J. Marion Sims

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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: December 16, 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.

J. Marion Sims

J. Marion Sims (1813 – 1883). American surgeon and gynecologist. James Marion Sims is considered the “Father of Gynecology". He was born in Hanging Rock, South Carolina. At age 12 he moved to Lancaster, South Carolina. Sims studied at the SC College and later moved to Philadelphia, PA where he studied Medicine at the Jefferson Medical College, graduating in 1835. He returned to Lancaster to practice, but shortly after moved to Montgomery, Alabama.

In 1845 Sims started his studies to close vesicovaginal fistulas, operating in the same patient many times. He was finally able to do this using a lateral recumbent position (later called Sims’ position) and a specially designed, U-shaped, vaginal retractor (later called Sims’ speculum). For this procedure he used silver wire as suture material. His findings were published in 1852 in his paper entitled “On the Treatment of Vesico-Vaginal Fistula”

After moving to New York J. Marion Sims helped in the founding and establishing the Woman's Hospital in the State of New York in 1855. Sims moved to Europe during the American Civil War. In Europe he became well-known and in 1866 published his book “Clinical Notes on Uterine Surgery”. While in Paris Sims performed the first cholecystostomy to relieve a blocked gallbladder.

He continued his contribution to gynecology advancing uterine prolapse surgery, advocating hysterectomy for bleeding fibroids, and suggested total hysterectomy as the only means of curing uterine cancer. One of his last contributions (not well accepted initially) was the indication for immediate exploratory laparotomy in abdominal gunshot wounds, burst ectopic pregnancy and any other sharp abdominopelvic trauma.

Sims died in New York on November 13, 1883

Sims’s life was and still is the cause of controversy. His use of slave patients, his professional jealousy and egotism, and his more than once reported disdain for patient privacy would not be accepted by today’s standards. Today in Lancaster his name helps the community thorough the “J. Marion Sims Foundation” dedicated to “support prevention and educational programs that help the citizens of Lancaster and the communities of Great Falls and Fort Lawn”

Sources:
1. “The Influence of J. Marion Sims on Gynecology” Heaton CE Bull N Y Acad Med 1956 32 (9): 685–688
2. “J. Marion Sims, the Father of Gynecology: Hero or Villain?” Sartin, JS South Med J 2004;97(5):500-505
3. “J. Marion Sims: A Defense of the Father of Gynecology” O’Leary JP South Med J 2004;97(5):427-429
4. “Carl Langenbuch and the First Cholecystectomy” Traverso LW Am J Surg 1976; 132; 81-82

J. Marion Sims

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