Lives of the fellows

Nathan Mutch

b.1886 d.3 June 1982
MA MB BChir Cantab(1911) MRCP(1913) MD(1917) FRCP(1920)

Nathan Mutch was educated at Manchester Grammar School and Emmanuel College, Cambridge, and completed his medical training at Guy’s Hospital, London. He married the third daughter of Sir William Arbuthnot Lane.

My first impression of Nathan Mutch was as a student at Guy’s before the war when, on going to the medical block (Hunts House) for my chief's rounds — which usually started on time — I passed, on my way up the wide staircase, a group of disconsolate students waiting for Nathan, for he was invariably late although he nevertheless managed to leave sharp on time. At that time, he seemed a rather distant figure to me, and there is undoubtedly truth in what is said of him in the obituary notice which appeared in the Lancet: to some extent he was overshadowed by his colleagues who were an outstandingly brilliant and forceful lot.

Nathan, on the other hand, was of a much more modest and retiring nature. In those days the resident medical staff would put on a play in which various members of the staff were portrayed, sometimes quite unkindly, and I recall one in which Nathan was caricatured and labelled as ‘Dr Nothing Mutch’. Nothing, in fact, could have been further from the truth, for there was very much to Nathan and the more one knew him the more one grew to admire and respect him, and this is precisely what happened to me during the years 1941 — 1943, when I had the good fortune to work for him, first as house physician and later as registrar, at the Guy’s Base Hospital, Farnborough, Kent. Nathan was then senior physician at Guy’s but spent all his time at Farnborough, living near the hospital, undertaking teaching rounds, and having the care of half the medical beds as well as carrying on research in the pathology laboratory, in his well loved field of pharmacology.

Contact with him then was close, for he spent a lot of his time in the Mess and took his meals with students and staff. He proved to be very different from the distant character we had thought him to be before the war. He was a warm, affectionate, amusing person with a great sense of fun. The more one saw him at work in the wards, the more one realized his extraordinarily wide grasp of medicine and his tremendous ability as a general physician, although gastroenterology was undoubtedly his main interest. He had various well known ‘quirks’ which related in particular to the gastrointestinal tract. I well remember his teaching, and trying the effect of some alkali-gel that he fondly imagined could settle in the base of the gastric ulcer and so fill it. Also, in gastric and duodenal ulcers, he would frequently want a Curtiss belt fitted, so that this would ‘raise the intra-abdominal pressure’ and so lift the stomach and help the ulcer to heal.

His other ‘quirk’ or ‘kink’ was focal sepsis. Anyone with a PUO would need to have been investigated for focal sepsis before being presented to Nathan. This involved a full jaw X-ray for apical abscess, a cholecystrogram for cholecystitis, and one other - which I have now forgotten, although I must have been asked for it not once but a hundred times. Another favourite was ‘uplift therapy’ - his own words. If someone presented with fatigue, and anaemia or other organic disease had been excluded, we would be told to give the ‘uplift therapy’. This meant kaolin and paraffin emulsion three times a day before meals and large doses of every vitamin conceivable. Strangely, and heaven only knows why, a lot of people seemed to feel the better for this. The ‘Master’ himself took it, and his fantastic good health, youthful appearance and ultimate longevity may, in retrospect, bear witness to there being something in this much derided ‘uplift therapy’ after all.

His interest in pharmacology started in his days at Cambridge, and he was a founder member of the British Pharmacological Society, and on the editorial board of the British Journal of Pharmacology and Therapeutics. His main contribution to therapy was the introduction of magnesium trisilicate as an antacid for the treatment of peptic ulcers.

As I have said, he was an outstandingly good general physician and a lovable man. He treated the staff with affection, consideration and patience. It was a treat to watch him examine a chest and teach us how to do it. I well remember summoning him urgently to the ward, one day after tea, to see a man I thought had suddenly developed aortic incompetence. Nathan listened for two or three seconds, stood up, and gently pointed out to me that it was pericardial friction.

Unfortunately, I can speak of him only as I knew him during that short time between 1941 and 1943.1 saw little of him after that, except for one brief encounter at the RSM around 1950 - when he looked as young and sprightly as ever.

G Thomas

[Lancet, 1982, 1, 54]

(Volume VII, page 420)

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