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.

Wilhelm His Jr.
Wilhelm His Jr.

Wilhelm His Jr. (1863-1934). Also known as Wilhelm His the Younger, was born in Switzerland in the city of Basel. His father was a well-known and famous anatomist by the same name who worked at the University of Basel. Wilhelm His Jr. studied in several universities, including Leipzig, Strasbourg, Bern, and Geneva. He received his medical degree from the University of Leipzig in 1889.

Although not an anatomist, his 1893 single and most brilliant contribution to the eventual understanding of the conduction system of the heart was the discovery and description of a muscular bundle that connected the atrial septum with the ventricular septum. Until that moment it was known that no muscles crossed from the atria to the ventricles, leading anatomists and physiologists to wonder how does the heart contract.  

In his article His states "after long search I have succeeded in finding a muscle bundle which unites the auricular and ventricular septal walls, and which, up to now, has escaped observation because of incomplete exposure, for it is visible in its entire extent only when the septa are cut exactly in their longitudinal direction".

What is interesting is that His not only found the bundle that today honors his name, but he included in that description the atrioventricular node, the actual structure that crosses the atrioventricular connective tissue barrier known as the "skeleton of the heart". The AV node was later to be clearly identified and researched by Sunao Tawara (1873 - 1952).

Dr. His continued his research on gout and joint diseases. He became a German citizen and joined the German army as a consulting physician. He retired in 1932 and died in 1934.

Although Wilhelm His Jr. did not discover or described the esophagogastric angle, in 1906 JD Cunningham started calling this angle the "Angle of His" in honor of Wilhelm His Jr. This eponym has stayed with us until today.

Sources:
1. "Wilhelm His Jr." JAMA. 1964;187(6):453-454
2. "His, Jr., W.: The Activity of the Embryonic Human Heart and Its Significance for the Understanding of the Heart Movement in the Adult" Arb Med Klin Leipzig, pp 14-49, 1893; Bast, TH,Gardner, WD trans: J Hist Med 4:289-318, 1949
3. "Wilhelm His, Jr. and the Bundle of His" Bast, TH, Gardner, WD J Hist Med All Sci; 1949; 4, (2) 170 -187
4. Firkin BG (1996) Dictionary of medical eponyms.London: Parthenon Publishing Group, 181
Original image
in the public domain, courtesy of the National Library of Medicine.