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TRIVIA ARCHIVE: 2012 - 2013 - 2014 - 2015

TRIVIA QUESTIONS

Which department did Thomas Mütter chair at Jefferson Medical College?

Surgery

Thomas Mütter had a natural energy and enthusiasm for teaching. His lectures were well devised, amply demonstrated, and outstandingly delivered. He quickly became a favorite of students. He engaged with his students. His lectures were not one-sided orations. He encouraged student participation – unheard of at the time.

The early days of Jefferson Medical College were marked by infighting among the faculty members and a contentious relationship with the Philadelphia medical community.

When the Board of Trustees searched to fill departmental chair positions, they looked for something more than talent in the classroom. They hoped for a harmonious faculty of professors. In 1841, the board elected their youngest and most inexperienced faculty member to chair the department of surgery. Thomas Mütter rose to this position at the age of 30 and held it until he retired in 1856.

In those days, surgery was a gamble. Some patients preferred to live with their malady and forgo an operation and its torturous aftermath. 

What is the blood infection when the body has an overwhelming immune response to bacteria or viruses?

Sepsis

Certain infections can cause overwhelming systemic inflammatory responses that, when disseminated into the blood stream, can be life threatening. Septic shock is characterized by a very high fever and low blood pressure. It is a common cause of death in hospital critical care units.

Before the days of sterilization, doctors could spread infection during operations with unwashed hands and contaminated tools. Although antisepsis was not a term or a concept used in his time, Thomas Mütter instinctively understood that doctors should keep their hands, clothes, tools, and surgical areas clean.

Looking back, it seems amazing that this idea of cleanliness was controversial. At that time, many surgeons believed that doctors were gentleman and all gentlemen were clean.

In lectures and articles, Thomas Mütter insisted on proper care of patients, before during, and after surgery, and in the most hygienic way possible.

Thomas Mütter devised a surgical technique where skin from one part of the body is sewn onto another area. What is this reparative graft called?

The Mütter Flap

Thomas Mütter understood that the human body is likely to reject foreign skin, and could reject even its own skin if moved from one area to another. If blood could continue to flow uninterrupted to the area, he thought it would have a better chance to adhere and grow normally. The trick was not to sever all the blood vessels.

In 1842, Mutter performed surgery on a young woman that had been badly burned as a child. Burns were common in Mütter’s day, especially for women. Women’s clothing consisted of layer over layer of cotton and silk fabrics, tied to the body with ribbons and lace. Any spark or ember could easily set them afire.

During the operation, Mütter cut away the scar tissue covering the woman’s neck. Next, he cut into a patch of skin on her shoulder and back, careful not to sever it completely. He twisted the skin around her neck and sewed it in place. Because blood still flowed, the skin took hold. She was able to lift her head, close her mouth, and blink normally – things she had been unable to do in 20 years. It was said that Mütter “unmade monsters”.

This became known as the Mütter Flap.  It was used for the next 100 years until advances were made in microsurgery.

This week's answer:

What type of animal was (and is) used by doctors to help promote blood flow?

Leeches

This parasitic worm has a long history in the doctor’s medical kit. Leeches are attached to a patient’s body to draw blood to or from a specific area. They have unique saliva that promotes blood flow and prevents clotting. Once a leech is attached, a wound may bleed for hours while veins have time to regrow and regain circulation.

Some physicians consider leeches a near perfect – and self replicating – surgical tool and was certainly found in the arsenal of equipment used by Thomas Mütter.

Next week's question:

Mutter suffered with a medical condition that would flare up and hampered his ability to perform surgery. What was it?

Hint: Benjamin Franklin also suffered with it.

 

Past questions and answers are in the trivia archives: 2012 / 2013 / 2014 / 2015

Questions? Comments? Corrections? Contact Mary Leonard, mleonard@mail.med.upenn.edu

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