Sir William Osler

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A Moment in History

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
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Details: Published: July 22, 2013

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.

Sir William Osler
Sir William Osler

Sir William Osler (1849-1919). William Osler was born in Bond Head, Canada, in what today is known as Ontario, of English parents. He started his college studies to become a minister, but realizing his true vocation was in medicine, he entered the Toronto School of Medicine, earning his medical degree in 1872.

Osler completed postgraduate studies in Europe, returning as a Professor at the McGill University. In 1884 he moved to Philadelphia to the University of Pennsylvania. In 1889 he left to become Physician-in-Chief and one of the founders of the newly-built John Hopkins hospital. His contributions to this new hospital and the American medical education are innumerable. Dr. Osler initiated the residency programs used today, as well as the programs of third and fourth year medical students in bedside patient rounds.

A prolific writer, Dr. Osler penned over 1,500 articles, monographs, and books, some of which are famous. His “Principles and Practice of Medicine” was published for a record 17 editions and 76 years (1892 -1968)! One of his most famous addresses is “Aequanimitas”, which he delivered when leaving the University of Pennsylvania. The book by the same name is a collection of some of his speeches and is part of my personal library.

His book collection grew over the years and he had a full-time librarian in charge of curating it. Her name was Marcia Crocker Noyes (1869 - 1946) and she had an interesting history, including the creation of the Osler Library bookplate.

In 1905 Dr. Osler accepted the position of Royal Chair of Medicine at Oxford, in England, and in 1911 he was awarded the title of “Sir William Osler”.

Personal Note: In June 1999, I had the opportunity to visit the collection of the John Martin Rare Book Room at the University of Iowa Medical School. I was allowed to read and handle original copies of the Fabrica and the Epitome by Vesalius as well as other original and rare medical books, including De Muto Cordis, by William Harvey. The books I had the opportunity to review were placed on an antique desk that belonged to Sir William Osler. A moment that has stayed with me, as it was the confluence of great individuals: Andreas Vesalius, the anatomist; William Harvey, the physiologist, and Sir William Osler, the medical educator. Dr. Miranda

Sources:
“Sir William Osler, M.D., C.M.” Sarik, J. Yeo, Ch.Pinckney J. The American Surgeon78.4 (2012): 385-7.
“Sir William Osler and gastroenterology” Chaun H. Can J Gastroenterol (2010) 24:10 615-618
“Sir William Osler (1849-1919)” Haas, LF J Neurol Neurosurg Psychiatry 1999 67: 137
“Sir William Osler (1849-1919)”Christian, HA Proc Amer Acad Arts Sci (1922) 496-499

Sir William Osler

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