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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By Maurits Biesbrouck, MD. Continued from "Andreas Vesalius’s fatal voyage to Jerusalem (5)".

For the first page of this article, click here.


Passage in Abraham Ortelius’s Teatro del Mondo with Pigafetta’s report on Vesalius’s burial place. In Italian
Passage in Abraham Ortelius’s Teatro del Mondo with Pigafetta’s report on Vesalius’s burial place. In Italian


Leaving aside the discussion on the epitaph of Cicero, who did not die on this island [Zakynthos], I, Filippo Pigafetta, add having seen the grave of Andreas Vesalius from Brussels, famous anatomist and the first one to render in appropriate Latin wordings and accompanied with modern illustrations the fabric of the human body, as can be seen in his marvelous books.  While returning from a pilgrimage to the Holy Land he ended his life here after glorious years. An inscription to his memory was placed above the door to the church of Saint Franciscus, in golden letters on black velvet, that was taken away by the Turcs in 1571. Thus this island was ennobled likewise by the bones of such famous persons” (16). 

Reconstruction of Vesalius’ epitaph by Theodoor Goddeeris (2012)
Reconstruction of Vesalius’ epitaph
by Theodoor Goddeeris (2012)

Pigafetta saw the grave in July 1586, almost at the same time as Jean Zuallart, but he may have seen it yet in 1568, on his way to Cyprus, or during his travelling to Egypt and Mount Sion in 1576-1577. When his information dates from 1568, or was based on reliable sources later on, then the Turcs could have taken two inscriptions: his epitaph and a plaque at the entrance of the church (17). 

The church S. Maria delle Grazie

As far as is known, Fürer, Zuallart, and Pigafetta were the only three travellers to Jerusalem, to have seen Vesalius’s grave in the S. Maria delle Grazie with their own eyes. Thanks to them we are sure that Vesalius was buried in that church, built in 1488. Regrettably, it was destroyed on October 18th 1840 by a severe earthquake. It was then rebuilt, but moved a few meters inland. In 1893 the church was again destroyed by an earthquake. This time it was not restored, and the rubble was used by the fishermen along the coast to rebuild their houses, as told by Barbiani (18). 

Vesalius’s epitaph

So Fürer saw Vesalius’s epitaph before it was stolen, but he gave an incorrect description of Vesalius’ coat of arms on it. Anyway, it follows that Vesalius’ grave was indeed at this church, and that he must have been buried there and not by the side of a road somewhere. An effort was immediately made to give him a worthy burial place. The epitaph with the coat of arms, which was already present so soon after his death, is proof of this. The people of Zakynthos were well aware of who this person was. To correct the errors in the epitaph and in the coat of arms as well, some years ago, Dr. Theodoor Goddeeris, made a graphic reconstruction of both.

Conclusions 

I can summarize with four conclusions (19):

Andreas Vesalius' trip to Jerusalem had nothing to do with the Inquisition: he went to Jerusalem for religious reasons, and the King took the opportunity to send with him his financial support for the Holy Places, as he used to do.

Vesalius did not die in a shipwreck. He died most probably of a combination of exhaustion and illness.

He was not buried on some desolate spot, but in the church Santa Maria delle Grazie. His remains are not yet found, however. (see here for additional information on the search for Vesalius' grave).

His grave had an epitaph (and we know exactly what it said and looked like).

Personal note: My sincere thanks to Dr. Maurits Biesbrouck for contributing this article to "Medical Terminology Daily". His clear and factual analysis gives us an insight on the last months of Andreas Vesalius' life and the problems that eventually led to his death on Zakynthos, Greece. I am proud to have been one of the many international attendees to the 2014 meeting in the island of Zakynthos where I saw Dr. Biesbrouck deliver the presentation and research on which this article is based. Dr. Miranda.

Sources and author's comments:
16. Teatro del Mondo di Abrahamo Ortelio: da lui poco inanzi la sua morte riveduto, e di tavole nuove, et commenti adorno, e arricchito con la vita dell’Autore. Traslato in Lingua Toscana dal Sigr. Filippo Pigafetta, in Anversa, si vende nella Libraria Plantiniana, 1608 and 1612.
17. Maurits BIESBROUCK, Theodoor GODDEERIS, Omer STEENO. ‘Post Mortem Andreae Vesalii (1514-1564). Deel I: De laatste reis van Andreas Vesalius en de omstandigheden van zijn dood’ [After Vesalius’ Death: The Last Travel of Andreas Vesalius and the Circumstances of his Death] and ‘Deel II: Het graf van Andreas Vesalius op Zakynthos’ [Vesalius’ Grave in Zakynthos] in A. Vesalius, 2015, 27 (no. 3): 154-161 and (no. 4): 193-200, ill.
18. Nicolas Ant. BARBIANI, O André Vésale kai è proodos tès anatomias [Andreas Vesalius and the evolution of anatomy] – L’évolution de l’anatomie et André Vésale, Athens, 1953, 32 pp., ill.; in Greek with a French summary on pp. 7-8.
19. For more details see the papers mentioned in ref. 1.