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Originally published Sunday, September 21, 2014 at 6:05 AM

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‘Dr. Mütter’s Marvels’: bringing medicine out of the dark ages

In “Dr. Mütter’s Marvels,” Christin O’Keefe Aptowicz tells the story of Thomas Dent Mütter, a dedicated American physician who helped advance humane practice of medicine in the 19th century.


Special to The Seattle Times

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‘Dr. Mütter’s Marvels — a True Tale of Intrigue and Innovation at the Dawn of Modern Medicine’

by Cristin O’Keefe Aptowicz

Gotham Books, 384 pp., $27.50

Imagine needing surgery in the 1830s. There’d be no informed consent, no anesthesia other than wine, the doctor probably wouldn’t clean his instruments or wash his hands, and the more dry, crusted blood on his coat, the better, because copious stains meant he’d treated lots of patients.

If you survived the operation, you’d be sent home — no recovery room, no hospital, no after care — with a soggy, germ-ridden poultice over the wound.

In her fascinating book based on 15 years of research, award-winning poet/author Cristin O’Keefe Aptowicz portrays standard early 19th-century American medicine so vividly, it’s hard not to cringe and give thanks for how much has changed.

And one physician who contributed many changes was Thomas Dent Mütter, a Virginian born in 1811, orphaned by family illnesses but who scrounged passage to Paris and earned his medical degree in 1831.

Becoming a doctor then meant passively listening to lectures along with hundreds of other students for two years, then taking an exam. One bonus of studying in Paris was the bargain price of a cadaver: $6. Dissection was largely illegal in the United States.

Mütter left France to settle in Philadelphia, then called “the medical Athens of America.” Without connections to the upper class, he struggled to build a practice. He had suffered many childhood illnesses that left him frail; surgery, whose outcomes could be swift and life-altering, appealed to him. By 1841, he was named Jefferson Medical College’s chair of surgery.

A flamboyant dresser, Mütter wasn’t the dour, all-knowing professor like many of his colleagues. Friendly and kind, he learned his students’ names and encouraged them to answer questions; he took them on field trips. He brought interesting specimens to class.

Jefferson had America’s first teaching clinic, where students watched their teachers treating patients. There, Mütter was a stickler for cleanliness, explained procedures to patients before surgery and consulted them during it. He lobbied the college to add postoperative care. He worked to get a year-round hospital, too.

One specialty he had been drawn to in Paris was plastic surgery. It’s almost beyond belief to think of patients sitting up, restrained by a gang of strong observers, while deformities were reduced or removed. Mütter would sometimes carve a flap of nearby skin with which to patch the wound — it was already understood a body would reject foreign tissue — then dress it with clean, dry lint and insist the patient be allowed to rest. Unlike some doctors, he was concerned with patients’ pain and urged his students to follow conservative approaches first, choosing surgery only when vital.

He began using ether in the 1840s although the medical community opposed it, citing the risk of death and the inability to speak with patients during procedures as reasons.

Aptowicz does an excellent job of establishing the context of the times and competing personalities. For example, Charles Meigs, an obstetrician, believed a doctor’s lofty calling meant he couldn’t possibly spread disease, yet he caused a great many women’s deaths from childbed fever because he would not wash.

Mütter died at age 47. But he is remembered fondly for his genial nature, extraordinary teaching and surgical skills, as well as his enthusiasm and sympathetic approach. Too, his extensive collection of anatomical specimens, models and medical instruments housed in a special building at The College of Physicians in Philadelphia, has remained open since 1858. As Aptowicz clearly shows, his legacy lives on in many aspects of medicine we now take for granted.

Irene Wanner is a writer living in New Mexico.



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