As per other images in the book, please note that special care was taken to acquire images of people and places as close as possible to the time period described in the chapter in which the image appears, but it was not always possible. With this in mind, please note that the portrait of George McClellan was taken in the 1840s, the photograph of “The Pit” was taken in the 1890s, and the image of Mütter performing his first ether surgery was created for and published in JMC Clinic, a student yearbook, in 1929.
Additionally, I feel I should mention that the “Muscle Man” image that opens Chapter Seven was a teaching illustration used to show the placement and function of the muscles within the body; the American flag shown at the beginning of Chapter Twenty-Three flew over Jefferson Medical College for all four years of the Civil War; and, though it is impossible to know from seeing the image in its black-and-white form within the book, I am delighted to share that Mütter’s Surgical Admission Ticket, which serves as one of the opening images for Chapter Fifteen, was printed—in typical Mütter style and in contrast to the beige-and-gray admission tickets of the day—on bright pink paper.
As with all nonfiction projects, it was not unusual to come across conflicting information and/or bald spots within the research. I mined the extensive research seen in these endnotes to draw the best possible conclusions when those circumstances arose, and I would love to quote Erik Larson speaking about his own research for The Devil in the White City (an enormous inspiration for this book): “The citations that follow constitute a map. Anyone retracing my steps ought to reach the same conclusions as I.”
——PROLOGUE——
endless torture of pain and disease: R. J. Levis, M.D., “Memoir of Thomas Dent Mütter,” The Medical and Surgical Reporter, whole series no. 129, new series II, no.6 (May 7, 1859): 113–118 (Philadelphia: Crissy & Markley, 1859)
Levis had been Mütter’s student at: “Part I: Jefferson Medical College 1846 to 1855 (pages 55–88)” in Frederick B. Wagner Jr., MD, and J. Woodrow Savacool, MD (eds.), Thomas Jefferson University—A Chronological History and Alumni Directory, 1824–1990, 1992, http://jdc.jefferson.edu/wagner1/16
1859, the year Levis would be named lead: Ibid.
His ingenuity, his early excellence: Levis, “Memoir of Thomas Dent Mütter”
the poor and humble: Ibid.
Mütter’s office was thronged with patients: Ibid.
gather around him with a confidence and infatuation . . . I shall be whole: Ibid.
An expert and efficient surgeon . . . requisite appliance: Ibid.
constant physical struggles that made Mütter’s too-short life blaze so brightly: Ibid.
by the failings of his own body: Ibid.
trips across the Atlantic, where he was greeted . . . medical men of London and Paris: Ibid.
spared no labor or expense in securing the most . . . private surgical cabinets of his time: Ibid.
“The subject of this memoir needs no eulogium from us, before the medical profession,” read the piece later published . . . relieve the miseries of others”: Ibid.
“His life, until his retirement, was one of incessant labor. . . . the close of a useful life”: Ibid.
“What an epitome of this life it is to know that . . . hushed in the endless silence of the tomb”: Ibid.
“other and abler pens write for him, to coming ages . . . the history of American Surgery”: Ibid.
“The Medical Man Must Obtain a Thorough Medical Education . . . human wit”: Thomas D. Mütter, Charge to the Graduates of Jefferson Medical College of Philadelphia, delivered March 8, 1851 (Philadelphia: T. K. and P. G. Collins, Printers, 1851)
——CHAPTER ONE——
high cheekbones, full upturned lips, glittering deep-set eyes: All physical descriptions of Madame Dimanche are based on the wax model from Mütter’s original collection, on display at the Mütter Museum and as seen in Gretchen Worden, The Mütter Museum of the College of Physicians of Philadelphia (New York: Blast Books, 2002).
twenty years old when he graduated from . . . storied medical college: Richard W. Slatten, “Thomas Dent Mütter, Surgeon and Teacher” (Unpublished biographical sketch, 1983)
the absolute pink of neatness: Autobiography of Samuel D. Gross, M.D., with Sketches of His Contemporaries (in 2 vols.) (Philadelphia: George Barrie, 1887)
secured just enough money to get him to his destination . . . wits to get him back home: Slatten, “Thomas Dent Mütter”
“am afraid that I shall not be able to obtain an order . . . furtherance of my plan”: Correspondence, Carter Family Papers, 1667–1862, Special Collections, Earl Gregg Swem Library, College of William & Mary, Mss. 39.1 C24
the Kensington . . . had sold after all, to the Imperial Russian Navy: Slatten, “Thomas Dent Mütter”
(later to be renamed the Prince of Warsaw by Tsar Nicholas himself): Ibid.
colorfully dressed women sweeping the streets . . . on Sundays, absolutely everyone did: Descriptions of Paris are based on descriptions found in August K. Gardner’s Old Wine in New Bottles, or, Spare Hours of a Student in Paris (New York: C. S. Francis, 1848)
“principal error is rather too much fondness . . . proper for a boy his age”: Correspondence, Carter Family Papers
“experience be acquired by the attentive student . . . field for observation . . .”: Gardner, Old Wine
the most frightful instances of venereal ravages: B. H. Benjamin, “The Hospitals and Surgeons of Paris,” The New World, October 28, 1843
publicly whipped: Ibid.
the lowest classes of society . . . already in a hopeless or dying condition: Ibid.
(called sages-femmes): Ibid.
one in every fifty women who entered Hôpital de la Maternité did: Ibid.
vast majority of the children there had arrived via le tour: Ibid.
Every night, a dozen or so infants were received in precisely this way: Ibid.
adopt children from the Hôpital des Enfants-Trouvés . . . fallen out of fashion: Ibid.
sixteen thousand children were considered wards . . . would live to adulthood: Ibid.
There were hospitals for lunatic women . . . married couples who wished to die together: Ibid.
École Pratique d’Anatomie . . . dogs kept tied up in the back: David McCullough, The Greater Journey: Americans in Paris (New York: Simon & Schuster, 2011)
using marvelous speed to incise the face and rip out the bones with a huge forceps: Samuel X. Radbill, “Joseph Pancoast (1805–1882): Jefferson Anatomist and Surgeon, and His World,” Transactions & Studies of the College of Physicians of Philadelphia, ser. 5, vol. 8, no. 4 (1986): 233–246
the spectacle of it, how the partially conscious . . . fainted in their seats: Ibid.
the hospital system maintained its very own wine . . . extensive collection: Benjamin, “Hospitals and Surgeons of Paris”
“natural consequence of this state of things . . . obtain distinction and worldly prosperity”: Ibid.
“had not Monsieur Dupuytren been compelled from poverty . . . Baron Dupuytren”: Ibid.
“the bandit of the river bank”: J. Chalmers Da Costa, M.D., “The French School of Surgery in the Reign of Louis Philippe,” Annals of Medical History Vol. IV, Spring, Summer, Autumn, and Winter 1922
“that man with the face of an ape and the heart of a crouching dog”: Ibid.
dazzled his classes with his graceful and brilliant: Ibid.
“his operations were the poetry of surgery”: Ibid.
an interne at the hospital to which Dupuytren was attached: Levis, “Memoir of Thomas Dent Mütter”
“quick, active, appropriative mind . . . readily imbued . . . distinguished [Parisian] teachers”: Ibid.
Thomas Dent Mütter—with a perfectly European umlaut over the u: Slatten, “Thomas Dent Mütter”
——CHAPTER TWO�
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“The Physician Should Be an Ambitious Man . . . it gives life and heat to all around”: Mütter, Charge to the Graduates, 1851
the entire government shut down:, Russell F. Weigley (ed.), Philadelphia: A 300-Year History (New York: W. W. Norton, 1982)
all but abandoned by friends and family: Ibid.
the Pennsylvania Hospital and Almshouse refused to receive yellow fever victims: Ibid.
die alone in the streets: Ibid.
“depository [for] victims of the plague who had nowhere to go and nobody to care for them”: Ibid.
“heroic bleeding and purging”: Ibid.
more than one-tenth of the city’s entire population was dead: Ibid.
Philadelphia publishing house Carey, Lea & Blanchard . . . of medical books: Ibid.
inform the public of the progress and hopeful treatment of this terrible disease: Ibid.
“heroic role of the medical profession in battling the infection”: Ibid.
silver pitchers of recognition: Ibid.
she became pregnant with Thomas in the summer of 1810: Slatten, “Thomas Dent Mütter”
she was fifteen and he was twenty-five: Ibid.
Lucinda had been born into the established Gillies family . . . prestigious families in the South: Ibid.
(five Armistead brothers would fight in the War of 1812 . . . future U.S. national anthem): Ibid.
(whose family would include not only governors . . . future leader of the Confederate Army): Ibid.
(whose patriarch, Robert Carter, was so powerful . . . farmland, and more than one thousand slaves): Ibid.
women were frequently married in their late teens: Michael R. Haines, “Long Term Marriage Patterns in the United States from Colonial Times to the Present” (NBER Historical Paper No. 80, Issued March 1996), http://www.nber.org/papers/h0080.pdf
father endeared himself to his new countrymen . . . in the Revolutionary War: Joseph Pancoast, A Discourse Commemorative of the Late Professor T. D. Mutter, M.D., LL.D., Introductory Lecture to Anatomy Course at Jefferson Medical College, Delivered October 14, 1859 (Published by the Jefferson Medical College, 1859)
John ran a healthy business as a factor and commission agent: Slatten, “Thomas Dent Mütter”
these men not only aided farmers in selling their crops . . . purchase of slaves for a client: Clement Eaton, A History of the Old South (Prospect Heights, IL: Waveland Press, 1975), 230.
Lucinda named him Thomas, after her husband’s late father: Slatten, “Thomas Dent Mütter”
She named him James, after her own late father, a beloved doctor: Ibid.
luck began to run out: Ibid.
buried her small body in Baltimore’s St. Paul’s Church: Helen W. Ridgeley, “The Ancient Churchyards of Baltimore,” The Grafton Magazine of History and Genealogy 1, no. 4: 8–23 (New York: Grafton Press, 1908)
thirty-three, a widower, and a single father to Thomas, who was only three: Slatten, “Thomas Dent Mütter”
bought a large house in Henrico County, Virginia . . . He called it Woodberry: Ibid.
couldn’t shake a rattling cough: Ibid.
placing him in the care of Tom’s grandmother, Frances Gillies, his late wife’s widowed mother: Ibid.
Four months into this journey, on a winter’s passage of the Alps, John Mutter died: Ibid.
a martyr for many years to gout: Pancoast, A Discourse Commemorative
Frances Gillies . . . passed away too: Slatten, “Thomas Dent Mütter”
he didn’t even need a license—a practice that Philadelphia . . . of the nineteenth century: “Part I: Jefferson Medical College 1835 to 1845 (pages 27–54)” in Frederick B. Wagner Jr., MD, and J. Woodrow Savacool, MD (eds.), Thomas Jefferson University—A Chronological History and Alumni Directory, 1824–1990, 1992, http://jdc.jefferson.edu/wagner1/15
Almost every act a doctor performed—invasive examinations . . . sun or lamplight: J. Chalmers Da Costa, M.D., “Then and Now: Oration Delivered at the Celebration of the Fiftieth Anniversary of the Founding of the Philadelphia County Medical Society, January 14, 1899,” in Joseph M. Spellissy, M.D., ed., Proceedings of the Philadelphia County Medical Society, Vol. XX, Session of 1899
infectiousness of diseases, were still under heavy dispute: Ibid.
Tetanus was widely thought to be a reflex irritation: Ibid.
Appendicitis was called peritonitis, and its victims were simply left to die: Ibid.
“The grim spectre of sepsis” was ever present: Ibid.
It was absolutely expected that wounds would eventually fester with pus: Ibid.
“yellow ooze” was seen as a good “laudable pus”: Richard Gordon, Great Medical Disasters (London: Hutchinson, 1983)
“ichorous pus” (a thin pus teeming with shredded tissue) . . . of cadaverous putrefaction”: Ibid.
Medicine was not standardized, so accidental poisoning was common: Da Costa, “Then and Now”
drugs were often bulky and nauseating: Ibid.
doses of purgatives were given by even the most conservative men: Ibid.
To treat a fever with a cold bath would have been “regarded as murder”: Ibid.
There was no anesthesia—neither general nor local: Ibid.
If you came to a doctor with a compound fracture, you had . . . chance of survival: Ibid.
Surgery on brains and lungs was attempted only in accident cases: Ibid.
“a pauper in the almshouse more comfortable . . . than a king”: Ibid.
In the early 1800s, there was not a single female physician in Philadelphia: Ibid.
“very generally ignorant, often dirty and sometimes drunk”: Ibid.
The Boston Medical and Surgical Journal ran a letter . . . better things are expected: The College and Clinical Record 1, no. 5 (May 1880): 78 (JMC)
“Individual discoveries are glorious and worthy . . . fame and wealth apply them”: Da Costa, “Then and Now”
“Our fathers did wonders with the resources they could . . . science lives and advances”: Ibid.
——CHAPTER THREE——
The Willing Mansion . . . his first office for the practice of surgery: Slatten, “Thomas Dent Mütter”
to become distinguished would require not only earning . . . professional colleagues: Ibid.
showcasing the fantastic techniques he’d learned in Paris: Levis, “Memoir of Thomas Dent Mütter”
“Adopting, with all the enthusiasm of his nature . . . more endurable”: Pancoast, A Discourse Commemorative
he tried his best “to be agreeable, to be useful, and to be noticed”: Slatten, “Thomas Dent Mütter”
“cut[ting] quite a swathe”: Ibid.
in a low carriage behind a big gray horse, driven by a servant in livery: Ibid.
“Youthful looking, neat and elegant in his attire . . . fashionable thoroughfares”: Pancoast, A Discourse Commemorative
“immaculately dressed young man riding about . . . an intrusion”: Slatten, “Thomas Dent Mütter”
“one Frenchman [is] equal to a dozen Americans”: Howard A. Kelly, M.D., LL.D., F.A.C.S. Hon. F.R.C.S., and Walter L. Burrage, A.M., M.D., American Medical Biographies (Baltimore: The Norman, Remington Company, 1920)
The oft-repeated stories of the daring surgical exploits . . . drawing a long bow: Autobiography of Samuel D. Gross
“Mütter’s early disappointment professionally was . . . to be helpful as well as to be noticed”: Slatten, “Thomas Dent Mütter”
His life and future were now entirely dependent on . . . all but strangers to the boy: Ibid.
keen intelligence and an unfailingly amiable disposition: Ibid.
Sabine Hall, the Carter family’s sprawling estate: Frances Archer Christian and Susanne Williams Massie, eds., Homes and Gardens in Old Virginia (Richmond, VA: G
arrett and Massie, 1932)
two trunks of clothing, a small toy hobby horse . . . a drawing of his mother in ink: List of Items with which Thomas Mutter arrived, courtesy of Carter Papers, Special Collections, Earl Gregg Swem Library, College of William & Mary
The enormous brick and stone building featured four large white cypress columns: Christian and Massie, Homes and Gardens in Old Virginia
six meticulously curated gardens extending over five opulent terraces . . . fields: Ibid.
enormous front parlor flanked by a hand-carved staircase. . . . Colonel Carter himself: Ibid.
a broad classical pediment was added to the roof . . . carpentry to finish: William M. S. Rasmussen, “Sabine Hall: A Classical Villa in Virginia,” Journal of the Society of Architectural Historians 39, no. 4 (Dec. 1980): 286–296 (Published by University of California Press on behalf of the Society of Architectural Historians)
entire redbrick exterior be painted white and . . . the roof and chimneys be lowered: Ibid.
“gay and splendid city”: Ibid.
its streets “as beautiful as any in the world.”: Ibid.
First Bank of the United States had a similar oversize portico . . . very similar to: Ibid.
“I felt for our friend Mr. Mutter the most sincere . . . Estate as possible”: Carter Papers
“I certainly feel much delicacy and reluctance by assuming . . . unremitted condemnation”: Ibid.
forced to sell both Woodberry . . . debts that no one knew John Mutter had: Slatten, “Thomas Dent Mütter”
the court system to release the funds to him: Ibid.
“The charge Mr. Bradley makes for the child’s clothes . . . the present submit”: Carter Papers
Charles Goddard . . . The established rapport between tutor and pupil: Slatten, “Thomas Dent Mütter”
relieving the Carter household of some of the disciplinary duties: Ibid.
However, when Thomas turned twelve, Carter decided . . . boarding schools: Ibid.
$140 a year, Thomas learned English, French, and Latin . . . boarded with his own teacher: Ibid.
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