bulletIn OF AneStHeSIA HIStOrY 25 Continued on Page 26 Mount Auburn Cemetery and Its Importance to the History of Anesthesia* By Bronwyn Cooper, MD Department of Anesthesiology UMass Memorial Health Care Worcester, Massachusetts and Sukumar P Desai, MD Department of Anesthesiology, Perioperative and Pain Medicine Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts background Boston, Massachusetts, is home to many sites related to the first public demonstra- tion of ether, including the Ether Dome, the Ether Monument, and several homes in which William T. G. Morton lived. 1,2 Notably, many of the participants in Mor- ton’s successful demonstration of ether are buried in nearby Mount Auburn Cemetery in Cambridge, Massachusetts (Figure 1). 3 Here we explore how changing burial cus- toms in early 19th-century America brought so many of these individuals to rest in one location. We explain how Mount Auburn Cemetery was established, the difficulties it faced, how it evolved, and the role it plays today. Moreover, we describe some of its re- markable features and explore some unusual structures located within this institution so very closely associated with the history of anesthesia. existing burial Practices Early 19th century customs in the United States were similar to those of England and Europe and reflected the deep religious, social, and political beliefs of the times. In many cities and towns, graveyards were located near churches. Rural cemeteries, often owned by patrons, were found on the outskirts of cities. There were a few lawn cemeteries away from towns, and these were usually managed by professional superinten- dents and owned by private corporations. 4 Lawn cemetery graves are covered by grass and marked with a small horizontally placed commemorative plaque. The crowded and impersonal graveyards of 19th century Boston were a convenient and necessary place for the disposal of the dead, while also serving as a constant reminder to the living, not only of their own fragility but also of an urgent need to prepare for death. 3,4 Death was considered not merely the termination of earthly ex- istence, but equally (or more importantly) the beginning of life in heaven. To remain in good standing with the Church was es- sential, and prayers were regularly offered for the collective dead. Eternal damnation could be avoided by charitable actions, after which one could expect the reward of heavenly bliss. Temporal life was devalued and de-emphasized, while simplicity dic- tated that gravestones, if any, were engraved with simple epitaphs such as memento mori (remember your mortality) or fugit hora (the hour flies). Due to the scarcity of land in cit- ies, it was not uncommon for many bodies to share one grave or tomb, a practice called ‘stacking.’ This often took place beneath or on the side of a church, making it difficult for family members to clearly locate the spot where their loved ones were buried. Com- munal burials emphasized the importance of the group over individual autonomy. While wealthy families had the option of building a graveyard or chapel on their property, the masses had to make do with crowded city graveyards. Burial at a significant distance away from churches was reserved for indi- viduals and families considered undesirable: the excommunicated, executed individuals and their families, and those who had com- mitted suicide. An urgent need for change Several factors caused a shift away from church-administered graveyards to secular- ized cemeteries. Attitudes amongst members of the educated upper class and the popu- larity of the Unitarian movement brought about reconsideration of society’s approach to burial customs and the Church’s role in this process. Increased urbanization due to the industrial revolution brought about a scarcity of burial space. In the absence of any regulatory controls, it was only a mat- ter of time before society could no longer ignore some obvious problems with current burial practices. For instance, the foul odor emanating from shallow graves in the center of the cities became especially worrisome in light of epidemics of diseases such as cholera, small pox, diphtheria, scarlet fever, yellow fever, and measles. Health officials proposed a correlation between the outbreak of such epidemics and contaminated water run-off from burial grounds. 4 The recom- mended secularization of burial customs as well as the changing beliefs regarding nature and melancholy provided the necessary impetus for the emergence of the rural cem- etery movement in the early 19th century. Secularization also allowed churches to opt out of the legal requirement to bury every parishioner on their grounds, especially if such parishioners did not attend services. Thus, secularization was a practical solu- tion not only to society at large but also to the Church. Once it became acceptable not to bury the dead in the church graveyards, surviving loved ones began to return to secular burial sites to remember, mourn, reminisce, and meditate on the departed. This was not always possible in the crowded, malodorous church graveyards of mostly anonymous graves. However, the idea about how best to design secular graveyards came from Europe. Père lachaise cemetery The need for a new approach to burial practices had already been realized in many European cities. The French were the first to *Work presented here was funded entirely from intramural sources and was presented at the 16th Spring Meeting of the Anesthesia History Association, April 28-30, 2011, in Dallas, Texas.