Bartolomeo Eustachius

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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
Original image courtesy of "Images from the History of Medicine" at www.nih.gov

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Details: Published: October 15, 2015

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.

Bartolomeo Eustachius

Bartolomeo Eustachius (c1500 - 1574) Italian physician and anatomist, also known as Bartholomew Eustachius, Esutachi, and Bartholomaeus Eustachius. He was born in the small town of San Severino Marche, in the province of Macerata, central Italy. His father was a respected physician, and may have attended as a student the University of Sapienza, where he later taught as a professor of practical medicine. Eustachius’ life is mostly unknown and some of his works remained hidden for over 150 years. His birth date is only an estimate and data varies from c1500 AD to c1510 AD.

It is known that Eustachius lived and worked in Rome from 1549 to 1574. He was both an anatomist and a physician to the Vatican. As an anatomist, Eustachius is credited for having been the first to prepare anatomical images for printing using copper plates.

As a hospital physician, Eustachius was adamant on the need of autopsies on patients who died at the hospital, crediting him with being one of the first pathological anatomists.

Eustachius’ is credited with several anatomical discoveries, which he published in short monographs, on topics like the kidneys, the suprarenal glands (which he was the first to describe), the movements of the head, the azygos vein, etc. One of these was entirely dedicated to dentistry, “Libellus de Dentibus”, which have led to some to call Eustachius “The Father of Dental Anatomy”.

Eustachius dedicated himself to prepare a number of anatomical copper plates, apparently getting ready to publish a book to rival Vesalius’ “Fabrica”. It is known that Eustachius disliked Vesalius because of Vesalius’ contempt for the teachings of Galen. Eustachius died before completing his work and the copper plates were forgotten for over a century. After being rediscovered, these plates were published with commentaries by anatomists, until a final publication in Latin by Bernard Siegfried Albinus (1697 – 1770) entitled “Explicatio Tabularum Anatomicarum Bartholomaei Eustachii Anatomici Summi” (An explanation of the Anatomical Picture of Bartholomew Eustachius, Supreme Anatomist”.

Besides the suprarenal gland, Eustachius is credited for having discovered the stapes, the tensor tympani muscle, the valve of the inferior vena cava, the cervical sympathetic chain and the thoracic duct.

Interesting note: Eustachius’ assistant Petrus Matthaeus Pinus, who helped develop the copper plates, voiced his master’s dislike of Vesalius in a poem that was published by Albinus over a hundred years after the death of all of them, it is also an epitaph for a great anatomist:

“Just as the Master from Pergamon (Galen)
Teaching his method of healing, once refuted
The false writings of the ignorant Thessalus,
So also my BARTOLO (Eustachius)
Teaching his method of denoting every detail, position,
Shape, structure, order, number and condition
Has repulsed the shameless arrogance and claims
Of the impudent Vesalius
To him (Eustachius) all future generations
Adhere In reverential admiration
The age to come will envy us on account of you Father,
And historians will wish they had lived sooner
They will extol our era, through you fortunate,
Lucky beyond measure"

Sources:
1. "The root of dental anatomy: a case for naming Eustachius the "Father of Dental Anatomy"" Bennett, G (2009) J Hist Dent (1089-6287), 57 (2) 85 -88
2. “The papal anatomist: Eustachius in renaissance Rome” Simpson, D, ANZ J Surg (2011) 81: (12)905 -910
3. “Bartholomeo Eustachio – The Third Man: Eustachius Published by Albinus” Fahrer, M. (2003) ANS J Surg; 73: 523- 528
4. "Bartolommeo Eustachio; a great medical genius whose masterpiece remained hidden for 150 years" Wells, WA Arch Otolaring (1925) 48: 58

Original image courtesy of: Wikimedia Commons.

Bartolomeo Eustachius

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