The training of the surgeon : the annual address in medicine delivered at Yale University, June 27, 1904 / by William Stewart Halsted.

  • Halsted, William, 1852-1922.
Date:
[1904]
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Licence: In copyright

Credit: The training of the surgeon : the annual address in medicine delivered at Yale University, June 27, 1904 / by William Stewart Halsted. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    was known to the school of Alexandria; carried, it is said, [268] to Rome by Euelpistus, it is mentioned by nearly all surgical writers of importance from Celsus to the Renaissance. The brilliant Fallopius (1523-62), Fare’s contemporary, alas a very short-lived one, wrote much about the use of the liga- ture for the arrest of hemorrhage. Nevertheless, until Har- vey demonstrated (1628) the true course of the blood, the principles underlying the control of bleeding by the ligature could not be understood, and surgeons studiously avoided operations w’hich entailed hemorrhage and necessitated its control. M e can hardly understand in these days that surgeons who were at the same time anatomists and physiologists could have accepted for so many centuries, almost without remon- strance, Galen’s views. Our inability to comprehend their state of mind with reference to this problem illustrates par- ticularly well the difficulty experienced when we attempt to transport ourselves to other times, to obtain the point of view which subjugated our forefathers of centuries ago. It is now, as it was then and as it may ever be; conceptions from the past blind us to facts which almost slap us in the face. The blood which spurted from the divided artery was believed to come not from the left heart, but in some mys- terious and indirect way from the veins, in which it was sup- posed to flow and ebb to and from the right heart. Harvey knew nothing of the paths by which the arterial and venous systems communicate, and his discovery was not made complete until Malpighi in 1661 demonstrated by the micro- scope the capillaries. How bewildering hemorrhage must have been when a wound suddenly filled with blood from a source unknown, and when sometimes, with little bleeding, a patient suddenly died from aspiration of air into the veins! What more nat- ural than to pack quickly the wound, as Heliodorus and others were wont to do, with compresses of lint or sponge, to ligate large masses of tissue by circumvection, to draw the bleeding edges of a wound tightly together by stitches, as is still sometimes done, or to sear the bleeding surfaces with the cautery or with boiling oil! Imagine the terror and