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

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that she never saw her father without his hat on. He never attended service in the churches, and the explanation was always assumed to lie in the unwillingness either to remove the covering from his head, or to attend church wearing his hat. He would decline to take off his hat in court on the occasions when his expert testimony was sought: and the sole occasion on which a judge seems to have insisted that the doctor should be uncov- ered brought from Mettauer the suggestion that if his evidence were essential to the case he would be pleased to give it with his hat on, and that if it were not so, he would be quite as well pleased to leave the court-room, meanwhile, of course, wearing his hat. With posthumous insistence, Dr. Mettauer left directions that he should be buried with his hat on, and a coffin a trifle over eight feet long was found necessary to contain his body with this favorite article of dress and the considerable number of instruments which, along with a parcel of letters from his first wife, he directed to be buried with him. It is really not likely that lVlettauer's absence from religious and social gatherings should be put down to oddity. There is far more probability that the same lack of time for anything other than the tasks he set himself, which marked him out as a man without a pastime, also prevented his attendance on any occasion where his professional service was not in demand. Dr. Mettauer formed for the community in which he was born an affection which was little short of passion. He had numerous opportunities to come out into the great world under the fairest auspices, but he found when he tried it that he dragged a length- ening chain wherever he roamed that anchored him back in Prince Edward again. He once made a settlement, which proved a brief one, in Norfolk. He tried life in Baltimore as professor of surgery in Washington University, but soon the longing for his native scenes swept over him, and he came home to stay. lVlettauer's versatility was so truly great that he might have resented an intimation which identified him with any particular branch of practice to the exclusion of the others. Pre-eminent as he was in surgery, he certainly did resent what he considered the invidious attempt of some of his brethren to classify him as a specialist in that direction, and, though he would have scorned a consideration which rested solely on his writings, these were, in magnitude and in force, enough to malce the magnum opus of another man. I have in my possession a very large number of manuscripts on various medical and even quasi medical topics. These were produced in his most active literary period, from l825 to l845. Among them are articles and essays on yellow fever, congestive fever, puerperal fever, Asiatic cholera, continued fever, remitting and intermitting fever, and a most interesting article on the prophylactic use of drastic purging in the early treatment of puerperal fever, etc. During these years he was a most voluminous and valued contributor to nearly every medical journal published in this country, and on my book-shelves are un- counted piles of the older journals containing contributions from Nlettauer, to which the editors well-nigh uniformly assign the place of honor in their magazines. 24

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of silver sutures in vesicovaginal fistula. His reference to Mettauer, even in these cir- cumstances, is so slight that at first reading I overlooked it. He says in part, ln IS45 I conceived the idea of curing vesicovaginal fistula, etc. lVlettauer's first reference to the matter appeared in the Boston Medical and Surgical journal, vol. xxii. p. I54. twelve pears before Sims' communication, and it clearly outlines the operation which ought always to be associated with his name. ln the American journal of the Medical Sciences, new series, vol. xiv. p. ll7, five pears before Sims' communication, Nlettauer says, I am decidedly of the opinion that every case of vesicovaginal fistula can be cured, and my success justifies the statement. It seems almost marvellous that so little should be known of Mettauer, when we go on to say that his was clearly the earliest operation for cleft palate performed in the Western world the used for the work a novel instrument made for the purpose by himselfl, and that he was clearly among the first of American surgeons in adopting or adapting the best of the advance suggested by any other man. He was, also, the original suggester of the employment of iodine in the treatment of scrofula, and among the first in such major operations as amputation of the shoulder, ligation of the carotid, and resection of the superior maxilla. And last, but not least, it is by no means sure that, in the care and detail of his preparations, he may not be ranked as the American Lister, and it is certain that the excellence of his precaution seems almost, by a sort of invested inheritance, to have come to him from some ad- vanced man of our day. Dr. Mettauer was a man of striking appearance, tall, well-formed, and robust: his piercing black eyes were shadowed by a heavy fringe of brow, and above arose a fore- head high and of the most intellectual shape. He was seclusive in his habits, and few persons were admitted to any closeness of acquaintance, and very few to any sort of intimacy. ln fact, from the first dawn of manhood to his death he was busy. His practice with the patients who came to him in his office at home and that at Farmville, where he was to be found at certain hours every day, would have appalled the average worker: his medical school was, in the language of our streets, a good deal more than one man's job, and, in addition, he did an amount of writing which would have kept the ordinary scientific man engaged all of his time, and satisfied him wholly with himself. To this eternal business may be attributed much of Mettauer's failure in the social duties, and it is vain to inquire whether, in other circumstances, he might have been more ap- proachable. That he was master of some, at least, of the social charms is witnessed by the fact that he was four times married, and in each instance to a woman of attraction and excellent social connections. To an extent, which never failed to make his character of interest, but which never subjected him to ridicule, Mettauer was eccentric. There was, indeed, about him that which would have saved him from ridicule, even had he been far more eccentric than he was. I have referred to his invariable custom of wearing on all occasions and at all times a preposterously tall hat. One of his children, now surviving, has told me 23

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ln all respects the most remarkable of his performances along this line is his manu- script work on surgery. It would be endless to attempt to make one appreciate this by giving quotations to show how clear was his analysis and how finely chosen was his phrase. I should almost prefer to attempt to arouse your appreciation by the well-known method of the Dutchman who described Dr. .Iohnson's Rasselas. s'Dot vas quite a leedle buke, he said, mein bruder writ a buke more as five times as big. Dr. lVlettauer's surgery contains about 3000 pages of manuscript, closely and most clearly written on the old blue legal cap paper of his day. I am glad to say that l have the original, and, I assume, the only draft of this manuscript, and a truly remarkable piece of work it is. I have no means of knowing why the book was never published. It could hardly have been for the lack of money, since Mettauer numbered among his loyal admirers many persons who would probably have been delighted to show ap- preciation for the benelit conferred by his skill, and to take on themselves the charges necessary to bring the book to light in case the doctor was unable to attempt it at his own expense, and this latter is by no means probable, since Mettauer, from the super- abundance that he might have gathered in, appears to have had quite money enough at all times for his needs. The book shows an intimate and enormous knowledge of all the directions that surgery in his time took, and not a little of the choicest fruit of elegant acquaintance with the older literature is scattered here and there throughout the work. The description of tuberculosis orchitis is, perhaps, especially striking. l-le says: Young persons of strumous constitutions are the chief subjects of this affection, and the epididymis is more frequently the seat of the morbid deposits than the substance of the gland. The adven- titious deposit presents the same appearance as in the lungs and lymphatic glands, con- sisting of small isolated masses rarely larger than a pea or in the form of inliltrations, which, after a time, transmute the testis into a yellowish, curdy, cheese-like substance. The deposition may take place into the cellular tissue of the organ, or in the seminiferous tubules, which most commonly are its recipients. There is always more or less enlarge- ment, induration, and change in the shape of the testis, and the disease begins insidiously, is painless, free from tenderness under pressure, and often remains stationary for months, or even years in some instances. Finally, however, the scrotum becomes adherent and of a dark hue: the tuberculous matter softens, resulting in abscess, which sooner or later bursts, forming an ill-looking ulcer. So great is my interest in seeing full justice done to the genius of Mettauer that I am seriously contemplating some extended work in the way of a biography. To this I relegate more detailed mention of his writings, and in it I hope to give some ex- tended and valuable extracts from the surgery. ln 1875, in the month of November, Dr. Mettauer was called to attend a case ot morphine poisoning a short distance from his house. He was just about completing his eighty-eighth year, but was alert and erect and as interested in his science as when in 25