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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I had the honor of being invited to participate in the 53rd Annual Chilean Meeting of Anatomy (XLIII Congreso Chileno de Anatomía) which was held in conjunction with the 1st Latin American Congress of Clinical Morphology (Primer Congreso Latinoamericano de Morfología Clínica). Along with these meetings were two symposia: The First Joint Symposium of Chilean/Korean Anatomists and the First Joint Chilean - IFAA-FIPAE Symposium (International Federation of Associations of Anatomists - Federative International Program for Anatomy Education).

Universidad de Los Andes, Chile
Universidad de Los Andes, Chile

This meeting was held on November 11- 14, 2023 and was hosted by the University of Los Andes (Universidad de Los Andes), a Chilean institution of private higher education that offers careers and postgraduate programs in different areas of knowledge including Education, Engineering, Nursing, Obstetrics, Medicine, Psychology, Law. etc. Their campus is located on the slopes of the beautiful Andes mountains overlooking the city of Santiago, Chile.

The image shows the Main Library of the University, where the meeting was held.

On November 9 and 10, the days leading to the meeting, there were six Postgraduate Courses, from anatomy to radiology and surgical reconstruction. There were two that I would like to highlight. The first one  was a workshop "Mastering Anatomical Radiology with  IMAIOS", where one of the instructors was my good friend Dr. Cristian Uribe, who was one of the Meeting organizers. Dr. Uribe is one of the contributors to Medical Terminology Daily.

The second one was a "Workshop on Art & Science: A Theoretical-Practical Course on Anatomical Illustration". This course was directed by my good friend, Dr. Carlos Machado, world-renown medical illustrator, physician, and anatomist, editor of Netter's Atlas of Anatomy. Along with him two professors, Drs. Daniel Casanova and Valentina Cerda.

Nov. 11, 2023 Meeting opening
Nov. 11, 2023 Meeting opening

The Meeting was officially opened by Dr. Juan Carlos Lopez, Director of the Morphology Department of the Los Andes University. This was followed by a presentation on "The Role of the Placenta on the Modulation of Human Potential" by Dr. Sebastian Illanes. On the picture, from left to right, Dr. Jens Wasche (Germany), Dra. Valentina Cerda (Chile), Dr. Carlos Machado (Brazil/USA), me (Chile/USA), and Dr. Andres Riveros Valdes (Chile), a good friend and anatomist. Dr. Riveros is the President of the LatinAmerican Meeting on Clinical Morphology.

There were so many great presentations in this meeting! I think the attendees will agree with me that the conference by Dr. Carlos Machado on "The Art of Learning and Teaching Anatomy with Art" was one of the highlights of the Meeting. In his presentation Dr. Machado shared some of his early drawings and his career in Medicine and Medical Illustration, how he has used art to show patient pathology, and most important, the work and dedication that is required when developing a single image that will later become part of the Anatomy Atlases with which he collaborates. 

Dr. Carlos Machado
Dr. Carlos Machado

The image above shows Dr. Machado during his presentation. On the screen an anatomical image he drew when he was 12 year old!.

Dr. Carlos Machado
Dr. Carlos Machado

Dr. Cristian Uribe
Dr. Cristian Uribe

Poster presentations during a coffee break
Poster presentations during a coffee break

The meeting was also geared toward morphology students of different careers including Veterinary, Nursing, Dental School, and Medicine. The students presented their research posters during the coffee breaks. There were very high-quality and in-depth research, including the first osteology atlas of the Chilean flamingo (Phoenicopterus chilensis).  I had interesting discussions on Latin terminology with these students.

There were extremely interesting topics throughout the week, including liver anatomy and liver transplant, ethics, philosophy, body donation, etc.

My presentation was based on the conference I delivered in May 2023 at the University of Antwerp, Belgium. Since the Belgium conference was delivered to a group of Andreas Vesalius experts, this one included much more information on Andreas Vesalius, his work, and additional information on printing techniques circa 1550.

Dr. Miranda during his presentation at the XLIII  Anatomy Meeting in Chile
Dr. Miranda during his presentation at the
XLIII  Anatomy Meeting in Chile

The presentation added information on the history of the woodblocks used to print the 1543 Fabrica, the 1555 Fabrica, as well as other books that include the 1925 "The Iconography of Andreas Vesalius" by M.H. Spellman, and the 1934 Icones Anatomicæ.

The included picture was taken towards the end of my presentation where with the help of Dr. Uribe we unveiled Giovanni Paolo Mascagni's (1755-1815) work. At the center is a life-size copy of one of the pages of his book "Anatomiæ Universæ Icones", published in 9 installments between 1823 and 1832. It is important to note that each page of this book was hand-colored by Antonio Serantoni (1780-1837), thus the time it took to print and publish this book.

Mascagni's book, the largest book ever printed, shows in separate pages one third of a larger, life-size individual. Because of the rarity and value of this magnificent work, it cannot be cut and pasted.There are 16 know copies of Mascagni's anatomical opus magnus in the world, one of them at the University of Cincinnati, Ohio. USA.

With the help of Mr. Gino Pasi curator of the Henry Winkler Center for the History of the Health Professions, and the help of Mrs. Samantha Scheck, graphic designer, we measured and scanned some pages of the "Anatomiæ Universæ Icones", cleaned the background (no changes were done to the image itself) and pasted them digitally. The result is a life-size male 5.9 ft tall (1,75 mt). The images are incredible, and having traveled back and forth to Belgium and Chile, they are now part of my personal library.

Once again, my thanks to my old and new friends for making my stay so interesting, both personally and professionally. My thanks to the organizers of these meetings and symposia:

Dr. Juan Carlos López Navarro
President XLIII Chilean Anatomy Meeting
Director Morphology Department - Universidad de Los Andes

Dr. Andrés Riveros Valdés
President I Latin American Clinical Morphology Meeting
Professor - Universidad San Sebastián

Dra. Viviana Toro Ibacache
President Scientific Committee
Professor - Universidad de Chile

Dr. Emilio Farfán Cabello
President Chilean Anatomy Society
Professor - Pontificia Universidad Católica de Chile