MCIG according to MCIG: Historic Documents Research Draft Reading Version PLEASE DO NOT CITE WITHOUT PERMISSION OF THE AUTHOR Nicholas W. Richards University of Wisconsin-Milwaukee Paper presented in Symposium: People that no one had use for, had nothing to give to, no place to offer: The Milwaukee County Institution Grounds Poor Farm Cemetery at the 80nd Annual Society for American Archaeology Meeting, San Francisco, California, April 15-19, 2015. Richards SAA 2015 2 Alongside the main mortuary documents just discussed and outside of contemporary newspapers, the historic record of the MCIG cemetery and related institutions is broad and rich, particularly from the mid1890s on. The results of a survey of these documents are presented here using three sources of documents as examples. In documents associated with Milwaukee’s early medical schools, reports and publications from the Milwaukee County pathology department, and annual accounts from the county’s home for dependent children, we can see ways this record might be used to learn about the cemetery in wider context, the individuals buried there, and the MCIG historical record itself. One source of documents, taken together, is Milwaukee’s pair of late 19 th century medical schools. Wisconsin College of Physicians and Surgeons (1893-1913) and the Milwaukee Medical College (18941907). Catalogs and correspondence from these schools show some of the contemporary methods for and attitudes towards the transformation of unclaimed bodies into cadavers. These medical schools were Milwaukee’s two earliest ‘officially’ recognized by the American Medical Association (albeit, by 1908 still in Class C, “Colleges requiring a complete reorganization to make them acceptable”. These schools, and later Marquette University Medical School or alternatively Department, were listed as places of burial on county death certificates, and there are many more records for some form of ‘anatomical purposes’. Coroner’s inquests found by drew contain letters from the medical schools confirming they obtained anatomical material from the bodies of unclaimed dead. The MMC was a stock company and operated independently before Marquette University adopted it as its own medical program in 1907. The WCPS also began as a profit-seeking venture, growing an initial capital stock of 1500.00 dollars to 100,000 before faculty “became more interested in […] students, than in making their stock pay dividends” in 1906. It was nominally the medical department of Carroll College by 1910, but in 1913 was also acquired by Marquette University. Both schools claimed ready access to anatomical materials. Although MMC encouraged 1907 matriculants to “own a human skeleton”, the college had “secured a large number” to be lent for a nominal fee. Access to fresh cadavers, however, was paramount and adherence to their official curricicula would have required 2 Richards SAA 2015 3 it. The anatomy laboratory was the prevailing concern at these colleges, which operated in short semesters from mid October through early March. In 1906 students at the MMC were to be in the anatomical laboratory from 2:00-6:00 in the afternoon for their first four semesters, during which time they would complete at least two dissections and observe operations in the auditorium. There was a similar schedule at the Wisconsin college of physicians and surgeons, which urged students to make as many dissections as possible, reminding them the dissection room was always open in the winter. For early medical societies and schools in Wisconsin, the official cadaver-getting process was straightforward. As in many states at the time, the schools could rely on a state law to take anatomical material for the nominally unclaimed bodies of poor people. Death certificates, coroner’s reports, and school correspondence show that between 1895 and 1913, county officials gave 283 individuals to MMC and 149 to WCPS, and later 82 to Marquette between 1913 and 1925. This was done pursuant to state statutes first adopted in 1868 directing any public official in possession of an unclaimed body to notify an appropriate county medical entity, which then assumed the cost of transportation and ‘proper’ burial if used as a cadaver. If the school had need of the body, they were to request in writing its consignment to their agent, usually an undertaker, who would deliver the body to the school and then presumably to the cemetery. For those for whom an inquest was held, the inquest document often includes the official letters from the medical colleges. For instance, Daniel Shea died on September 3rd of 1906 after falling into a ditch, according to Henry Broegman, coroner. Noting in the death certificate that the body must be delivered to a medical school for anatomical purposes, Broegman received a letter dated September 18 th from William Washburn, the secretary of WCPS, requesting that the perennial Milwaukee undertaker Charles Judson be allowed to transport Shea’s unclaimed body to WCPS for anatomical purposes. Although the schools had been obtaining bodies under state law since 1895, this advantage was codified into legal language specific to them in 1903 when both schools were specified as proper recipients for unclaimed bodies from the eastern U.S. judicial district. MMC came to use a form letter for this purpose, a hint of a distinctly modern, business-like approach taken to procurement. Despite the material benefit to 3 Richards SAA 2015 4 their business this law granted, even so their needs may not have been fulfilled: MMC would have had on average only 15 cadavers a year if they relied solely on the poor cited under state law, while requiring cadavers for demonstrations, dissections, and anatomical specimens for a student body of 150 by 1906. Almost half (845/1639) of all the medical cadavers known from death certificates have only ‘anatomical purposes’ or some variation thereof listed as a place of burial. If the medical schools took material beyond the cadavers they official requested in the death certificates it seems likely they drew from this group. Disposal of the remains after anatomical uses was a problem from the beginning: in 1896, the city was horrified when a dismembered woman was found at a rendering plant, the latest in a series of incidents where cadavers were thrown in the trash or left in empty lots. Of those who were interred, the 2013 excavations recovered the remains of many to whom the schools did not consistently fulfill their legal obligation after they used their bodies. The societal and spiritual need for decent burial, then as now, would not have included trash, or more than one person in a coffin. The laws permitting these uses remained relatively unchanged across the early iterations of medical education in Milwaukee and although by 1925 burial of cadavers had ceased at the cemetery excavated in 2013, a version of the CH. 406 Sec 2 law remained through the early 1940’s which eventually required the unclaimed bodies in morgues across the state be given over not only to anatomical laboratories for educational purposes but embalming colleges as well. Official reports from the county pathology department form another important group of sources documenting post-mortem interventions. Milwaukee County Historical Society and Milwaukee public library holdings include official reports from the superintendents of the various county institutions to the county board of supervisors. These reports are comprehensive and complete to varying degrees, but are often frustratingly oblique in their relationship to the cemetery itself. Although the annual summaries from the pathology department did not contain the extensive autopsy records sometimes found with the coroner's documents, the writers do reflect on the basic work typical of early 20th century pathology labs which they carried out in their efforts towards scientific and career advancement. Beginning in the basement of the old hospital, the pathology department eventually got it's 4 Richards SAA 2015 5 own building complete with an auditorium and a museum in 1904. Note the road leading directly from the laboratory building to the unmarked area corresponding to the 1882-1925 cemetery. Autopsies and specimen collection were done here before the pathology department and county laboratories moved into the new main hospital building in 1922. Unlike the medical schools, the pathologists who worked here had trouble acquiring either enough time or permission to complete all the desired post-mortems in their department. They performed an average of 76 autopsies a year based on available reports, and collected hundreds of ‘very valuable specimens” for their anatomical museum, but in the first decade of the 20 th century the administration of the department routinely complained about the “unfortunately low number” of autopsies performed the previous year and laments their inability to take advantage of the “abundant” anatomical material generated by the operation of the county hospital. It seems the dead were selected for autopsy or speciminization based on medical interest first, rather than the legal and scholastically useful availability of a corpse as at the medical schools. Significantly for this survey, several of the doctors also published articles in contemporary medical journals: In 1911 department personnel had received permission to publish “interesting cases” from the wards. Some of the articles included reports of cases that were investigated at the county hospital, replete with initials and other identifying medical information of the patient, and these documents confirm that the county pathology department was another origin of the post-mortems interred at the MCIG cemetery. One such publication, “An unusual case of so-called pseudoleukemia” later put out in the 1916 journal of the medical sciences was appended to the Resident pathologist Louis Warfield’s 1912 report. The initials JT and the November 11 th date of the death matched that of the burial register’s John Todych, a young Russian man who died after treatment at the county hospital and was then autopsied. Three other accounts of post-mortem investigations were linked in this way to entries in the burial register: Earl Buchanan, a 23-year old from Arkansas, 64-year old laborer Michael Mclean, and a Bulgarian named Dmitriz Starjov, 27, all died at the county hospital and were autopsied in the pathology building just next door. It is not at all clear that these people had any idea of or gave any consent to an autopsy or medical research. The publications using these bodies, while perhaps important for the continual improvement of hospital operations, also improved these professionals’ prospects for career advancement. Warfield, who reported the case of John Todych, later went on to chair the Internal Medicine at the University of Michigan. 5 Richards SAA 2015 6 The historical record of the Milwaukee County home for dependent children is no less suited to this type of reading, as forthcoming research beyond the scope of this paper shows. Here, however, taken as a third example in this document survey, an examination of one small subset of data from the children’s home shows how one might further use comparisons of historical and archaeological data to evaluate the potential accuracy of the county’s record keeping. Drew shows that the burial ledger, foundational to MCIG historical research though it is, is variously inconsistent, incomplete, and inaccurate over its thousands of entries, as one might expect of a multigenerational hand-written ledger. It isn’t even known who wrote the entries so skepticism of their integrity, especially for secondary source records like the statistics presented in the official county reports, is useful. Drew has also demonstrated that the archaeological investigations at MCIG can be used to evaluate and expand the historical record of the cemetery and county. The home for dependent children opened on February 2 1898 as the county’s attempt to mitigate the problem of minors ending up in various county institutions not designed or willing to deal with them. Upon opening Superintendent August Kringel emphasized the mission of the home to provide housing in primarily temporary arrangements as there was general agreement that a place in certain private residences was best for a child’s welfare. Nevertheless the home operated as an ersatz orphanage for thousands of children for varying lengths of time through the 1970s. The early 20 th century saw the home departmentalize a nursery, kindergarten, and primary school, and it later came to administrate an indentured work program for the individuals under care. Like all the county institutions, the home complied with county law requiring an annual account of the preceding year’s operations in the form of a report to the county supervisors. Statistics reported on what were unfortunately referred to as ‘inmates’ included age by duration of stay, family background, indenture-hood earnings, and more. Of special interest to this document search were the yearly tables of deaths by age and cause. The information in these tables was deserved focus for three reasons. They are from a report set that was comparatively complete: Only 4 of 27 yearly reports were unavailable, and the cumulative totals kept allow for a count of subadult deaths of unknown age during those years for which a report was not found. They contain a data set of comparatively 6 Richards SAA 2015 7 manageable size. They are unusual among the county documents in their precision: some of the ages of death are given in weeks, and several children died of a cause that was recorded only once. Are these records accurate? According to recently identified documents, they probably aren’t, These recently identified documents indicate that there were to put it lightly contemporary doubts about kringels administration, serious enough to warrant an investigation running to many volumes, which is a subject of other forthcoming research. It is enough to mention here that the minority report in this investigation accused kringel of, among other things, under-reporting infant deaths by up to 50%. (kringel comes off in this minority report, broadly, as a vindictive and greedy monster). Clearly this suggests that these tables are not a full account of deaths at the county home, but they might be half true in their own special way. The combined archaeological and historical approach can work as a test. If these records are an accurate account of a sample of the deaths. by age, of a temporally and spatially specific subadult assemblage, to say nothing of the listed causes of death, the age pattern should reflect the age range estimates for a historically similar recovered death assemblage, like that recovered during the MCIG 2013 excavations. A comparison of the data transcribed from the home for dependant children’s reports and three different aging estimate methods used during analysis of the MCIG 2013 subadult population seems to fit, and indeed shows a close fit between the fusion estimates and the home’s data, mirroring especially the low incidence of late childhood and adolescent deaths. This indicates that if not a total record of deaths at the children’s home, they are not entirely fabricated either. In any case, no clear documentary evidence linking the people for whom these tables account and the MCIG subadult death assemblage was located, but this search is a continuing investigation. There is again indirect evidence, like the accounting entries for coffins received from the almshouse around the turn of the century, but even without such threads the records’ comparison with the archaeological evidence supports the accuracy if not precision of this particular 27-year record and encourages further examination of the voluminous century-old county statistics. These three document sources, a small fraction of the available record, were chosen to exemplify ways to learn about the societal context, the individuals, and the historical record of the MCIG 2013 cemetery. 7 Richards SAA 2015 8 Beyond the uses just presented, further searches seem likely to benefit the central MCIG project of restoring identity to the people buried in what came to be unmarked graves. Any such uses of this record will of course be contingent on the ongoing multidisciplinary analysis of these people, and a final disposition of their remains which ensures this analysis will reach its full humanizing potential would favor the unknown buried at MCIG, and is irreplaceable to anyone who hopes to find them. REFERENCES Broegman, H. J. (1906). Inquest of Daniel Shea September 3rd, 1906. (pp. 1-3). Milwaukee. Flexner, A. (1910). Medical education in the United States and Canada bulletin number four (The Flexner Report). New York (NY): The Carnegie Foundation for the Advancement of Teaching. Wisconsin, Sanborn, A. L., & Sanborn, J. B. (1906). Supplement to the Wisconsin Statutes of 1898: Containing All General Laws Enacted at the Regular Sessions of 1899, 1901, 1903, 1905 and the Special Session of 1905 : Annotated with Notes of All Wisconsin Cases Through the January 1906 Term and Selected Decisions of Other States: Callaghan & Company. Wisconsin College of, P., Surgeons, Wisconsin College of, P., Surgeons, & Department of Dental, S. (1894). Annual announcement of the Wisconsin College of Physicians and Surgeons. Annual announcement of the Wisconsin College of Physicians and Surgeons. Milwaukee, Wis.: Wisconsin College Physicians and Surgeons. Annual report of the Milwaukee County Home for Dependent Children, Wauwatosa, Wisconsin (18991925). Wauwatosa, WI: Milwaukee County Home for Dependent Children. Milwaukee County (1894-1925). Consolidated annual reports. Wauwatosa, WI L. M. Warfield, H. T. K. (1916). Hodgkin's Disease of the Intestines. Johns Hopkins Hospital Bulletin (No. 299), 24-28. Gilchrist, R. T. (1911). Report Of A Case Of Primary Carcinoma of the Lung. Interstate Medical Journal, 19, 765-769. Warfield, L. M. (1922). Report of A Case of Disseminated Gummatous Sporotrichosis, with Lung Metastasis. The American Journal of Medical Sciences, 164, 72-82. L. M. Warfield, H. T. K. (1916). An Unusual Case of So-Called Pseudoleukemia (Lymphosarcoma). American Journal of the Medical Sciences, 152, 222-231. Milwaukee Medical College Medical Department Thirteenth Annual Announcement for Session 1906-1907 (1906). (pp. 34-35). Milwaukee: Milwaukee Medical College. Board of Administration of Milwaukee County. (1921). Milwaukee County Institutions under the control of the Board of Adminstration of Milwaukee County. Milwaukee County Board of Supervisors. (1915). Minority Report of Kringel Investigation 8 Richards SAA 2015 9 9