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very part of the transaction was secret.

The grieving mothers couldn’t afford to bury their dead infants, so they sold the tiny bodies. The doctors buying the corpses knew the arrangements were illicit and left no paper trail.

These hushed transactions helped build the foundation of anatomy as medical students now learn it.

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Many of the historical details have been lost — but a paper published Thursday in the Journal of Anatomy reveals the story behind 54 skulls of infants and fetuses stashed away in the University of Cambridge’s department of archeology and anthropology. The earliest was from 1768, the most modern from around 1913.

The researchers who discovered the skulls could trace every move the 18th- and 19th-century anatomists made as they studied the small corpses. Instead of the huge incisions often made on adult cadavers, all but one of these skulls showed tiny cuts from knives that were used to delicately divide the skin. There were also grooves left by brushes used to remove soft tissues.

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“We found that the anatomists were dissecting them in a completely different way because they are so special. They would dissect them very gently and keep their bodies in the lab for generations to come, instead of reburying them as they did for adults,” said Dr. Piers Mitchell, a biological anthropologist, historian, and pediatric orthopedic surgeon at Cambridge, who coauthored the study.

The finding begins to solve a long-standing medical mystery. Historians knew that some anatomists used emaciated young bodies to show their students vasculature and the nervous system, as well as the stages of development. But until now, there was almost no archeological evidence that these infant dissections had ever taken place.

Selling cadavers by the inch

In the 18th and 19th centuries, trying to understand the human body at any age often meant breaking the law.

In 1752, the British government passed the Murder Act, which allowed the bodies of criminals who had been hanged to be taken by medical professors, but that only provided an average of 77 corpses a year — and some medical schools used as many as 500.

So the doctors relied on what they called “resurrectionists”: gangs who stole fresh corpses from graveyards and grieving households. Anatomists also occasionally purchased bodies from impoverished mothers after a stillbirth, an infant death, or, in some desperate cases, infanticide. This illicit trade in corpses was so strong that it continued even after poorhouses began to donate their unclaimed dead.

The mystery of the dissected children emerged, in part, from remains unearthed in old English graveyards. Archeologists found plenty of bodies that bore the scars of dissection — the tops of skulls sawn off, rib cages broken apart — but they were almost all adult men.

“People had presumed that they didn’t dissect kids and they just dissected adult males, because we just kept finding adult males in cemeteries who had had their ribs and their skulls cut open,” Mitchell said.

Yet there were accounts from grave robbers about selling “smalls” — infant corpses, priced by the inch. And 19th-century English doctors learned and published a lot about the anatomy of the child. Mitchell uses some of that knowledge even today when operating on children.

“This was the time [when] people found the structure of the child. All this kind of stuff we only know because of dissections back in the 1800s,” he said.

He was curious. So he and his collaborator Jenna Dittmar headed into the anatomic collections at Cambridge, where centuries’ worth of bones are kept in acid-free cardboard boxes. As they zeroed in on the infant skulls, small enough to fit in the palm of a hand, they could pick out the scratch marks left by the dissections and figure out how they were made.

Those traces of a gentler dissection technique can explain why archaeologists weren’t finding the sawed-off skulls of children in hospital graveyards. But much about the practice remains mysterious.

“It’s such a hidden history,” said Elizabeth Hurren, a historian of medicine at the University of Leicester in England, who has written extensively about dissections in the 18th and 19th centuries.

She has looked at more than 30,000 cases of historical dissection and found that doctors always performed a Christian burial when they were done with the cadavers, even if the ceremony had to be held in secret, at night, with a trusted, tight-lipped clergyman from the Church of England.

The skulls tucked away in those boxes do not seem to fit that pattern. But to Hurren, this study opens another small window onto a part of medical history that is largely unknown.

“It’s a contribution that the poorest have made to medical research,” she said. “We owe the poor … the most tremendous debt in the medical world.”

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