Hampden Sydney College - Kaleidoscope Yearbook (Hampden Sydney, VA)

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picion that the uncommon size of lVlettauer's account was rather a piece of humor- sometimes pretty grim to the second party-than anything else. ln this direction is tl.e story of Mr. l, who, with a number of new one-hundred-dollar notes held cori- spicuously in his hand, dropped into the oflice to settle his account. He handed a note to the doctor, who, to his surprise, did not pocket it, but still held out a hand, into which, after a moment's delay, another note was placed, and then, with a moment of embarrassing silence, another, and then, when the silence grew to be eloquent, another. Four hundred was clearly the limit to which the visitor could be got by silence. howeier eloquent, or by embarrassment, however deep, and still Mettauer held out his hand. At last he gently suggested, One more, if you please, Mr. and the gentleman, half hypnotized, deposited his last note. lVlettauer appears, however, to have placed no value on money, except as a me? is of carrying on his work, and an exterior a little repellant concealed a heart as great and warm as ever throbbed in human breast. A vast deal of his time was given to practice, whence he could hope for neither fortune nor fame, and this not spasmodically, but regularly and for years. Again, the course of his work at home was interrupted, particularly very early in his career and late, when he could leave in the hands of his highly accomplished sons the interests of his local patients, and Dr. Mettauer would undertake journeys of weeks for the relief of persons who were unable to come to him. A drive from Prince Edward down into Georgia was about the most considerable of these undertakings, and we should be likely to agree, if confronted by a similar proposition, that it was quite considerablf enough. It is hardly possible that less than two months was consumed in this expedition, and it is a matter of legend that the fee which Mettauer received-one thousand dollars-was regarded to be stupendous. There are no means of mapping out th: trip into Georgia, but there is some reason to assume that the doctor combined with hii main object several calls which he was desirous to make somewhat along his route. But, even with a considerable allowance for combinations, such a trip as this was E great sacrifice of time and strength, and it makes one of the records that shed on lVlettauer's career that kindly light in which we recognize the genuine enthusiast and the self- forgetful man of science. Returning to the consideration of Mettauer personally, I would remark that all the contemporary evidence agrees that he was of phenomenal skill and daring as a surgeon. His one peculiarity in operations seems to have been an invincible objection to watching any other man at work, and this peculiarity carried him to the extent of refusing assistance even in a long and exhausting case. The reason probably lay partly in his nervous need to keep occupied in order to distract his attention from the patient's suffering, which in the preanaesthetic days must have been a serious trial to the sym- pathetic surgeon: and it is likely that Mettauer was moved also by the need for haste and the knowledge of what unerring and lightning skill lay in his supple hands. 21

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occupy most of his time and to enable him to follow the bent of his genius and devote himself almost exclusively to surgical work. Patients came to him from an area that ever increased: from the most distant parts of the United States and in some instances from abroad. Step after step the quiet country home took on the aspect of the hospital, and the whole neighborhood became permeated with interest that grew out of the accomplish- ments of a single man. This is, perhaps, as proper a place as any to make some reference to the almost incredible amount of surgical work that Mettauer accomplished. Persons now living who remember the circumstances, and had more than common opportunity to know whereof they speak, have told me that for a period of about forty years the number of surgical patients who gathered to Mettauer for treatment was sufficient to keep him con- stantly with from 45 to 60 cases under his care. Often it was true that about every good house in the community sheltered some person who was convalescing or awaiting his turn for operation. I have heard his operations for cataract put in number far beyond the 800 that can be accounted for: Dudley's great record in cutting for stone 225 times in a practice of forty years must yield to lVlettauer's total of 400 operations, and the number of strictures relieved is commonly put at something over 200. Three operations are recalled, performed in the last week of his life, when, at the age of eighty-eight years, his eyes were yet keen enough and his hands steady enough for him to make a successful operation for cataract, for stone, and for amputation of the breast. Writers of renown have given us the picture of the placid rural life in old Virginia, and it is no part of my task to attempt a description of the conditions and manners of the people there a hundred years ago. It must suffice for my purpose to say that lVlettauer's r-ative country was a typical part of the old South, in which but two classes, the highest and the lowest, the master and the slave, played an important part. Of the middling sort of folk-the yeomen-the civilization needed few, and to them were relegated such employments as were beyond the condition of the slave, and beneath the dignity ol the gentlemen-such employment as conducting shops and the small mills and stores throughout the countryside. Into Prince Edward Court House, a representative old-time village, poured an ever-increasing stream of patients, who sought the services of Mettauer. from the necessity of the case, the greater part of those who came from a distance were people of consequence, and in many instances they travelled in their own carriages and with their own retinue of personal attendants, and formed at times a crowd sufficient to try to the utmost such modest accommodations as were afforded by the doctor's private hospital, and by the two houses of entertainment at Kingsville and Worsham, referred lo in the phrase of that day as commodious taverns. l-lad Dr. Mettauer possessed an eye single to the main chance which has degraded the skill of some of our brethren, the dreams of avarice could scarcely set a limit to the wealth he might have amassed. An occasional story of a considerable fee is met with, but commonly there are circum- stances of the patient's reputation for wealth and parsimony which might warrant the sus- 20

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No characterization of Mettauer could be complete unless it took note of the practical common-sense which guided him in his work whenever there was no other guide to be found in his own experience or in that of other men. ln employing the methods suggested in the most advanced journals he was by no means sure to follow even remotely the details of an operation. An instinct enabled him to grasp the essential of the matter. and, this accomplished, he was rather more likely to improve and to shorten the details than to follow in the track laid down by him who first described some new method. ln exactly the same direction it mattered not seriously to Mettauer whether hc had an instrument of the make of the most celebrated shops or of his own fashioning, or none at all. To turn any sort of thing into a reasonably sufficient tool was a common trick of his, and hence we read of emergency catheters made out of pipe-stems and of every sort of employment of the commoner articles of daily use to serve some pro- fessional turn. When one calls an American country surgeon of the old day daring, he has in mind no trace of the fussy, vain desire for notoriety, which we sometimes now associate with the advertising surgeon, and which some writers have pretended to discover among some of the surgeons of France. Surgical daring is a matter of the when, not of the nvhat. The ancient poet gives oak and triple brass about the breast to him who first trusted his frail bark to the savage deep, and now the trackless highways of the ocean are safe as lighways of the land. In the sense that he was far ahead of his age, and only in that sense, was Dr. Mettauer a daring surgeon. Many of his operations would stamp him as a high leader in surgical advance, and on several of these the fame of an ordinary or even an ordinarily great man might securely rest. But lVlettauer's most brilliant work in the way of operations was his method of vesicovaginal fistula, and his successful em- ployment of wire sutures made of lead, in which he antedated by a good many years even Sims, whose name is generally associated with this operation. So successful was Mettauer that he declared his belief that every case of this sort was curable by his method, and, so far as his efforts were reported, I am not aware that he ever failed in one. Proper pride and regard for his own reputation in the coming years must make every surgeon careful to a degree in assigning credit for useful and honorable achieve- ments to those who have preceded him, and there is in the history of surgery no claim more clear and unmistakable than that of John Peter Mettauer to the honor of discovery in this case, and he is plainly entitled to rank in medical history and in the grateful memory of his successors in the same class with McDowell and Dudley and Sims and Mott. Strangely enough, Mettaueris isloated position and his little conspicuous way of life have barred him from well-earned fame, and he is not even mentioned in some such works as lVlumford's Narrative of Medicine and Park's History. Even where it would appear that circumstances demanded a thorough knowledge of Mettauer and of his work, the reference to him is so slight as to be slighting. In l858 Sims takes occasion to rebuke an old associate of his for the attempt to defraud him of the credit of the use 22