Which department did Thomas Mütter chair at Jefferson Medical College?
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?
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.
What type of animal was (and is) used by doctors to help promote blood flow?
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.
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.
Gout is one of the most painful kinds of arthritis. It occurs when too much uric acid builds up in the body. Stressful events, alcohol or drugs, a diet high in purines, or, as in Thomas Mütter’s case, heredity, can bring it on.
Mütter’s gout was felt mostly in his hands, which was especially trying for a surgeon. When gout flared up, Mütter could not do classroom demonstrations, nor keep to his surgery schedule in his private practice.
In addition to gout, Mütter had lifelong lung problems. Orating in classrooms and breathing in noxious chemicals day after day only complicated the condition. By the mid 1850s, Mütter’s health worsened and he was unable to lecture or perform surgery. In 1856, he resigned from Jefferson.
Thomas Dent Mütter died in 1859 at the age of 48.
How did the umlaut get into in Thomas Mütter’s name?
He put it there.
Thomas Mütter was born Thomas Mutter. After graduating medical school and a spending a year in France, he decided to add some European flair to his last name. He went over to France as a Mutter and came back as a Mütter.
Mütter was a favorite among students at Jefferson Medical College and was greatly respected as a surgeon by the general public, but the Philadelphia medical elite was not quite as enamored with him.
Mütter did himself no favors. He was fastidious in dress, he name-dropped (he put an umlaut in his name!), and he did not hide his displeasure with the medical community that he felt didn’t live up to his standards. Being from the south, he had no social connections in Philadelphia. Although lauded in Europe, he struggled to be accepted in the United States.
Mütter was an expert and efficient surgeon with great respect and compassion for his patients. He spent 16 years at Jefferson Medical College, training the next generation of physicians.
As Mütter’s health declined, he worried about his legacy. Taking a clue from a French surgeon, he decided to donate all his medical specimens and oddities he had collected over the years. The obvious choice was to give them to Jefferson Medical College. Jefferson declined.
Where did Mütter’s unusual collection find a home?
The College of Physicians of Philadelphia
Jefferson had neither the space nor the money to house Mütter’s collection properly.
He then asked the College of Physicians of Philadelphia to accept them. The College of Physicians is a place for medical professionals and the general public to learn about medicine as both a science and an art. Mütter requested the items be stored in a fireproof building and he offered salary for a curator. The College agreed to his terms.
The original Mütter Museum was built after his death. It opened in 1863 at its original location, at 13th and Locust Streets. In 1909, it moved to its present location at 19 South 22nd Street.
The mission of the Mütter Museum is to promote understanding of the mysteries and beauty of the human body, and to appreciate the diagnosis and treatment of disease.
In 1874, the Mütter Museum bought a collection of human bones from a Viennese anatomist. What type of bones are they?
Viennese anatomist Joseph Hyrtl amassed a collection of skulls in an effort debunk phrenology, a pseudoscience that theorize physical features of a skull are evidence of intelligence, personality, and racial differences. Hyrtl’s aim was to show that cranial anatomy varied widely even within a single race, in this case Caucasians of Eastern Europe. Hyrtl sold his collection of 139 skulls to the Mütter Museum in 1874 where it has been on display ever since.
The skulls are displayed with comments about the original owner’s age, place of origin, and cause of death. The collection has sometimes been referred to as “The Grinning Wall”.
The addition of the Hyrtl Skull Collection gave legitimacy to the museum. It changed it from a personal collection to a full-fledged medical museum.
Pieces of what world famous scientist are on display in the Mütter Museum?
After Einstein’s death in 1955, a New Jersey pathologist, Thomas Harvey, autopsied the body and, without permission, removed the brain. Dr. Harvey kept it for decades in a succession of glass jars and in cider box under a beer cooler in his home. Eventually the Einstein family consented to allow him to keep the brain on the condition that it would be used for research only.
Dr. Harvey dissected the brain into 240 blocks, cut them into slices and mounted them on 1000 microscopic slides. He sent pieces of Einstein’s brain to researchers all over the world. Slices were given to a Fellow of the College of Physicians in Philadelphia who then donated them to the Mütter Museum.
Scientists have long wondered what made Albert Einstein so smart. By studying the pieces of his brain, we now know his brain was a little smaller than average, had an overabundance of glia cells, and lacked several degenerative changes that should have been present in a 76-year-old.
The most famous plaster cast on display in the Mütter Museum is of conjoined twins Chang and Eng. What organ did the twins share?
Chang and Eng were born in 1811 in Siam, now known as Thailand. They are the original Siamese twins – in fact, due to their birthplace and condition, the term was invented to describe them.
In 1829, they came to the United States as a traveling exhibition, but after tiring of touring, they settled down on a farm in North Carolina, married sisters, and had 21 children between them.
Their livers were fused but independently complete. In later years when Chang drank, Eng never felt the alcoholic effects. There was talk of separation but doctors advised against it fearing neither could survive the loss of blood during the operation.
After their death in 1874, their bodies were sent to the College of Physicians of Philadelphia to be studied, photographed, and dissected. A plaster death cast was created and is displayed at the Mütter Museum. The museum holds a large collection of conjoined fetal specimens and other artifacts related to conjoined twins.
In 1875, a construction project in center city Philadelphia caused several graves to be exhumed. A woman’s remains were found to have turned into adipocere. What is she now known as?
The Soap Lady
When exposed to anaerobic bacteria in a warm, moist, and airless environment, body fat can turn into a soap-like substance called adipocere. Researchers believe water leaked into the Soap Lady’s coffin and transformed her body as it decomposed.
Due to modern technology, it is now estimated that the Soap Lady died sometime in the 1830s when she was in her late 20s. You can see her on display in the Mütter Museum.
What is the cognitive process of selectively concentrating on one piece of information while ignoring other perceivable information?
Our brains are bombarded with information at every moment. Our brains must select which sounds, images, thoughts, and feelings to consider, and which ones to disregard.
Researchers have divided types of attention into two categories: involuntary and voluntary. Involuntary attention is the spontaneous and effortless response to sensory or intellectual stimuli (example: a clock ticking) Voluntary stimulation is the act of selecting from a variety of competing stimuli. This type is also called “directed” attention. (example: a doorknob turning)
When one is deeply immersed in work, unaware of the passage of time, they are in a nearly meditative state that psychologists call “flow”.
When one is interrupted, how long does it usually take to get one’s concentration back?
Our focused attention is not like a switch that can be turned off and on. It takes time to become immersed in a project. This state of flow can be destroyed in a moment by an interruption such as a phone call.
It usually takes 15 minutes or more to return to the same state of concentration.*
Directed attention is fatiguing. It takes effort to achieve focus and inhibit distractions. A brain used in this way becomes less effective over time. Because brains have a limited amount of processing resources, we can eventually become bored, irritable, and impatient.
Attention may be “restored” by changing to a different task that uses a different part of the brain.
*DeMarco and Lister (1988) Peopleware: Productive Project and Teams
Attention Restorative Theory (ART) contends that people concentrate better after spending time where?
In nature, our minds are allowed to wander and rest that part of the brain used for directed attention. Flowing water, sunsets, or clouds moving across the sky are examples of “soft fascinations” found abundantly in the natural world.* Reacting to this type of stimuli allows the brain to disengage and improve our mental abilities.
A study at the University of Michigan tested students before and after a 50-minute walk. Half of the group walked through a park and the other half walked through a heavily trafficked city center. Performances on memory and attention tasks were greatly improved by the group who walked in the park.**
Cities provide an abundance of stimulation that dramatically captures our attention. Maneuvering through crowded city streets requires a lot of directed conscious attention that can impair our mental processes.
*Rachel and Stephen Kaplan (1989) The experience of nature: a psychological perspective Cambridge University Press
**Berman, MG, Jonides J, and Kaplan S (2008) The cognitive benefits of interacting with nature. Psychological Science 19(2):1207-1212.
Do you have to be out in nature to enjoy its benefits?
Researchers have found that patients in hospitals recover faster in rooms with a view of trees. In a landmark paper from 1984*, the author reports that patients with a view of nature from their hospital room took lower dosages of pain relievers, experienced fewer minor post-surgical complications, and had shorter post-operative stays.
Just being near nature is beneficial to our health. In fact, looking pictures of nature is just as good as being in nature.
In 2013, solitary confinement prisoners in the Snake River Correction Institution in Oregon were given an option of spending an hour in the “Blue Room” where nature videos are projected. The results look promising. Nature, even in an artificial form, has been reported to have a calming and therapeutic effect on even the most hardened inmates.
*Ulrich, RS (1984) View through a window may influence recovery from surgery. Science 224:420-421
What is defined as a “condition where person-environment transactions lead an individual to perceive a discrepancy between the demands of a situation and the biological, psychological, or social resources of the individual”?
Stress has been described as the brain’s response to any demand. An overstimulated brain depletes its processing power. Stress affects organs and tissues, and disturbs our equilibrium. Immunity suffers. People under chronic stress are prone to more frequent and severe viral infections.
Frederick Law Olmstead, probably the most famous American landscape architect, was convinced that green spaces are favorable to the health and vigor of men and their intellect. Stress hormones, heart rate, and brain waves are affected when we spend time in green spaces. Your prefrontal cortex can rest and recharge.
We evolved in nature – our senses are adapted to interpret information about plants and streams, not traffic and high rises.
Nature is the antidote to modern life.
Next week's question:
What is the world’s most popular fruit?