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A Moment in History

Dr. Thomas Dent Mütter
Dr. Thomas Dent Mütter (1811-1859)

Dr. Thomas Dent Mütter

(1811-1859)

Thomas Dent Mutter was born on March 9, 1811, in Richmond, VA. His mother died in 1813, and his father died of tuberculosis in 1817. Thomas was orphaned when he was barely 8 years old. His father left him a somewhat meager inheritance and in his early life had to do with less that others with his objectives in life. He was well educated under the tutelage of Robert Carter, his guardian, and in 1824 he started his studies at the Hampden Sidney College of Virginia. He continued with a medical apprenticeship with a Dr. Simms in VA. He was well respected and even at his early age he would do home visits for his medical benefactor with great results. He started medical studies at the University of Pennsylvania, where he earned his MD in 1831. The new young doctor, Thomas Dent Mutter, MD was only 20 years of age.

At the time, Europe was the place to go to if you wanted advanced medical studies. Dr. Mutter had no money, so he applied as a ship surgeon to be able to cross the Atlantic. Once in Europe, he spent time in Paris, where he studied under the tutelage of Dr. Guillaume Dupuytren. He later studied for a short time in England where he met Dr. Robert Liston. Following Dupuytren's teachings, Mutter was fascinated by plastic surgery.

A chance encounter with what was to become his first well-known acquisition of a medical curiosity, Mutter started thinking on how to help those people that were known at that time as “monsters”, patients who the general public did not see, because they did not appear in public. The curiosity in question was a wax reproduction of the face of a French woman who had a “horn” arising from her forehead. This piece is on exhibit at the Mütter Museum.

Back in the United States in 1832, Thomas Dent Mutter changed his last name to give it a more “European” sound and added an “umlaut”, so now he was Thomas D. Mütter, MD. It may also be that he wanted to pay homage to his Scottish-German heritage, who knows? He opened his medical office in Philadelphia and although it took time, eventually he had a thriving practice. One of his specialties was the work on “deformities” so common at the time because of facial scars born out of the use of open fires in houses, and deformities caused by burns and loss of tissue due to chemicals used in local industry. Dr. Mütter is the pioneer of what we call today “Reconstructive Surgery”.

In 1835 he was asked to join the Medical Institute of Philadelphia as an assistant professor of Surgery. He was an instant success. Dr. Mütter was adored by his students because, he would question the students and guide them to discovery instead of just lecturing and leaving. In his Discourse eulogy of Dr. Mütter by Joseph Pancoast he writes:” The power of attracting students near him by his mingled gentleness, energy, and enthusiasm; of fixing their attention by the lucid and methodical arrangements of his Subject, by his clear demonstrations, and sprightly oral elucidations, came so readily to him, and was so early displayed) as to seem almost intuitive.” In 1841 Dr Mütter was appointed Professor of Surgery at the Jefferson Medical College in Philadelphia.

Dr. Mütter had always had poor health, even in childhood, and his dedication to his passion, long hours, took its toll on his body. In 1956 he set sail for Europe and resigned his teaching duties. He was named Emeritus Professor of Surgery. Unfortunately, the trip did not help, and he returned to the US in early 1958. Fearful of another winter in cold Philadelphia, he moved to Charleston, SC, where he died on March 19, 1859.

Dr. Mütter’s story does not end here. He was an avid collector and throughout his short life he had pulled together an impressive collection of medical oddities, samples, and curiosities. Knowing that his life was at an end, he negotiated with the Philadelphia College of Physicians to have them host his collection in perpetuity as well as the creation of a trust fund that would ensure that the public and medical students would have access to this incredible collection. Through the years this collection has increased and is known today as the Mütter Museum of the Philadelphia College of Physicians. I strongly urge our readers to visit this incredible museum. For more information, click here.

Personal notes: In the late 90’s, I attended a meeting of the American Association of Clinical Anatomists.  During the meeting I met Gretchen Worden, who at the time was the Curator of the Mütter museum. Gretchen was inspirational, fun, and a great conversationalist! I had the opportunity to visit Gretchen at the Mütter museum and had the luck to be treated to a “behind the scenes” tour. What an experience! I was saddened to hear that Gretchen Worden passed on August 2, 2004. Still, in my recent visit to the Mütter Museum, I was glad to see a new section at the museum that remembers Gretchen. Her biography can be read here.

I would like to thank Dr. Leslie Wolf for lending me the book by O’Keefe that lead to me writing this article. Dr. Miranda

Sources:
1. “Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine” O’Keefe, C. 2015 Penguin Random House, LLC
2. “A Discourse Commemorative of the Late Professor T.D. Mütter” Pancoast, J. 1859 J Wilson Publisher
3. “Thomas Dent Mütter: the humble narrative of a surgeon, teacher, and curious collector” Baker, J, et al. The American Surgeon, Atlanta 77:iss5 662-14
4. “Thomas Dent Mutter, MD: early reparative surgeon” Harris, ES; Morgan, RF. Ann Plast Surg 1994 33(3):333-8
5. “5 Things I Learned from Thomas Dent Mütter” O’Keefe C.


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ANDREAS VESALIUS: A biography

Document modified from the original by Efrain A. Miranda, Ph.D. , and published here as a courtesy of Clinical Anatomy Associates, Inc.

Original written by: Richard S. Westfall, Ph.D. (1924-1996)
Department of History and Philosophy of Science 
Indiana University

The image shown here is the only known portrait of Andreas Vesalius done in his lifetime, found opposite the title page of his masterpiece book "De Humani Corporis Fabrica Libri Septem" (Seven Books on the Structure of the Human body). published on May 26, 1543. This image was most probably drawn by Jan Stefan Van Calcar, although the name of the artist who did the woodcarving of this image is lost to history.

The second image, which appears when you do a mouse-over over the portrait of Vesalius is  is the 22nd plate of the first book. In the original plate of the Fabrica a Latin phrase was included "Vivitur ingenio, caetera mortis erunt" - (Intelligence lives on, the rest is mortal). I believe, just as Vesalius did, that the only way to care for and improve your intelligence is constant study and constant learning. This sentence has become my personal motto and the logo of my company.

During his life he was knows by different names: 

 Andrea Vesalius Bruxellensis. This is the Latinized version of his name with which he signed the Fabrica.

• Andreas Von Vessels

• André Wesele (Witing) Crabbe

• Andrea Vesalius

Plate 20

ANDREAS VESALIUS

1. Dates

Born: Brussels, 31 December 1514, 05:45 AM
Died: Zakynthos (Zanthe), 15 October 1564
Dateinfo: Dates Certain
Lifespan: 49years, 9 months and 14 days

2. Family

2.a. Father Name: Andries van Wesele
Occupation: Government Official

2.b. Mother Name: Isabella Crabbe

2.c. Children of Andries Van Wesele and Isabella Crabbe

Nicolas Wesele (Witing) Crabbe
Andr? Wesele (Witing) Crabbe
Francois (Franciscus) Wesele (Witing) Crabbe
Anne Wesele (Witing) Crabbe

2d. Personal family

Vesalius was married c.1545 to Anne Van Hamme, one daughter ,Anne, was born c.1546. No further information has been found on the whereabouts of Vesalius' daughter.

3. Nationality
Birth: Belgian Area
Career: Italy, Spain, Germany, Belgian Area

4. Education
Schooling: Brussels, Louvain, Paris, Padua

5. Religion
Affiliation: Catholic

6. Scientific Disciplines
Primary: Anatomy, Medicine, Physiology
Subordinate: Pharmacology

7. Means of Support
Primary: Patronage, Medicine
Secondary: Academia

8. Patronage
Types: Physician, Court Official

9. Technological Involvement
Types: Medical Practice, Pharmacology

10. Scientific Societies
Memberships: None

11 Publications

1537 - A Paraphrase on the Ninth Book of Rhazes - baccalaureate thesis (Louvain,1537; Rober Winter, Basel, 1537)
1538 - Tabulae sex (Winter)
1538 - Institutionum Anatomicarum secundum Galeni Sententiam ad Candidatos Libri Quator. - A revision of Johan Guinter fo Andernach’s original work. (Giunta)
1539 - The Venesection letter (Winter, Basel)
1541 - The Opera Galeni - A revision of Galen’s works. (Giunta, 1541, Froben, 1542)
1543 - De Humani Corporis Fabrica, libri septem (Johannes Oporinus)
1546 - Letter on the China Root (Johannes Oporinus)
1555 - The Humani Corporis Fabrica Epitome (Johannes Oporinus)
1564 - Andrea Vesalii Anatomicarum Gabrielis Falopii Observationum Examen Augustinus Gadaldinus, May 24

11a. Postmortem publications

1934 - Icones Anatomicae - Wiegand, Lambert and Archibal Malloch

BIOGRAPHY

Andreas Vesalius real name was André Wesele (Witing) Crabbe. He was born in the city of Brussels, at 05:45 AM on December 31st., 1514.

His family descends from the Witing family original from the city of Wesel, Northern Germany. After moving to Brussels Vesalius grandfather adopted the name “Von Vessels” which later derived into Vesalii (in Latin).

His father, Andries van Wesele, was an apothecary to Emperor Maximillian and then his son Charles V. He became a constant attendant to Charles, a valet de chambre. His father was the illegitimate son of Everard van Wesele, physician to the Emperor, and Marguerite Swinters. Due to the value of his work, Andries Van Wesele was later declared legitimate by the Emperor.

His great-grandfather John Witing, (Johannes van Vessels ?-1485) served Frederick III and was granted the heraldic device of three weasels. Vesalius came from a long line of physicians who were in royal service.

His great-great-grandfather, Peter, was a physician who gathered an extensive library which Vesalius inherited in part.

Vesalius took his elementary studies in Brussels most likely at the school of the Brothers of the Common Life. He matriculated at the University of Louvain on February 25, 1530 (15 years of age) as “Andreas Van Wesel aus Bruxella”, to pursue an arts curriculum. It is unknown when he decided to study medicine, possibly after 1531 when the Emperor legitimized his father in consideration of his continual service as valet de chambre.

Vesalius commenced his medical schooling at the University of Paris two years later (registered on September, 1533). Studied Anatomy with Johan Guinter of Andernach (1487-1574) and Jacobus Sylvius (Jacques du Bois of Amiens, 1478-1555). He left Paris in 1536 because of the war between France and the Holy Roman Empire. He returned to Louvain and with the support of the local Burgomaister he was able to reintroduce anatomical dissection at the local school. He received his bachelor's in medicine the following year. At Louvain, Vesalius studies under three professors, Leonard Willemaers, Arnold Noots, and later Joannes Armenterianus.

In the same year, he enrolled in the medical school of the University of Padua. With his previous work at Louvain and Paris it was only months before Vesalius passed his exams (December 1st to 5th, 1537) and received his title as doctor in medicine cum ultima diminutione. A few days later he was appointed to the Faculty of the University of Padua as Professor of Anatomy and Surgery.

He acquired great skill in dissection but remained under the influence of the Galenic concepts of anatomy. Immediately after his graduation from Padua he began lecturing on surgery and anatomy.

In 1537, Vesalius published his first book, A Paraphrase of the Ninth Book of Rhazes. He despaired for the lack of Latin translation for the arabic terms used in medicine at that time.  After receiving his doctorate in medicine (1537) at Padua, Vesalius accepted a position there as explicator chirurgiae. He was responsible for lecturing on surgery and anatomy.

Unlike many other lecturers of the time, Vesalius insisted on carrying out his own dissections for his classes. He produced for the aid of his students four large anatomical charts. After one of them was plagiarized and published, he printed the remaining three charts with three views of the skeleton by Jan Stephen, a student from Titian's studio. This work appeared in 1538 as Tabulae anatomicae sex. The Tabulae had sketches believed to have been drawn by Vesalius and by Jan Stefan Van Kalkar, a sudent of the Titian’s studio.

The same year he produced an anatomical manual for his students, Institutiones anatomicae. This book is a revision of a book originally written by Johan Guinter of Andernach, and originally published in Basel in 1536. Vesalius' anatomical researches were beginning to call into question some of Galen's findings. By 1540 he was certain that Galen's research did not reflect human anatomy; rather it was the anatomy of an ape and other animals.

In 1539, after a visit to Matteo Corti, and a discussion on bloodletting, he published an essay on the topic, known as the Venesection Letter.

In May 26, 1543 Vesalius published two works on anatomy directed to two separate audiences. The first book, has become world known as the first scientific book on anatomy. This is "The Humani Corporis Fabrica, Libri Septem" (Seven Books on the Structure of the Human Body), also known as the Fabrica. This book was published by Joannes Oporinus in Basel, Switzerland. In the longer of the two books, the Fabrica, Vesalius hoped to persuade the established medical world to appreciate anatomy as the foundation of all other medical research. The errors of Galen and of others could be corrected by active dissection and observation of the human structure.

The second book was a work for students, "De Humani Corporis Fabrica Epitome", also known as the Epitome, which also emphasized the importance of dissection and anatomical knowledge in general to the practice of medicine. Both works were amply illustrated possibly by students from Titian's studio, and published by Johannes Oporinus ( John Herbst, 1507-1568). The epitome was published so that the students could cut and paste images one on top of the others thus emphasizing the spatial relationships of the structures. This is one reason why not many Epitomes are left intact in the world today. Most of them were cut, pasted, and colorized with notes by their owners. It was for all purposes, a workbook.

In late 1543, he left academic research to become physician to the imperial household. Vesalius held this position until Charles V abdicated in favor of his son Philip II, whom Vesalius served until his own death. While in royal service Vesalius acted as a military surgeon during the Hapsburg campaigns. He also served various members of the court and was so esteemed as a physician that he was called to consult on serious cases.

Vesalius dedicated two of his earlier works to Nicolas Florenas, a physician and family friend. Vesalius referred to Florenas as the patron of his earlier studies.

Vesalius served the courts of both Charles V and his son Philip II. He dedicated his Fabrica to Charles V.

In June 13, 1546 Vesalius wrote a letter on the discovery and therapeutic use of the china root in the treatment of syphilis to his friend Joachim Roelants. This letter was later published as the Epistola on the China Root. This letter was copied (handwritten). His brother Franciscus Vesalius obtained a copy of the letter and sent it to Joannes Oporinus who published it. Read an article on this blog on this topic here.

The following year he introduced a new procedure, the surgically induced drainage of empyema.

In 1553, Vesalius started his medical private practice in Brussels.

In 1555, Vesalius published a revised version of the Fabrica, along with an unrevised second edition of the Epitome. This second edition of the Fabrica includes important revisions, such as the description of the vein valves, undiscovered in 1543. These valves were described to Vesalius in 1546 by Gianbattista Canano, an Italian physician.

In 1559, Vesalius left his private practice an became a physician to the King of Spain. These were hard years for Vesalius, due to the fact that he was rejected by the Spanish physicians.

In 1561 he wrote the book An examination of Gabrielle Fallopio’s Anatomical Observations.

In early 1564, Vesalius left Spain and went to Marseilles, and from there to Venice. Apparently he was re-appointed as a professor at Padua. In March or April of 1564, Vesalius started a journey to Jerusalem. The reasons for his trip to the Holy Land are not clear. There are many versions, some of which seem mythical, including a legend where he was forced to do this trip because he did a dissection on a specimen who turned out to be alive! Another one states that he was sentenced to death by the Spanish Inquisition, but had his sentence revoked for a trip to the Holy Land. It seems that Vesalius wanted to do this trip as a way to make a new start. Dr. Maurice Biesbrouck recently studied four letters discovered letters in Salamanca, Spain which content leads him to believe that Vesalius did his trip from piety and with the support of the King of Spain who asked him to deliver money to the Holy Land. Vesalius stayed at least six months traveling and studying botany in the region.

Vesalius  was on the return voyage on his way back to Padua when he fell ill. He died on the island of Zanthe (Zakynthos), off the cost of Greece. Again, the story is that Vesalius was shipwrecked and was washed ashore on the beach of Laganas in the island of Zakynthos in Greece. According to this myth Vesalius was left to die on the beach because the locals did not want to help.  This story has been repeated enough that a monument was erected a the Laganas beach, at the end of the Vesal street which opens to the beach. In 2014. at the  Vesalius Continuum meeting Dr. Mauritz Biesbrouck disputed these legends with recently found letters by George Boucher to Johanes Metellus. George Boucher was a German jeweler that traveled with Vesalius back from Jerusalem and paid for Vesalius’ burial and monument at the church of Santa Maria della Grazie. These letters were authenticated and analyzed, bringing light to Vesalius’ place of disembarkment in Zakynthos. According to these documents the ship that brought Vesalius back from the Holy Land was stranded without winds for over forty days. leading to famine and thirst. When the ship finally got to the port of Zakynthos Vesalius was very sick, weak, and frail. The letters state that Vesalius got off the ship and slowly walked towards the doors of the city where he fell dead. The doors to the city, which no not exist today, were very close to the Solomos square in Zakynthos (which because of its location used to be called "Port Square"), close to the church of St. Nicholas of the MoleVesalius' bust is located less than one hundred yards from that location. 

As to the reasons for his death, there have been many theories, but the latest and most compelling was presented by Pavlos Plessas at the 2014 Vesalius Continuum meeting in Zakynthos, Greece. Pavlos Plessas presented a study "Powerful Indications that Vesalius Died from Scurvy". Scurvy is rare today, but in Vesalius' time the deficit of Vitamin C was usually found in sailors. Vesalius stayed for six months in an area where Vitamin C was not easily found, add the forty days at sea, and you have a compelling case. Patients with scurvy are usually immobile, depressed, with phobic and paranoid behavior, which Vesalius was reported to have. They can have sudden death syndrome upon restart of physical activity, which would also explain Vesalius' sudden death at the gates of the port of Zakynthos.

The above mentioned theory has its detractors and have also been published. Theo Dirix and Dr. Rudi Coninx wrote the article "Did Andreas Vesalius really die from scurvy on the island of Zakynthos in 1564? Evidence does not support this theory." Pavlos Plessas also published his counterarguments in the article "An answer regarding the death of Andreas Vesalius". What is the truth about the death of Andreas Vesalius? Maybe we should find his body.

We know that Vesalius was interred at the cemetery of the Church of Santa Maria Della Grazie. Unfortunately this church was destroyed twice by earthquakes. The last earthquake in August 12, 1953 leveled the city and the church was not reconstructed. Even the streets today do not follow the path of the old streets. in 2013 and 2014 a Geographical Information System (GIS) study was undertaken by Dr. Sylviane Déderix and Dr. Pavlos Plessas using GPS, and old maps of the island as reference. This study points the location of the Church of Santa Maria Della Grazie to a place at the intersection of today's Kolokotroni and Kolya streets in Zakynthos, Greece. Only time will tell if we will be able to find and identify the remains of the great anatomist.

Additional work is being sponsored by several researchers who are looking to find the lost grave of Andreas Vesalius. In 2014, Pascale Pollier, a Belgian artist and scientist, undertook the job of reverse engineering Vesalius' skull starting from the only known portrait of the anatomist. Since the location of the cemetery where his body is interred has been confirmed, now additional research needs to be funded to continue on the quest for the lost grave of Vesalius.

In 1934 the original wood blocks were used to print 617 copies of the "Iconaes Anatomica". This book is rare and no more can be printed. Sadly, during a 1943 bombing raid in WWII over Munich all the wood blocks were burnt. Vesalius is probably one of the most written about individual on the Internet. A Google search for "Andreas Vesalius" recently reported over 345,000 hits!

The postmortem story of his book is still being written. Several authors have attempted the translation of the Fabrica with only partial results. In 2014, Drs. Daniel Garrison and Malcolm Hast succeeded in publishing "The Fabric of the Human Body" after 20 years of painstaking labor. For more information on this book, click here.

Sources
1.Harvey Cushing, A Bio-Biography of Andreas Vesalius, (Hamden, 1962). Spec. QM16 .V5 Z6
2. C.D. O'Malley, Andreas Vesalius of Brussels 1514-1564, (Los Angeles, 1965). QM16 .V5 O5
3. Jerome Tarshis. “Andreas Vesalius, Father of Modern Anatomy”( New York, 1969) The Dial Press Inc. LCN 71-88649
4. Saunder And O’Malley. “Vesalius, the illustrations from his works” 1950 World Publishing company.
5. "Andreas Vesalius; The Making, the Madman, and the Myth" Joffe, Stephen N. Persona Publishing 2009