Title of the Review: Genius Recognized

Reviewed by: Dr. Joseph S. Maresca CPA, CISA

The author, Dr. Gerald Imber, MD does an excellent job of

documenting the life and times of Dr. William S. Halsted MD.

Dr. William Stewart Halsted was educated in New York initially.

He attended Yale and the College of Physicians and Surgeons

at 23rd St. and 4th Av. in NYC.

Scholastically, he graduated in the top 10 of his class

and won $100 in an essay contest for the description of

the arteries of the neck. He worked at

New York Hospital and read extensive surgical

scholarship written in Europe. He held positions at

Blackwell’s Island and Emigrant Hospital, although the

workload was staggering .

At an early age, he began to understand the intricacies

of blood group incompatibility. He found that intestinal

anastomosis using fine silk sutures incorporating the submucosal

layer withstood the pressures of normal bodily functions.

He demonstrated this aspect graphically.

By 1889, rubber sterile gloves were introduced to protect

the skin from irritation. Halsted perfected radical surgery

with extensive fine suturing for breast cancer.

He reconstructed hernia defects in the groin by using muscle

and tough fascial sheath of the oblique muscles of the lower

abdomen to reconstruct the inguinal canal floor. Halsted sutured

the muscles and fascia to Poupart’s ligament, an anatomical

inguinal ligament that traverses the iliac bone of the pubis.

Strong silk sutures were used to tighten the internal abdominal

ring as well. These suturing techniques could have important

application for the repair of dropped bladders, major surgical

intestinal resections, downsizing mega-intestines (over 27 feet )

and complications from radical hysterectomies.

He perfected hernia repair and found that silver (Ag) had

antiseptic qualities as well.

On April 4, 1892, Halsted was made a Professor of Surgery,

although he had no formal institution to practice the art

at the time. By 1900, he perfected two gold standard operations,

placed surgeons’ hands in sterile gloves and commenced a

training system for 3 generations of the most influential

surgeons in the USA.

Today, some of Dr. Halsted’s techniques could be enshrined

in modern artificial intelligence and “Advice-Giving” systems

and processes on knowledge databases.

Cushing was the most impressive of a group of 17 Halsted

residents. He was the first to use anesthesia in hernia

repair, the first to operate on the pituitary gland ;and,

the first to routinely open the skull to

decompress the brain and develop neurological surgical

prototypes.

Halsted performed the first successful excision of an

aneurysm of a major blood vessel. He passed on from

lobar pneumonia on 9-7- 1922.

The work is a classic covering the slow but steady

evolution of basic surgery in the late 19th century and early

20th century. The presentation would make excellent

reading for a wide constituency of journalists, historians,

physicians and academicians everywhere .

Dr. Joseph S. Maresca CPA, CISA
Rating: 5 / 5