Medical Terminology Daily - Est. 2012

Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

William S. Halsted, MD

William S. Halsted, MD
(1852 – 1922)

American anatomist, teacher, and surgeon, William Stewart Halsted was born in New York City, USA to a wealthy family of English origin. His father was involved in charitable work and Governor and trustee to a city hospital. Not a brilliant student initially, Halsted took an undergraduate in Liberal Arts in Yale, CT., after which he entered the Medical College of Physicians at the Columbia College, where he excelled.

As a second-year medical student Halsted applied and obtained a position in surgery at a local hospital. In here he learned about Lister’s antiseptic technique and became an adamant proponent of it to reduce infection. In 1877 Halsted obtained his MD. After a short time as House Physician at the New York Hospital, Halsted traveled to Europe to further his education studying for two years at the Universities of Vienna, Leipzig, and W?rzburg.

Besides being at the forefront of surgical and antiseptic techniques (introducing the use of rubber gloves in surgery), Halsted was extremely concerned with the way medical students were taught in the US. He pioneered bedside clinical round discussions with the medical students after two years of basic sciences studies. Halsted developed the idea of a patient chart; he also developed the residency program for medical students in use today.

Halsted is probably the most influential researcher and surgeon at the turn of the century. He dedicated time to the study of intestinal anastomoses and the use of silk as a suture material. His experimental work in 1887 proved that the inclusion of the submucosa layer in an anastomosis was mandatory, as well that a single layered anastomosis was enough to attain closure. Perhaps Halsted’s most important contribution was the application and use of the scientific method to surgical questions. Halsted’s principles, also known as  "Halsted's Rules of Surgery", set the standards used today in surgical suturing and surgical stapling.

He also pioneered the development and surgical techniques for radical mastectomy as a treatment for breast cancer.

As a side effect of this studied in anesthesia and the use of cocaine for anesthesia, Halsted became addicted to this substance, a problem that followed him through the years. Without impairing his capacity as a researcher and a surgeon, Halsted eventually recovered. He died in Baltimore in 1922 as a complication to surgery.

Sources:
1. Dubay, A. D., & Franz, G. M. (2003). Acute Wound Healing: The Biology of Acute Wound Failure. Surg Clin NA, 83, 463-481.
2. Halsted, W. S. (1887). Circular Suture of the Intestine - An Experimental Study. Am J Med Sci, 436-461.
3. “William Stewart Halsted: his life and contributions to surgery” Osborne, P. Lancet Oncol 2007; 8: 256–65
4. “William Stewart Halsted: Surgical pioneer” Burress, P Endoc Today (2010), 8: (2) 22
5. “William Stewart Halsted (1852–1922) Neurological stamp” Haas, LF J Neurol Neurosurg Psych 2000;69:641
Original image courtesy of "Images from the History of Medicine" at  www.nih.gov


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I recently received a book from Chile. This book is in French and is titled “Traité D’Accouchements” (Treatise of Childbirth) or a “Treatise in Obstetrics” and was published in 1898 in Paris. The author is Dr. Pierre-Victor Alfred Auvard, (1855 - 1940), a French Obstetrician and Gynecologist.

The book belonged to the library of San José Hospital. The Old San José Hospital is a former hospital located on San José Street, next to the General Cemetery of Santiago, in the Independencia district of Santiago, Chile. Built between 1841 and 1872, it functioned as a hospital until 1999, when the new San José Hospital was built. Parts of this hospital are now being demolished and a new one will be built in its place, but the old books from the library were discarded without a second thought. An engineer in charge of the new construction managed to rescue some of these books, and one of them was brought from Chile to the United States by another friend of mine, Carlos Verdugo, a classmate.

The book was in terrible condition, with a barely legible title, the spine was broken, and the signatures (groups of pages that together from the text block) separated as the threads that kept the book together were torn. Bookbinding and book repair being another one of my hobbies, I undertook the task and now it will be added to my collection. Here are some pictures of the process. Click on the image to see a larger version.

Repair process Auvard “Traité D’Accouchements” 1898

Repair process Auvard “Traité D’Accouchements” 1898

Repair process Auvard “Traité D’Accouchements” 1898

Repair process Auvard “Traité D’Accouchements” 1898

 In one of its pages, the book has an old and barely legible stamp the reads “Manuel Casanueva del C.” A short search indicated that this was the Ex-Libris stamp of a Chilean surgeon Dr. Manuel Casanueva del Canto. Of course, I had to do some research on the past owner of this book.

Manuel Casanueva del Canto was born in the city of Linares, Chile on July 5, 1908. From 1925 to 1931 he coursed 1st to 6th year of medical school at the Medical College of the University of Chile (where I studied). At that time the College of Medicine was in the Independencia neighborhood in the city of Santiago. In 1930 he obtained his medical license.

Repair process Auvard “Traité D’Accouchements” 1898
The repaired book in my library

Between 1930 and 1931 he was a surgical resident at the Hospital San Francisco de Borja (where I was a patient as a child), passing through Internal Medicine, Emergency Medicine and Surgery, and Obstetrics, obtaining his surgical degree in May 1932. His thesis for the degree was entitled “Pathological Anatomy: Inflammatory alterations of the gallbladder”.

As a surgeon, he worked at the Santiago Military Hospital, Central Emergency Services, and the Central Trauma Hospital. In 1952, going back to his roots, he moved to the Surgical Department of the University of Chile at the Hospital “Jose Joaquin Aguirre”. This hospital is on the same campus as the Medical College where he studied.

In 1955 he applied for (and obtained) the position of Professor Extraordinaire of Pathological Surgery in the Medical College of the University of Chile. At this time, he already had a great teaching career, several medical awards, authored the book “Practical Blood Transfusion” in 1939 as well as co-authored several medical books and over 81 papers.

He became Chief of Surgery at the Jose Joaquin Aguirre Hospital and in 1961 he invited Pablo Neruda, Chilean Nobel Prize winner in literature, to lecture at the hospital.

In 1975 Editorial Andres Bello published his book “Surgery”, two volumes in Spanish. I have not been able to trace this book. Not much is known of him after this date. No photography or portrait has been found.

He married Maria Yolanda Carrasco Coral (date unknown), they had three children: Maria Cristina, Isabel, and Manuel Luis.

He died on February 13, 1981, in the city of Viña del Mar, and is buried in Santiago, Chile. Further research indicated that this book I received as a gift was donated to the library of Hospital San José by Dr. Casanueva where it eventually was discarded, rescued, transported to the US, and repaired.

Final cover with made with leather and linen book cloth

Final cover made with leather and linen book cloth

Marble endpapers

Marbled endpapers

I hope this article reaches the Casanueva del Canto family in Linares (today they probably are Casanueva Carrasco and/or Casanueva Iommi) and they can help me update this research, and hopefully a photograph of Dr. Casanueva del Canto. To this end, here is the Spanish version of this article.