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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This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Marie_Francois Xavier Bichat
Original image courtesy of
Images from the History of Medicine

Marie-Francois Xavier Bichat
(1771 - 1802). French physician, surgeon, anatomist and physiologist, Marie-Francois Xavier Bichat was born in the village of Thoirette. His father was a physician, influencing his early instruction and vocation. In Lyon he studied anatomy and surgery. At 28 years of age Bichat was appointed physician to the Hôtel (Hospital) Dieu. His life was influenced by his mentor, Pierre-Joseph Dassault (1738 - 1795). Upon his mentor's death Bichat took upon him to continue and finish his work, while supporting his mentor's family.

Bichat is know for the concept of the body composed of distinct tissues, which he originally called "membranes". Without the aid of the microscope Bichat described 21 different tissues and is considered the founder of the science of histology. His name is preserved in many eponymic structures such as Bichat’s fossa (pterygopalatine fossa), Bichat’s buccal fat pad, Bichat’s foramen (cistern of the vena magna of Galen), Bichat’s ligament (lower fasciculus of the posterior sacroiliac ligament), and Bichat’s tunica intima (tunica intima vasorum). 

Xavier Bichat also contributed to a newer description of the humoral physiological theory, later becoming the basis of hematology. He was also interested in the description of life and death, proposing the existence of an "organic life" and an "animal life". An interesting note is that Bichat died because of an infection he acquired while dissecting a cadaver. Remember that at the time, no embalming was used!

Today Bichat's name is almost forgotten, although in some countries the buccal fat pad is still called "Bichat's fat pad" In many Spanish-speaking countries this structure is referred to as "la bola grasa de Bichat", and many still refer to the removal of this fat pad as "Bichectomy". For an image of the before and after of the procedure, click here.

Sources:
1. "Marie-Fran?ois Xavier Bichat (1771-1802) and his contributions to the foundations of pathological anatomy and modern medicine" Shoja M.M., Tubbs R.S., Loukas M., Shokouhi G., Ardalan M.R.(2008) Annals of Anatomy, 190(5),413-420
2. "Physiological Researches on Life and Death" Bichat, Marie-Francois Xavier, 1827. Translated from French by F. Gold. Richardson and Lord, Boston.
3. "A Historical Perspective: Infection from Cadaveric Dissection from the 18th to the 20th Centuries" Shoja, MM et al. Clin Anat (2013) 26:154-160