Looking for the Golden Fork

by Dr Alan Bates, Honorary Senior Lecturer in Pathology, University College London

When Baron Percy opened the body of Tarrare, he was performing an autopsy, a procedure designed to reveal what the Italian anatomist Giovanni Morgagni had called, some thirty years earlier, ‘the seats and causes of disease.’ The search for post-mortem physical changes that could show what illnesses a patient had suffered during life was to develop into the new science of anatomical pathology, and Morgagni’s phrase was incorporated into the motto of the London College of Pathologists almost two hundred years later. We may take it for granted that a post-mortem examination can discover the cause of death, but in Percy’s time, the idea that the appearance of particular organs and tissues could be used to diagnose disease was novel. There were no professional pathologists to make post-mortem examinations; surgeons had to do it for themselves, and it helped if, like Percy, they were skilled anatomists. The study of disease in terms of the pathology of tissues and organs helped to dispel the time-honoured concept of four bodily humors that got out of balance when a person was ill. From a modern perspective, however, it is far from clear that Tarrare’s depraved appetite was due to disease in a particular organ: an abnormal constitution, or mental illness, have just as well have been responsible, in which case Percy was seeking something that he could never have found.

THE DEPRAVED APPETITIE OF TARRARE THE FREAK-2

Many people think that the autopsy was developed by opening up the bodies of the unwilling poor, just as anatomists relied on body-snatchers to supply corpses, and was hampered by opposition from the Catholic Church. In fact, autopsies were fashionable among the well to do, who saw them as intellectually enlightened, and were performed on popes and princes. The unclaimed bodies of patients who died in hospital did provide an important resource for study, and were used without the patient’s or relatives’ consent, but this was relatively uncontroversial. It must be borne in mind that in the eighteenth century there was nothing akin to the modern notion of informed consent in medicine; the question of who owns a body was raised, but the correct legal answer was (and still is) ‘no-one,’ for bodies are not property and cannot be stolen.

The shift in emphasis in late-eighteenth century medicine from the whole body to specific organs and tissues, sometimes studied at microscopic level, was not uniformly welcomed. While there were many enthusiasts for the modern, scientific medicine of the clinic and the laboratory, some patients bemoaned the disappearance of the ‘holistic’ doctor with a kindly bedside manner, who saw them as a whole person and not a collection of cells and tissues. The two approaches are not incompatible, and it can be helpful to consider illness from these different perspectives. Our understanding of Tarrare’s troubles comes partly from Percy’s autopsy findings but also from reconstructions of his life through which we can imagine his experiences as a patient. Suffering, seeking a cure and feeling isolated or even freakish remain part of a patient’s journey despite medicine’s scientific advances.

We are entitled to ask, however, what was wrong with Tarrare from a modern medical point of view, and whether present-day treatments could have helped him. Tarrare had a huge appetite, drank water copiously, and was ‘apathetic.’ His body was reported to have had an unusual odour, especially after eating. Despite his excessive consumption, he never gained weight, and sweated profusely. Did he suffer from a damaged amygdala, part of the brain that controls appetite? Perhaps he had diabetes – a disease unknown at the time – which when untreated can produce all of these symptoms. We cannot know whether Percy, given access to a modern pathology laboratory, could ever have found what he was looking for, or whether Tarrare’s condition was truly something unique to him.

About this Blog

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This research and development blog is supported by Wellcome Trust and maintained by Research IT at Bristol University

Project Partners

Dr Alan Bates, Honorary Senior Lecturer in Pathology, University College London
Dr John Lee, Director of Intercalated BA in Medical Humanities, Bristol University
Professor David M. Turner, Swansea University

The Depraved Appetite of Tarrare the Freak is supported by

Wellcome Trust
Arts Council England
Tobacco Factory Theatres
Bath Spa University
New Diorama Theatre
Puppet Place
Bristol Ferment at Bristol Old Vic
Theatre Bristol
Weston College

Creative Team

A Chamber Opera by Tom & Tobi Poster
Director // Sita Calvert-Ennals
Associate Director, Director of development process // Laura Purcell-Gates
Story in collaboration with Hattie Naylor
Produced by Strike A Light // Executive Producer, Sarah Blowers; Producer Ellie Harris
Production Design // Rebecca Wood
Lighting Design // Mark Parry
Puppet Design // Wattle & Daub with Emma Powell
Music Director // An-Ting Chang

Exhibiting the ‘Freak’

by Professor David M. Turner, Swansea University

The term ‘freak show’ evokes past attitudes to biological diversity very different to our own. The exhibition of human and animal anomalies has become synonymous with exploitation, cruelty and, given the increasing popularity during the eighteenth and nineteenth centuries of shows involving ‘exotic’ non-European human beings, racism. But human exhibition took a variety of forms in the past, and had a variety of motives. Indeed, the modern notion of the ‘freak show’ as a travelling form of entertainment involving several performers working for a manager or showman was an invention of the mid-nineteenth century, thanks to entrepreneurs such as P. T. Barnum in the United States, and Tom Norman in England.

The exhibition of ‘monsters’ and other human and animal curiosities became popular in Europe during the sixteenth and seventeenth centuries. During this period pamphlets detailing ‘monstrous births’ were popular. These phenomena were sometimes interpreted as portents – sending messages of divine displeasure – or as medical curiosities. The development of learned societies such as the Académie des Sciences in Paris and the Royal Society in London from the late seventeenth century fostered growing scientific interest in the wonders of nature and a desire to use them to understand better the natural processes of human development. This learned interest in monstrosity contrasted with popular curiosity in human aberrance, catered for by the display of conjoined twins, people of restricted or exceptional growth, or those born without limbs in fairs and taverns. Human exhibition was not confined to physical ‘deformity’. Popular performers in seventeenth-century England included the ‘posture master’ Joseph Clark – a contortionist – and Nicholas Wood, the ‘great eater of Kent’, who like Tarrare was famed for his remarkable powers of digestion.

During the eighteenth century some performers gained considerable fame, helped by the growth of the newspapers and the use of advertising for performances. Although the social elite increasingly distanced themselves from tavern and fairground entertainments, some performers aimed their shows at more genteel audiences. Matthew Buchinger (1674-1739), the ‘little man of Nuremburg’, born without arms or legs, exhibited himself before royalty and aristocracy across Europe before coming to England in 1716. He deliberately courted an elite audience, promising private performances in the homes of ‘ladies and gentlemen’ and seeking their patronage for artistic work such as drawing coats of arms and family trees. Russian emperor Peter the Great collected examples of human diversity and exhibited them at his court. Many performers advertised their exceptional skills and refined manners. The appeal of human exhibition as an entertainment often depended on the contrast between the performer’s ‘normal’ attributes (such as their good manners or settled domestic life) and their remarkable appearance or talents. Some entertainers such as Buchinger made a good living from displaying themselves and human exhibition may have been a preferred choice of making a living for some people with disabilities for whom other options may have been limited. However, their success depended on their novelty, which meant that they often had to travel and seek out new audiences and patrons.

V0007013 Matthias Buchinger, a phocomelic. Engraving after a self por

Matthias Buchinger, a phocomelic. Engraving after a self portrait. Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org

When concerns were raised about human exhibition in the eighteenth century, they primarily focussed on the potential for disorder associated with large plebeian gatherings at fairs or taverns rather than the exploitation of performers. However, in 1810 the case of Sartjie Baartman, the so-called ‘Hottentot Venus’, became a legal cause célèbre in London when a lawsuit was brought against her ‘keepers’ for exhibiting her without her consent. Baartman was born to a Khoisan family in the East Cape of South Africa in 1789 and had been persuaded to travel to Britain to exhibit herself to audiences fascinated by her distinctive anatomical features (particularly her large buttocks). However, following Britain’s ending of the slave trade in 1807 the abolitionist group, the Africa Society, brought a case challenging her exhibition. In her own evidence, Baartman claimed that she exhibited herself freely and claimed the right to earn a living this way. However, her case revealed the vague terms on which human exhibits were employed by their promoters. She moved to Paris in 1814 where she became the subject of interest of doctors and naturalists, while continuing to exhibit herself to popular audiences. After her death in 1815 she was dissected.

L0048076 Hottentot Venus Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Small poster advertising the exhibition of the Hottentot Venus, a black woman (presumably Sarah Baartman, 1789-1815) from "the most southern parts of Africa" in what was probably seen in the less enlightened days of 1810 as a travelling "freak show". People from various racial backgrounds toured these show circuits, dressed in traditional costume, entertaining people who had never seen other than local, white people before. Sarah Baartman was extensivley toured, exhibited and subsequently dissected upon her death in 1815. Just arrived from London, and, by permission, will be exhibited here for a few days at Mr. James's Sale Rooms, corner of Lord-street : that most wonderful phenomenom of nature, the Hottentot Venus : the only one ever exhibited in Europe. 1810 Just arrived from London, and, by permission, will be exhibited here for a few days at Mr. James's Sale Rooms, corner of Lord-street : Published: [1810]

Small poster advertising the exhibition of the Hottentot Venus Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org

Sartjie Baartman moved between the popular world of entertainment and learned medical interest – just as Tarrare did. Interest in the ‘freak’ was never simply a matter of raucous entertainment or cruel exploitation of the ‘unfortunate’ (although may be part of the story). The taste for ‘freaks’ in the eighteenth and early nineteenth centuries was part of a broader interest in the limits of the human, in classifying and explaining the variety of nature. The world of the ‘freak’ crossed boundaries between science and showmanship, between autonomy and exploitation and between the elite and the popular. ‘Freaks’ were exhibited for their difference, but taught people about what it meant to be human.

Performing the Freak

The University of Bristol’s one-year intercalated BA in Medical Humanities (iBAMH) is the only degree of its kind in the UK. It gives around a dozen students from Medicine (and sometimes from Dentistry and Veterinary Sciences) the opportunity to study literature and philosophy, and to look at medical practice from the perspective of those disciplines.

The end results of the course are various, as the students talk of them. Some talk of having gained a better cultural understanding of medicine, of its history and institutions; some of having changed how they think about what constitutes medical evidence; and some of having found some new tools with which to understand and interact with their patients, and with their own responses to their patients and their patients’ sufferings.

Most of the students time is spent, as might be expected, studying academic classes. But alongside these is the Oakhill programme. This part of the course is more free-wheeling; for a programme director, it has the great advantage of having a structure flexible enough to take advantage of opportunities as they come along.

One such opportunity arrived in 2013, when Wattle and Daub got in touch with us, wondering whether we might be able to work together. It sounded a great opportunity for the students, and a schedule of meetings was devised whereby the students would help with medical aspects of the development of the opera.

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Tarraré’s case history is fascinating, but the real interest of the meetings lay in the way in which ‘other’ Tarrarés quickly emerged as the case history was juxtaposed with dramatic staging which was in turn influenced by the musical and vocal scores. The different ‘treatments’, in other words, produced different subjects, all of whom are versions of the historical person. Which might be most helpful to Tarraré? Which to us? And what if that ‘us’ is an audience of patients? or doctors? For the iBAMH, seeing the opera take shape was to gain a richer sense of the possibilities of dialogue between medicine and the arts.

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Research trip to the Old Operating Theatre

Link

A fascinating trip to the Old Operating Theatre with one of our scientific collaborators Dr Alan Bates, Senior Lecturer in Pathology at UCL, seen here describing a typical autopsy:

Many interesting discoveries made, but here are some of the key points we took away from our discussions:

On conducting an autopsy:

  • Showed us how he would conduct an autopsy (see above) – pulling the guts up with considerable force and removing them as a whole, sawing off the top of the skull and removing the ‘blancmange’ like brain. ‘I’m old enough to have done this without electric saws’.
  • Has a preference for a short sharp knife – some of his friends prefer long ones – he uses a long one for the brain, as they’re so easy to slice.
  • ‘I sometimes feel that I don’t produce anything. Sometimes you wonder have I actually made a difference?’

On operations:

  • No anaesthetic at the time – the doctor’s assistants (‘dressers’) had to physically restrain the patient. Alan talked about the sheer brute force it took to operate or conduct autopsies (this is still true for autopsies), which got us thinking about the character of the doctor – he’ll need to be physically large, and his physicality when treating Tarrare and conducting the autopsy needs to be strong, brutish, heavy.
  • Patients were often blindfolded and/or gagged; Alan pointed out a surgeon’s walking cane that was used as a gag and was therefore bowed in the middle.
    • On this point – when we discussed wanting to show how horrible/painful pre-anaestetic treatments: ‘You really can’t overemphasise how horrible it was.’

On Tarrare’s specific condition:

  • At the time there was a particular fear of that which crossed from animal to human – a fear of French revolution unleashing ‘barbaric’, ‘animalistic’ characteristics in the revolutionaries. Both surgeons and Tarrare played into this fear of cannibalism/transgressing the human body.

All photos and video by Kasha Miller

Notes from Advisory Panel Meetings

Laura and Tobi met with the following project partners:

  • Dr Alan Bates, Honorary Senior Lecturer in Pathology, University College London

  • Dr John Lee, Director of Intercalated BA in Medical Humanities, Bristol University

  • Professor David Turner, Swansea University

‘Incurable Freaks’

David discussed the term ‘incurable’ – Tobi had chosen it for its paradoxical quality; David confirmed that in fact the term ‘incurable’ existed in 18th and 19th-century France, when there was an interest in the fate of the incurables, who by definition fell outside of medical care and were often thrown out of hospitals. In 1710 a boy was thrown out of St Thomas hospital for being incurable, and died on the streets.

Treatments

We asked what treatments might have been carried out on Tarrare in the hospital, in order to write the song ‘Cures’ in which the Doctor describes what he is doing to Tarrare and to gather ideas for staging the scene

  • Suggestions that ended up in the show included:

    • bloodletting by knife or leeches (Tarrare’s arm is cut open by the Doctor’s assistants)

    • enemas (the Doctor’s assistants give Tarrare an enema)

    • purging (Tarrare vomits following his enema as the Doctor sings about purging)

    • force feeding (Tarrare is force-fed eggs by the Doctor’s assistants)

  • Other suggested treatments that didn’t end up in the show:

    • cupping (according to Alan this wasn’t a very painful treatment)

    • psychological

    • dark room

    • locked in cold bath up to neck

Insults

We asked for examples of insults that might have been used against someone like Tarrare, particularly as the term ‘monster’ did not have the same negative connotations as it does today. Suggestions were incorporated into the libretto, and included:

  • beast

  • unnatural

  • degenerate (degeneration a big theme)

  • primitive

  • savage

Why was Percy so interested in Tarrare as a case study?

Alan suggested that Percy was probably more interested in studying Tarrare than in actually curing him; the way to get patients is to promise to cure them, but actual motive is to study them – combination of actual curiosity and publicity for him. John pointed out that in the 19th century there was a great deal of work on Hamlet and his patient – the idea of a case history that gains you public attention, giving you status. Alan suggested that Percy uses medicine as an enlightenment project.

Freak show as performance; public autopsy as performance

  • Wattle & Daub have been interested in incorporating the theme performance into the show as much as possible, as this is part of our aesthetic of making the workings of performance visible (puppeteers that can be seen, the makings and working of puppetry are always visible), and because staging a true story is an act of interpretation and therefore inherently a performance. This is helped in this show by the fact that Tarrare was put on display (a performance) in two ways: the freak show, and the public autopsy

    • David pointed out that by dramatising two performances in the 18th century (which had different sensibilities to today), we’re making the audience complicit in these kinds of performances

    • John discussed the fact that in France public dissections were bodies of criminals, so going to watch it has a moral value; part of process of justice by going to see it

    • Alan pointed out that in this country public dissections were purely symbolic (just a little cut in abdomen, then sent off to get actually dissected)

    • David discussed opposition to this practice – even dissecting a criminal for some people goes beyond what’s acceptable

  • We discussed how we are positioning the audience (as audience to autopsy – med students & high-ranking military people e.g.), as audience to freak show (general public – seen as lesser, more threatening)

Why did the Doctor never find the golden fork?

  • This was a fact taken from Baron Percy’s autopsy notes – he searched for the golden fork that Tarrare claimed had killed him, but never found it. For Wattle & Daub this becomes a metaphor for a failure of understanding the other – for the Doctor and for everyone who came into contact with Tarrare.

  • At an advisory panel meeting, we discussed the question of the golden fork:

    • Alan: Golden fork is a metaphor for pathological findings he never makes – he describes what he sees but does not understand. Like taking apart a car and just being left with parts of a car. Intangible part of humanity he isn’t going to get at. But there is something valuable – how can everything about a human being be captured within one knowledge system?

    • John: One of many well intentioned beginnings that don’t arrive anywhere – this is one step on a much longer journey.

    • Alan: Percy’s had plenty of time to look at the whole picture but he looks for only one thing.

    • Fork represents unknowable medical/bodily thing; also represents his humanity; John discussed interest in personality at time, what makes a personality)

    • Within medicine monsters were seen as something to be systematised and cured (therefore they disappear). Percy wants to understand everything. Wants to make everything fit. Freaks don’t fit.

Tarrare doesn’t fit into any of the worlds that try to contain him

David suggested this idea that Tarrare doesn’t fit into any of the worlds that attempt to contain him (the world of the freak show, of the military, and the hospital – the three worlds that Hattie Naylor helped Wattle & Daub identify within the narrative arc of the story). David talked about the uncontrolled side to Tarrare – fear of what might he do next. This is what people don’t like about him. The three worlds of the freak show, military, hospital all attempt to fit him into their respective civilising project, yet none can contain him. David suggested that, for instance, in the freak show there’s a sense that he’s gone too far when he eats/rips apart the cat (the audience are horrified).

This idea became a central motif for Wattle & Daub’s approach to how Tarrare engages with each of the three worlds of the freak show, the military, and the hospital, informing planning with Hattie Naylor and Director Sita Calvert-Ennals.

The freak show

David discussed freak shows in the 18th century, describing a sense that the freak show is impolite – it becomes popular/unseemly for the elites to be present; so the space of the freakshow is disreputable. He talked about adverts advertising both the difference of the freak and all the ways on which they are similar to ‘regular’ people – marriage, good manners, politeness. This both normalises and emphasises their difference. John talked about Caliban as a perfect example of the monster/human juxtaposition within this framework.

The Doctor’s mess in the autopsy room

Order/disorder – the Doctor ends up in mess of blood and guts in the autopsy room at the end; everything has unravelled as he’s tried to classify it, to use medicine to make order. This was based on a suggestion from Alan, who liked the Doctor’s mess and confusion at beginning of the autopsy in the work-in-progress – he described his work as a pathologist as really being a bit like that.