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A Moment in History

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

Dr. Thomas Dent Mütter


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

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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The Balmis expedition

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

The Balmis Expedition (1803 -1806)  The “Royal Philanthropic Vaccine Expedition”, otherwise known as the "Balmis expedition" is a little known chapter in the history of the eradication of smallpox from this world.

One of the unintended consequences of the Spanish invasion of the New World and the work of the “Conquistadores” was the introduction of smallpox to a virgin population. Other viruses were also introduced, so that between smallpox, measles, rubella, etc. it is said that in 1520 almost 50% of the population of Mexico died because of a biological infection.

Edward Jenner (1749 – 1823) discovered in 1796 that someone infected with cowpox would be protected against smallpox. The vaccine and the expansion of its use brought some relief to Europe, but the damage caused by smallpox in the Spanish colonies was catastrophic. Smallpox in its more virulent variety carried at the time a mortality rate close to 30%, leaving those who survived the virus with skin pockmarks or blinded for life. It is estimated that towards the end of the 18th century, 400,000 people died in Europe because of smallpox, and one third of the survivors were left blind.

 Don Francisco Javier de Balmis y Berenguer

A solution was needed, so in 1803 the Spanish king Carlos IV commissioned Don Francisco Javier de Balmis i Berenguer (1753 – 1819), a Spanish phyisician, to find a solution to the smallpox problem. While planning what was later to be known as the “Royal Philanthropic Vaccine Expedition” Balmis received critical contributions from Don Antonio de Gimbernat y Arb?s (of Gimbernat’s ligament).

The main problem to this expedition was that there was no refrigeration, and the vaccine production and storage as we know it today had not been invented. The procedure was simple: Inoculate the live virus of cowpox from someone who was infected with cowpox. The solution was brilliant. A group of 10 physicians and 25 orphaned children were recruited along with nurses, and having at least one infected child on board each ship, the expedition sailed on November 30, 1803. During the long voyage, child after child were sequentially infected with the smallpox virus so that four months later, on March 19, 1804, the expedition landed in Venezuela with a child with the virus.

From here, the same method was used to distribute the vaccine North and South, to cover all of the Spanish territories until 1810. The original expedition is known as the “Balmis expedition”, and Balmis returned to Spain in 1806. Other expeditions were named after other leaders (Salvany, Justiniano, Grajales y Bola?os, etc.) but all carried the original strain brought to the Americas by Balmis. Although the original 25 children were granted the title of “special children of the Spanish nation”, no one knows how many children were used in the end, or what was their eventual fate transplanted away from their homes.

The image in this article, courtesy of Wikipedia, is a bust found at the Medical College of the Miguel Hernandez University in San Juan de Alicante, Spain

1. “La viruela, aliado oculto en la conquista espa?ola” Sanchez-Silva, DJ. INFORMED 2007; 9 (12) 581-587
2. “La expedici?n de Balmis” Laval ER Rev Chil Infect 2003; 107-108
3. “Antonio de Gimbernat, 1734-1816” Matheson NM. Proc R Soc Med 1949; 42: 407-10.
4. “La vuelta al mundo de la expedici?n de la vacuna (1803-1810)” Diaz de Yraola, G. (2003)
5. “La segunda expedicion de Balmis” Tuells, J.; Duro-Torrijos, JL G Med Mex 2013 (149) 377-84

Original image courtesy of Wikipedia