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.

Ether Dome Skylight
Ether Dome Skylight

During one of many trips this year, I found myself with a free day in Boston, Massachusetts. Had a recommendation to try and visit the Ether Dome, which I did, and it was an interesting, although short, experience.

The Ether Dome is the name given by the Massachusetts General Hospital (MGH) to the first operating room of the MGH and it is located under the dome at the top of the Bullfinch Building, named after its architect Charles Bullfinch (who later became one of the architects for the USA Capitol). The reason for the location of the operating room is that there is a large skylight that provided the light for the operations.

The operating room was in service between 1821 and 1867 and over 8,000 operations were performed here. It was later used as a storage are, a nurse’s dormitory, a dining room, and today as a teaching auditorium. It still has the arrangement of a semicircular staired pavilion, as in the early days of the operating room. The Ether Dome was designated a National Historic Site in 1965.

National Historic Site 1965

The reason for the name Ether Dome is that in this location, on October 16, 1846, anesthesia was used successfully for the first time. The surgeon was John C. Warren, one of the MGH’s founders. The anesthesiologist was William T. G. Morton, a dentist. The patient was Gilbert Abbott. The operation was the excision of a neck tumor. Upon waking up, the patient said that he had felt no pain.

Ether Dome Auditorium


This event was so revolutionary that painting and images have bee created all over to remember the occasion. One of most creative was the work done for a mural called “Ether Day, 1846” The artists were Warren and Lucia Prosperi, who in 2000-2001 took photographs of surgeons and administrators at MGH in period clothing in different poses to recreate the event of the first use of anesthesia. An oil painting of the mural can be seen at the Ether Dome.  If you are interested in visiting the MGH, I recommend planning your visit with the Paul S. Russel Museum of Medical History and Innovation. The museum itself is worth visiting. If you want, the Russel Museum has a virtual tour of the Ether Dome and the Hospital, click here.

Painting of the operation by Warren and Lucia Prosperi

Since the Ether Dome is an active teaching auditorium, it is not always available for visitors, to it is good to call ahead, I did not, and was lucky to enter the auditorium prior to a welcome meeting for first year medical students. What an historical location to begin your medical career!

The Ether Dome houses a plaster cast of a Roman statue, the Apollo Belvedere, an Egyptian mummy, and an old human skeleton used for teaching. 

Human skeleton at the Ether Dome

The Apollo Belvedere at the Ether Dome

 A large plaque on the wall reads: ” On October 16, 1846 in this room, then the operating theatre of the Hospital, was given the first public demonstration of Anæsthesia to the extent of producing insensibility to pain during a serious surgical operation. Sulphuric ether was administered by William Thomas Green Morton, a Boston dentist. The patient was Gilbert Abbott. The operation was the removal of a tumor under the jaw. The surgeon was John Collins Warren. 
The patient declared that he had felt no pain during the operation and was discharged well, December 7. Knowledge of this discovery spread from this room throughout the civilized world and a new era for surgery began.”

Ether Dome Plaque


Here is a photograph of a later operation in 1847 where Morton and Warren can be seen.

Warren and Morton, c.1847


I have written several articles about this topic, the event, and its protagonists. Here are some of the links:

 Note: Ether Dome Skylight image. Ravi Poorun [oddityinabox] CC BY-SA 3.0, via Wikimedia Commons. Public Domain