Thomas Dent Mütter is one of the earliest plastic surgery pioneers in the United States, specializing in reconstructive surgery for severe deformities before anesthesia. In the new book "Dr. Mutter's Miracle: The True Story of Conspiracy and Innovation in the Dawn of Modern Medicine", author Christine O'Keeffe Aptovic explores the life and times of this unique American doctor.

Today it is famous for its namesake museum, Philadelphia's famous Mutter Museum, 19th century doctor Thomas Dent Mütter (Thomas Dent Mütter) as a young surgical prodigy for the first time known by his own name. Mütter specializes in reconstructing severe deformities before anesthesia and is one of the earliest plastic surgery pioneers in the United States.

In the new book "The Miracle of Dr. Mutter: The True Story of Conspiracy and Innovation in the Dawn of Modern Medicine" (Gotham Books, 2014), author Cristin O'Keefe Aptowicz explores the life and times of this unique American doctor.

When they were wearing tights and cooking in front of an open flame, it was not uncommon for women to be severely deformed due to burns at home. Shame often prevents these women from seeking medical treatment. However, Mütter invented a new treatment method, which he called Mütter flap surgery, which completely changed the treatment of burn deformities. Women (and men) with severe burns from all over the country came from all over the country to receive his treatment, despite the lengthy and painful surgery performed while the patient was awake. As an early form of skin transplantation, Mütter flap surgery is still in use today more than 150 years after Mütter's death.

During his career, Dr. Charles D. Meigs (1792-1869) is one of the most prominent and influential doctors in the United States, and a colleague and colleague of Dr. Thomas Dent Mütter (1811-1859). These two men were both faculty members at the Jefferson Medical School in Philadelphia, and they often clashed because of their fundamental opposition to the philosophy of medicine. For example, although Mütter (a surgeon) taught his students to spend a few days slowly desensitizing various parts of the patient’s body with gentle touch and massage, Meigs (an obstetrician) did not believe in giving birth to women Pain management. Standing at the back of the Bible verse and saying "You will give birth in grief", Megs instructed his students to absolutely avoid "fussing", such as when their female patient gives birth. He encouraged students to follow his lead and simply "read and write in another room until the delivery is ready."

Dr. Charles D. Meigs (1792-1869) is famous for his brutality with his female patients, but this is because he firmly believes that the field of obstetrics and gynecology is hindered by the prejudice and false modesty of women. When in many places, obstetricians can only examine pregnant women’s abdomen through a blanket, how should a doctor like Megs treat women effectively? Megs has little patience with women whose physical shyness proves to be his obstacle. He firmly believes and passionately preaches that treatments that others might think are rude and savage are usually the best between the stupid patient and the treatment that the doctor knows is needed. Fast way.

Another colleague of Thomas Dent Mütter (1811-1859) and Charle D. Meigs (1792-1869) is Dr. Joseph Pancoast (1805-1882), a surgeon and the head of the Department of Anatomy at the Jefferson School of Medicine. Place taught by all three. Like Mütter, Pancoast's early career as a surgeon took place most of the time before anesthesia, so his patients were awake during the operation. In a public operation, Pancoast tried to boldly excise the patient's upper jaw, using "astonishing speed" to tear off the bone with huge forceps. But for public display, surgery may be too much. A student present would later recall how some of the awake patients vomited blood, bones and teeth, while the restless student in the audience vomited and fainted in the seat.

At Jefferson School of Medicine, Dr. Thomas Dent Mütter (1811-1859) served as the popular surgical director and issued admission tickets to registered students every year. Medical students must attend two-year lectures and pass exams to obtain a medical degree. Although most tickets are printed on light brown or gray paper, the gorgeous Mütter tickets are often printed on pink paper.

The years when Mütter was chairman of surgery were a period of revolution in medicine, and the large number of students who learned from him will continue to help change American medicine. One of the students was Edward R. Squibb. He was very impressed with Mutter’s ether operation (Mutter performed his first ether operation in Philadelphia on December 23, 1846), but he also shared his opinion Ether lacks consistency and frustration in quality. Some time before standardized medicine. Bristol-Myers Squibb's passion for creating standardized and pure forms of medicines (including ether) helped him form a medical supply company, which eventually developed into the modern pharmaceutical giant Bristol-Myers Squibb.

Due to the persistent, painful and severe attacks of gout, Mutter was forced to end his surgical career ahead of schedule. Gout is a disease he inherited from his grandmother. As a surgeon, Mutter's hand is one of his most valuable tools. Mütter is agile, fast and accurate, and his hands are dexterous and equally skilled. ("Very few people can brag about [hands dexterity]... and usually, many people actually only have two left hands," a doctor colleague once quipped).

In his lifetime, Mutter has accumulated a large number of pathological miracles, many of which are very unusual. There are "usual preparations for skeletal, neurological, vascular, muscular, ligamentous, and other anatomical presentations", but his collection also contains a large number of wet preparations (specimen in jars); diseased bones and stones A wide range of paintings and sculptures, representing healthy and diseased parts, fractures, dislocations, tumors... and the surgical procedures needed to relieve these diseases; as well as graphic models of medical conditions in wood, plaster and wax. When Mütter realized that his life was ending prematurely due to a lifelong struggle with health, he began to focus on finding a suitable home for his collection, which he considered to be "the main goal of my career." He reached an agreement with the Philadelphia College of Physicians, which opened the Mutter Museum in 1862 (three years after Mutter's death).

The Mutter Museum in Philadelphia is one of the most popular science museums in the United States. There-at a moderate entry price-you can stand in front of the giant's skeleton. Or marvel at a cow-sized colon, which was extracted from a person known only as a human balloon. Or, of course, staring at Madame Dimanche's face, the French widow began to grow a horn from her forehead one day, and her wax model fascinated Mutter so much that he took it across the ocean. There, you will also find a woman called a soap girl. After her death, her body has turned into a waxy soap-like substance, and her small face is frozen like a permanent scream. In the century and a half after Mutter’s death, the museum’s collection continued to increase, including tumors cut from the president, brains of lunatics and geniuses, deformed bones displayed in exquisite glass cabinets, and civil war surgical tools still stained with dried blood. Even the dead actors of Chang and Eng Bunker, the famous vaudeville show, a pair of Siamese brothers inspired the word Siamese twins. All of this and more can be found under one roof, and all of this is monitored by a dashing portrait of a person: Thomas Dent Mütter. "So, on his deathbed," his old friend Dr. Joseph Penncost (1805-1882) said of the museum, "has he left a valuable legacy for this industry."

From Dr. Mütter's Miracle: The True Story of Conspiracy and Innovation in the Dawn of Modern Medicine by Cristin O'Keefe Aptowicz

Knowing that surgery is his mission, Mütter traveled across the streets of Paris to study the work of the greatest doctor. His pursuit is radical, squeezing through crowds in surgical lectures to ensure the best seats, or firmly keeping as close as possible to the doctors who are giving lectures when they are on rounds in the hospital, no matter how much other students push. When he made the schedule for the next week, the meal of spiced lamb and fresh bread was halfway through. A bowl of milk coffee was discarded so that he could start early every morning, eager to start a new day.

He came to Paris and believed that the doctors would have the greatest influence on him, and these people were legendary in their time. Chief among them was Guillaume Dupuytren, who ruled Hôtel-Dieu, the city's largest hospital, and changed the method of surgery. He is a very good operator, showing amazing dexterity, acting at almost incredible speed, and his rude arrogance is as famous as his achievements in the operating room. Jacques Lisfranc de St. Martin is the head of Hôpital de la Pitié, the city’s second largest hospital. He was Dupuytren's best friend who became his most bitter opponent, and he spent most of his life trying to get rid of Dupuytren's shadow. As we all know, Lisfranc refers to Dupuytren as "Riverbank Bandit", while Dupuytren often refers to Lisfranc as "Man with ape-faced face and crouching dog heart". There is Philibert Joseph Roux-his elegant and brilliant work dazzles his class, so much so that some people say "his surgery is the poetry of surgery", but a few years ago he won the hand of the woman they all love, and also won Dupuytren's contempt. And Alfred-Armand-Louis-Marie Velpeau's obstetrics textbook is very influential. It has been translated into English by one of America's most respected obstetricians: Philadelphia's own Charles D. Meigs.

Mütter was impressed by the bold talents and seemingly endless professional ethics of these surgeons. However, it was not anyone who changed the trajectory of Mütter's life in the end, but a new surgical field that had just emerged in Paris. Even the French called it la chirurgie crazye.

Who seeks this kind of radical surgery?

monster. This is how patients are classified in the United States. Mütter is used to seeing them copied in wax for classroom presentations, or hidden in secret rooms away from public view. He once saw them in a jar, and the fetus was expelled from the mother and suffered irreparable harm. Monsters, tags will read.

Some of these monsters were born like this: a severely cleft palate with a face that looked like it had been split in half by an axe. He could barely eat or drink, spit in the pool on the child's clothes, his tongue lazily opened around his mouth, clumsy and exposed.

Others are naturally "normal", but their bodies will slowly turn them into monsters, because the tumors surround their torso or limbs, making their legs swollen like soaked wood, and their eyes are tight, almost burst.

Other times, monsters are man-made: people whose noses are cut off in battle, either as punishment or revenge, evolve into a big tear in the center of their faces; women’s skirts catch on fire and become a fire that the owner cannot escape. Dui, the skin on their faces turned into melted wax, and their mouths were permanently frozen in the screams.

monster. This is their name, this is how they are treated. For such tortured people, death is often seen as a blessing.

However, in Paris, the surgeon has a solution. They call it les Operations plastiques.

Is it a lie? Mütter wanted to know when he first heard about it. Is this a trick? Will these unfortunate people appear like juggling? Do the doctors in the audience want to learn or be dumbfounded? What can surgeons do to help these desperate cases?

In the first class, Mütter began to understand the difference between conventional surgery and les opérations plastiques.

The patient was often greeted by a gasp of fear and pity, and when the surgeon performed the examination, he stood motionless, fearless. These regrets did not show the anxiety of normal patients; their eyes did not return to the door they entered, and they could escape through this door. Gradually, Mutter understood the reason.

In regular surgical lectures, patients rarely understand their troubles. When the knife pierces the skin for the first time, they will suddenly realize that life without surgery may still be happy. Therefore, running away is the best solution and the choice they want to exercise right away.

However, patients of les opérations plastiques often know their lives too much: a monster. This is inevitable. They all covered their faces when they walked down the street. They hid in the back room and left when someone knocked on the door. They cried when they saw the children. They understand the half of their life they are destined to live, and their uncontrollable jealousy of others—the whole person does not realize how lucky they are to wear the human label.

It is not uncommon for these patients to enter the operating room to prepare for death. Death is an opportunity for them to be willing to take risks, and it can bring a certain degree of calm and normalcy to their broken faces or painful bodies. In order to save their lives, surgery is not physically necessary. Instead, they do this so that patients can lead a better, normal life. This is the promise of les opérations plastiques.

Plastique is a French adjective that translates as "easy to shape or shape". This is the hope of this operation: mainly use materials from the patient's own body, such as tissue, skin or bone, to reconstruct or repair certain parts of the body.

Of course, surgery is not always successful-if the patient's problem is so easy to solve, it can be corrected by a smaller doctor a few years ago. But other times-these are the moments when the audience is waiting, the moments that make Mutter's hair stand up-the end result is nothing short of a miracle.

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