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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1543 Fabrica Title Page
1543 Fabrica Title Page

One of the most collectible books in medical sciences and specifically in human anatomy is “De Humani Corporis Fabrica; Libri Septem” (Seven books on the structure of the Human Body) published in 1543 by Andreas Vesalius. This book is known as the “Fabrica” among Vesaliana enthusiasts.

The story of the Fabrica is complicated and the books, research papers, paintings, statues, medals, etc. on Vesalius and the Fabrica number in the thousands.

The first edition of the Fabrica was published in 1543, it was well received and was followed by the second edition in 1555. Vesalius died in 1564 and no further editions of the Fabrica were published. There are several translations in different languages, the latest is the “New Fabrica” published in 2013. This book included annotations by Vesalius himself found in a 1555 Fabrica. This particular “Annotated Fabrica” has a history worth reading and is one of the most expensive books ever sold at an auction in February 2024 for 2.23 million US dollars.

Part of book collectibles are single pages cut off a book. This method was quite common among antiquarians in the late 1800’s and early 1900’s. As a book collector, I think it is not a good idea to destroy a great book in the quest to obtain more money selling it as individual pages.

Be that as it may, in early 2023 I was notified by my good friend Dr. Randall Wolf, one of the contributors of Clinical Anatomy Associates, of an auction by Potter and Potter where two loose pages of the 1543 Fabrica would be placed on the auction block. With his help and lots of luck, I was able to secure item 298, which was a single page of the Fabrica, page 187, one of the “muscle men”, which depicts the “Liber II, Sexta Musculorum Tabula” (Book 2, Sixth Muscle Image).

Potter and Potter Auctions June 2023Cover page of the June 2023 Potter&Potter Auction

Potterandpotter187 smItem 298 description

One of the problems that collectors face is to prove that a certain item is original, the second one is provenance (where does the item come from?).

The first question was answered in Belgium when Dr. Wolf and I visited Dr. Francis Van Glabbeek and his personal collection in June 2023 with occasion of the 2023 Vesalius Triennial Meeting in the city of Antwerp. We were able to compare in minute detail the original image and my single page, including the type of paper and the text on the opposite page. They were a perfect match, proving that this page was indeed taken of an original 1543 Fabrica.

Reviewing the 1543 Fabrica with Drs. Wolf and Van GlabbeekStudying page 187

Getting goosebumps...
Getting goosebumps...

Reviewing the 1543 Fabrica with Drs. Wolf and Van GlabbeekLooking at details...

Confirmed

Confirmed!! It is an original 1543 page!

The second question was answered by the auctioneer, as the page belonged to the library of Ronald K. Siegel, PH.D. (1943-2019), an American psychopharmacologist and associate research professor in the Department of Psychiatry and Behavioral Sciences at the University of California, Los Angeles (UCLA). Before Dr. Siegel, we do not know how or when he acquired this single leaf of the Fabrica.

The page was carefully framed by Becky Gebhart, owner of “Picture This” in Lebanon, OH, and is secured with museum-quality glass. It in now on the wall facing my desk. Here it is:

Page 187 of the 1534 FabricaPage 188, the verso of page 187 is not visible because of the frame. This page title is "Sextæ Musculorum tabulæ charactermum index" and lists the symbols on the image.

Fabrica page 188