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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Torus - By LucasVB [Public domain], via Wikimedia Commons
Click for a larger image

The word [torus] is of Latin origin and refers to “a rounded protuberance or swelling”. In science, it refers to a doughnut-shaped structure (see image). It also refers to the rounded, bulging, and circular base component of a pillar, found between the square plinth and the main body of the pillar. The torus can be seen in Egyptian, Greek, and Roman style pillars.

The term is used in anatomy and medicine to denote normal or abnormal circular or semicircular protuberances, as in the case of the “torus tubarius”, a normal semicircular elevation found at the ostium of the auditory tube (of Eustachius) in the lateral walls of the rhinopharynx. The torus tubarius elevation is due to the presence of lymphoid tissue which can get inflamed.

Torus mandibularis. An exostosis that develops on the inner side of the mandible
Torus palatinus: a benign, small exostosis that appears in the midline of the hard palate

In orthopedics it is used to denote a compression fracture where the cortex of a long bone close to one of its epiphyses buckles under longitudinal (axial) compression. The look of the fracture is similar to the location of the torus in a pillar. An example of this is the torus fracture (also known as buckle fractures) in children.

The term [torulus] is related to [torus], as it means a “small torus” and it refers to a small elevation, which is synonymous with the word “papilla”. An example of this is the term torulus tactiles palmaris, referring to small elevations on the palms of the hand. Another related term is [torulosis], referring to a large number of small elevations or pimples.

The following images are of a Greek pillar taken in 2014 in Athens showing the location of the torus. The next image shows a torus fracture. The image is from www.kidsfractures.com/forearm/ and we thank them for sharing the image with us. This is a great site for information on fractures in children.

Greek pillar - Personal picture Athens 2014
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Torus fracture - www.kidsfractures.com/forearm/
Click for a larger view

Sources:
1. “Medical Meanings: A Glossary of Word Origins” Haubrich, WS. Am Coll Phys. Philadelphia 1997
2. “The Origin of Medical Terms” Skinner, HA 1970, New York. Hafner Publishing Company
3. “Taber’s Cyclopedic Medical Dictionary” 16th Ed. 1989. Philadelphia. FA Davis Company
4.  www.kidsfractures.com/forearm/

Torus image: By LucasVB [Public domain], via Wikimedia Commons

Thanks to Jackie Miranda-Klein for suggesting this post.  Dr. Miranda.