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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morbidity sm

In the many years I have lectured for the medical industry, the one word that representatives, managers, engineers, etc. usually do not master is “morbidity”.

In most cases when I ask for a definition of “morbidity” most in the audience try to guess and in the medical arena and medical devices industry guessing is not acceptable. So, I would like to ask those who follow my articles and posts to repost this information so that it is available for as many people as possible. By the way, the most common answer I receive is that "morbidity" means death...not so!!

The term “morbidity” arises from the Latin word morbus which means Ill, sick, or sickly. It has been in use in English for centuries and what today we call “pathology” used to be known as “morbid anatomy”. There are many terms in medical history that included the term “morbid” such as “morbus indecens” (venereal diseases); morbus gallicus (syphilis), “morbus sacer” (epilepsy, the sacred disease), etc.

To be simple, today we use the term “morbidity “to mean “complications”, As an example, when we use the term “postoperative morbidity” what we’re trying to say is simply “postoperative complications”. When you ask what is the morbidity associated with a certain treatment (a new medication, as an example) what we’re trying to say is what are the complications associated with that medication or treatment.

Now, the associated term “comorbidity” causes the same problems. Many think they know its meaning, but they are actually guessing, and it can lead to embarrassing conversations between a medical device representative and a surgeon or physician.

The term comorbidity is a portmanteau (French) word, that is, a word formed by the mixing of parts of two words. In this case, the components are COncommitant (meaning associated) and MORBIDITY, (meaning complications). Simple stated, comorbidity means “associated complications”. As a side note, do not add a hyphen, as in co-morbidity: this is wrong.

There are many portmanteau words in English, such as “brainiac”; “bromance”, “Brexit”, “fog”, etc. For additional portmanteau non-medical words follow this link.

Sources.
1. "The origin of Medical Terms" Skinner, AH 1970
2. "Medical Meanings - A glossary of Word Origins" Haubrich, WS. 1997