American Civil War Medicine & Surgical Antiques

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Rubin D. Mussey, M.D.

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Prop. Rubin D. Mussey was born in Pelham township, Rockingham County, New Hampshire, June 23d, 1780. He was the son of Dr. John Mussey, a very respectable country physician, but who was unable to contribute much toward giving him a suitable education, although anxious to do so. When eleven years of age, he moved with his father to Amherst, N. H., which circumstance gave him the advantage of several weeks' instruction in the winter at the district school. His father taught him the elements of Latin, and at fifteen years of age he was sent to the Aurean Academy at Amherst. At this school he became qualified to enter the freshman class in one of the New England colleges. He kept himself supplied with means for prosecuting his studies, by laboring more or Jess on the farm in summers, and teaching school in winters. At the age of sixteen he commenced teaching, and thus employed his winters until he entered the junior class at Dartmouth College in 1801. The winter vacations were also spent in teaching, and he was thus enabled, with the addition of a little paternal assistance, to make his way. His position in college was always among the foremost of his class. In August, 1803, he graduated, and immediately thereafter entered upon the study of medicine as a pupil of that eminent man, Dr. Nathan Smith, founder of the New Hampshire Medical School. The next summer, for the purpose of recruiting his finances, he taught an academy in Peterborough, N. H., at the same time pursuing his studies closely with Dr. Howe, of Jaffrey> N. H. Excepting during this time, his studies were continued under Dr. Smith. He received the degree of Bachelor of Medicine in Aug., 1805, after a public examination, at which he defended a thesis on Dysentery. In Sept. of that jear, he settled in the South Parish of Ipswich, now Essex, in Essex county, Massachusetts, at which place he was very successful. He remained here three years, when he collected his earnings and proceeded to Philadelphia, remaining there nine months under the private instruction of Dr. Benj. Smith Barton, whose botanical lectures he attended. While in Philadelphia, ho attended lectures in the University of Pennsylvania, in the days of Rush, Wistar, Physic, Dorsey, Barton, Wood- house, Chapman, and James, and graduated in 1809. Dr. Rush at this time, and for some years previous, had taught the doctrine of the non-absorption of the human skin; in which belief he was strengthened by some experiments in which the experimenter breathed through a tube fastened to his mouth at one end, while the other passed through a wall into a distant apartment to which fresh air was freely admitted; his body was then rubbed with various odorous substances, such as turpentine, etc. None of these odors being detected in the urine, it was inferred that no absorption took place from the skin. The plan in experimenting on cutaneous absorption pursued by Dr. Mussey, was to immerse himself for three hours in a madder bath containing three pounds of madder and sufficient water to cover the entire body. For two days the urine showed that it contained madder, when the proper chemical tests were applied. This experiment was repeated with the same results, and they formed the subject of his thesis on Graduation.

These experiments and results were very satisfactory to the profession, and a portion of the faculty. Several other similar experiments were made by substituting rhubarb, indigo, arnotto, redwood, logwood, and cochineal. Rhubarb was unquestionably detected, while in the case of the other substances the appropriate chemical tests failed in exhibiting them, tn reference to the madder and rhubarb, the experiments were so carefully made and so often repeated, that no doubt could exist.

One experiment in this series was not Attended with danger. He immersed himself for three hours in a strong infusion of nut galls, and then went into a strong solution of sulphate of iron, lying in that three hours more. No ink was found in the urine. A vein was opened in his hand for the purpose of seeing whether the blood exhibited anything peculiar. About an ounce and a half was obtained, when it ceased to flow; and, exhausted by his six hours' immersion, he sank faint to the floor. The serum of this blood had a tinge slightly different from common blood, and was slightly coagulated — resembling very much the serum of common blood in which a quantity of powdered nutgalls had been stirred up and allowed to settle, from which it was inferred that some portion had entered the circulation. This experiment was not repeated, and its effects were not wholly recovered from for several days.

None of these experiments have ever been published, except those made with madder and rhubarb — although the minutes of them still exist, in Dr. Mussey's possession. As a matter of course, they excited, at the time, not a little discussion among the profession at Philadelphia ; and it is said that some gentlemen — one of whom, at least, before referred to — had made experiments with odorous bodies, proceeded to repeat Dr. Mussey's experiments, with certain precautions, which they alleged he ought to have taken, viz.: they plastered up very carefully the outlets of the body, and then went into the madder and rhubarb baths. Notwithstanding these precautions, they readily detected the foreign coloring matter in the urine. They varied their experiments somewhat, and at length made the announcement, that they had found only a few patches upon the body, which were capable of imparting these substances to the circulation by absorption or imbibition. These patches were inside of the leg, and thigh, and arm. The teachings of Dr. Rush, after this, were somewhat modified : he admitted that madder and rhubarb had a very " penetrating quality," and were capable of finding their way into the circulation, through certain points only. In this he was followed substantially by Dr. Chapman, the late Professor of Theory and Practice in the same institution.

All this was, soon after, effectually refuted by experiments made, at the request of Dr. Muasey —by his friend the late Dr. Sewall, of Washington City — then resident in Massachusetts. He immersed his hand and wrist, and afterwards his foot and ankle — for periods of eight and ten hours — in a madder bath— repeating the experiments, and finding, upon each examination, plenty of madder in the urine.

Dr. Mussey, desirous to ascertain if mercury in any form is absorbed from the alimentary canal, and exhaled by the skin, made the following experiment with his pupil, Mr. S. 0. Porter, in 1821. Mr. P., laboring under some slight derangement'of the alimentive functions, was desirous to take an active cathartic. The doctor gave him forty grains of blue mass — at the same time applied a half-eagle gold piece to the bend of the arm. He covered it with a large patch of wash leather, spread with adhesive plaster, bound it on with a bandage, and let it remain for three days.

The medicine operated upon the bowels somewhat freely ; on removing the gold piece, the side which lay upon the skin was beautifully whitened over with a coat of quicksilver.

He has repeated the same experiment upon a patient in Ohio, and with a like result,— excepting that the quantity of medicine given was not more than half the other, and the coating of quicksilver was thinner, but very distinct.

More than thirty years since, a young lady from a distance was put under Dr. M.'s charge, for a large chronic swelling of the thyroid gland. The doctor applied a strong iodine ointment to one side of the tumor, covered the ointment with tin foil, and applied the two conductors of a small galvanic battery — of a dozen three-inch double plates —to the two sides of the swelling ; applying the pole which attracts iodine, to the side of the tumor upon which there was no ointment. A strong prickly sensation, as of fine needles, was felt through the tumor. This was repeated every day or two for some weeks.

Reversing the poles was often tried in these applications, with uniformly the same result, viz.: the prickly sensation ceased. Ultimately, there was a distinct fluctuation in the tumor, which was opened by a bistoury. A thin, turbid fluid escaped, giving a strong smell of iodine. This was followed by suppuration, and a discharge of pus, for some weeks. The to- mor gradually subsided, and when the discharge ceased, only a slight enlargement above the natural dimensions of the neck, remained. The pus discharged, gave the iodine odor; leaving the inference that some small quantity of this article was one of its elements. The family in which the patient stayed, complained very much of the iodine smell of the discharges. This mode of treatment, and its results, were regarded at that time as rather novel.

By the foregoing history it will be seen that Dr. Mussey is entitled to much credit as an original experimenter, by which some important physiological questions have been elucidated. His professional fame does not rest entirely on his surgical practice, as is generally supposed. On returning from Philadelphia Dr. Mussey settled in Salem, Massachusetts, at that time a town of twelve thousand inhabitants. Here he formed a professional partnership with that excellent and learned man, Dr. Daniel Oliver, afterward Professor Oliver, of the New Hampshire Medical School.

These gentlemen gave in connection, in two successive years, two popular courses of lectures on Chemistry, which was a new feature in the attractions of that town. Dr. M. resided in Salem between five and six years, most of the time engaged in a large practice. His obstetrical practice in particular, was very large during the last three years, amounting, on an average, to a fraction over three cases per week. In this place he commenced his surgical operations, of which a considerable number were performed — particularly on the eye.

He was appointed to, and accepted, the Chair of Theory and Practice of Physic, in Dartmouth College, in the fall of 1814. On account of some difficulties and changes in the College, he lectured on Chemistry for one session, successfully and satisfactorily. After the settlement of these difficulties, Dr. M. was appointed to the Professorship of Anatomy and Surgery. The duty of these two Chairs, (having to deliver two lectures per day,) his duties as a practitioner, and the necessity of a special study of anatomy, compelled him to work by day, and largely encroached upon the night, in such a manner that it is to be apprehended but few of our young men at the present time, would be willing to undertake such a task.

He continued in the performance of his duties in these branches, until the close of the session of 1838 ; in addition to which he was called upon to give lectures for a time on Materia Medica, and also on Obstetrics, to meet some occasional emergencies of the College.

In the summer of 1817, he gave a course of lectures on Chemistry at Middlebury College, in Vermont.

Early in December, 1829, Dr. Mussey left Hanover for Paris, where he remained several

months, attending the Hospital Cliniques.— During this absence he passed several weeks in London, visited many of the Provincial Hospitals and Museums of Anatomy, as well as those of the metropolis; and formed the acquaintance of many distinguished professional gentlemen.

From this absence of ten months he returned in season to complete his college duties, by giving double and treble lectures in the session of 1830.

At this time, the Medical School of Maine, having lost by death its Professor of Anatomy and Surgery, invited Dr. Mussey to give the lectures in those branches ; which he did, for four successive winters — the session in Maine commencing after that in New Hampshire had closed.

For two successive seasons, in 1836 and 1837, after the close of the New Hampshire session, Dr. M. went to Fairfield, Herkimer Co., N. Y., to give lectures on Surgery, in the College of Physicians and Surgeons located there, an institution then very flourishing, but some years afterward given up.

In the fall of 1838, Dr. M., worn with the laborious country practice in a cold climate, and looking to his future, as probably of longer usefulness in a city, accepted an invitation to the Professorship of Surgery, in the Medical College of Ohio, at Cincinnati, and removed thither with his family. In that institution, for fourteen successive years, he gave the lectures on Surgery, besides having charge of the surgical department of the Commercial Hospital of Cincinnati, and sustaining a full practice.

Dr. M. resigned the chair of Surgery in the Medical College of Ohio, after having delivered fourteen courses of lectures. During the summer of 18o2, the Miami Medical College was organized, and Dr. Mussey was offered the chair of Surgery, which he accepted, and he has delivered in this school four full courses of lectures, and has had, during the sessions, charge of the surgical department of St. John's Hotel for Invalids. He now occupies these positions.

In 1854 the degree of LL. D. was conferred upon him by Dartmouth College.

At and before the time of Dr. Mussey'a visit to Europe in 1830, the doctrine of the non-union of intra-capaular fractures of the neck of the thigh bone, was taught by Sir Ast- ley Cooper, and admitted by many distinguished members of the profession in Great Britain. Dr. M. carried with him a specimen, which, io the opinion of several surgeons both in Paris and London, satisfactorily demonstrated the fact of such bony union. When this was shown to Sir Astley, he at first remarked, " This was never broken." After a more careful inspection of it, especially its interior, which had been sawed into two vertical portions to render it accessible to the eye, he remarked, " This does look a little more like it, to be sure, but I do not think the fracture was entirely within the capsular ligament." Few surgeons who saw the specimen, had the assurance to deny that it was a case of bona fide fracture. That distinguished surgeon, Mr. John Thompson, of Edinburgh, author of a treatise on Inflammation, valuable in its time, did, however, upon taking the specimen in his hand, declare "upon his troth and honor," that it had never been broken. This opinion, given with an ex-cathedra emphasis, foreclosed all further conversation. Since that time, Dr. Mussey has procured several specimens, which prove indubitably a bony re-union of this intra- capsular fracture.

Before his visit to Europe, Dr. M. had operated upon a young man, for a large, bleeding, and ulcerated nsevus, upon the vertex of the head — by tying in succession both carotid arteries, at twelve days' interval — and a few weeks afterward, removing the tumor. An account of this case, contained in the American Journal of the Med. and Phya. Sciences for February, 1830, had been received in London a short time before Dr. M.'s arrival there. As this was tho first published case of tying both carotids, it necessarily excited some interest in the profession, and enlarged Dr. M.'a facilities of intercourse with its scientific members in that metropolis.

As a physician and operative surgeon, Dr. M. has sustained a prominent rank in the profession of our country. While in New Hampshire, he had a widely extended field for the exercise of his professional abilities ; and although he had not the advantage of that close association with medical men which large cities give, the privation resulted in a more thorough development of his own powers, and a more self-reliant professional judgment.

It was in this period, that he successfully treated, by operation, a case of uni-locular ovarian disease.

Another rather rare operation was one upon hypertrophied tongue, in a boy of thirteen. The disease commenced at the age of nine months, and at the time of operation, the tongue measured eight inches in circumference where it issued from the mouth, and five inches in

length, from the upper lip to the tip of the tongue. The operation was successful. Reported in the Philadelphia Journal.

Another extraordinary case was one of osteo- sarcoma, which commenced in the thumb and forefinger, and for which an operation was performed, consisting of the removal of the entire metacarpal bone of the thumb, and three- fourths of that of the forefinger. Thirteen years afterward, the disease had invaded the radius, and the os humeri; especially its upper half, which had become very large, and exceedingly painful. At that time, the arm was amputated at the shoulder joint. Six years after this, the patient came a third time to Dr. M., with the same disease, in the form of a large tumor, occupying the greater part of his shoulder blade and collar bone. He was then put upon farinaceous diet, for a month — drinking only milk or water — preparatory to a third operation. This consisted in the removal of the entire shoulder blade and collar bone, and resulted successfully ; the first operation of the kind, it is believed, ever performed. This was in October, 1837. The patient is still living and well (1856).

In Ohio, Dr. Mr. had, in the summer of 1845, a case somewhat like the preceding. Mr. Stark, from Lower Sandusky, had a very large osteo-sarcoma of the arm, shoulder blade, and outer portion of the collar bone. Dr. Mussey removed the arm, the entire shoulder blade, and more than half of the collar bone. In a letter received from this patient in the spring of 1854, he reports himself well, having had no symptom of a return of the disease since the operation.

In the summer of 1845, Dr. Mussey, for osteo-sarcomo of the lower jaw, disarticulated that hone, removing more than half of it, and accomplishing this without dividing the duct of Steno, or the facial nerve. The object was to preserve the symmetry of the mouth for the patient (a beautiful young lady) and it was fully realized.

Dr. M. was not at the time aware that the lower jaw had ever before been disarticulated, and a large portion of it removed, without implicating the facial nerve.

Dr. M. has kept no record of the number of his operations, except those of three classes,

viz.:

Lithotomy, 52 ; 4 deaths. Lithotrity, 1; successful.

Strangulated hernia, 40; 8 deaths. Varicocele, 49 ; by subcutaneous ligitation of the spermatic vein, with never a bad symptom following. In all the oases followed out — and it is believed in the whole number — a perfect cure.

Dr. M. recollects four cases of successful operation for perineal fistula; and two for stricture of the urethra, of long standing, and so complete as not to admit the passage of either catheter or bougie, into the bladder. In both cases, the recto-vesical tapping of the bladder was practised, as a necessary measure, to prevent speedy death from entire obstruction of the urine. After the subsidence of the irritation, the point of a staff, pushed as far as it would go into the urethra, was cut down upon through the perineum ; and as no instrument, not even the smallest probe, could be passed into the stricture, an artificial canal was made, by passing, without a guide, a straight, narrow, sharp-pointed bistoury into the bladder, and was kept open by an elastic gum catheter. In both cases, the wound in the perineum was ultimately healed, and the artificial urethra, kept open by the occasional use of the bougie, for the first year, and very rarely afterward, answered a good purpose. One of the patients, who went to a distant part of the country, was heard from five years after the operation, and was reported to bo well. The other, now about thirty-eight years old, still lives in Cincinnati. He stated to Dr. Mussey, in May, 1854, thirteen years after the operation, that ie sometimes felt a slight difficulty in passing his water, but that for some years he had not, except in a few instances, been induced to pass a bougie.

In a third case of impervious stricture, in which there was enough dribbling of urine to prevent the necessity of puncturing the bladder, an operation similar to the foregoing was practised, within the last three years, with less satisfactory results. The patient — between fifty and sixty years of age — after a long confinement with severe symptoms, recovered, and went home able to urinate with a small stream, accompanied at each urination with the discharge of a few drops through a small aperture still remaining in the perineum.

In several instances he has removed the upper, and parts of the lower jaw, for the diseases not unfrequently invading those bones - and within the last ten or twelve years, he has had numerous cases in plastic surgery. In three cases, he had fair success, in making an artificial nose, and in one case, failed. In repairing cheeks and lips, lost by sloughing in childhood, he has had several cases, with very sat- iifactory results.

Within the last four years, Dr. Mussey ligitated, at four weeks' interval, both carotids successfully, for aneurismal enlargement of the arteries about the ear. Within the same period, Dr. M. obtained a perfect cure by operation, of a recto-vaginal fistula. Both cases are detailed in the Amer. Jour- Med. Science, at Philadelphia, 1853.

His health at the present time is unusual for a man who is seventy-six years of age. He has the vigor, elasticity, and capability of men much younger. He attends to his daily professional duties, performs surgical operations, and delivers his didactic and clinical lectures, with great ease to himself; and his teachings are highly appreciated by his class. —Cincinnati Med. Observer.


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