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.
What is the world’s most popular fruit?
Although considered exotic in the United States, fresh mangoes have been reported to be the most eaten fruit throughout the world. They are the national fruit of India, Pakistan, and the Philippines.
Some consider mangoes the king of all fruit because they are rich in vitamins C and E, beta carotene, niacin, iron and potassium. Besides being delicious, mangoes fight cancer, alkalinize the body, aid in weight loss, help regulate diabetes, improve digestion, and strengthen your immune system. Whew!
What fruit was declared a vegetable by the U.S. Supreme Court?
A fruit is the seed-bearing structure that develops from the fertilized ovary of a flower. A tomato contains and protects seeds so it is indeed a fruit. And yet… the Supreme Court declared it a vegetable in 1893.
An importer refused to pay the vegetable tax on his West Indian tomatoes when they landed at the Port of New York in 1886. This case made it all the way to the Supreme Court where it was decreed that since people eat tomatoes the way they eat vegetables (during dinner) and not like they eat fruit (during dessert), it was a vegetable.
Nearly as popular as the mango, tomato and tomato products are widespread. Tomatoes are a common ingredient in recipes around the world – whether they are eaten raw in salads or cooked in pasta sauce. In eating a Wendy’s cheeseburger, you will get tomatoes in two ways: the traditional sliced fruit/vegetable and the ketchup.
But why even take a side in the fruit versus vegetable debate? Arkansas has made tomatoes their official state fruit AND vegetable.
Why does an apple float but a penny sinks?
It’s all about density
After a piece of fruit has been picked, it still needs oxygen for respiration to produce sugar and energy to maintain good health. Air needs to be able to pass through the fruit or it will turn brown and eventually rot.
An apple has tiny irregular cavities between cells that allow oxygen to pass through to its core. In fact, apples are ~25% air. Since an apple contains so much air, and air is less dense than water, it will float!
These days a penny is made of 97.6% zinc and 2.4% copper (copper-plated zinc). Because metal is denser than water, a penny lacks buoyancy and will sink in water.
How much caffeine does an apple contain?
Caffeine speeds up your heart and breathing rate, which stimulates your central nervous system and helps you to start your day.
An apple contains no caffeine but many people believe it is preferable to a cup of coffee to help you wake up in the morning. An apple has about 13 grams of natural sugar. These sugars provoke a similar response to caffeine making you feel more awake. Unlike the rush from a cup of coffee, the natural sugars in an apple are released slowly throughout the body. There are no jolts or jitters that caffeine provokes.
What do we call the edible parts of plants that don’t contain seeds?
Formally, plants have six parts - roots, stems, leaves, flowers, fruits, and seeds. A fruit is defined as the seed-bearing structure that is formed from the ovary after the plant has flowered. We call any other part of the plant that is edible a vegetable. Think leaves (lettuce), stems (asparagus), roots (potatoes).
Fruits and vegetables are defined by two different methods, botanical and culinary. In the supermarket, you will find fruits and vegetables separated by usage. Fruits that are more savory than sweet can often be found with the vegetables.
Vegetables play an important role in nutrition. They are mostly low in fat and carbohydrates and high in vitamins, minerals, and fiber.
How would a botanist separate the following items? Fruit or vegetable?
Eggplants - fruit
Beans - fruit
Corn - fruit
Radishes - vegetable
Bell peppers - fruit
Pumpkins - fruit
Cucumbers - fruit
Squash - fruit
Ginger - vegetable
Broccoli - vegetable
If a strawberry isn’t a berry, what is it?
An aggregate fruit
It has been argued that a strawberry isn’t a fruit because its seeds are on the outside, but the answer is a bit more complicated.
Botanists categorize fruit depending on how many ovaries the plant has and how it develops. A fruit is that part of a flowering plant that contains the seeds and matures from the ovaries after fertilization. Scientifically speaking, a berry is simple fruit with seeds and pulp produced from a single ovary.
A strawberry is derived from the receptacle that holds the ovaries and not the ovaries themselves. What appear to be seeds on the surface of the strawberry are actually tiny dried fruits with seeds inside (called achene).
The pulp of a strawberry is actually the swollen receptacle tissue containing many tiny dried fruits, formed from ovaries with their seeds inside – the very definition of fruit.
Do cranberries grow underwater?
Cranberries grow on long trailing vines in soft marshy grounds with acidic peat soil. Before harvesting, the beds are flooded with water. Cranberries float and are easily gathered. This process is called wet harvesting.
In addition to harvesting, the cranberry beds are also flooded to protect the vines from cold, drying winds in winter, and to help control pests. Cranberry vines can last many years. Some vines in Massachusetts are over 150 years old.
What fruit is sometimes called a “star berry” because it has a star shaped crown on top?
Blueberries are packed with antioxidants, which work to neutralize free radicals linked to the development of cancer, cardiovascular disease, and other age-related conditions.
The wide variety of antioxidant nutrients packed into blueberries benefit whole body health. They help regulate blood sugar and blood pressure, strengthen the cardiovascular system, and help protect against neurodegenerative disease.
It has been said that the blueberry is the king of antioxidant foods, which seems appropriate since it already has a crown.
What fruit got its name because it looks like a pinecone?
Pine cones and pineapples resemble one another and for a while they shared the same name…. but not the one you might think. Both the fruit and the woody reproductive structure grown on pine trees were both called “pineapples”.
What we now call pine cones grew on pine trees and resembled apples (a term used generically at that time to refer to fruit), hence the name “pineapple”. Because the tropical fruit looked similar, they TOO were called pineapples. The term “pine cone” began to appear in the English language in the late 1600s.
Pineapples (the fruit) are native to South America but as people began to move around the globe, they brought pineapples with them. This fruit is so beloved that has come to symbolize friendship and hospitality.
Pineapples have been carved into headboards, sewn into intricate needlework, and forged into metal. In fact, over on Spruce Street, Hub Bub Coffee welcomes you with a pineapple as the centerpiece of its logo.
Japanese researchers have devised a new way to store and stack watermelons. How?
They made them square!
Researchers in Japan found that growing a cube-shaped watermelon has its benefits. Square watermelons stack easily into a supermarket display, fit compactly in a refrigerator, and won’t roll when cut.
The melons are grown in a box and assume the shape of the container. Watermelons of this type are mostly seen as a novelty. They are very expensive, often double or triple the cost of an average version of the fruit.
But why stop at cubes? Watermelons are also grown in the shapes of hearts and pyramids.
What vegetable is never sold frozen, canned, processed, cooked, or in any form other than fresh in a supermarket?
Freezing is an easy and convenient way to preserve many vegetables, but not lettuce. During the freezing process, water inside the cell forms ice crystals. As the crystals expand they damage the fragile walls surrounding the cell.
Vegetables like corn and peas contain a lot of starch so the cellular walls can withstand the freezing process. Vegetables like lettuce and cucumbers contain so much water that freezing them destroys their natural structure and creates mush.
As for cooking, most vegetables are heated so they can be eaten easily. Lettuce is already tender. Cooking weakens its delicate texture. Lettuce can certainly be cooked – the internet is full of recipes to grill, bake, or boil lettuce but in the supermarket, it is sold in its raw form.
Which fruit is known to interfere with the absorption of medicine?
Grapefruit and grapefruit juice can increase the absorption of a drug in the bloodstream. A vital enzyme in the small intestine, CYP3A4, metabolizes many drugs. Substances in grapefruit juice block the action of CYP3A4, causing more of the drug to enter the blood stream and stay in the body longer, risking an overdose.
Yet, with other drugs, it’s just the opposite. Grapefruit juice interferes with the body’s transporter proteins. It blocks the amount of drug absorbed by the body and reduces the medicine’s effectiveness.
When new medicines are created, the FDA must understand how it is absorbed, metabolized, and transported in the body before it is approved and labeled. Grapefruit juice is packed with vitamin C and potassium so it is very healthy, but when mixed with certain medicines can be dangerous.
What big American city was named after garlic?
Chicago is located in an area where garlic and onions grew profusely. American Indians living in that area had a long tradition of using botany-based names when identifying landmarks. They named the area at the southwest end of Lake Michigan “sikaakwa” (or “smelly onion”) for the plant resources that grew there.
French explorers traveling through the area in the late 1600s frenchified the name and transcribed it as “Checagou”. They described the plant there as a species of garlic, but with broader and shorter leaves and a taste that was not quite as strong as garlic in France.
In 1830, the area was officially recognized as a municipality and its name was officially recorded as “Chicago”.
What plant has the nickname “The Stinking Rose” even though it is a member of the Lily family?
Garlic has had the nickname “The Stinking Rose” going back to ancient Greek and Roman times. The adjective “stinking” is obvious due to garlic’s strong odor, but rose? Garlic (allium sativum) is a member of the lily family. Its cousins are onions, shallots, leeks, and chives. It is surmised it was called a rose because a bulb of garlic from below resembles a white rose.
Garlic is produced worldwide and is a primary part of dishes in many cultures.
A restaurant in San Francisco, “The Stinking Rose”, features garlic in nearly every menu item. Their motto is “We Season Our Garlic With Food.”
Garlic is known to be:
- a) anti-fungal
- b) anti-bacterial
- c) anti-viral
- d) all of the above
All of the above
Garlic is the most recognized medicinal herb all over the world. Garlic contains several compounds that possess anti-bacterial, anti-fungal, and anti-viral properties. Garlic contains calcium, potassium, and more than 100 sulfuric compounds – powerful enough to wipe out bacteria and infections.
A diet rich in garlic appears to protect against various cancers including breast, prostate, and colon cancer. It helps prevent arteriosclerosis. Evidence shows it helps lower blood pressure in people with high blood pressure. No wonder it is nicknamed “poor man’s penicillin”.
And it’s safe. Garlic cloves can be eaten raw or cooked, dry or powered, or extracted into oils or liquids. For centuries, people have known the health benefits of garlic. Greeks would feed it to athletes before Olympic games.
What is the healthiest way to eat garlic?
- a) Swallowed whole
- b) Eaten raw after cutting or chopping
- c) Eaten after cooking
b) Eaten raw after cutting or crushing
Garlic, along with onions, shallots, and leeks contain sulfur-rich derivatives of the amino acid cysteine.
Allinase is the chemical that is responsible for garlic’s strong odor. Garlic will release allinase as defense mechanism when it is damaged, as when cut or crushed. When it interacts with the cysteine compound allin, allicin is produced.
Allicin is the most important medical substance in garlic. It may be the world’s most powerful antioxidant and can help lower blood pressure and cholesterol, and treat chronic conditions such as cancer and cardiovascular disease.
It is recommended that to get the full health benefits in garlic, it should be eaten raw. Cooking can inactivate alliinase. The optimal antioxidant level is created about 10 minutes after cutting, before allicin can break down and lose its effectiveness.
Next week's question:
What other vegetable in the allium family, defends itself by releasing toxic chemicals when cut?