDIATELY |
Author: Thomas Ind
Sunday, 09 January 2000 - 06:43 pm | | To continue. Diana's question concerning the right kidney and the liver is an interesting one. I didn't think of these injuries being associated with an attempt to remove the right kidney. Describing anatomy is difficult. Mainly because there are three dimentions not the two that are present in a diagram. The pelvis for example angles downwards when a patient is flat and knowing what is meant behind and above is difficult. If this discussion persists for a long time I will teach you how we describe it today.
It is true that if you look immediately downwards onto an abdomen, the right lobe of the liver is above the apex of the right kidney. However the liver is actually behind the ribs. If you make an incision in the abdomen and feel up towards the liver, your hand is passing behind the ribs anterioly. If you pass below the liver it angles out of the way. The liver would not really get in your way of accessing the right kidney. The liver is a difficult organ to access through the abdomen. My interpretation is that knife was stuck upwards and in a general slash damaged. However, the Kelly mutiliations are interesting for a different reason. Clearly he had more time with this murder being inside and I will expand on this later.
The ascending colon (not transverse colon) is in the way of the right kidney). The transverse colon stomach and spleen are all attached to each other which is interesting as it is not clear to me what was removed attached to each other and what was removed seperately. The heart must be difficult to reach abdominally and no-one with any anatomical knowledge would knowingly attempt to access it through the inferior pericardium. If I was JTR and wanted a heart I would smash the rib cage and get it out of the chest. I have only seen a heart surgically as a medical student I must add.
The simple answer would be to perform an experiment (that would cost more money than I could afford). We could approach a slaughter house and ask for a number of dead pigs. We could dim the lights and set about these dead pigs with knives and see what I, Mike and lay people on the site got in terms of organs. I doubt that I would be very good. Before we jump on this idea though we need to find out how similar the anatomy would be. I know that a pigs uterus is what we would call bicornuate and we would have to find out about the gut and spleen. However, if the anatomy was reasonably similar, if we got lay people on the site to open the abdomen and remove anything they could feel and Mike and I did the same I doubt that Mike and I would be any better than the lay people on this site.
Just an idea. I imagine that most wouldn't want to participate. I'm not sure that I would but could probably be persuaded if there was a lot of enthusiasm.
Finally, does anyone know how I can order the Rippermania Journal or what ever it is called now. |
Author: Thomas Ind
Sunday, 09 January 2000 - 07:11 pm | | I have jut been reading the posts again and have two more comments.
Firstly I totally agree with you Mike about everything you say but come to a different conclusion. I think it would be so difficult (even for me) to make a conscious effort to dissect away the organs that these must surely be a situation of opening an abdomen, and blindly removing what can be felt. The question I must ask you as a physician is this. Do you really believe that your training makes you more capable of performing these excisions that a lay person who is having a feel around? I think that your answer would be no. If that is the case, then Druit, Gull and Paget would be no better. As someone who does regularly opens up an abdomen, I would not be able to make a dissection such as these. The only way I could do it would be by feeling around and removing anything I touched. In Eddowes case that would involve a slash in the abdomen, lifting out the bowel and cutting it off. Oopse, suddenly I would feel the left kidney (difficult to see because of perinephric fat but easy to feel). I would cut it out. The uterus could be felt and cut out also. So if this theory is correct we could probably assertain the handedness of JTR. I know that Chapman and Eddowes were found near walls. If their right side was against the wall then this would mean that a left handed approach would be easier. This is especially so with Chapman as such a thorough excision was made. It might be that the subtotal hysterectomy of Eddowes was related to an approach from the wrong side. So (not knowing the answer to this question and knowing that most do) then I would say this;
1) If Chapman and Eddowes both had their right side against a wall then JTR was left handed.
2) If Chapman had her left side against the wall and Eddowes her right, JTR was right handed.
3) If both had their left side against the wall the JTR was right handed.
3) If Chapman had her right side against the wall and Eddowes her left, JTR was left handed.
That assumes that the uterus was held with one hand and cut with another. This is why it is so important to know if the uterus was diseased with pelvic imflammatory disease or not. Do you think an ommision of any mention of it means that it wasn't? I'm sure that you will all tell me now that their head or feet were against the wall resulting in no conclisions being made.
The answers to the above questions helps us. If we conclude from this that JTR is left handed we can conclude that the MO was an attack from the front. If we conclude he was right handed then the bending against the wall theory is more accurate.
Thomas Ind |
Author: Thomas Ind
Sunday, 09 January 2000 - 07:26 pm | | I've now read all my posts. SORRY ABOUT THE SPELLING. They were just typed (with 2 fingers) and posted.
Any butchers able to comment on my question of knife sharpening and perhaps they could answer Diana's question aswell. Do they think that they would be any better than a lay person at performing these excisions |
Author: Jon
Sunday, 09 January 2000 - 07:55 pm | | Dr Ind
Chapmans body was much too close to a wooden fence along her left side for any person to be working from.
Eddowes had a house wall along her left side but her body was not too close that a person could not stand on her left side, the light in Mitre Square was provided by a wall fixture over 70 ft away to her right, perpendicular to her body, parallel with her head. And one street lamp approx 70 ft away towards the diagonal corner of the Square, in the direction of her right foot.
So, obviously not much light at all, however if Jack crouched at her right side he would block out any possible light but more importantly would have his back to anyone approaching him from the other distant entrances to the Square.
He may have wanted to work from her left side, for his own peace of mind.
Also, from the placement of the body it appears Jack could have looked straight up Church Passage and watched P.C. Harvey approach the Square, then turn and return back up the Passage. Very eerie, P.C. Harvey would not have seen Jack across the Square due to him stopping and standing under the wall light, effectively limiting his vision across the Square.
I spent 3 years as a butchers apprentice back in the early 70's and I frequently would sharpen my knives, but more out of habit than actually assessing if they were becoming blunt.
You get into a habit of working for a typical period of time, then stop to sharpen the knife, without thinking why.
So, I would agree with you on that point.
Thankyou for some very informative postes.
Regards, Jon |
Author: Diana
Sunday, 09 January 2000 - 09:27 pm | | | many texts say Druitt was a DR. but in fact he was a barrister from a family of Drs. |
Author: Diana
Sunday, 09 January 2000 - 10:13 pm | | If JTR indeed did slash and grab, then the next question is, did he have any idea what organs he was getting? Did he care? It has always been assumed (and perhaps wrongly so) that since JTR was not normal mentally, he had a perverted interest in securing the uterus because of all the emotional and sexual connotations that organ has. If the dim light created a level playing field (that is Dr. Ind could not do any better than I could, and niether could a butcher, veterinerian, hunter, etc., etc.) then Jack was randomly grabbing whatever gobs of tissue he could without reference to what they actually were and the fact that he cut out the uterus three times and ran off with it twice is mere coincidence. (I always did wonder why, if he was so obsessed with uteri, he cut out Kelly's and then didn't take it.) Has anyone thought to check what the phases of the moon were on the murder dates? I don't suppose moonlight would be enough.
If I know nothing of anatomy but I want to secure a uterus, first of all I might make the wrong assumption that it is located much higher than it is. I would base this on what I had observed in terms of pregnant women. By the time the pregnancy is visible the uterus appears to be quite high. If I somehow managed to figure out that I needed to search in the lower pelvic area and I cut my victim open from the front, the first thing I come to (correct me if I'm wrong) is going to be the bladder. Might I not make the wrong assumption that this was the uterus? Jack knew he had to look in the pelvis and he ignored the bladder and got behind it to the uterus. Maybe I've been thinking backwards. Maybe he was fascinated by the urinary system. That's why he took a kidney, and when he took those two uteri he actually thought he was getting the bladder? I'm off to find out if any place on the web lists moon phases going back to 1888. |
Author: Leanne
Monday, 10 January 2000 - 01:55 am | | G'day Diana,
Try: http://tycho.usno.navy.mil/uphase.html
LEANNE! |
Author: Leanne
Monday, 10 January 2000 - 02:12 am | | SORRY,
Try this:
http://tycho.usno.navy.mil/vphase.html
LEANNE! |
Author: Villon
Monday, 10 January 2000 - 12:34 pm | | Hello all,
Dr. Ind, thank you for supporting my opinion regarding pid.
To answer your other points.
1.I do not believe (though someone please correct me if I am wrong), that any of the autopsy reports make any mention of pid, but I don't think we should assume this to mean there was no obvious disease.
My father has made some study of the history of forensic pathology and he tells me that pre-1920s, many post mortems, spercially those involving possible death by violence, tended to be very incomplete and concentrate on assumed probable cause of death, excluding everything but a cursory assessment of other organs, even when they were manifesting quite gross pathology.
By the way I believe Eddowes hysterectomy was not subtotal.
2. You ask if I think my medical training would make me better able than a layman to find a uterus or kidney in the dark.
My answer is - yes, I think it would.
I would liken it to finding your way across a dark room.
If you put two people into this hypothetical room, one who knew its layout well and one who had never been there before, then both would blunder around far more than if they could see, but the man who had been there before would make fewer mistakes and find his way around much faster.
I think my relative familiarity with an opened abdomen would give me a much greater chance of finding what I wanted, in the dark, in great haste, than someone who had never done such a thing before.
I think Jack's treatment of Eddowes and Chapman shows considerable purpose. There are pretty few aimless slashes, no more than you would expect from the best surgeon struggling in the dark.
Everything the man did seems to show intent. He knew where the uterus was and found it and cut it out in moments. He knew where the kidney was, and may even have known how much easier to access the left than the right it is.
Basically, there is not enough mess and too little time for a slash and grab technique.
3. I agree,the only way to be absolutely sure of what a layman could do in the situation is to replicate it. But would anyone be prepared to do this even with a dead pig?
By the way, give my regards to the London Hospital I have some memories of the place.
Is this why we are both interested in the ripper? I wonder if there are any other medical people lurking out there.
lastly I tentativly make the suggestion that a medical site is set up here, with all the autopsy information and commentary from contemporary and modern medical opinion?
Mike |
Author: Jim DiPalma
Monday, 10 January 2000 - 12:44 pm | | Hi All,
Diana, the Casebook Productions site has information on lunar phases and weather conditions on the nights of the murders:
http://business.fortunecity.com/all/138/explore/weather.htm
Jim |
Author: Villon
Monday, 10 January 2000 - 01:00 pm | | Just some more thoughts;
Dr. Ind, I think we have to assume the uterus and 'appendages' does refer to the ovaries as it would today. Otherwise, what could it refert to?
Everyone here:
Dr.Ind has made a good point about this, which I confess had not occurred to me.To put it in general non-jargon terms:
in a non-diseased pelvis the ovaries are not directly attached to the uterus, and if you cut out the uterus the ovaries will stay behind in the pelvis.
So if Chapman's ovaries were removed with her uterus what does it mean?
It means either that they were stuck to her uterus by old scar tissue or inflammations, so that they all came out of a piece, OR Jack not only knew what ovaries looked like, and understood their reproductive importance, but was able to take them as well as her womb in one or two cuts.
If the latter, this must be almost incontrovertible evidence of medical skill, since there is no way that any layman would have the knowledge, let alone be able to do such a double trick, in the dark in three or four minutes.
So it becomes crucial to know if Chapman had pelvic disease, and if this disease had caused her ovaries to stick to her uterus. But I think this information is not to be had, am I right?
Mike |
Author: Peter R.A. Birchwood
Monday, 10 January 2000 - 01:45 pm | | Evening all:
I have to confes that I haven't in the past paid too much attention to the intricacies of the mutilations. Having myself been a kidney transplant patient I much prefer to believe that the inside of the body is completely solid. I even refused a copy of the operation video.
If however we assume that Mr. Ind is correct and the missing organs were grabbed more by luck than judgement then it could be possible that JtR really didn't know what he was carrying away, whether it be in his black bag or under his bowtie. In that event, what would it do to the Lusk letter and contents? Would Jack have recognised a kidney? Could Mike Villon and Thomas Ind give their opinion as to whether a human kidney would be recognisable to the layman? It would also of course cause problems with the diary as "Maybrick" does seem to recognise that he has a kidney rather than a spleen. Maybe the Lusk writer and the diary author just read what was missing, one a few days later and the other 100 years later!
Peter. |
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