Western Medicine Around 30s and 40s of the Nineteenth Century

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John Ross, Cristin O’Keefe Aptowicz, Dr Mütter's Marvel; A true tale of intrigue and innovation at the dawn of modern medicine. Gotham, 2014)
online.wsj.com/articles/book-review-dr-mutters-marvels-by-cristin-okeefe-aptowicz-1409348263

Excerpt in the window of print: Lacking anesthesia, Mütter massaged his patients for hours before surgery in the hope of desensitizing them.

Note:
(1) The reviewer John M Ross DO, 47, practices family medicine at Orland Park, Illinois.
(a) Doctor of Osteopathic Medicine
en.wikipedia.org/wiki/Doctor_of_Osteopathic_Medicine
(The practice of osteopathy began in the United States in 1874)
(b) Orland Park is a village just outside of Chicago.

(2) “Doctors still clung to the ancient dogmas of Hippocrates [c 460 – c 370 BC] and Galen, with grisly results.”

Galen
en.wikipedia.org/wiki/Galen
(129-c 200/216)

(3) “When [Thomas Dent] Mütter was born in 1811, he seemed to be a child of fortune. His mother was a bookish and beautiful product of Virginia's planter aristocracy, and his father was a well-to-do wheeler-dealer of Scottish stock. But both parents were tubercular and sickly, and their prosperity would prove illusory. By age 7, Mütter was an orphan. The son inherited his father's delicate lungs, restless ambition and debt-ridden estate.”

tubercular (adj): “of, relating to, or affected with tuberculosis <a tubercular patient>”
www.merriam-webster.com/dictionary/tubercular

(4) “After attending the young republic's premier medical school, the University of Pennsylvania, he went abroad to Paris, at that time the world's Mecca of medicine. French medicine was skeptical, progressive and cruel, combining Enlightenment rationality and medieval brutality. Paris had two hospitals devoted entirely to the care of syphilis, one of which required all patients to be publicly whipped before and after treatment. The city also had a renowned school of anatomy, which solved the problem of cadaver disposal by feeding the remains to a pack of ravenous mongrels 雜種狗.”

(5) “On the plus side, an American in Paris could watch technical wizards such as Roux, Lisfranc and Dupuytren at work in the operating theater.”
(a) Philibert Joseph Roux
en.wikipedia.org/wiki/Philibert_Joseph_Roux(1780-1854)

The French surname Roux: “from Old French rous ‘red’ (Latin russ(e)us)”
(b)
(i) Jacques Lisfranc de St Martin
en.wikipedia.org/wiki/Jacques_Lisfranc_de_St._Martin
(1790-1847; The Lisfranc joint and the Lisfranc fracture are named after him)
(ii) Lisfranc (Midfoot) Injury. American Academy of Orthopaedic Surgeons (AAOS), undated
orthoinfo.aaos.org/topic.cfm?topic=A00162
(iii) The WSJ review states, "Jacques Lisfranc * * * is mainly remembered for describing a midfoot crush injury in a Napoleonic cavalryman who got his foot tangled in a stirrup while falling from his mount.”

The en.wikipedia.org says Dr Lisfranc “first described the injury in 1815, after the War of the Sixth Coalition” (1812-1814, resulting in Napoleon's exile on Elba).
(iv) French English dictionary
* lis (noun feminine): “Lily"
en.wiktionary.org/wiki/lis

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(12) “Every hero needs a good antagonist and Mütter had a great one, a professor and blowhard named Charles D. Meigs who was as contrary as a Missouri mule.”

Missouri State Animal: Missouri mule
www.statesymbolsusa.org/Missouri/MissouriStateAnimal.html

(13) “Mütter is mainly remembered today for the splendid museum of medical curiosities that he bequeathed to the College of Physicians of Philadelphia.”
(a) College of Physicians of Philadelphia
en.wikipedia.org/wiki/College_of_Physicians_of_Philadelphia
(the oldest private medical society in the United States; founded in 1787)   

is not a medical school.

(This Wiki page says, “America's first public hospital [Pennsylvania Hospital], founded 1752, and first medical school [University of Pennsylvania], founded 1765, were in Philadelphia, as were some of the earliest public health measures, including America's first public water supply in the 1790s.”)
(b) Thomas D Mütter Collection. Scott Memorial Museum, Thomas Jefferson University, undated
jeffline.tju.edu/SML/archives/collections/finding_aids/mutter.html
(“Dr Mütter (1811-1859) was the third Chairman of the Department of Surgery at Jefferson Medical College, 1841-1856”)

The (b) talks about documents and papers, not medical curiosities.

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(9) “Mütter was one of the first plastic surgeons in America. Plastic surgery seems to have been born in India, where the cutting off of noses was an ancient means of public punishment and private revenge. The absence of a nose being a grave social liability, there were many patients desperate for help. An anonymous Hindu brickmaker of genius came up with a solution, probably many centuries ago, and passed the secret down to his descendants. A wide flap of skin was cut from the middle of the forehead, swung downward, shaped into a plausible facsimile of a nose and sewn into place. A London surgeon named Carpue heard of the Indian method and used it in the early 1800s to restore noble British noses that had been lost to syphilis. Mütter used his own modification of this procedure to replace Yankee noses which had been bitten off in barroom brawls.”
(a) rhinoplasty
en.wikipedia.org/wiki/Rhinoplasty
(section 1 History of surgical rhinoplasty: Sushruta, Third Anglo–Mysore War (1789–1792))
(b) nasal reconstruction using a paramedian forehead flap
en.wikipedia.org/wiki/Nasal_reconstruction_using_a_paramedian_forehead_flap

View photos only.
(c) Joseph Constantine Carpue
en.wikipedia.org/wiki/Joseph_Constantine_Carpue
(1764-1846)


(10) “Mütter was also a pioneer of burn surgery. Victorian women worked around open fires while imprisoned in petticoats and corsets. Minor domestic mishaps could result in horrific burns, as with Miss Havisham in ‘Great Expectations.’"

Miss Havisham
en.wikipedia.org/wiki/Miss_Havisham
(After Pip leaves, Miss Havisham's dress catches on fire from her fireplace)

(11) “Mütter operated on one young woman who had suffered such a burn in childhood. Thick layers of scar tissue on her neck had made her head immobile and distorted her face and jaw. He removed the scars and rotated a flap of skin from the neck and shoulder to fill in the defect. The procedure, now known as the ‘Mütter flap,’ was a complete success and is still used today.”
(a) L-P Kamolz, MG Jeschke, RE Horch, M Küntscher and P Brychta (eds), Handbook of Burns (vol 2); Reconstruction and rehabilitation. New York: Springer–Verlag, Wien, 2012, at pp 142-143
books.google.com/books?id=hpxB0pxvyVgC&pg=PA142&lpg=PA142&dq=M%C3%BCtter+flap+expanded&source=bl&ots=O5NEUu_YqX&sig=q8ljeu32lVE1P9Qkap0nCpRwYis&hl=en&sa=X&ei=vO8EVJLgFInJsQTC5YLYBg&ved=0CDIQ6AEwAw#v=onepage&q=M%C3%BCtter%20flap%20expanded&f=false
("SIF flap[:] * * * first described by Mutter in 1842 * * * was based on supraclavicular artery * * * The supraclavicular island flap [SIF] * * * was first introduced to reconstruct mentosternal contractures * * * The technique of SIF flap pre-expansion with expanders in te anterior shoulder region increased the size of ultra-thin pliable skin with good texture match to cover the whole aesthetic unit of the face")
(i) Regarding the “mentum” in the compound adjective “mentosternal”:
(A) mentum
en.wikipedia.org/wiki/Mentum
(B) Latin English dictionary

mentum (noun neuter): “chin”
en.wiktionary.org/wiki/mentum
(ii) sternum
en.wikipedia.org/wiki/Sternum
(b) What it says and shown (in photos) in the preceding book will be apparent in the following

Norbert Pallua and Erhan Demir, The Supraclavicular Artery Island Flap in Reconstructive Facial Surgery. QMP Plastic Surgery News, 2: 1-2 (2009)
www.plasticsurgerypulsenews.com/ ... =67&QnCurPage=2
(i) QMP = Quality Medical Publishing, Inc (based in St Louis)
(ii) Read the text under the sectional heading "Patient Example": an expander was inserted under the skin, gradually filled with saline (?) through a port to stretch skin (to create more skin), with a pedicle near the neck and the flap turned to cover the face. The raw area in the shoulder, I guess, would be grafted with skin from the legs.

choi

(continued)

(6) “Mütter also saw Paris's greatest surgeon, the brilliant and dastardly Baron Dupuytren, presiding over its greatest hospital, the Hôtel-Dieu. Pierre-François Percy, chief surgeon to the Grande Armée of Napoléon I, called Dupuytren ‘the best of surgeons, the worst of men.’ To Lisfranc, Dupuytren was ‘the brigand of the Hôtel-Dieu.’ Dupuytren was a self-made man, the workaholic son of a bankrupt country lawyer. As an impoverished medical student during the French Revolution, he had studied by the light of candles made of tallow filched from cadavers. In the operating room, he was a perfectionist, abiding by the motto ‘nothing is more to be despised than mediocrity.’ Driven by greed and sporadic fits of empathy, he outmaneuvered his colleagues to rise to the top of his profession and was awarded a barony by Louis XVIII.”
(a) Guillaume Dupuytren
en.wikipedia.org/wiki/Guillaume_Dupuytren
(1777-1835)
(b) Hôtel-Dieu
en.wikipedia.org/wiki/Hôtel-Dieu
("hostel of God;” is the old name given to the principal hospital in French towns, and may refer to: Hôtel-Dieu de Paris, founded in the year AD 660)
(c) Grande Armée
en.wikipedia.org/wiki/Grande_Armée
(d) brigand (n): "one who lives by plunder usually as a member of a band : BANDIT"
www.merriam-webster.com/dictionary/brigand
(e) Louis XVIII of France
en.wikipedia.org/wiki/Louis_XVIII_of_France
(1755-1824; reign 1814 to 1824 except for a period in 1815 known as the Hundred Days; younger brother of Louis XVI)


(7) “The young man [Dr Mütter] made one additional discovery in the course of his travels: the umlaut. On his return to America, in 1832, poor Tom Mutter teh orphan became the more imposing Thomas Dent Mütter, Philadelphia social climber.”
(a) umlaut
www.merriam-webster.com/dictionary/umlaut
(b) It says that his birth (sur)name was Mutter. When he returned to US from Europe, his surname became Mütter.
(c) The English surname Muter (Mutter is a variant) means “a spokesman, from Middle English mutere, motere ‘one who speaks at public meetings’, Old English motere, an agent derivative of (ge)mot ‘gathering’, ‘meeting.’”
(d) The south German surname Mütter denotes a person “employed to measure grain, from Middle High German mutte, mütte ‘bushel’, ‘grain measure’ (Latin modius) + the agent suffix -er.”

(8) “Mütter eventually found an academic home at the city's Jefferson Medical College (now Sidney Kimmel Medical College).”

Sidney Kimmel
en.wikipedia.org/wiki/Sidney_Kimmel
(1928- ; Jewish; The Jefferson Medical College was renamed the Sidney Kimmel Medical College of Thomas Jefferson University in June 2014, following a $110 million grant from the Sidney Kimmel Foundation, the fifth-largest ever gift to a medical school)