Halstead never wrote a textbook or treatise. All his written contribution were in the surgical journals of the day. In 1889 he published a technique of inguinal hernia repair and in the early 1890s he described a radical mastectomy for breast cancer with which his name is associated. 1892 he described ligation of the subclavian artery. In the early 1900s he published on autotransplantation of the parathyroid gland. Halstead was a great surgical educator who, influenced by his early years in Germany, introduced basic laboratory medicine into clinical practice and a formal training program for junior surgeons. He was the founder of the surgical training program at the Johns Hopkins University on which many other teaching systems were modeled.
"The only weapon with which the unconscious patient can immediately retaliate upon the incompetent surgeon is haemorrhage"
Surgery Multiple Choice Questions
He described the use of phenol in the washing of hands and also the use of sterile absorbable sutures (catgut) to reduce wound infection. Despite initial resistance, his methods were rapidly adopted throughout Europe particularly by the military in the Franco-Prussian war. By 1878 ,in Germany, Robert Koch was using steam for sterilising surgical instruments and dressings
Trendelenberg was a great practical surgeon who was keenly interested in the history of surgery. His doctoral thesis De Veterum Indorum Chirurgiais discussed ancient Indian surgery. The closing years of his life were spent in Nikolassea, Germany. He died from carcinoma of the lower jaw at the age of 81 years.
Friedrich Trendelenberg (1844-1924)
Susruta doing Plastic Surgery of Ear
6th century BC
Sushruta was the first surgeon in the world who lived in ancient India and is the author of the book Sushruta Samhita.
Susrutha is the father of Plastic Surgery and Cosmetic Surgery. His technique of forehead flap rhinoplasty that he used to reconstruct noses that were amputated, is practiced almost unchanged in technique to this day.
The Susrutha Samhita contains the first known description of several operations, including the uniting of bowel, the removal of the prostate gland, the removal of cataract lenses and the draining of abscesses.
In 1670, when war broke out between the Mughals and the Aadilshah of Bijapur, some Mughal soldiers captured the villagers and as a punishment, their noses were cut off. However, after some days all of them received new noses. How ? Describing the treatment of the native surgeons, Niccolao Manucci, the Italian traveller who was in India in those days, says :
"The surgeons belonging to the country cut the skin of the forehead above the eyebrows, and made it fall down over the wounds on the nose. Then, giving a twist so that a live flesh might meet the other live surface, by healing applications, they fashioned for them other imperfect noses. There is left above, between the eyebrows, a small hole, caused by the twist given to the skin to bring the two live surfaces together. In a short time the wounds heal up, some obstacle being placed beneath to allow of respiration. I saw many persons with such noses, and they were not so disfigured as they would have been without any nose at all." (Storia do Mogor or Mogul India, 1653-1708 AD).
