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W. Bruce Fye Center For the History of Medicine: The Autopsy: In Pursuit of Pathology

The Autopsy: In Pursuit of Pathology

An autopsy is a postmortem procedure done by pathologists, who attempt to determine the cause of death, trace the extent of known diseases and conditions, and confirm medical diagnoses.

Photo of Louis B. Wilson

In the early years of Mayo Clinic, according to Louis B. Wilson, M.D., “the checking of clinical diagnoses and operative procedures at autopsy of patients that died had been as extensive at Rochester as in most hospitals elsewhere,” with autopsies performed on about a quarter of deceased patients in 1904. Stimulated by the quest for knowledge, “though it was with difficulty I induced those persons particularly interested in securing – or blocking – consent for postmortems to keep out of the picture,” Dr. Wilson claimed to have performed postmortem examinations on 70% of the patients who died under Mayo Clinic’s care in 1905. 

Belgian physician Pierre Depage, M.B., a Mayo Foundation fellow from 1922 to 1924, recalled how autopsy results were routinely discussed at staff meetings: 

Photo of Pierre Depage"Every Wednesday evening, before the members of the permanent 'staff', cases of death for the week are reviewed. A resume of the clinical history, the preoperative diagnosis, the operation and the autopsy findings are projected on a screen. The clinician gives the case as he has seen it at consultation; the surgeon gives his motives for intervention, taking account of what happened afterwards; then the anatomist, supported by his sections, explains the result of the autopsy, and his frankness spares neither the errors of technique nor the errors of judgment."

Despite the invaluable information autopsies provided in improving knowledge of pathology, it became increasingly important in the 20th century to maintain a sense of dignity and respect for the deceased and their relatives, leading to the implementation of a strict policy of obtaining consent from family members. The policy, written circa 1924, made it clear that Mayo Clinic had moral and legal obligations to uphold.

In May 2016, the Office of Decedent Affairs opened. Offering 24/7 assistance for autopsies, organ and tissue donation, death certificates, and other elements of end-of-life and postmortem care at Mayo Clinic, the office strives to provide compassionate and knowledgeable support to patients, families, and staff. 

At present, the Department of Laboratory Medicine and Pathology’s Autopsy Laboratory performs over 900 autopsies per year, with 1,084 cases in 2022. 

Photographs: At left is Louis B. Wilson, 1909. At right is Pierre Depage, undated.

Satterlee bone saw, 20th century

Image of Satterlee bone saw

This style of bone saw is known as a Satterlee saw. During the US Civil War, surgeon Richard Satterlee was commander of New York City’s Medical Purveyor’s Office, which distributed medical instruments – including bone saws for surgical amputations – to the Union Army. Many of the instruments were manufactured by George Tiemann & Co. After the war, Tiemann & Co. began selling a bone saw featuring a pistol-grip handle, designed by Edward Pfarre; by the late 1870s, this design was being marketed as “Satterlee’s saw”. Although motorized bone saws are now popular in autopsy and surgical settings, Satterlee saws continue to be issued by the US military to surgical teams in combat zones facing a potential loss of electrical power.

Autopsy Table, undated

Autopsy table

Autopsy table in the Medical Science Building, Section of Pathologic Anatomy.

Facsimile of 17th century postmortem book

Title page of Govert Bidloo's book

Govert Bidloo
Anatomia hvmani corporis, centum & quinque tabvlis, per artificiosiss
1972, Facsimile of 1685 copy

Govert Bidoo (1649-1713), a Dutch physician, anatomist, poet, and playwright, was a professor of anatomy and medicine at the University of Leiden and served as personal physician to William III of England. 

Plate from Bidloo's book

His best-known work, Anatomia Hvmani Corporis, was published in 1685. Two notable scientific mentions described in the book include the first described case of a lipomyelomeningocele, or a fatty mass which he describes as a tumor, as well as illustrations of the ridge structure of fingers. 

Plate from Bidloo's book

The 107 copperplate engravings by Dutch Golden Age painter and pupil of Rembrandt, Gérard de Lairesse, are the most notable legacy of the book.

Plate from Bidloo's book

Garrison-Morton notes “Lairesse displayed his figures with everyday realism and sensuality, contrasting the raw dissected parts of the body with the full, soft surfaces of undissected flesh surrounding them… thus [bringing] the qualities of Dutch still-life painting into anatomical illustration, and gave a new, darker expression to the significance of dissection.”

Farm Accident

Wax model of pitchfork accident

Wax model, after 1935

This farm accident wax model was once one of the most visited objects in the Mayo Medical Museum (1935-1983). Decades after the Museum closed, visitors to the Plummer 3 Historical Suite still ask staff about “the model with the pitchfork.”

Autopsy book entry
Autopsy record of a pitchfork case, 1910 

Newspaper account of farm accident

Clipping, Olmsted County Democrat, August 12, 1910

Though it does not have a patient number, it was thought to have been identified by an August 1910 article that appeared in multiple Minnesota newspapers. However, 1910 predates the documented creation of the first Mayo wax models in 1925 by dental surgery resident, Kenji Hiyama. It is possible that the pitchfork model was made using earlier photographs of the accident, or perhaps another accident of the same nature occurred later when clinic artists were available to depict it in wax.

Autopsy policy excerpts, circa 1924

Photo of Harry Harwick

These excerpts are from a document found in the papers of Harry J. Harwick (1887-1978). Mr. Harwick joined Mayo Clinic as a bookkeeper in 1908 and was appointed business manager in 1918. He was instrumental in developing the Mayo Foundation and served as chair from 1939 to 1953. Mr. Harwick also served as executive officer of the Board of Governors from 1933 until his retirement in 1952.

Autopsy policy

In this document, staff were instructed to obtain consent from family members before performing an autopsy. This was not simply an ethical issue, but a legal one, as anyone who performed an unauthorized autopsy would be “guilty of a gross misdemeanor and punishable by imprisonment for not more than one year or by a fine of not more than $1000.00 and…likewise liable for damages in a civil action.”

Autopsy policy

Casual postmortem examinations of surgical patients’ bodies were strictly forbidden: “The fact that an operation has been performed and that you can make a partial examination through the incision does not justify you in doing so without consent.” Staff were strongly reminded that both individuals and Mayo Clinic itself could be held liable for any “unnecessary mutilation” carried out on the premises.

16th century postmortem book

Plate from Matteo Realdo Colombo's

Matteo Realdo Colombo
De re anatomica libri

Matteo Realdo Colombo (1515-1559) was an Italian professor of anatomy and a surgeon. He was a colleague and friend of Andreas Vesalius, with Vesalius crediting Colombo with numerous discoveries in his revolutionary book De Fabrica. They later became rivals after Colombo noted several errors in Vesalius’s book while teaching. 

This is a first edition of Colombo’s only book, though he did not live to the final printing. The woodcut title page is the only illustration in the text and is inspired by Vesalius’s Fabrica as well as The Heart of the Miser, a bas-relief by Donatello.

Page from  Matteo Realdo Colombo's

In a chapter titled “Those Things Rarely Found in Anatomy”, Colombo shares a collection of curiosities he encountered during his career, including when he performed an autopsy on Saint Ignatius of Loyola. He was not present to consider a cause of death, but rather a routine procedure prior to embalming. 

These pages show the section discussed, beginning with the last paragraph on page 266 and continuing on to page 267. 


“Often with my own hands I extracted innumerable stones of various colors discovered in the kidneys, lungs, liver and portal vein, as you, Jacopo Boni, have seen with your own eyes, in the venerable Ignatius, general of the Society of Jesus. I also saw little stones in the ureters, bladder, colon, hemorrhoidal veins and in the umbilicus. Also, in the gall bladder, although the gall had escaped. I found little stones of various colors and shapes; and in some, a great many I saw an abscess, but what good is it to talk of abscesses…”

Crop of text on book pages

Medical students observing an autopsy, 1986 April 17

Medical students performing an autopsy

Dr. Donald R. Cahill performs an autopsy as medical students observe the procedure, 1986.

Dr. Cahill was appointed head of the Section of Anatomy at Mayo Clinic in 1984 and became professor of anatomy at Mayo Clinic College of Medicine in 1985 where he received two Outstanding Faculty Recognition Awards. He also instituted the Convocation of Thanks, a closure ceremony for families of donors to the Anatomy Donor Program at Mayo Clinic.

18th century postmortem book

Leather cover of Baglivi's book

Giorgio Baglivi
De praxi medica ad priscam observandi rationem revocanda

Page from Baglivi's book

Duro Armeno (1668-1707) was born in Croatia and later renamed Giorgio Baglivi by his adoptive father, Pietro Angelo Baglivi, a well-known physician in Lecce, Italy. 

Pages from Baglivi's book

After receiving his degree, Baglivi worked in several hospitals across Italy before moving to Bologna to become a pupil of Marcello Malpighi. In this role, he performed physiological experiments, animal dissection, and numerous autopsies. Baglivi followed Malpighi to Rome, and they collaborated until Malpighi’s death in 1694. Baglivi performed an autopsy on Malpighi (in accordance with Malpighi’s wishes) and thoroughly described his cause of death by cerebral apoplexy. 

Page from Baglivi's book

An English translation is available via Google Books.

Ohaus Dial-O-Gram balance, circa 1960

Image of Ohaus Dial-O-Gram balance

The Ohaus Dial-O-Gram balance was introduced in 1957. The Ohaus company was founded in New Jersey in 1907 by German immigrant Karl Ohaus and his son, Gustav, and specializes in producing scales and balances for diverse applications in the medical, laboratory, education, jewelry, and industrial sectors. In an anatomic pathology setting, balances and scales are used to weigh organs and tissue.

19th century postmortem book

Leather cover and table of contents of Virchow's book

Rudolf Virchow
Description and explanation of the method of performing post-mortem examinations in the dead house of the Berlin Charité Hospital: with especial reference to medico-legal practice
Translated from the second German edition by T.P. Smith

Pages from Virchow's book

Rudolf Virchow (1821-1902) has been called the Father of Modern Pathology. Born in what was Prussia, now Poland, Virchow had a variety of interests and held many roles including physician, anthropologist, pathologist, medical historian, social reformer, writer, and politician.

Pages from Virchow's book

Virchow introduced the concept that cellular changes are the foundation for understanding disease in pathology and autopsy. He suggested physiologic pathology, the study of the operation of the body in the study of disease, should be the future of anatomical study.

A prolific writer, Virchow has over 20 entries in Garrison-Morton, a bibliographic reference detailing the most significant books in the history of health sciences. The first German edition from 1876 is included on the list as a landmark title regarding the technique of dissection. 

Pages from Virchow's book

In this book, Virchow features his comprehensive process for autopsy dissection. This involves examining organs in situ and relative to one another, then removing them for further study and dissection. He also endeavored to keep related components together for use in presentations. He designed this technique to detect abnormalities in organs. While he was unique in his effort to dissect organs one by one, this has now become the standard method.   

Pages from Virchow's book

Rudolf Virchow
Description and explanation of the method of performing post-mortem examinations in the dead house of the Berlin Charité Hospital: with especial reference to medico-legal practice
Translated from the second German edition by T.P. Smith

20th century postmortem book

Title page of Cajal and Munoz's book

Santiago Ramón y Cajal and Jorge Francisco Tello y Muñoz
Manual técnico de anatomía patológica (autopsia--histología patológica--bacteriologia)

Pages from Cajal and Munoz's book

Spanish neuroscientist Santiago Ramón y Cajal (1852-1934) is best known for receiving the Nobel Prize in Physiology or Medicine with Camillo Golgi in 1906 for their work on the structure of the nervous system. He was also a pathologist, histologist, and prolific artist. His father, Justo Ramón Casasús, was a professor of dissection and helped his sons study anatomy.

Pages from Ramon and Munoz's book

Pages from Cajal and Munoz's book

In the introduction of this text, Ramón y Cajal notes the first edition was written as a manual for students but given the advancements with microscopes, a new book detailing technical rules was needed to assist with a more precise diagnosis of disease and identification of infectious bacteria. He collaborated with Dr. Tello, Head of the Department of Autopsies at the Cajal Institute and Director of the Section of Epidemics of the National Institute of Hygiene. 

Pages from Cajal and Munoz's book


This exhibit was designed and curated by the staff of The W. Bruce Fye Center for the History of Medicine and the History of Medicine Library. All images and artifacts are from the Fye Center or Library unless otherwise stated.

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