This Mortal Coil: The Human Body in History and Culture
How we feel and think about our bodies "has shifted across times and cultures, taking and losing definition due to any number of forces and trends-philosophical, religious, cultural, technological."
Getting it Straight Spines, Scoliosis, and the Hunchback King
Spine (spın̄ ) n. (OED)
1. A series of vertebrae extending from the skull to the small of the back, enclosing the spinal cord and providing support for the thorax and abdomen.
2. The central feature or main source of strength of something; [mass noun] resolution or strength of character.
3. The part of a book’s jacket or cover that encloses the inner edges of the pages.
4. (Zoology) & (Botany) Any hard, pointed defensive projection or structure.
5. (also pay spine) A linear pay scale operated by some large organizations.
6. (Geology) A tall mass of viscous lava extruded from a volcano.
During the 2014 Easter holidays I took my children to the Chessington World of Adventures Resort. We queued for an hour for the ‘Vampire’, a gothic-themed ride through the rooftops, boarding inside a mock gothic abbey complete with dim lighting and dramatic music. Centre-stage was an animatronic organist bent over a pipe organ, his frizzy, cobwebbed head moving in time to the music. The organist’s crusty black tailcoat accommodated a large round hump on one side. ‘Why are hunchbacks always so creepy?’ my teenage daughter asked. ‘They are either social misfits or evil. It’s not right. They wouldn’t be able to do that to people with any other disability.’ Millie had more reason to mind than most. At the age of twelve she was diagnosed with severe scoliosis, an abnormal curvature of the spine. Her backbone had not grown straight, but bent twice in an ‘S’ shape. These twists rotated her ribcage, pressed against her lungs and pushed out one of her shoulder blades.
I had to admit that my daughter had a point. In history, those with twisted spines are either morally dubious, gothically creepy or figures of public ridicule and condemnation; it is a straight spine that suggests, as in the above dictionary definition, the ‘main source of strength of something’, and ‘resolution’, even ‘strength of character’. Arguably the most famous character in history to have diagnosed spinal ‘deformity’ was Richard III, characterized by William Shakespeare as a grotesque and morally bankrupt hunchback ‘rudely stamp’d’, ‘deformed’, and ‘unfinished’. Richard III begins the eponymous play with a soliloquy that draws attention to his perceived physical deformities:
But I, that am not shaped for sportive tricks,
Nor made to court an amorous looking-glass;
I, that am rudely stamp’d, and want love’s majesty
To strut before a wanton ambling nymph;
I, that am curtail’d of this fair proportion,
Cheated of feature by dissembling nature,
Deformed, un nish’d, sent before my time
Into this breathing world, scarce half made up,
And that so lamely and unfashionable
That dogs bark at me as I halt by them.
Shakespeare’s Richard III was a man marked by cruelty, as testified by his murder of Edward and Richard, the legitimate heirs to the throne and the so-called ‘princes of the tower’. The association of spinal deformity with moral crookedness at the core of Shakespeare’s play reflects age-old associations between ugliness and evil on the one hand, and beauty and virtue on the other. While beauty reflected the goodness inside a person, to be as ‘ugly as sin’ meant the very opposite: ugliness and deformity were equally vilified. Shakespeare’s interpretation has influenced most historical criticism of the character of Richard III, though it was published more than a century after the king’s death at the Battle of Bosworth. Richard III is not the only famous hunchback; there is also Igor, the crooked assistant of Frankenstein, and Victor Hugo’s hunchback of Notre Dame (Notre Dame de Paris, 1831), whose Disney incarnation proved the exception to the rule that hunchbacks were evil -- though of course the character was too conventionally unattractive to find love.
This chapter explores the history and meanings of the skeleton, especially the spine, and the languages used to describe it. It will start with a more detailed consideration of Richard III, before considering both healthy spines and those affected by scoliosis, a condition that has been relatively neglected in the history of medicine. The spine is usually imagined as the framework of the body, the scaffolding on which everything else sits -- a metaphor that, as we will see, has a long history. Perhaps more than any other part of the body the spine is viewed mechanically. Indeed orthopaedics, the medical speciality that deals with bones and their deformities, takes its name from the straightening of crooked bones in youth (derived from the Greek ‘orthos’ for straight and ‘pais, gen. sg. paidos’ for child).
The Case of Richard III
Richard III’s remains were discovered within the site of the former Greyfriars Friary Church in Leicester in 2012. Osteo-archaeological evidence suggests that Richard III was not a hunchback, though he did live with scoliosis. His excavated skeleton showed no sign of kyphosis, the condition in which the spine curves outwards and creates the characteristic ‘hump’ of Shakespeare’s hunchback. Leicester University scholars Sarah Knight and Mary Ann Lund, two of the academics charged with dealing with the press after the discovery of Richard III’s skeleton in a car park, have convincingly argued that Shakespeare’s terminology has clouded judgement of the king’s disability. Indeed the discovery of Richard III’s skeleton launched a plethora of articles that sought to rehabilitate the king as an impressive and brave warrior rather than a dismal hunchback, who lived with, but was not incapacitated by, scoliosis (see Fig. 1).
Since Shakespeare was writing during the age of Elizabeth I, whose grandfather was crowned after Richard’s death, it is perhaps understandable that his character is depicted in a less than flattering light. There is also much art historical evidence that suggests portraits of Richard III were tampered with in the Tudor age, increasing the height of one of his shoulders in one instance, to visually show that the king was physically deformed.
To understand why Richard III was depicted as a hunchback, and the antipathy towards hunchbacks in history, we must consider contemporary attitudes towards disability. Charity towards the weak and infirm has been a staple of Christian tradition since the life of Jesus, but Leviticus made a clear association between physical deformity and moral decrepitude. Certainly no man with a ‘defect’ was qualified to have a leading role in the church:
16 The Lord said to Moses, 17 ‘Say to Aaron: “For the generations to come none of your descendants who has a defect may come near to offer the food of his God. 18 No man who has any defect may come near: no man who is blind or lame, disfigured or deformed; 19 no man with a crippled foot or hand, 20 or who is a hunchback or a dwarf, or who has any eye defect, or who has festering or running sores or damaged testicles. 21 No descendant of Aaron the priest who has any defect is to come near to present the food offerings to the Lord. He has a defect; he must not come near to offer the food of his God. 22 He may eat the most holy food of his God, as well as the holy food 23 yet because of his defect, he must not go near the curtain or approach the altar, and so desecrate my sanctuary. I am the Lord, who makes them holy.” ’
The specific wording may have changed slightly from William Tyndale’s edition available in the 1530s, but the relevance of the link between physical and moral decrepitude has not. Biblical texts help explain the metaphors that we still associate with the spine, and its association with strength and straightness or crookedness and deception (‘spinelessness’, of course, being a common term for cowardice). Though figurative, these moral associations dominate the cultural history of the spine, both straight and curved.
Spine as Framework
The skeleton comprises about 206 bones, several of which fuse together during the ageing process. The spine consists of twenty-four articulating vertebrae and nine fused vertebrae in the sacrum (a triangular bone in the lower back), and the coccyx. The framework of the bones intrigued Renaissance anatomists. In the sixteenth century the Belgian anatomist Andreas Vesalius wrote of the skeleton as part of the core structure of the human being, using architectural language that is still in use today. Professor of Surgery and Anatomy at the University of Padua and later Imperial Physician at the court of Emperor Charles V, Vesalius is commonly regarded as the founder of modern human anatomy, based on the precision and detail of his anatomical plates and his analytical description grounded in dissection and observation.
Vesalius’ De humani corporis fabrica consisted of seven books or sections, each of which depicted a different system of the body. The first two books were devoted to bones and muscles, with Books 3 to 7 giving an account of soft tissues, including nerves, the vascular system, the digestive and reproductive systems, heart and lungs and brain. The spine was therefore covered in the first book, which dealt with ‘Things that sustain and support the entire body, and what braces and attaches them all.’ For Vesalius the spine evidenced ‘the signal craft of Nature, which fashioned a vertebra in the midst of the back, stable and supported on both ends just as we see builders place one stone between two others in vaulted and arched buildings’.
The skeleton was thus a scaffold on which the entire body’s tissues, fibres, and organs rested. Thus the Italian anatomist Niccolò Massa wrote in Anatomiae Libri Introductorius (1536) of the bones as ‘the foundation of the rest of the parts of the body’. Massa explicitly invoked the work of the ancient physician Galen, who sought to explain the parts of the body in relation to one another, and to construct a set of names for distinct anatomical features in De ossibus ad tirones (On Bones for Beginners). The bones are ‘the hardest and driest parts of the living body,’ Galen wrote, as well as the earthiest: ‘they sustain and support the other elements of the body as a foundation, for everything is secured and attached to the bones’.
In discussing the ‘earthy’ nature of the bones, Galen was referring to one of the four elements -- earth, air, fire, and water -- which along with the four humours composed the fundamentals of traditional medicine. Since humours and fluids governed the body, the condition of its constituent parts depended on its degree of heat. Galen believed that the skeleton was made from the same matter as sperm, as evidenced by its pale colour. The eminent Arab natural philosopher Ibn-Sīnā (known in the West as Avicenna) similarly claimed that bones were derived from the blood, and from dried-up humours. In both the Galenic and the Islamic traditions all the body came from the same matter as sperm, and the bones were ‘clothed’ with flesh:
We created humanity from a quintessence of clay, then We made it a drop of sperm in a firm abode. Then We made the sperm-drop into a clot of blood and We made the blood-clot into a lump, and made the lump into bones, and clothed the bones with flesh. Then We made it as a new creation. Blessed be God, the best of creators!
Fay Bound Alberti is Wellcome Trust Senior Research Fellow and Senior Research Fellow in History at Queen Mary University of London.
Reprinted from This Mortal Coil by Fay Bound Alberti with permission from Oxford University Press USA (footnotes and illustration omitted). Copyright © Fay Bound Alberti 2016 and published by Oxford University Press USA. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.