William Stewart Halsted
Encyclopedia
William Stewart Halsted (September 23, 1852 – September 7, 1922) was an American surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...

 who emphasized strict aseptic technique
Aseptic technique
Aseptic technique refers to a procedure that is performed under sterile conditions. This includes medical and laboratory techniques, such as with microbiological cultures. It includes techniques like flame sterilization...

 during surgical procedures, was an early champion of newly discovered anesthetics, and introduced several new operations, including the radical mastectomy
Radical mastectomy
Radical mastectomy is a surgical procedure in which the breast, underlying chest muscle , and lymph nodes of the axilla are removed as a treatment for breast cancer....

 for breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

. Along with William Osler
William Osler
Sir William Osler, 1st Baronet was a physician. He was one of the "Big Four" founding professors at Johns Hopkins Hospital as the first Professor of Medicine and founder of the Medical Service there. Sir William Osler, 1st Baronet (July 12, 1849 – December 29, 1919) was a physician. He was...

 (Professor of Medicine), Howard Atwood Kelly
Howard Atwood Kelly
Howard Atwood Kelly was an American gynecologist. He was one of the "Big Four" founding professors at Johns Hopkins Hospital. Howard Atwood Kelly (February 20, 1858 – January 12, 1943) was an American gynecologist. He was one of the "Big Four" founding professors at Johns Hopkins Hospital....

 (Professor of Gynecology) and William H. Welch
William H. Welch
William Henry Welch, M.D. was an American physician, pathologist, and medical school administrator. He was one of the "Big Four" founding professors at Johns Hopkins Hospital. William Henry Welch, M.D. (April 8, 1850 - April 30, 1934) was an American physician, pathologist, and medical school...

 (Professor of Pathology), Halsted was one of the "Big Four" founding professors at Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

. Throughout his professional life, he was addicted to cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...

 and later also to morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...

.

Early life and education

William S. Halsted was born on September 23, 1852 in New York City
New York City
New York is the most populous city in the United States and the center of the New York Metropolitan Area, one of the most populous metropolitan areas in the world. New York exerts a significant impact upon global commerce, finance, media, art, fashion, research, technology, education, and...

. His mother was Mary Louisa Haines and his father William Mills Halsted, Jr. His father was a businessman with Halsted, Haines and Company. Halsted was educated at home by tutors until 1862, when he was sent to boarding school in Monson, Massachusetts
Monson, Massachusetts
Monson is a town in Hampden County, Massachusetts, United States. The population was 8,560 at the 2010 census. It is part of the Springfield, Massachusetts Metropolitan Statistical Area.The village of Monson Center lies at the center of the town....

. He didn't like his new school and even ran away at one point. He was later enrolled at Phillips Academy
Phillips Academy
Phillips Academy is a selective, co-educational independent boarding high school for boarding and day students in grades 9–12, along with a post-graduate year...

 in Andover, Massachusetts
Andover, Massachusetts
Andover is a town in Essex County, Massachusetts, United States. It was incorporated in 1646 and as of the 2010 census, the population was 33,201...

, where he graduated in 1869. Halsted entered Yale College
Yale College
Yale College was the official name of Yale University from 1718 to 1887. The name now refers to the undergraduate part of the university. Each undergraduate student is assigned to one of 12 residential colleges.-Residential colleges:...

 the following year. At Yale, Halsted was captain of the football team, played baseball and rowed crew. Upon graduation from Yale in 1874, Halsted entered Columbia University College of Physicians and Surgeons
Columbia University College of Physicians and Surgeons
Columbia University College of Physicians and Surgeons, often known as P&S, is a graduate school of Columbia University that is located on the health sciences campus in the Washington Heights neighborhood of Manhattan...

. He graduated in 1877 with a Doctor of Medicine
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...

 degree. Though raised a Presbyterian
Presbyterianism
Presbyterianism refers to a number of Christian churches adhering to the Calvinist theological tradition within Protestantism, which are organized according to a characteristic Presbyterian polity. Presbyterian theology typically emphasizes the sovereignty of God, the authority of the Scriptures,...

, Halsted was an agnostic
Agnosticism
Agnosticism is the view that the truth value of certain claims—especially claims about the existence or non-existence of any deity, but also other religious and metaphysical claims—is unknown or unknowable....

 by adulthood.

Medical career

After graduation, Halsted joined the New York Hospital
NewYork–Presbyterian Hospital
NewYork–Presbyterian Hospital is a prominent university hospital in New York City affiliated with two Ivy League medical schools: Columbia University's College of Physicians and Surgeons and Cornell University's Weill Medical College. It is composed of two distinct medical centers, Columbia...

 as house physician, where he introduced the hospital chart which tracks the patient's temperature, pulse and respiration. It was at New York Hospital that Halsted met William H. Welch
William H. Welch
William Henry Welch, M.D. was an American physician, pathologist, and medical school administrator. He was one of the "Big Four" founding professors at Johns Hopkins Hospital. William Henry Welch, M.D. (April 8, 1850 - April 30, 1934) was an American physician, pathologist, and medical school...

, who would become his closest friend.

Halsted then went to Europe to study under the tutelage of several prominent surgeons and scientists, including Edoardo Bassini
Edoardo Bassini
Edoardo Bassini was an Italian surgeon who was born in Pavia. In 1866 he received his medical degree from the University of Pavia, and afterwards joined the Italian Unification movement as an infantry soldier under Giuseppe Garibaldi . In 1867 he was seriously wounded and taken prisoner...

, Ernst von Bergmann
Ernst von Bergmann
Ernst von Bergmann was a Baltic German surgeon. He is the beginner of aseptic surgery.Born in Riga, Livonia , in 1860 he earned his doctorate at the University of Dorpat, and later returned to Dorpat in 1871, where he was a professor of surgery until 1878...

, Theodor Billroth
Theodor Billroth
Christian Albert Theodor Billroth was a German-born Austrian surgeon and amateur musician....

, Heinrich Braun
Heinrich Braun
Heinrich Friedrich Wilhelm Braun was a German surgeon remembered for his work in the field of anaesthesiology. He was a native of Rawitsch, Province of Posen ....

, Hans Chiari
Hans Chiari
Hans Chiari was an Austrian pathologist who was a native of Vienna. He was the son of gynecologist Johann Baptist Chiari , and brother to rhinolaryngologist Ottokar Chiari ....

, Friedrich von Esmarch, Albert von Kölliker
Albert von Kölliker
Albert von Kölliker was a Swiss anatomist and physiologist.-Biography:Albert Kölliker was born in Zurich, Switzerland. His early education was carried on in Zurich, and he entered the university there in 1836...

, Jan Mikulicz-Radecki
Jan Mikulicz-Radecki
Jan Mikulicz-Radecki was a Polish-Austrian surgeon. He was born May 16, 1850 in Czernowitz in the Austrian Empire and died June 4, 1905 in Breslau, German Empire .While his mother Freiin von Damnitz was Austrian, his parental ancestors of the Mikulicz...

, Max Schede
Max Schede
Max Schede was a German surgeon who was a native of Arnsberg.Schede studied medicine at the Universities of Halle, Heidelberg and Zurich, and earned his medical doctorate in 1866...

, Adolph Stöhr
Adolph Stöhr
Adolph Stöhr was professor of philosophy at the University of Vienna. His lectures and publications covered subjects such as logic, metaphysics, philosophy of language, experimental psychology, psychology of perception, and psychology of association.- Published works :* Philosophische...

, Richard von Volkmann
Richard von Volkmann
Richard von Volkmann , was a prominent German surgeon and poet.He was born in Leipzig in 1830, the son of A.W. Volkmann. Richard entered medical school in Berlin and graduated in 1854...

, Anton Wölfler
Anton Wölfler
Anton Wölfler was an Austrian surgeon who was born in Kopezten, a village near Kladrau, Bohemia.In 1874 he earned his medical doctorate from the University of Vienna, where he was a student of Theodor Billroth . Afterwards, he remained in Vienna for several years as Billroth's assistant...

, Emil Zuckerkandl
Emil Zuckerkandl
----Emil Zuckerkandl was a Hungarian-Austrian anatomist.He was educated at the University of Vienna and was an admiring student of Josef Hyrtl...

.

Halsted returned to New York in 1880 and for the next six years led an extraordinarily vigorous and energetic life. He operated at multiple hospitals, including Roosevelt Hospital
St. Luke's-Roosevelt Hospital Center
St. Luke's-Roosevelt Hospital Center, an academic affiliate of Columbia University College of Physicians and Surgeons, is a 1,076-bed, full-service community and tertiary care hospital serving New York City’s Midtown West, Upper West Side and parts of Harlem....

, the College of Physicians and Surgeons, Charity Hospital, Emigrant Hospital, Bellevue Hospital
Bellevue Hospital Center
Bellevue Hospital Center, most often referred to as "Bellevue", was founded on March 31, 1736 and is the oldest public hospital in the United States. Located on First Avenue in the Kips Bay neighborhood of Manhattan, New York City, Bellevue is famous from many literary, film and television...

 and Chambers Street Hospital. He was an extremely popular, inspiring and charismatic teacher. In 1882 he performed one of the first gallbladder
Gallbladder
In vertebrates the gallbladder is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated....

 operations in the United States (a cholecystotomy performed on his mother on the kitchen table at 2 A.M.). Halsted also performed one of the first blood transfusions in the United States. He had been called to see his sister after she had given birth. He found her moribund from blood loss, and in a bold move withdrew his own blood, transfused his blood into his sister, and then operated on her to save her life.

In 1884, Halsted read a report from Karl Koller
Karl Koller (ophthalmologist)
Karl Koller was an Austrian ophthalmologist who began his medical career as a surgeon at the Vienna General Hospital, and was a colleague of Sigmund Freud.Koller introduced cocaine as a local anaesthetic for eye surgery...

, describing the anesthetic power of cocaine
Cocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...

 when it is instilled into the eye. Halsted realized that cocaine may be a great local anesthetic. Having learned the scientific method when he was in Europe, Halsted, together with his students and fellow physicians, began to experiment with cocaine. They injected each other's nerves and showed that cocaine when injected into a nerve can produce safe and effective local anesthesia. Halsted became addicted, and was eventually sent to Butler Sanatorium
Butler Hospital
Butler Hospital is a private, non-profit, psychiatric and substance abuse hospital for children, adolescents, adults, and seniors, located in Providence, Rhode Island. The hospital is affiliated with the Warren Alpert Medical School of Brown University, and is the flagship for Brown University's...

 in Providence, Rhode Island
Providence, Rhode Island
Providence is the capital and most populous city of Rhode Island and was one of the first cities established in the United States. Located in Providence County, it is the third largest city in the New England region...

. There they attempted to cure him by converting his addiction from cocaine to morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...

. After being discharged from Butler in 1886, Halsted moved to Baltimore, Maryland to join his friend William Welch at the soon-to-be-opened Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

.

Halsted was the first chief of the Department of Surgery at Johns Hopkins Hospital when it opened in May 1889. He was appointed surgeon-in-chief in 1890 and became Professor of Surgery in 1892 with the opening of Johns Hopkins University School of Medicine
Johns Hopkins School of Medicine
The Johns Hopkins School of Medicine , located in Baltimore, Maryland, U.S., is the academic medical teaching and research arm of Johns Hopkins University. Hopkins has consistently been the nation's number one medical school in the amount of competitive research grants awarded by the National...

. At Johns Hopkins, Halsted was credited with starting the first formal surgical residency training program in the United States.

Halsted’s surgical residency program consisted of an internship (the length was left undefined and individuals advanced once Halsted believed they were ready for the next level of training). Internship was followed by six years as an assistant resident and then two years as house surgeon. Halsted’s first resident was Frederick J. Brockway, who started in May 1889 but dropped out of the program in October 1890 to teach anatomy. Halsted went on to train many of the academic surgeons of the time including Harvey Williams Cushing, Walter Dandy
Walter Dandy
Walter Edward Dandy, M.D. was an American neurosurgeon and scientist. He is considered one of the founding fathers of neurosurgery, along with Victor Horsley and Harvey Cushing...

 and Hugh Hampton Young, founders of neurosurgery and urology respectively.

He is also known for many other medical and surgical achievements. As one of the first proponents of hemostasis
Hemostasis
Hemostasis or haemostasis is a process which causes bleeding to stop, meaning to keep blood within a damaged blood vessel . Most of the time this includes blood changing from a liquid to a solid state. Intact blood vessels are central to moderating blood's tendency to clot...

 and investigators of wound healing
Wound healing
Wound healing, or cicatrisation, is an intricate process in which the skin repairs itself after injury. In normal skin, the epidermis and dermis exists in a steady-state equilibrium, forming a protective barrier against the external environment...

, Halsted pioneered Halstead's principles
Halstead's principles
Halsted's principles, also known as Tenets of Halsted in the medical community, are the basic principles of surgical technique regarding tissue handling, vascular occlusion, etc...

, modern surgical principles of control of bleeding, accurate anatomical dissection, complete sterility, exact approximation of tissue in wound closures without excessive tightness, and gentle handling of tissues. The first radical mastectomy
Radical mastectomy
Radical mastectomy is a surgical procedure in which the breast, underlying chest muscle , and lymph nodes of the axilla are removed as a treatment for breast cancer....

 for breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

 was performed by Halsted (before this time, such a diagnosis was a virtual death sentence). Other achievements included the introduction of the latex surgical glove and advances in thyroid
Thyroid
The thyroid gland or simply, the thyroid , in vertebrate anatomy, is one of the largest endocrine glands. The thyroid gland is found in the neck, below the thyroid cartilage...

, biliary tract, hernia
Hernia
A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the esophageal opening in the diaphragm....

, intestinal and arterial aneurysm
Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...

 surgery.

H.L. Mencken considered Halsted the greatest physician of the whole Johns Hopkins group, and Mencken’s praise of his achievements when he reviewed Dr. MacCallum's 1930 biography is a memorable tribute. “His contributions to surgery were numerous and various. He introduced the use of local anesthetics, he was the first to put on rubber gloves, and he devised many new and ingenious operations. But his chief service was rather more general, and hard to describe. It was to bring in a new and better way of regarding the patient. Antisepsis and asepsis, coming in when he was young, had turned the attention of surgeons to external and often extraneous things. Fighting germs, they tended to forget the concrete sick man on the table. Dr. Halsted changed all that. He showed that manhandled tissues, though they could not yell, could yet suffer and die. He studied the natural recuperative powers of the body, and showed how they could be made to help the patient. He stood against reckless slashing, and taught that a surgeon must walk very warily. Though, like most men of his craft, he had no religion, he yet revived and reinforced the ancient saying of Ambroise Paré: ‘God cured him; I assisted.’ Above all, he was a superb teacher, though he never formally taught. The young men who went out from his operating room were magnificently trained, and are among the great ornaments of American surgery today.”

In 1890, Halsted married Caroline Hampton
Caroline Hampton
Caroline Hampton Halsted, was the first to use rubber gloves in the operating room, at the instigation of her to be spouse William Stewart Halsted. She was a member of a prominent southern family; her uncle, Wade Hampton III, was a Confederate General, governor of South Carolina, and a US senator....

, the niece of Wade Hampton III
Wade Hampton III
Wade Hampton III was a Confederate cavalry leader during the American Civil War and afterward a politician from South Carolina, serving as its 77th Governor and as a U.S...

, a former general in the Confederate States Army
Confederate States Army
The Confederate States Army was the army of the Confederate States of America while the Confederacy existed during the American Civil War. On February 8, 1861, delegates from the seven Deep South states which had already declared their secession from the United States of America adopted the...

 and also a former Governor of South Carolina
Governor of South Carolina
The Governor of the State of South Carolina is the head of state for the State of South Carolina. Under the South Carolina Constitution, the Governor is also the head of government, serving as the chief executive of the South Carolina executive branch. The Governor is the ex officio...

. They purchased the High Hampton
High Hampton Inn Historic District
The High Hampton Inn Historic District is an estate and resort nestled in the mountains of western North Carolina, in the Cashiers Valley in Jackson County...

 mountain retreat in North Carolina
North Carolina
North Carolina is a state located in the southeastern United States. The state borders South Carolina and Georgia to the south, Tennessee to the west and Virginia to the north. North Carolina contains 100 counties. Its capital is Raleigh, and its largest city is Charlotte...

 from Caroline's three aunts. There, Halsted raised dahlias and pursued his hobby of astronomy. He died on September 7, 1922.

Eponyms

  • Halsted's law: transplanted tissue
    Tissue (biology)
    Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

     will grow only if there is a lack of that tissue in the host
    Host (biology)
    In biology, a host is an organism that harbors a parasite, or a mutual or commensal symbiont, typically providing nourishment and shelter. In botany, a host plant is one that supplies food resources and substrate for certain insects or other fauna...

  • Halsted's operation I: operation for inguinal hernia
    Inguinal hernia
    An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. They are very common , and their repair is one of the most frequently performed surgical operations....

  • Halsted's operation II: radical mastectomy for breast cancer
  • Halsted's sign: a medical sign
    Medical sign
    A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....

     for breast cancer
  • Halsted's suture: a mattress suture for wounds that produced less scarring
  • Halsted mosquito forceps: a type of hemostat
    Hemostat
    A hemostat , is a vital surgical tool used in almost any surgical procedure, usually to control bleeding. Therefore, it is not uncommon to see the initial incision lined with hemostats closing blood vessels awaiting ligation during the initial phases of surgery...


Further reading

  • Garrison, Fielding H. “Halsted,” American Mercury, v. 7, no. 28 (April 1926) 396-401. First mention of rubber gloves in the operating room.

External links

An interview with Gerald Imber, author of Genius on the Edge, and an excerpt from the book.
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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