Hakaru Hashimoto (1881-1934)

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A Moment in History

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
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Details: Published: June 23, 2026; Hits: 754

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.

Hakaru Hashimoto (1881-1934)

Hakaru Hashimoto, was a Japanese surgeon known world-wide today by the thyroid disease that bears his name… Hashimoto’s disease, a condition which causes goiter and hypothyroidism

Hashimoto was born in the village of Iga, about 30 miles (50km) east of Nara, the first permanent capital of Japan on May 5th, 1881. His family had practiced medicine for generations. He was the son and grandson of physicians.

After graduating from high school in Kyoto in 1903, he decided to study medicine at the Fukuoka Medical College of the Kyushu Imperial University and graduated by 1907. He was invited by his professor of surgery at Fukuoka, Hayari Miyake (1867–1945) to stay. Dr. Hashimoto completed his surgical training in 1912. Interestingly, Dr. Hashimoto did his surgical training while Dr. Sunao Tawara (1873 - 1952), discoverer of the heart's atrioventricular node, was a professor of pathology at the same university. For sure their paths crossed more than once!

During his surgical training Dr. Miyake asked Hashimoto to examine the pathological features of four unusual goiter cases, all women over 40 which had been subject to a partial thyroidectomy. At the time it was thought by some that the disease was an initial stage of Riedel’s(*) thyroiditis, which has far more fibrosis than what we know today as Hashimoto’s disease. Riedel’s thyroiditis also presents with rock-hard thyroid glands which adhere to the surrounding tissues making surgery difficult, which was not the case of these four women.

Dr. Hashimoto noted that the histology of these women was similar to Graves’(**) disease (a type of hyperthyroidism) but that both conditions were clinically different, as some of the four patients were hypothyroid.

An important difference was what he found regarding the common colloid goiters. There was a massive overgrowth of lymphatic elements which, as already stated, were similar to Graves goiters.

Illustration from Hashimoto's 1912 publication

Under the guidance of Professor Miyake he reported his findings and named this condition as “Struma Lymphomatosa” publishing an article in German “Zur Kenntniss der lymphomatosen veränderung der Schilddrüse (Struma lymphomatosa)” [On the lymphomatous change of the thyroid gland (struma lymphomatosa).] in the “Archiv für Klinische Chirurgie” in 1912.

He left Japan for Göttingen University in Germany to study with Professor Kaufman, chairman of the Department of Pathology, and worked on tuberculosis of the urinary tract. He left for London in 1914 after the outbreak of World War I where he studied for another year before returning to Japan.

In 1916 he set up a surgical clinic at his own home and married in 1920. Unfortunately, he contracted typhoid fever while working hard against an outbreak in his district in 1933. Dr. Hashimoto died on January 9. 1934. He was 52 years old.

His discovery opened avenues of research leading to great advances in endocrinology and immunology among others. Hashimoto’s disease was finally recognized as an entity by the end of the 1930’s and the term has been widely used since then.

Personal note: This article was suggested and written by my good friend and classmate Dr. Roberto Villaseca Najarian, an endocrinologist in Santiago, Chile. Dr. Miranda.

Sources:
1. Krustrimoviv, N; Fazzino, GFM; Gallo, D. et al. Dr Hashimoto and the discovery of autoimmune hypothyroidism. (PDF) Medicina Historica 2023; Vol. 7, N. 2: e2023034 9
2. Sawin, Clark T. M.D. Hakaru Hashimoto (1881–1934) and His Disease. The Endocrinologist 11(2):p 73-76, March 2001
3. Hashimoto, H. Zur Kenntniss der lymphomatosen veränderung der Schilddrüse (Struma lymphomatosa) Archiv für Klinische Chirurgie, 1912 (PDF)
4. Hashimoto, K. Life and Times: Hakaru Hashimoto. ThyroWorld Spring 2006:16. (PDF)

Notes:
(*) Bernhard Moritz Carl Ludwig Riedel (1846-1916) German surgeon.
(**) Robert James Graves (1796 – 1853) Irish surgeon.
Dr. Hashimoto's portrait, public domain, enhanced via AI

Hakaru Hashimoto (1881-1934)

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