New Yorker William S. Halsted graduated with an A.B. from Yale in 1874. In 1876, having won an appointment to Bellevue Hospital as a surgical intern through a competitive examination, Halsted began his medical studies. He was awarded an M.D. in 1877 by the Columbia University College of Physicians and Surgeons. After a year spent as a house physician at New York Hospital, Halsted went abroad to study modern European practices in medicine, anatomy, embryology of the central nervous system, and surgery. When he returned to New York in 1880, he held affiliations at six local hospitals where he gained high repute as a surgeon, diagnostician, and an advocate of aseptic technique. During this period of exceptional activity, Halsted was also teaching and conducting research to advance the practice of surgery. In 1884 he was the first to describe injection of cocaine into the trunk of a sensory nerve to block pain transmission and the use of localized ischemia to prolong cocaine's anesthetic action.

Intern staff of Bellevue Hospital, 1877, Halsted is in the center.
(This is a detail of larger group photograph; click on image to see the full group.)

William H. Welch invited Halsted in 1886 to come to Baltimore to join him in the newly formed pathology laboratory. Halsted and Franklin P. Mall spent the three years before the opening of the Johns Hopkins Hospital perfecting techniques for intestinal suture and wound healing in dogs. It was during this concentrated period of research that the concept for the Halsted School of Surgery evolved. Halsted's methods consisted of strict aseptic technique, gentle handling of tissue, use of the finest silk suture material, small stitches and low tension on the tissue, and complete closure of wounds whenever possible. These basic procedures had a far-reaching effect on the practice of surgery, making it safer and more effective than it had been previously.

In 1890 Halsted was appointed the first surgeon-in-chief of the hospital. He was named the first professor of surgery of the medical school in 1892. Renowned both as a surgeon and as a clinical teacher, Halsted combined experimental work in physiology and pathology with innovative surgical techniques, making significant contributions to the study and treatment of the thyroid and parathyroid glands, blood vessels, breast cancer, and hernia. A vigilant and constant proponent of aseptic technique, he introduced the use of rubber gloves in 1890.

Dr. Halsted giving a clinic.

One of the most important aspects of the Halsted School of surgery was the training of residents to be not only surgeons but also teachers of surgery. Halsted succeeded well: seven of his seventeen resident surgeons became professors of surgery at such schools as Harvard, Yale, and Stanford, and another six went on to other positions at medical schools or teaching hospitals. Eleven of Halsted's residents set up residency training programs in their new posts, thereby spreading the system even wider. Halsted selected four of his assistant residents to organize and direct the surgical subdivisions of orthopedics, otolaryngology, roentgenology, and urology. Without question, he left an indelible mark on an entire generation of American surgeons and on the practice of surgery itself.

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