Sponsor   

Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. We will post a workweek daily medical or surgical term, its meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

Click on the link below to subscribe to the MTD newsletter. If you think an article could be interesting to somebody else, click on the mail link at the top of each article to forward it. 

You are welcome to submit questions and suggestions using our "Contact Us" form. The information on this blog follows the terms on our "Privacy and Security Statement"  and cannot be construed as medical guidance or instructions for treatment. 


Click here to subscribe to the Medical Terminology Daily Newsletter

fbbuttons sm

We have 166 guests and no members online


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.


"Clinical Anatomy Associates, Inc., and the contributors of "Medical Terminology Daily" wish to thank all individuals who donate their bodies and tissues for the advancement of education and research”.

Click here for more information


Rare & Collectible Books at AbeBooks.com 

 

Arterial circle of Willis

UPDATED: The arterial "circle of Willis" is a roundabout of arteries found at the base of the brain, allowing for collateral circulation at this level. This arterial circle has been described by many anatomists, but it was Thomas Willis (1621 - 1675) who described it in most detail, and he was the first to understand its function.

The circle of Willis receives blood from the two main paired arteries that provide blood supply to the head and brain: the carotid arteries anteriorly, and the vertebral arteries posteriorly.

This arterial circle is formed by the anastomosis of several arteries, paired and unpaired:

Anterior cerebral arteries: These paired arteries are one of the terminal branches of the internal carotid arteries. They provide blood supply to the medial aspect and part of the lateral aspect of frontal and parietal lobes of the brain

• Anterior communicating artery: A single unpaired small artery communicating both anterior cerebral arteries and providing potential collateral circulation between them

• Internal carotid arteries: These two bilateral arteries are one of the branches of the carotid artery found at the root of the neck. Its two main terminal branches are the anterior cerebral arteries and the middle cerebral arteries

Arterial circle of Willis (en.wiklipedia,org)
Image courtesy of www.wikipedia.org 

• Posterior cerebral arteries: These two arteries are formed by the bifurcation of the basilar artery, which itself is formed by the junction of the right and left vertebral arteries. The posterior cerebral arteries provide blood supply to the occipital lobe and part of the temporal lobe of the brain

Posterior communicating arteries: These paired arteries provide communication between the carotid and vertebral arterial territories 

Middle cerebral arteries: Although not technically part of the arterial circle of Willis, these paired arteries are one of the two terminal branches of the internal carotid arteries. The middle cerebral artery travels deep in the lateral sulcus (Sylvian fissure) of the brain and provides blood supply to the lateral aspect of the brain including the frontal, parietal, occipital, temporal, and insular lobes

The arterial circle of Willis provides all of the arterial blood to the brain. Cerebral blood flow in humans averages 55 mL per 100 g of brain tissue per minute. This is a about over 742.5 mL/min for the average 1350 g brain. Depending on the situation the brain will use between 15 to 20 percent of the total cardiac output, although by weight the brain is only about two to three percent of the average body weight. Incredibly, the brain uses more oxygen that most organs averaging close to 25% of the total oxygen needs of the body!

The importance of the arterial circle of Willis is that beyond this point the arterial supply to the brain becomes terminal, that is, there are little or no anastomoses between the bifurcating branches exposing the brain to ischemia and necrosis should there be an arterial stenosis or stricture. The circle of Willis is an area prone to aneurysms, with over 27,000 cases yearly in the US.

For an image of the vascular territories of the brain, click here.

Clinical anatomy, pathology, and surgery of the brain and spinal cord are some of the lecture topics developed and delivered by Clinical Anatomy Associates, Inc.

Thanks to Jackie Miranda-Klein for making me review this post and update it!... and congratulations to Jackie for starting her Physician Assistant Master's degree at Kettering College. Dr. Miranda.