The People’s Pathologist Transcript

The murder mystery is a form that brings forth certainty from uncertainty. The job of the detective is to sort through the chaotic mass of clues and testimony to create an ordered, coherent narrative of how a crime was committed. Medical evidence forms a vital part of this process, often creating the parameters for a murder investigation with an estimation of the time of death.

At the same time as detective fiction was growing in popularity in Britain in the first few decades of the twentieth century, the field of medical jurisprudence was undergoing a quiet revolution. From the disordered, contradictory mess of Victorian toxicology was emerging the new field of forensic pathology, which proposed a scientific and evidence-based approach to the problem of understanding death. The pathologist is now a permanent fixture of any kind of crime drama, from CSI to Silent Witness and more, and that can all be traced back to one man who was forging his reputation in the mortuary while the golden age of detective fiction was just getting started.

Today, we’re going to meet Bernard Spilsbury.

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Welcome to Shedunnit. I’m Caroline Crampton.

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There is nothing in Spilsbury’s background or early years that hints at what he was to become. This man who would at the height of his powers be described as “England’s modern Sherlock Holmes” was born in 1877 in Leamington Spa. Little Bernard’s father James was a chemist in the town, and since childhood had nursed a frustrated ambition to be a doctor. James passed this cherished aspiration on to his son. It was with this end in mind that Bernard went to Magdalen College Oxford in 1895, and then on to St Mary’s Hospital near Paddington in London in 1899 to complete his medical training. He had not been an especially distinguished student at Oxford and intended to become a general practitioner once getting through his qualifications.

That was not to be, however. Once arrived at St Mary’s, Bernard Spilsbury’s life was forever altered by the trio of mentors that he encountered there. Dr A. P. Luff and Dr William Wilcox were toxicologists to the Home Office and Dr A.J. Pepper was an eminent pathologist. Together, this trio had pioneered a new approach to forensic medicine based on close attention to morbid anatomy and pathology. Spilsbury, who already preferred to work alone, began to specialise in this new field and eventually received his medical degree in 1905.

At the very beginning of the twentieth century, these forensic investigators were still hampered by something that had happened in the 1850s. In 1859 a doctor called Thomas Smethurst had been put on trial for the murder of a woman named Isabella Bankes, who he had married bigamously. Smethurst claimed that she had died of a gastric illness, but the circumstances were suspicious enough for an autopsy to be conducted and for her medicines to be tested. An eminent toxicologist and lecturer in medical jurisprudence, Professor Arthur Swaine Taylor, was called in to do the analysis. He found no trace of any toxins in Isabella’s body, but did detect arsenic in one bottle of medicine, referred to in the case as bottle 21. Since Smethurst had been treating his wife, he was arrested and tried for her murder.

Here’s where it all goes wrong for the proto Victorian scientists. Very reluctantly, Taylor took to the stand during Smethurst’s trial as an expert witness. Under oath, he was forced to admit that he had made a mistake with the tests and that the arsenic in his results for bottle 21 had actually come from the copper gauze in his equipment, not the medicine inside. Taylor continued to insist that although his methodology was flawed, Smethurst was still guilty of poisoning Isabella, but he just couldn’t prove it. The professor’s muddled testimony  was still sufficient to cause the jury to convict Smethurst of murder, even though many in the legal profession felt that the case had not been proved beyond the “reasonable doubt” required by English law.

Medics throughout the UK and Ireland were outraged by Taylor’s blunder and there was much correspondence in the press about it, which eventually resulted in the Home Office taking the rare step of pardoning and releasing Smethurst from jail. The ramifications of this one trial were felt by the medical profession for decades. In the eyes of the public, expert medical witnesses like Professor Taylor were not reliable and their so called science could not be trusted. Subsequent trials, like that of Florence Maybrick which I have covered in two episodes in 2019, were a complete mess of expert medical witnesses disagreeing with each other and confusing jurors. Oddly, Taylor himself seems to have emerged relatively unscathed even as his field was so maligned. His 1865 book Taylor’s Principles and Practice of Medical Jurisprudence became a standard text in criminology and remained in print for a century. Indeed, it was such a well known work that both Dorothy L. Sayers and Anthony Berkeley reference it in their fiction.

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When Bernard Spilsbury was appointed to a lectureship in pathology at St Mary’s in 1907, then, forensic pathology was still recovering its reputation for reliability in the eyes of the justice system and the wider public. As an indication of the move towards a more forensic approach to detection, it’s worth noting that it was in this same year that R. Austin Freeman published The Red Thumb Mark, his first novel featuring the medical jurispractitioner Dr John Thorndyke. Thorndyke is a medical doctor who has also qualified as a lawyer, and he practices a kind of detection that relies heavily on detailed observation and analysis, often using the laboratory that he has set up at his chambers in the Inner Temple. This particular story is about a jewel theft where the criminal has left a single bloody fingerprint at the crime scene, which the police have used to identify a principal suspect. This man protests his innocence, but his lawyers advise him to plead guilty because no defence could succeed against such cut and dried evidence. Thorndyke agrees to take up his cause, and via his method of observation without assumption is able to demonstrate how this same piece of evidence can lead to a completely different conclusion.

There’s a little of Sherlock Holmes about Dr Thorndyke, who shares the Baker Street sleuth’s obsession with analysing small portions of ash, mud and fabric in order to bring clarity to a crime scene. Where they differ, however, is in character and patience — Thorndyke has none of Holmes’s brio or instability. Freeman later wrote that he had deliberately not based Thorndyke on any particular individual but that “in a professional sense he may have been suggested to me by Dr. Alfred Swaine Taylor”, thereby making the connection with forensic science explicit.

Bernard Spilsbury got his own chance to take centre stage in an investigation in 1910, three years after Thorndyke’s debut. On 13 July that year a Scotland Yard detective named Walter Dew had found a mass of mutilated, partly decomposed human remains hidden under the floor in the cellar of a house inhabited by an American dentist named Hawley Harvey Crippen. Dew had been investigating the apparent disappearance of Crippen’s wife Cora, who performed on the music halls under the name Belle Elmore, and had already interviewed him several times. By the time the remains were discovered, Crippen and his mistress Ethel Le Neve had fled, leaving Dew with a potential murder scene, a lot of body parts, and an international manhunt to conduct.

The amazingly named Dr Augustus Pepper, the pathologist from St Mary’s Hospital, was called in to do what he could with the remains in the cellar. He brought Bernard Spilsbury onto the case with him to act as his assistant, and together they removed the mass of dissected human remains  to the mortuary. Their challenge was twofold: identification and cause of death. In order to build a case for murder against Crippen, prosecutors first needed to know that it was actually his missing wife buried under the floor, and second they required some idea of how she had been killed.

The cause of death proved easier to establish — Pepper’s colleague the analyst Dr Luff was able to detect the presence of high levels of hyoscine in the tissues, a drug used for a variety of purposes including anaesthesia. The identification was more difficult. It all hinged on one piece of skin, about 5 and a half inches across and 7 long. On it, Pepper identified what he thought was a horseshoe shaped scar from a surgical operation, consistent with the hysterectomy the missing woman was known to have had while still a teenager in New York.

Others wondered if this scar was just a crease from how the body had been mutilated and buried, but Pepper was certain enough to put his idea in the report that went to the police. Spilsbury had made a special study of scarring and scar tissue as part of his pathology apprenticeship at the hospital, and as a result he was set to work on confirming that the skin tissue was from an abdomen and that the scar was surgical. He spent eight weeks on this analysis, eventually confirming Pepper’s hypothesis. This finding was cross referenced with Cora Crippen’s medical records and the identity of the body in the cellar was established.

By rights, it should have been Dr Pepper who appeared as the expert witness in the trial to explain these conclusions. He was the senior medic and had more experience of the justice system. But eighteen months before, he had been severely shaken by a different case in which he appeared to give evidence for the prosecution against a mother accused of slashing her own son’s throat. He had reported his findings about blood splatter patterns and the police had considered a conviction virtually guaranteed, but somehow the jury’s scepticism of medical evidence won out and the woman walked free. Because of this, and because of Spilsbury’s work on identifying Cora Crippen’s scar, Pepper pushed for his junior to be the one who spoke at Dr Crippen’s trial.

This was the court appearance that was to change Bernard Spilsbury’s life. In contrast to his chief’s uncertainty and equivocation on the stand, Spilsbury spoke confidently, giving testimony that was, according to biographer Colin Evans, “clear, resonant and without any trace of uncertainty”. The young scientist was succinct and sure of his ground. Apparently “Spilsbury never used three words where two would do.” Asked by the judge if he had any doubts at all about the nature of the scar, Spilsbury said “absolutely none at all”. He offered to let the judge look at the slides through his microscope, which he had brought with him to court just in case. He exhibited this evidence to the jury, allowing them to look in turn, in an act of apparent transparency that was unprecedented for an expert witness. The prosecutors were unsure how helpful this was, but it was this act that instigated Spilsbury’s reputation as “the people’s pathologist”.

The prosecutors had no evidence that directly proved that Crippen had either killed or mutilated his wife, nothing that actually put the weapon in his hand. But it didn’t matter. After just 27 minutes of deliberation, the jury returned a verdict of guilty. Bernard Spilsbury’s evidence had done the trick.

After the break: a near death experience in the bath.

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Bernard Spilsbury was 33 at the time of the Crippen case. The combination of his decisive manner on the witness stand and the crucial nature of his evidence in an already-famous trial lead to a lot of media coverage of this young pathologist and he quickly became a household name. He was offered a position by the Home Office in the aftermath of the verdict, meaning that he could be called upon by Scotland Yard much more frequently in future. He continued to work and teach at St Mary’s as well, but from now onwards he was a semi-public figure, regularly consulted by detectives and called upon to do autopsies of both victims and criminals.

There isn’t time in a single episode to talk about all of the fascinating cases that Spilsbury was employed upon in his long career. I would recommend reading one or more of the biographies I’ve cited in the show notes if you’d like to dive into them all. I do, however, want to highlight two in particular that I think are relevant for understanding how formative he was to the role of pathologist in crime fiction.

The first is that of George Joseph Smith, the “brides in the bath” murderer. I’ve done a full episode about all his victims before, which I recommend looking up to learn more about this extraordinary Edwardian conman and serial killer. Smith was eventually arrested in 1915 after nearly two decades of preying on women because one of his murders was covered widely enough in the press that the father of a previous victim saw the story and was able to help the police connect the deaths. Spilsbury was called in three days after the arrest and given the task of proving that the three women who had died in their baths — Margaret Lofty, Alice Burnham and Bessie Mundy — had all been killed by violent means rather than drowning by accident.

Spilsbury conducted exhumations and post mortems, and found that all three bodies showed minimal signs of violence or even much sign that they had drowned. He requisitioned the bathtub from each crime scene and studied them in tandem with the victims’ bodies, trying to work out how three apparently healthy women could all have so conveniently died in the same way.

He eventually hit upon the theory of drowning via vagal inhibition, which occurs when a sudden flood of water into the nose inhibits the vagus nerve causing near instantaneous unconsciousness. It’s the same way that a chop to the throat in just the right place can kill. This effect with the water up the nose can happen by accident if someone jumps feet first into a pool, but Spilsbury’s theory here was that Smith had achieved the same effect by suddenly jerking the woman’s legs upwards with a hand under the knees and simultaneously forcing her head under the water so as to propel the water suddenly into her nose. In this circumstance, Spilsbury estimated that there would be no sign of a struggle and very little evidence of asphyxiation, because unconsciousness and heart failure happens so quickly.

To test his idea, Spilsbury recruited Inspector Neil, the detective on the case, who in turn lined up three expert women swimmers about the same size as Smith’s victims. On the pathologist’s instructions, Neil tried various methods of drowning them by submerging them in the baths, but the women were always able to struggle free enough to escape his clutches. Then, Neil suddenly tried Spilsbury’s leg-yanking idea on one of the women without warning. It worked perfectly — she slid under the water unconscious immediately — and the experimenters had an anxious few minutes trying to resuscitate her once they got her out of the water.

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I think Bernard Spilsbury was a bit of a showman. Biographer Colin Evans records that the pathologist was “an impressive figure, an inch or two over six feet, conspicuously well dressed, and endowed with a haughty, aristocratic bearing that many found intimidating”. This, combined with his confidence in his own findings, made him an excellent courtroom performer. On top of that, he seems to have had an instinct for communicating complicated medical jargon in terms the layperson could easily comprehend. During the George Joseph Smith trial, he had one of the baths set up in the court room so that he could show the jury exactly how vagal inhibition would occur, and he was quite unmoveable on it when cross examined by the defence.

Smith was convicted and the news temporarily pushed the First World War off the newspaper front-pages, with Spilsbury coming in for the lion’s share of the credit. In the years that followed, the phrase “Spilsbury called in” became popular media shorthand for “this is a big case”. He became something of a minor celebrity, with the press reporting on his outings to West End theatres as well as his cases. His imposing and decisive demeanour completely restored then public’s faith in medical evidence.

Spilsbury’s critics, however, have argued that he was a little too decisive at times, and that the unwavering trust that jurors had in his authority as an expert witness had a detrimental effect on justice at times. This brings me to the other case from his long and varied career that I wanted to talk about: that of Norman Thorne in 1925. He was a chicken farmer in Crowborough, Sussex, and in December 1924 his fiancé Elsie Cameron had come down from London to stay with him for the weekend. She was never seen again, and a month later police discovered her dismembered body and personal belongings buried on Thorne’s farm. He was arrested and charged with her murder, but he maintained that he had found Elsie dead in one of the farm’s outbuildings, having committed suicide, and had buried her body in a panic.

Spilsbury was called in to perform a post mortem on Elsie’s body, and reported that he had seen bruising consistent with violence on the body. However, on the witness stand he admitted that he had seen this bruising only at “tissue level” and that there were no visible bruises on the surface. Thorne successfully applied for an exhumation and a second autopsy was performed by another pathologist, Dr Robert Brontë, with Spilsbury observing. The latter claimed that the body had deteriorated so much that no proper conclusions could be drawn by this time, but Brontë gave evidence that cast doubt on the initial assertions about the victim’s bruises. The two pathologists contradicted each other on the witness stand continually, but it didn’t seem to matter — the jury found Thorne guilty after only half an hour of deliberation, and after a failed appeal he was hanged for Elsie Cameron’s murder.

Just before his execution, Norman Thorne wrote a letter to his father, which was subsequently published in the press. “Never mind, Dad, don’t worry,” Thorne wrote, “I am a martyr to Spilsburyism.” What he meant by this, I think, was that the cult of the great pathologist was by now so intense that it transcended facts — once Spilsbury had suggested that there was cause to consider him guilty, Thorne had no hope.

The Law Journal was similarly critical of the verdict at the time. Even Sherlock Holmes creator Arthur Conan Doyle, who happened to live near Thorne in Sussex, expressed uncertainty. He gave an interview after the trial, and said: “Thorne is entitled to feel that he has been condemned by a tribunal which was not capable of forming a first hand judgement but followed the man with the big name.”

The first wave of Spilsbury biographers were inclined to dismiss this idea that he became a personality rather than purely a scientist, but more recent appraisals of his work have taken into account the performative nature of his court appearances and how the attention he received in the press shaped perceptions of what forensic pathology was capable of.

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The Thorne case seems significant with hindsight, but at the time it barely dented Spilsbury’s reputation. He went on to serve as an expert witness in a string of high profile investigations over the next 15 years, including that of Herbert Rowse Armstrong, the Hay Poisoner, and Tony Mancini, the so called Brighton trunk murderer. During the Second World War he continued his worth in London while also working for the government in a highly secret and grisly capacity, performing autopsies on the German spies executed under the Treachery Act. He also examined some of the artefacts Allied troops found in concentration camps, confirming for the authorities that objects such as lamp shades and knife cases had indeed been manufactured from the human skin of the Nazis’ victims.

The 1940s were increasingly difficult for Bernard Spilsbury. In 1940 his son Peter was killed when a bomb hit the hospital where he was doing his medical training. The last of his original colleagues from St Mary’s, William Willcox, died suddenly of a stroke in 1941, and his own health began to fail. His wife Edith had moved out of their London home at the start of the war to be in the country during the Blitz, and they never lived together again. Then in 1945 another son, Alan, died suddenly from tuberculosis.

On 17 December 1947, Spilsbury went for dinner at his club and then returned to his lab in Gower Street and turned on the gas. He was found dead, slumped over his work bench, by a colleague and the janitor later in the evening. Like so many of the cases he had worked on, his own end was front-page news, even meriting coverage in other countries. The New York Times called him the “nemesis of slayers” and described him as “a living example of the characters that writers of detective stories conjured out of their imaginations”. The paper also made an allusion to his supposedly instinctive powers of deduction, as if he was Dr Thorndyke himself: “It was said of him that he only had to see a body to know its cause of death.”

It is suggested by several of his biographers that Bernard Spilsbury had been planning this ending for a while. He usually ordered his post mortem forms in batches of 500, but in 1947 his last order was for only a hundred. By mid December he had used them all up, and had written a letter to his friend Dr Eric Gardner in Switzerland saying that by the time he read this missive “it would be all over” and that he would no longer be a burden to anyone.

I think part of the reason that Bernard Spilsbury looms so large in the popular history of twentieth century murder is because his media profile was his chief legacy. Despite his exalted reputation during his lifetime, he left behind few academic publications or students to carry on his work. He is now lauded for taking a role as a lecturer at the London School of Medicine for Women as a way of breaking down prejudice against women becoming pathologists, but he doesn’t seem to have had any proteges among the students.

In 2008 the Wellcome Collection acquired a collection of the index cards upon which he kept notes during post mortems, which you can now view online. They read like penny dreadfuls, with headings like “poisoning from rhubarb”, “mummified baby in left luggage office” and “electrocution in the bath”. There is some evidence that he was trying to organise this mass of information so that he could write a forensics textbook, but the day to day work never seems to have let up sufficiently for him to make progress. Some historians have suggested that his ego and his obsession with working alone left Spilsbury professional isolated, others that it was just the sheer demand for his services that kept him rushed off his feet.

Whichever it was, he was quickly superseded by the next generation of forensic pathologists, and the next. They distanced themselves from his showmanship, from his absolute certainty, and from his infallible reputation, but their profession was profoundly shaped by him, nonetheless.

Even now, whenever I see a pathologist in a TV crime drama in their full protective outfit, I think of Bernard Spilsbury in his big apron over his high collard suit and spats. He set the scene for everything that was to follow.

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This episode of Shedunnit was written and narrated by me, Caroline Crampton, and edited by Euan MacAleece. You can more information about this episode and links to all the books mentioned at shedunnitshow.com/thepeoplespathologist. I provide transcripts for every episode of the podcast too: find them at shedunnitshow.com/transcripts.

Thanks for listening. I’ll be back soon with another episode.