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 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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The ventricular system of the brain is an interconnected system of cavities and ducts within the brain through which cerebrospinal fluid (CSF) circulates. The CSF is produced in the choroid plexuses located within the ventricles.

Ventricular system of the brain (www.bartleby.com)
Ventricular system of the brain

4th ventricle - Human brain dissection
Brain dissection - 4th ventricle

 There are two large curved lateral ventricles, each found within a cerebral hemisphere. They connect with the third ventricle via an opening called the "foramen of Monro". The third ventricle connects with the fourth ventricle by way of a slender canal called the "cerebral aqueduct" or the "aqueduct of Sylvius".

The third ventricle is found deep within the brain between the right and left diencephalic portion of the cerebrum.

The fourth ventricle is located between the pons of the brain stem anteriorly and the cerebellum posteriorly. This ventricle has a rhomboidal shape and it connects with the external aspect of the brain and the subarachnoid space. Failure of this CSF drainage from the ventricles to the subarachnoid space can lead to pathological accumulation of CSF within the ventricles and hydrocephalus.

The line drawn image shows a lateral view of the brain with a superimposed image of the ventricular system. If you click on this image, you will see a superior view of a cast of the ventricular system (by Retzius). 

The dissection image shows a posterior view of the brain stem and the cerebellum which has been opened in the median plane to expose the 4th ventricle. Click on the image to see a larger version.

Line images in the public domain by Henry VanDyke Carter, MD. (Gray's Anatomy) Dissection images property of CAA, Inc. Photographer E. Klein