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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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Did Andreas Vesalius really die from scurvy? (1)


Did Andreas Vesalius really die from scurvy on the island of Zakynthos in 1564?
Evidence does not support this theory.

NOTE:  The following article authored by Theo Dirix, and Dr. Rudi Coninx, is a rebuttal of Pavlos Plessas' theory that Andreas Vesalius indeed died from scurvy. The original article entitled "Powerful indications that Vesalius died from scurvy" by Pavlos Plessas was presented in a meeting at the island of Zakynthos in 2014.


Andreas Vesalius, the father of modern anatomy, was a famous man in his time. Born Andries van Wesel in 1514 in Brussels, he became the most important authority on anatomy of his time, daring even to correct the teachings of Galen, the ultimate reference on anatomy since the ancient times. Author of the most famous book on anatomy, the seven-volume "De Humani Corporis Fabrica, Libri Septem" , professor of surgery and anatomy in Padua at age 23 in 1537, imperial physician to the court of King Charles V and personal physician of the emperor of the Spanish Empire, King Philip II, Andreas Vesalius’ accomplishments are multifold. Yet, surprisingly, there are lots of things we do not know about him: how did he look like, for example, but also –and that is the topic of this paper- how did he die, what did he die from, and where exactly is he buried?

There have been more items related to Vesalius’ life that were wrongly transmitted through time, but recent investigations have put to rest a number of “disputed” facts that were erroneously reported and commonly accepted. They often made into the general history books or even into Wikipedia. The two most glaring ones were

1. That Andreas Vesalius had to leave the Imperial Court in Spain because the Inquisition was investigating him for allegedly doing an autopsy on a person that was not yet dead.

Theo Dirix and Dr. Rudi Coninx, authors of this article
Dr. Rudi Coninx, and Theo Dirix, authors of this article

• We now know that Andreas Vesalius did not leave the Imperial Court for his pilgrimage to Jerusalem under pressure of the Inquisition, as is often alleged [1], but that he left on his own accord and with the full support of the Emperor who provided him with introduction letters to Spanish embassies abroad. We thought the Vesalius and the inquisition myth was laid to rest in 1928 [2], but has to be refuted again and again to this day, it seems [3].

2. That Andreas Vesalius was shipwrecked, and presumably drowned

• Vesalius did not die shipwrecked, as it was still alleged by Wikipedia recently [4] (but now corrected. His ship arrived safely at the harbour of the island of Venetian owned island of Zante (now Zakinthos, Greece) and Andreas Vesalius went ashore there.

What do we know for sure about the last days of Andreas Vesalius? 

• We know that Andreas Vesalius undertook a pilgrimage to Jerusalem in early March 1564, arriving in Venice late April, and that he sailed from Venice via Cyprus to Jerusalem in early May. He only stayed for a short time in Jerusalem, probably one month. He then traveled from Jerusalem through the Sinai desert to Alexandria, Egypt and boarded a Venetian ship there in September 1564, heading for Venice. 

• We know that the return journey was eventful. The ship was initially driven off course and then stuck without winds for over forty days which lead to food and water shortages on the ship. Most passengers fell ill, and many died. Their bodies were thrown overboard. This caused great anxiety to Andreas Vesalius who feared being thrown overboard unceremoniously in case he died. Vesalius became ill himself and lay sick in the hold with nobody taking care of him. (Account of Reinert Soleander, quoted by Biesbrouk et al.) [5].

• We also know that he stepped off the ship on the Venetian island of Zante (now Zakynthos in Greece) on October 15, 1564, sick, weak and frail, that he slowly walked towards the gates of the city where he collapsed and fell dead.

These are the facts that can be attested, and are not in dispute. What remains disputed is: did this 50 year old man die from scurvy, as is alleged?

In this article we will look at the arguments advanced in favour of the scurvy theory and see if there is any evidence to support these arguments.

Most arguments in favour of the scurvy theory have been proposed by Mr. Pavlos Plessas at the 2014 Vesalius Continuum meeting in Zakynthos, Greece and posted online on his blog (and here) [5]:

• “Vesalius stayed for six months in an area where Vitamin C was not easily found.
• Vesalius’s travels and sightseeing during the summer months means that some of his body’s Vitamin C reserves were lost through perspiration.
• Over the duration of his pilgrimage this could have exceeded 20% of his initial reserves. He then stayed an additional forty days at sea becoming vitamin C deficient.
• He reports Vesalius as immobile, depressed, with phobic and paranoid behavior,
• These can have sudden death syndrome upon restart of physical activity, which would also explain Vesalius' sudden death at the doors of the port of Zakynthos [7]..


Article continued here: Did Andreas Vesalius really die from scurvy? (2)
Sources:

1. https://circulatingnow.nlm.nih.gov/2014/10/15/the-death-of-andreas-vesalius/ accessed 27.12.2016
2. Matheson Cullen, G. Vesalius and the inquisition myth. Lancet, January 14, 1928, p 105-6.
3. Dirix Th. In search of Andreas Vesalius. The quest for the lost grave. Lannoo, 2014.
4. https://en.wikipedia.org/wiki/Andreas_Vesalius accessed on January 21, 2016
5. Biesbrouck M, Goddeeris Th, Steeno O. The last months of Andreas Vesalius. A coda. In Vesalius, Acta Internationalia Historiae Medicinae. 2012, 18 (No 2), 70-75.
6. Plessas P. http://www.parathemata.com/2014/09/pavlos-plessas-powerful-indications.html 2014. Accessed January 21, 2016.
7. http://clinanat.com/andreas-vesalius
Aa https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
8. Fain, O. La Revue de Médecine Interne, 2004; vol 25, Issue 12, 872-880.
9. Hodges RE, Hood J, Canham HE, Sauberlich HE, Baker EM. Clinical manifestations of ascorbic acid deficiency in man. Am J Clin Nutr 1971;24:432-43.
x. Hirschman JV, Raugi GJ. Adult scurvy. Journal of American Academy of Dermatology, 1999, 41; No 6, 895-909.
xx. Bartley W, Krebs HA, O’Brien JRP. Vitamin C requirement of human adults. Medical Research Council Special Report Series No 280. London: Her Majesty’s Stationary Office; 1953. P 1-179. Quoted in Hirschmann et al.
xxx Hodges RE, Baker EM, Hood J, Saueberlich HE, March SC. Experimental scurvy in man. American Journal of Clinical Nutrition. 1969;22:535-48.
10. Harrisons Principles of Internal Medicine, 1998; p 484-85
11. Leung FW, Guze PA: Adult scurvy. Annals of Emergency medicine; 1981; 10:652-655
12. Bennet M, Coninx R. The mystery of the wooden leg: vitamin C deficiency in East African prisons. Tropical Doctor, 2005; 35: 81-84.
13. Carpenter K. The history if scurvy and vitamin C.Cambridge University Press 1986, p29.
11. Bown S R. 4he Age of Scurvy. How a surgeon, a mariner and a gentleman helped Britain win the battle of Trafalgar. Summersdale, 2003, p 96-99.
15. Lind J. A treatise of the scurvy. Containing an inquiry into the nature, causes and cure of that disease. Together with a critical and chronological view of what has been published on the subject. Edinburgh: Sands, Murray and Cochran: 1753.
16. Kinsman RA, Hood J: Some behavioural effects of ascorbic acid deficiency. The American Journal of Clinical Nutrition, 1971, 455-464.
17. Biesbrouck M, Goddeeris Th, Steeno O: ‘Post Mortem’ Andreae Vesalii (1514 – 1564). Deel II. Het graf van Andreas Vesalius op Zakynthos. A. Vesalius, nr.4 December 2015. [in Dutch].
18. Bruce M Rothschild. Scurvy imaging. http://emedicine.medscape.com/article/413463-overview