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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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.

Dr. Jean-Francois Calot
Jean-Francois Calot (1861 – 1944)

Jean-Francois Calot (1861 – 1944). French physician and anatomist, Jean-Francois Calot was born in Arrens-Marsous, a small farming community of the Hautes-Pyrénées. He received his bachelor degree in 1880 at Saint-Pe de Bigorre,  and then continued to study Medicine at the University of Paris, where he worked as an anatomy prosector. His doctoral thesis “De La Cholecystectomie” (On Cholecystectomy) was published in 1890 and republished in 1891.

Although his main interest laid in orthopedics and tuberculosis, Calot’s name is eponymically tied to an anatomical landmark described in his thesis, the “Triangle of Calot”, a triangular area that includes the biliary ducts associated with the gallbladder and the vascular supply to the gallbladder. This is an important region because of the high number of anatomical variations found in the area.

There is a discrepancy between the original description of this triangular region by Calot and what is used today. For more information, click on this link to read more on the “Triangle of Calot”, also known as the “cystohepatic triangle”.

During his medical career Calot worked at several French hospitals including the Rothschild hospital where he became Chief of Surgery. He was also the Chief of Surgery for the Cazin-Perrochaud Hospital, and the Orthopedic Institute of Berck-sur-Mer

Dr. Jean-Francois Calot and the treatment of Pott's disease
Dr. Jean-Francois Calot and
the treatment of Pott's disease

During his orthopedic career Calot published many books “Chirurgie et orthopédie de guerre”, “Les maladies qu'on soigne á Berck”, “Berck et ses traitements : les raisons de sa supériorit?”, but his opus magnus is the book “« L'orthopédie indispensable aux praticiens” (Indispensable orthopedics for practitioners).

Calot is also known for his treatment of tuberculotic abscesses, and a conservative approach to musculoskeletal tuberculosis. The surgical approach of the times was to surgically open and clean the tuberculotic bone. Calot is known to have said “Ouvrir la tuberculose, c'est ouvrir la porte d' la mort” (To open the tuberculosis is to open the door to death).

Continuing his studies and treatment of tuberculosis, on December 22nd, 1896 Calot presents the the French Academy of Medicine a study of the treatment of 37 patients with hyperkyphosis due to Pott’s disease, a tuberculotic spinal deformity, named after Sir Percival Pott. This method included traction and a brace. The second image shows this treatment. Dr. Calot is standing at the center, looking at the patient.

In 1900 Calot founded the “Orthopedic Institute of Berck” which today is known as “Calot’s Institute of Berck-sur-Mer”.

Sources:
1. “Calot's triangle” Abdalla S, Pierre S, Ellis H. Clin Anat. 2013 May;26 (4):493-501
2. “La Vie et l'OEuvre de Francois Calot, chirurgien orthopédiste de Berck” Loisel, P. (in French). Report presented at Société Francaise d'Histoire de la Médecine on 18 March 1987

Image 1: Original image courtesy of the National Library of Medicine
Image 2: Original image public domain courtesy of the Universite Paris-Descartes Histoire de la Santé