Biographical Memoir, of John C. Otto, M. D.

Biographical Memoir, of John C. Otto, M. D., Late Vice President of the College of Physicians, Read Before the College by Appointment, March 4th, 1845  (1845) 
by Isaac Parrish

Biographical Memoir,

of

John C. Otto, M. D.

Late Vice President of the College of Physicians,

Read Before the College by Appointment,

March 4th, 1845,

by

Isaac Parrish, M. D.


Printed by Order of the College.


Philadelphia:
Wm. F. Geddes, Printer, 112 Chesnut Street.


1845.

Memoir.


Among the founders and early members of the College of Physicians, were a class of men combining, in a rare degree, the science and learning of the Medical Philosopher, with the virtue and benevolence of the Christian.

These individuals, both by their private example and public doings, gave a tone to the medical community of Philadelphia, which has rendered us prominent as a harmonious and united brotherhood—devoted to the advancement of medical science, and zealous in the support of those beneficent attributes of our profession which elevate it above mere sordid and money-making pursuits. In the various public charities which distinguish Philadelphia—in every philanthropic enterprise—this class of physicians have been prominent actors. Not a few public institutions, now firmly established, and daily dispensing innumerable benefits to the sick and destitute, were either founded by them, or owe much of their present prosperity to their fostering care. Most of this honorable company have passed away; a scanty remnant are still in our midst, instructing us by their experience, and inspiring us with that respect which invariably follows a long and well-spent life.

The last of this worthy band, whose death we have been called upon to notice, was Dr. John C. Otto,—some account of whose life is expected from me on this occasion.

He was born Third month (March) 15th, 1774, near Woodbury, New Jersey; was the son of Dr. Bodo Otto, an eminent physician, and distinguished as a public character in the stirring periods of the American Revolution. Warmly attached to the republican cause, and an active promoter of the Independence of America, he was called, by the unanimous vote of the county in which he lived, to the Senate of New Jersey; and served, during the war, as an officer in the revolutionary army.

It is related of him, that, during an absence from home on military duty, his house was fired by his political antagonists, the Tories, and his wife and several young children—amongst whom was the subject of this Memoir—were driven from their homes in the midst of an inclement season, while all the products of his farm were consumed. The incendiaries were apprehended and convicted; and, notwithstanding the calamity into which their acts had plunged him, Dr. Otto interfered in their behalf, and actually took a long journey on horseback to obtain their pardon. His mission was successful; but being overtaken by a violent storm, he contracted a severe catarrh, which was soon followed by pulmonary consumption; and he died at the early age of thirty years—leaving three children, of whom Dr. John C. Otto was the youngest.

This anecdote is recorded, as evincing an instance of rare magnanimity, and as an evidence of the honorable parentage of our deceased fellow-member.

Dr. Otto's great-grandfather and grandfather were also physicians; the latter emigrated to this country, from Germany, in 1752, being then forty-three years of age. He settled in Philadelphia; and, having received a European education, then a somewhat rare circumstance, he was much esteemed for his literary and medical knowledge. He obtained a considerable practice, especially amongst the German population, being rather conspicuous for his surgical knowledge. He attended the American army to the encampment at Valley Forge, and had charge of the Hospital there, during the memorable winter of 1778.

He declined all compensation for these valuable services, although, at that time, quite advanced in years.

By the early demise of his father, Dr. Otto was deprived of the fostering care which so worthy a parent would have bestowed upon his education; this important duty was not, however, neglected by those left in charge of him, as he passed through a collegiate course at Princeton, where he took his degree in the year 1792. After leaving college, he was sent to Philadelphia, and entered the office of Dr. Rush in the spring of the year 1793. He was scarcely initiated in his new duties before the yellow fever made its appearance in Philadelphia; but being a novice in medicine, and of no assistance to his preceptor, his friends removed him to the country; and he resumed his studies in the autumn. During his pupilage, he was most attentive and assiduous, and, by his amiable deportment and promising talents, became a favorite pupil, and afterwards a warm friend of his distinguished preceptor, from whom he received many tokens of esteem and affection.

He graduated at the University of Pennsylvania in 1796, and the same year settled as a practitioner in Philadelphia.

In the epidemic yellow fever of 1798, he had ample professional occupation, but was soon attacked with the disease himself, while on his way to see a sick friend near Woodbury, New Jersey. He remained during his illness at the house of a medical friend there, and recovered with difficulty.

The prospects of Dr. Otto, at his entrance into medical life, were in every way flattering. He had been the pupil, and was now the friend, of Dr. Rush; his capacities for the profession of his choice were undoubted; his manners were mild and amiable; and his moral principles were above reproach. He soon occupied a highly respectable rank amongst his contemporaries, of whom were Griffiths, James, Parke, Dewees, Physick, Hewson, Chapman, Ruan, and others; and seemed destined to occupy the position which some of these gentlemen acquired, not only as a private practitioner, but as a public teacher of the science; but his extreme diffidence of his own abilities prevented him from attempting any public display. His talents were more solid than brilliant, and his tastes more consonant with the unobtrusive sphere of the private physician, than with the excitement of public station.

In the year 1798, he was elected one of the Physicians of the Philadelphia Dispensary; an institution which he faithfully served for a period of five years.

In 1802, he was married to Eliza Tod, the daughter of Alexander Tod, a highly respectable merchant of Philadelphia,—a lady in every way qualified to render his domestic relations happy and congenial. They had nine children, seven of whom survive.

In the year 1813, Dr. Rush died, and Dr. Otto was appointed to succeed him as one of the Physicians of the Pennsylvania Hospital. A better appointment, for the interests of the Hospital, could not have been made, if untiring devotion to the sick, sound medical knowledge, a matured judgment, and a deep sense of the responsibilities of the post, are to be considered as the most important requisites. Had a handsome salary awaited Dr. Otto for the services rendered the institution, instead of their being gratuitously offered, the duties could not have been more faithfully performed. In his treatment of the patients, he united tenderness with firmness, and a humane regard for their health and comfort, with that strict discipline so necessary to the good order of a large hospital. There was nothing rough or austere in his manners, and the poorest and most destitute often found, in their physician, a kind and sympathizing friend. The caste of his mind and the goodness of his heart, seemed to qualify him especially for the treatment of the insane, who, under the old regulations of the Hospital, were committed to the charge of the attending physician. He took a warm interest in the maladies of this deeply-afflicted class of patients, and devoted much time to the study and investigation of their diseases.

The vast improvements which modern science has introduced for the treatment of diseases of the mind, were heartily embraced by Dr. Otto; and, so far as his influence extended, he gave them his support. Unlike some of the veterans of our profession, whose dread of the spirit of innovation leads them to look with suspicion upon every thing new, he was open to the investigation of such novel facts and suggestions as are constantly presented in the advance of our science, and formed his conclusions of their value upon rational principles. In no department of medicine has modern inquiry been more successfully prosecuted than in the study of insanity; and to the humane mind of Dr. Otto, it must have been a source of peculiar pleasure to observe, that as he was passing from the stage of action, new light was breaking upon this obscure subject, and methods of treatment were instituted more consonant with reason and humanity than those which had prevailed in the earlier periods of his career.

Dr. Otto held the situation of Physician to the Pennsylvania Hospital during a period of twenty-two years.

At his resignation in 1835, the Board of Managers, deeply impressed with the valuable services which he had rendered the institution, adopted the following minute:

"A communication was received from Dr. John C. Otto, resigning the station of Attending Physician, after more than twenty-two years' service most acceptably rendered this institution. The Managers, on parting officially from the Doctor, tender to him their acknowledgments for his long, faithful, and useful labors; and assure him of their cordial regard, and best wishes for whatever may contribute to his future happiness."

It was from his connection with the Hospital, that our deceased friend became extensively known, throughout the United States, as a physician and clinical teacher. During the latter years of his service, he had charge of the medical wards while the lectures were going on at the schools, and at a time when the institution was visited by a large number of medical students from various portions of the country. His clinical remarks were made at the bed-side; were always concise, and invariably marked by great simplicity and practical good sense. The important features in the case before the class were modestly stated; the plan of treatment, and the indications upon which it was founded, announced; together with such observations upon the disease, or the individual case, as were naturally suggested.

This was done in a clear, audible voice, without the slightest attempt at oratory, or the least embellishment, but with a gravity and dignity becoming the occasion.

I doubt not there are many practitioners, in various sections of our country, who could now testify to the value of the lessons of wisdom thus received; who can look back with lively satisfaction, and recall the slender and slightly-stooping frame of this venerable physician, as he passed around the wards of the Hospital, stopping at each bed as he passed, kindly saluting his patient, making the necessary inquiries into his condition, and then, in the most unaffected, and yet impressive, manner, addressing himself to the assembled class, and fastening upon their minds some valuable medical precept.

The great merit of the clinical teaching of Dr. Otto was its simplicity and truthfulness. A more conscientious man is perhaps rarely met with; as has been well remarked of him by one who knew him intimately, "his zealous love of truth made him scrupulously accurate in ascertaining and defining its exact limits, having a natural and excessive shrinking from anything that was false, which rendered candor and probity his distinguishing characteristics."

It was this strict conscientiousness which imparted value to his clinical instructions. Any statement which he made might be relied on as true; so far, at least, as he was capable of forming a judgment of its correctness from the facts presented. He never ventured into the regions of hypothesis—preferring to confine himself to ascertained facts, and to the rational deductions of experience. He possessed but little of that imaginative caste of mind which is often the accompaniment of a brilliant genius, which delights to roam in the regions of the unknown in search of undiscovered truths, and to strike out new paths of investigation. If his sphere was less aspiring, it was not the less useful, while it rendered his practice safe and judicious, and gave weight and utility to his public teaching.

As a practitioner, Dr. Otto was an eclectic; he was attached to no particular theories of disease, but formed his opinion of the character of each case, and of the indications to be fulfilled, from the symptoms presented. He possessed considerable tact in the application of remedies, and generally had at his command a variety of resources, which reading and abundant personal experience suggested.

His opinions upon medical subjects were always highly esteemed by his medical brethren; and the more so, from the fact of his proverbial candor, and freedom from prejudice or bias in favor of particular theories or plans of treatment His advice, in consultation, was frequently sought by his fellow practitioners, and always in the full assurance of his earnest and faithful cooperation, and of the utmost delicacy and propriety of conduct towards those who were younger and less experienced. However superior he might be to the physician in attendance, either in point of age, knowledge, or experience, he always took special care not to exhibit, to the patient or his friends, the least evidence of a want of confidence or respect towards his colleague, or, by word or deed, to arrogate any superior merit to himself. The same modest and unpretending demeanor, which marked him in other situations, attended him on those occasions where a knowledge of his superiority was frequently the motive for seeking his aid.

As a writer, Dr. Otto is but little known. Like many of the most experienced physicians of the United States, whose opportunities for observation, combined with a sound judgment, would give weight and importance to their statements, he has contributed but slightly to the medical literature of the country. This is, perhaps, mainly owing to diffidence of his own abilities, and partly to a want of that facility in writing which is often acquired by practice, and in which men of busy occupation are not prone to engage, without a strong motive or a natural inclination.

The few communications from his pen, however, which have appeared in the Medical Periodicals, are possessed of great practical value, and cause us to regret that they were not more frequent.

In 1803, he published a short paper in the New York Medical Repository, entitled "An account of an Hemorrhagic Disposition existing in certain families;" containing some singular facts in regard to the occurrence of the most alarming, and even fatal, hemorrhagies, after slight wounds or scratches, in the male descendants of a woman named Smith, in the vicinity of Plymouth, New Hampshire. The females of the family were exempt from the idiosyncrasy, but still were capable of transmitting it to their male children. After the use of various remedies, under the direction of the most skillful physicians, without success, during a period of many years, the sulphate of soda, in an ordinary purging dose, and repeated two or three days in succession, was found to be completely successful in arresting the discharge, and was afterwards constantly employed by the family, thus disarming this extraordinary and fearful malady of its terrors.

In 1805, another paper, upon the same subject, was published by Dr. Otto in Coxe's Medical Museum, detailing the history of four fatal cases of hereditary hemorrhage occurring in the family of Benjamin Binny, of Maryland.

These papers were, so far as I am informed, the first which had appeared upon the subject of this singular idiosyncrasy, and gave rise to others from different writers, by which many curious facts were developed;—the most elaborate of which was from the pen of Dr. Reynell Coates, and appeared in the North American Medical and Surgical Journal for July, 1828.

In the 9th vol. of the Eclectic Repertory, we find a short, but exceedingly valuable, paper on the cure of chronic rheumatism, in the form of a letter from Dr. Otto to J. D. Spragins, which appears to be an answer to certain inquiries of the latter gentleman, in reference to the Doctor's treatment of this disease in the Pennsylvania Hospital.

This plan of treatment appears to have been peculiar to Dr. Otto, and consisted in the administration of small doses of calomel and opium, night and morning; continued until salivation was induced, and resumed on the decline of the ptyalism, so as to keep up the mercurial action for three or four weeks. In some constitutions, in which a severe or protracted salivation might be deemed imprudent, the compound decoction of sarsaparilla, with the application of blisters to the affected part, was either substituted for, or used in connection with, mercury. In mild cases, mercury was not advised, and the blisters and sarsaparilla mainly relied on. In regard to the use of blisters to the parts affected, Dr. Otto remarks: "So beneficial do these prove, that it often happens, as I pass through the wards of the Hospital, if blisters have not been directed, some rheumatic patient requests to have one applied."

The efficacy of the mercurial practice, as applied to a large number of cases treated at the Hospital, some of them of a very severe and protracted character, is thus strongly set forth by Dr. Otto:—"The result of my experience is, that every form of chronic rheumatism, in almost every instance, is removed during the ptyalism, if it is carried to a considerable extent; that the exceptions are very few, indeed, where there is not permanent relief obtained; and that, in a vast majority of cases, a complete cure is effected, if the salivation has been continued actively three or four weeks. Nor have I ever had reason to regret, in a single instance, its having been employed." And again:—"Persons who have been crippled a year or two, and been entirely disabled from work, have been often restored by this remedy to their former usefulness."

I have been thus particular in stating the contents of this paper, from a belief that it has not received that consideration from the profession which its merits demand, and which the high authority of its author would seem to warrant; and from the fact, that the practice therein recommended, appears to have been, to a great extent, peculiar to Dr. Otto.

Another publication, well worthy of notice, is a communication read before this body in 1828, entitled "Case of Epilepsy successfully treated."

This paper was published in the North American Medical and Surgical Journal, and has attracted considerable attention. It refers to a case of epilepsy, of a year's standing, in a boy about thirteen years of age. The attacks were frequent and violent, and the case altogether discouraging. The Doctor commenced the treatment with anthelmintic medicine, from a suspicion that the disease might be produced or aggravated by worms. After a considerable period, a portion of what was supposed to be a tape worm was discharged. He was likewise ordered three tea-spoonsful of a powder, consisting of equal parts, in bulk, of pulverized sage and ginger, and unbruised mustard-seed; this quantity to be given in water, syrup, or other agreeable vehicle, three mornings, fasting, and then omitted three mornings, and so on, alternately. The medicine was continued about a year, the convulsions becoming less frequent and violent, and, finally, they ceased altogether.

The patient continued free from the disease for four years; his mind, which had been enfeebled, regained its strength; and he was able to work diligently at his trade. It was not until this period that Dr. Otto reported his case—showing his extreme caution and conscientiousness in this respect.

The Doctor further states, that he never considers this remedy to have had a fair trial until it has been continued for at least six months; and that, even then, he is sensible that it restores but few, but that it has been more efficacious than any other article he has tried. He also recommends this powder in obstinate cases of chorea, and some of those painful chronic affections of the head appearing to depend on a deranged state of the stomach. It acts as a gentle tonic, and sometimes as a mild aperient; and is now known, and somewhat extensively used, as an excellent anti-spasmodic powder. Its utility, in some cases of epilepsy, has been attested by other practitioners, who have employed it at the recommendation of Dr. Otto.

This paper contains, also, some valuable practical suggestions on the general treatment of epilepsy, with an excellent description of a form of the disease occurring in young persons, not before described. It does the author great credit, and is a valuable contribution to medical science.

In the year 1830, Dr. Otto read before this College, a communication on "Congenital Incontinence of Urine," which was also published in the North American Medical and Surgical Journal, and is the last production of his pen which has come under my notice.

This paper contains some exceedingly valuable practical hints on the treatment of incontinence of urine occurring in children, illustrated by the history of five cases, successfully treated. The chief remedies employed in these cases were a decoction of the uva ursi, and the muriated tincture of iron, the cold dash to the perineum and nates, and, if occasion demands it, a blister to the sacrum. This practice has since been extensively adopted in this City, and, I have reason to believe, with the most encouraging results. We are indebted to Dr. Otto not only for suggesting these remedies, but for establishing as a disease what has been falsely considered a mere filthy habit—often subjecting innocent children to punishment and mortification, when the true method of cure consisted in the use of appropriate medicines.

From this brief synopsis of the labors of Dr. Otto as a writer, it will be seen that, although he has rarely appeared in that capacity, yet, when he did so appear, he never failed to add something to our stock of knowledge, or to throw additional light upon the topic which he discussed. Did medical writers generally pursue this course, what a vast amount of useless verbiage would be spared; how many erroneous opinions would be confined to those who conceived and nurtured them, instead of being thrust upon the world to do more extensive mischief; and how much more simple and clear would be the views of medical men, upon many topics now rendered obscure by the variety of conflicting opinions concerning them.

In addition to the responsible position held by Dr. Otto, as Physician to the Pennsylvania Hospital, he was connected with several other public charities. During a period of twenty years, he served the Orphan Asylum, where he was much beloved by the children, and by all connected with that useful institution. He was also Physician, during many years, to the Magdalen Asylum, in the prosperity of which he took a deep interest.

When the alarm of epidemic cholera reached Philadelphia, Dr. Otto was one of twelve of our most eminent physicians, who were appointed by the public authorities to adopt such sanatory measures as they might deem expedient to mitigate the force of the impending calamity, and to establish and conduct hospitals in the different sections of the City.

At the organization of this body, Dr. Otto was unanimously called upon to preside over their deliberations,—a mark of respect and confidence on the part of his medical brethren, which, while it must have been peculiarly grateful to his feelings, evinced to the public the high estimation in which he was held by those who had the best opportunities of forming a judgment of his merits.

In this position, as in all other public stations, he fulfilled the duties with the greatest propriety and punctuality—being always at his post at the appointed time, and taking a lively interest in the various operations of the Sanatory Board. The importance of these measures, and their influence upon the health and tranquillity of the community during this dreaded period, will be long remembered, and were at the time gratefully appreciated, by the inhabitants of Philadelphia.

As a member of this institution, we can all bear testimony to the warmth of Dr. Otto's zeal in promoting its interests and prosperity. Looking upon the College of Physicians, not only as a scientific body, through the influence of which medical knowledge might be advanced, but as a sort of conservator of professional morals, he was deeply interested in all its movements, and a diligent attender of its meetings.

His keen sense of propriety, and uncompromising adherence to principle, fitted him remarkably for the delicate office of Censor, which he filled to the satisfaction of the Fellows for many years. At the death of my lamented father, in 1840, he was elected as Vice-President; a position which he occupied at the time of his death.

In the late revision of the By-Laws and Rules for professional conduct, he took an active part, and was one of the committee of three who prepared this extended and admirable code for the action of the College.

This labor was amongst his last services, and was a fitting occupation for one who had so beautifully illustrated, through along life, the principles which he now presented for the acceptance of others. In fact, Dr. Otto was a model of excellence in all that pertains to the duties of the physician towards his brother practitioner, and towards the community.

His ethical views were based upon the highest moral considerations; he looked upon the physician as properly the minister of good to his fellow beings, and hence, as bound to act in all cases with reference, not to his own interest alone, but to those more elevated and enlarged views which bind us, by the ties of benevolence and humanity, to the common brotherhood of man. In his intercouse with his patients, he was candid, ingenuous, and open, never concealing, from them or their friends, his real views of the nature of their diseases, where such information was important to be known. Towards his professional brethren, his conduct was frank, liberal, and cordial, giving him a just claim to the affectionate regard in which he was held by the medical profession generally. My venerated father used frequently to remark, that Dr. Otto and himself presented a strong illustration of the falsity of the popular idea, that physicians, as a class, were quarrelsome. He and the Doctor lived within one square of each other for a period of thirty years, each busily engaged in kindred pursuits, and liable, had they been so disposed, to come into frequent collision; and yet, by the observance of those amiable and just principles which should regulate our intercourse with each other, they maintained, during the whole period, a warm and constant friendship, vieing with each other in acts of kindness and good neighborhood, rather than in efforts to promote their individual interests at the expense of each other.

Dr. Otto's private practice was less extensive and lucrative than that of some of his contemporaries of equal standing. He confined himself wholly to the practice of medicine, avoiding surgery and obstetrics; and though he enjoyed the patronage and confidence of some of the most substantial and respectable families of the City, yet his retiring and unassuming manners prevented him from aspiring to a place amongst the fashionable circles. Those who knew him best, valued him most, and some of those families who originally employed him had such confidence in his skill, and became so attached to him, that he continued to be their physician during his whole medical career; a period of nearly half a century.

In the social relations of life, our deceased friend was remarkable for the simplicity and ease of his manners, and for the instruction which pervaded his conversation. He rarely mixed in convivial parties, as they interfered with those habits of life which he had marked out for himself. He generally retired at ten o'clock, and rose before six o'clock in the morning—spending an hour before breakfast in serious reading and meditation, to fit him for the responsible duties of the day. He read the Scriptures morning and evening, and rarely passed a day without perusing a portion of Thomas à Kempis' admirable work, the Imitation of Christ

He was of a truly catholic spirit, and remarkably free from bigotry and prejudice towards any nation or sect. Although warmly attached to the doctrines and forms of the Presbyterians, he was disposed to form his estimate of men more by their daily practice than by their opinions, and never indulged in denunciation against those who differed from him in religious belief. His own religion was eminently practical and vital. By it, his passions were kept in subordination, and his desires circumscribed. In trouble and in sickness, he was patient and uncomplaining; in health and prosperity, humble and thankful; and in all the situations of life, full of kindness and benevolence towards his fellow beings. His scrupulous honesty as a medical teacher has before been alluded to; this same probity followed him in all the transactions of life, so that his integrity and uprightness were proverbial.

The life of this excellent man terminated about six o'clock P. M., on the 26th of the Sixth month, (June,) 1844, in the 71st year of his age. He had, for many years, been subject to frequent attacks of general gout, which were often of a most severe character, but which seldom confined him long to the house. For five or six months previous to his death, his strength had been gradually failing, without any acute or painful symptoms. There was that slow and progressive decline of the vital powers, which is uninfluenced by remedial measures, or by nutritious food, and which presages a dissolution of the frame at no distant period;—a sort of breaking up of the system, or a wearing out of the machine, which it is beyond the power of art to invigorate or repair. Towards the close of life, œdema of the extremities occurred, with great difficulty of respiration, which induced Dr. Hewson and myself, his medical attendants, to suppose that hydrothorax had taken place, and we had little doubt that this condition was preceded by extensive organic disease of the heart, although no post-mortem examination was instituted to test the accuracy of this opinion.

During this long illness, Dr. Otto maintained an unusual serenity and composure, and looked forward to the final result with entire resignation to the Divine will. He died, as he had lived, a humble and devout Christian—beloved and respected by all who knew him, and highly esteemed throughout this community.

I have thus endeavored, gentlemen, to present a faint sketch of the character of our late venerable friend. His presence in this Hall has often inspired us with respect and affection, and his departure from our midst has created a painful blank. It is true, he was not a great man, in the ordinary sense of the term; he had not attracted around him crowds of admiring votaries, who hung upon his accents as though they were oracular; he was not gifted with those splendid abilities which fit men for leaders in the onward march of science; his medical opinions were not, like those of his distinguished master, stamped upon the literature of his age and country. But, notwithstanding he was a plain, unpretending man, he was one of the soundest and most judicious physicians of our country,—well read in the school of nature, and his mind stored with the treasures of knowledge, derived from an intimate acquaintance with the works of ancient and modern authors. If his career was not brilliant, it was eminently useful. If his name is not emblazoned on the scroll of fame, it lives in the hearts of those who enjoyed the advantages of his kindness and skill, and who received the benefits of his wise counsels.

This work was published before January 1, 1927, and is in the public domain worldwide because the author died at least 100 years ago.