Dr. Mutter's Marvels

by Cristin O'keefe Aptowicz

  Medicine was not standardized, so accidental poisoning was common. Even “professionally” made drugs were often bulky and nauseating. Bleeding the ill was still a widespread practice, and frighteningly large doses of purgatives were given by even the most conservative men. To treat a fever with a cold bath would have been “regarded as murder.”

  There was no anesthesia—neither general nor local. Alcohol was commonly used when it came to enduring painful treatments, although highly addictive laudanum (a tincture of ninety percent alcohol and ten percent opium) and pure opium were sometimes available too. If you came to a doctor with a compound fracture, you had only a fifty percent chance of survival. Surgery on brains and lungs was attempted only in accident cases. Bleeding during operations was often outrageously profuse, but, as comfortingly described by one doctor, “not unusually fatal.”

  Physicians working in this time period were largely unaware that innovations were on the horizon that would make “a pauper in the almshouse more comfortable and cared for better after an operation than a king,” as one late-nineteenth-century Philadelphia doctor described the state of medicine in the first half of his century.

  And it was a strictly enforced male-dominated field. In the early 1800s, there was not a single female physician in Philadelphia. More than that, women’s role in medicine in any form was often disparaged. In a speech given at the Philadelphia County Medical Society, female nurses were described as “very generally ignorant, often dirty and sometimes drunk.” The Boston Medical and Surgical Journal ran a letter to the editor decrying an ad for a woman practicing medicine, stating, “Science itself is not only disgraced by being made the instrument of a petty income to an ignorant, presuming, flippant-tongued female, but she thus brings contempt upon the sex, of whom better things are expected.”

  “Individual discoveries are glorious and worthy, but we must give due need of praise to the hard working, obscure practitioners, who regardless of fame and wealth apply them,” a late-nineteenth-century doctor noted in a speech about mid-century medicine. “Our fathers did wonders with the resources they could command. The lesson of their lives is largely one of dignity, self-sacrifice, devotion to science and regard for the bonds of professional conduct and duty and carelessness as to wealth or fame. Men come and men go, but science lives and advances.”

  And it was into this world that Thomas Dent Mütter, an orphaned boy now grown up and fresh from his experiences in Paris, returned.

  CHAPTER THREE

  TO RENDER EVIL MORE ENDURABLE

  Philadelphia in the 1830s

  The Willing Mansion seemed like a perfect place for Thomas Dent Mütter to open his first office for the practice of surgery. Built by former Philadelphia mayor Charles Willing, the mansion was a lovely brick building, three stories high with eleven large windows facing bustling Third Street just below Walnut. It was a stately and impressive place to start what he was sure would be a distinguished career.

  Mütter knew that to become distinguished would require not only earning a favorable reputation with the public as a reliably successful surgeon, but also attaining distinction within a wide circle of his professional colleagues. He was sure he would do both and build an impressive practice by showcasing the fantastic techniques he’d learned in Paris.

  “Adopting, with all the enthusiasm of his nature, the new precepts which he had been taught for the relief of these affections, he settled down among us,” a colleague would later write of Mütter’s first year in Philadelphia, “with such a trusting belief in his own resources, such a just confidence in the brightness of his future, that it seemed almost as if he felt that he would be able to renew the marvelous times of old, when supernatural powers came to mingle themselves with men in order to render their evils more endurable.”

  But even months after opening his office, Mütter sometimes spent long mornings and afternoons alone. Patients were not forthcoming, even though he tried his best “to be agreeable, to be useful, and to be noticed.” In fact, Mütter had developed a reputation of “cut[ting] quite a swathe” as he rode around Philadelphia in a low carriage behind a big gray horse, driven by a servant in livery.

  “Youthful looking, neat and elegant in his attire,” he was described by a fellow doctor, “animated, cheerful, and distinguished in his bearing, whether observed in the social circle, or encountered, as, with his tall gray horse and handsome low carriage, he traversed our fashionable thoroughfares.”

  Mütter’s colorful silk suits were a shocking contrast to the staid black, gray, and brown Quaker-inspired fashions found on Philadelphia’s streets. But as always, he didn’t mind the stares. He wanted to be memorable during his relentless attempts to curry favor with the city’s best-known medical men by attending gatherings where they ate and drank and by trying to join the private societies they founded.

  But unfortunately for the struggling physician, many of the doctors he tried so hard to impress thought this “immaculately dressed young man riding about Philadelphia” was “something of an intrusion.” They complained that his conversation was often too full of his French masters, and how he boasted, openly and often, of their superiority, explaining how when it came to surgery, “one Frenchman [is] equal to a dozen Americans.” The oft-repeated stories of the daring surgical exploits of his French idols “were not received with pleasure in every quarter.” He was often accused of exaggerating, or drawing a long bow, as it was referred to in nineteenth-century slang.

  “Mütter’s early disappointment professionally was ironically due in part to the fact that he succeeded rather too well, both in his desire to be helpful as well as to be noticed,” a Virginia historian would later note. It seemed an odd stumble for someone whose welfare and happiness since the age of seven seemed wholly dependent on endearing himself to near strangers.

  • • •

  With the passing of his maternal grandmother, seven-year-old Thomas Dent Mutter entered a very vulnerable type of orphanhood. His life and future were now entirely dependent on the emotional charity of people who were all but strangers to the boy.

  Patrick Gibson—John Mutter’s business partner and the trustee of John’s will—had trouble at first trying to secure Thomas a new home. He was a spoiled boy, having been heavily doted upon by his father and grandmother, and in a time before the medical world fully understood how diseases were transmitted, there were concerns about risks a family might be taking by inviting into their home a little boy whose entire immediate family had been felled by illness.

  But Gibson was able to downplay young Thomas’s lack of discipline and disquieting family illnesses by shining a spotlight on his better qualities—specifically his keen intelligence and an unfailingly amiable disposition. To Thomas’s good fortune, Gibson convinced a very wealthy and prominent man to take the boy on as his ward.

  Robert Wormeley Carter, known as Colonel Carter for most of his life, was born into one of the best-known families in the South, and was also a distant cousin through marriage to Thomas’s mother, Lucinda.

  Once the agreement was struck, Thomas was taken directly to Sabine Hall, the Carter family’s sprawling estate. Built in the early 1700s on four thousand acres of rich Virginia soil, right on the lush banks of the Rappahannock River, Sabine Hall had been passed down through several generations of Carters. Colonel Carter was now its owner, and there he lived with his wife, his children, and several hundred slaves.

  When young Thomas arrived at Sabine Hall, he brought along everything he could from his old life: two trunks of clothing, a small toy hobby horse, and a working single-barreled gun. He also brought a Shetland pony, with bridle and saddle, and a satchel filled with his dead mother’s jewelry: two gold lockets, two gold rings, a pearl necklace, and a pearl pin. He brought paintings of his parents and a small red book that contained only one thing: a drawing of his mother in ink. He brought with him a bright mind, a willful stubbornness, and a moderatel
y effective charm.

  And he also brought along a deep and troubling cough.

  Sabine Hall

  To a little boy who had known only the bustling energy and modest homes of Richmond, Virginia, Sabine Hall was an intimidating place to try to call home.

  Robert “King” Carter—the family’s legendary eighteenth-century patriarch—had spared no expense in building the house for his son, Landon. The enormous brick and stone building featured four large white cypress columns that rose all the way to the second floor and were surrounded by six meticulously curated gardens extending over five opulent terraces, from the top of the hill down to the plantation’s fields. Entering the house, visitors were greeted by an enormous front parlor flanked by a hand-carved staircase. The house was decorated with numerous oil paintings of the Carter family: King Carter, Landon Carter, portraits of each of Landon’s three wives, and, of course, now, Colonel Carter himself.

  Colonel Carter was just twenty years old when he took in seven-year-old Thomas, and while Carter was born into a comfortable life, he was not afraid of change. During Thomas’s stay at Sabine Hall, he made many dramatic alterations to the building and its environment. He constructed a giant portico on the front of the house, a broad classical pediment was added to the roof on the river facade, and a sixty-foot veranda that stretched the entire length of the house was built facing the river, taking more than seventy days of relentless carpentry to finish. Carter then requested that the entire redbrick exterior be painted white, and even demanded that the roof and chimneys be lowered.

  In an odd coincidence—which might explain Mütter’s later attraction to the city—it was said that Carter’s main catalyst for making these changes was a visit he made to Philadelphia. He was deeply impressed with the “gay and splendid city” and was especially taken with its architecture, later writing in his journal that he found its streets “as beautiful as any in the world.” And indeed the new Sabine Hall did resemble some of Philadelphia’s best-known architecture. Philadelphia’s First Bank of the United States had a similar oversize portico and light-colored facade, and the city’s new Masonic Temple (designed by William Strickland), which Carter would later call “one of the most elegant buildings in America,” had a gate lodge of a style very similar to the Gothic one he had built for Sabine Hall.

  However, the attention to detail and visionary execution that Carter had lavished on the reinvention of Sabine Hall did not extend to the small boy he had just accepted as his ward. From the beginning, Carter made it clear to Patrick Gibson that he would provide a roof over Thomas’s head, food on his plate, and a bed for him to sleep in, but it would fall to others to guide the boy in his life.

  “I felt for our friend Mr. Mutter the most sincere friendship, and would most willingly do anything I could to promote the welfare and to place a foundation for the respectability and happiness of his son,” Carter wrote to Gibson shortly after receiving Thomas at Sabine Hall. “I should however wish clearly to understand the situation of the amount of the fund that Thomas must depend upon for his future subsistence and wishing at the same time to have as little to do with the fund of the Estate as possible.”

  And perhaps feeling a bit of remorse at taking on such a large responsibility—and the criticism that might come with it—the twenty-year-old Carter noted, “I certainly feel much delicacy and reluctance by assuming a character which requires me so much judgment, care and attention, and which procures for you in return little less than actual loss, or unremitted condemnation.”

  Money proved to be a constant source of frustration and concern for both Thomas and his guardian. Carter brought the boy in with the promise that his costs would be covered by his late father’s estate, but it wasn’t long before Carter himself would be forced to sell both Woodberry—the only home Thomas knew after the death of his mother—and its contents to pay off debts that no one knew John Mutter had.

  Hopeful that the rest of the estate’s money would be free eventually (though he could have no idea that it would take years for the court system to release the funds to him), Carter kept strict records of the money he spent on the boy and began keeping him under a strict budget. It was during this examination of the budget that Thomas’s fondness for expensive garments was first documented.

  “The charge Mr. Bradley makes for the child’s clothes, $23 apiece for his last two suits, is so very extravagant that they should if possible be made elsewhere,” a stunned Carter noted, “but not having his measure I must for the present submit.”

  But if there was one area that Carter refused to cut corners on, it was the boy’s education. Charles Goddard, the man who had tutored Thomas when his father was still alive, was brought to Sabine Hall and continued to serve in that role for another four years. The established rapport between tutor and pupil was a huge comfort to Thomas, and had the added benefit of relieving the Carter household of some of the disciplinary duties associated with the puckish, outspoken boy.

  However, when Thomas turned twelve, Carter decided it was time to look at boarding schools. He eventually selected for Thomas the Llangollen School in Spotsylvania County, a grammar school that prepared boys to attend college. There, for a bargain price of $140 a year, Thomas learned English, French, and Latin, studied geography and mathematics, and boarded with his own teacher, John Lewis, who wrote Carter often about his growing ward’s progress.

  Thomas proved to a bright and willing student, and Lewis’s letters always showcased the latest subject in which Thomas was excelling. However, Lewis’s letters to Carter also revealed that the growing boy continued to struggle with his health problems.

  “Early in the spring he had a slight attack of intermittent fever which soon yielded to the ordinary medicines . . . ,” Lewis wrote Carter before adding, “his general health I think is greatly improved from last month. He is stronger and more active and is considerably grown.”

  The following year, Lewis wrote, “His general health has been better than it was the last year,” though he was forced to add that the boy was still “occasionally attacked by bilious colic,” a painful condition marked by severe cramping, vomiting, and jaundice.

  In his own letters to Carter, young Thomas rarely mentioned his health or his scholastics. Rather, his letters were marked with frequent pleas for new clothing.

  “I wrote to Aunt to send me two pairs of shoes as I have not any at present,” he wrote Carter in 1824. “Please write Aunt to get my winter clothes and some shoes and socks as I am in want of them.”

  Six months later, he wrote, “As the warm weather is coming very fast I should like to get my summer clothes in time as I have but one very old suit. . . . I shall want some shoes about that time also. I do not wish to have any more made here as they cost as much as at Fredericksburg and are spoilt in the making.”

  A few months later, in his first letter to Carter since returning to school, Thomas told his guardian, “I am in great want of shirts as I have but two in the world and they are very old and tattered. I got some summer clothes from Mr. Lewis, but they are not sufficient for me nor nice enough to wear in town.”

  Thomas’s desire to appear stylish only grew when, in 1826, he finally left Llangollen School to attend college at Virginia’s Hampden-Sydney College. There, he ran up extravagant clothing bills and simply charged them to the school, with the hopes of earning scholarships and additional funds to pay off the debts. It was a ploy that didn’t always work. At the end of his first year there, a frustrated merchant sent Colonel Carter the overdue bill directly, demanding payment for the more than one hundred dollars’ worth of clothing and accessories Thomas had purchased on credit during the school year (and for which Thomas had only been able to pay back half).

  The bill shows that Thomas—who was just sixteen years old—had made such eclectic purchases as a fashionable leghorn hat, several patterned vests, jackets and pants, yards of ribbons made from silk and velv
et, several pairs of silk stockings, dog biscuits, a buck knife, and even several dozen cigars. In fact, Thomas’s clothing choices were so flamboyant in style that the college’s theater department was known to have borrowed from his wardrobe to outfit the actors in their plays.

  When Colonel Carter received the bill, he was understandably furious, and threatened to withdraw his support if Thomas didn’t fix his disobedient ways. Thomas promised he would.

  At Hampden-Sydney, Thomas continued to blossom scholastically. He was written up for being distinguished in scholarship, industry, and behavior, though he did find himself in trouble more than once for skipping chapel without an excuse. He grew so popular, well liked, and respected that he was elected by his class to write and give a speech representing the college; the experience proved to be a shaping one for the developing young man.

  Having felt largely invisible for much of his adolescence, Thomas thrilled at being center stage. His skills at charming tutors, professors, and caretakers to get his way translated well to engaging an audience, and he was praised for his natural gifts as a captivating presenter and for his voice, which was seen as being remarkable for both its range and amplitude.

  Thomas also began traveling more around the South, visiting the areas where his parents grew up and meeting with distant family members. He did this without Colonel Carter’s permission or approval, usually by borrowing enough money to make it to his desired destination, and then using his charms to secure the funds to get back home. Every so often, Colonel Carter would hear a tale of his ward’s wanderlust ways from friends or acquaintances who had bumped into the boy during his travels. Again, Colonel Carter would threaten to remove his support of the boy, and again the boy would vow to do better.