Sins of Our Fathers: Two of The Four Doctors and Their Roles in the Development of Techniques to Permit Covert Autopsies
Bibliographic record
Abstract
Abstract Context. —Sir William Osler, MD, and Howard Kelly, MD, were probably the preeminent practitioners of their respective specialties, internal medicine and gynecology, during the late 19th and early 20th centuries. Both were passionately interested in pathology. Although not widely known, during the 1880s, both allegedly pioneered “arm's length” methods to perform covert autopsies that involved removing abdominal and even thoracic organs via the anus, vagina, or a small perineal incision hidden behind the scrotum. These techniques were allegedly used, at least occasionally, to circumvent autopsy-consent regulations and to procure teaching specimens for medical museums. Objective. —To examine the historical evidence for these alleged events and to examine these behaviors within the context of (1) the need to obtain pathologic specimens for teaching gross pathology and clinical pathologic correlation to medical trainees, (2) the loose interpretation of autopsy-consent regulations at “charity hospitals” during the late 19th century, (3) the medical museum movement, and (4) the paternalistic approach to the practice of medicine typical of the times. Design. —To address these issues, standard historiographic methods were used to examine available primary and secondary historical sources. Results. —The evidence suggests that Kelly developed and published 3 arm's length methods for covert autopsies while a resident in Philadelphia, Pennsylvania, and that both Kelly and Osler pioneered the use of these methods in the 1880s. The brief history of these “minimally invasive” autopsy techniques is also examined by reviewing 19th and 20th century textbooks of autopsy technique. Conclusions. —Howard Kelly, MD, and William Osler, MD, pioneered arm's length methods for covert autopsies. In fact, this activity appears to have initiated the 2 doctors' long professional relationship.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.007 | 0.012 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".