Henry Dalton (poet)
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Henry Clay Dalton (May 7, 1847 – November 3, 1911) was superintendent of the St. Louis City Hospital, Missouri, United States, from 1886 to 1892, and later a professor of abdominal and clinical
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
at Marion Sims College of Medicine (now part of the
St. Louis University School of Medicine Saint Louis University School of Medicine is a private, Jesuit medical school. Part of Saint Louis University, the institution was established in 1836. The school has an enrollment of around 700, with about 550 faculty members and 550 residents in ...
) . He is noted for being the first American to perform the
suturing A surgical suture, also known as a stitch or stitches, is a medical device used to hold body tissues together and approximate wound edges after an injury or surgery. Application generally involves using a needle with an attached length of threa ...
of the
pericardium The pericardium, also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong connective tissue (fibrous pericardium), and an inner layer made of ...
on record. Spanish surgeon Francisco Romero was documented with performing two successful surgeries in 1801 and French surgeon Dominique Jean Larrey was documented as successfully performing surgery on a woman's pericardium in 1810.


Suturing of the pericardium

The operation occurred on September 6, 1891 at the City Hospital, on a twenty-two-year-old man who had been stabbed in the chest. Upon arrival of the patient, Dalton cleaned the wound and applied a dressing of antiseptic gauze. After several hours, the patient's condition worsened: the left side of his chest became dull to
percussion A percussion instrument is a musical instrument that is sounded by being struck or scraped by a beater including attached or enclosed beaters or rattles struck, scraped or rubbed by hand or struck against another similar instrument. Exc ...
; his temperature and pulse rate rose; his breathing became shallow; and he complained of considerable pain. He was taken to the surgical amphitheatre, where Dalton made an incision over the fourth rib and removed about of it. After tying the severed intercostal artery to control bleeding and removing the blood from the pleural cavity, Dalton observed a transverse wound of the pericardium about in length. With a sharply curved needle and catgut, he closed the wound by continuous suture, overcoming great difficulty caused by the
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
pulsations. The pleural cavity was then irrigated and the chest incision closed without drainage. The patient made "an uninterrupted, rapid recovery." The published report of the operation appeared in the state medical association's journal and another local periodical in 1894, and in the ''Annals of Surgery'' the following year.


Legacy

On July 10, 1893 African American surgeon Daniel Hale Williams became the first on record to replicate Dalton's success, repairing the torn pericardium of knife wound patient James Cornish. In the mid-1890s, attempts were made to further improve cardiac surgery. The first successful surgery on the heart itself was performed by Norwegian surgeon Axel Cappelen on 4 September 1895 at Rikshospitalet in Kristiania, now
Oslo Oslo ( , , or ; sma, Oslove) is the capital and most populous city of Norway. It constitutes both a county and a municipality. The municipality of Oslo had a population of in 2022, while the city's greater urban area had a population of ...
. The first successful surgery of the heart, performed without any complications, was by Dr.
Ludwig Rehn Ludwig Wilhelm Carl Rehn (13 April 1849, Bad Sooden-Allendorf – 29 May 1930) was a German surgeon. Rehn was born in 1849, in the village of Allendorf, the youngest of five children. After the visiting the convent school in Bad Hersfeld, he studi ...
of
Frankfurt Frankfurt, officially Frankfurt am Main (; Hessian: , "Frank ford on the Main"), is the most populous city in the German state of Hesse. Its 791,000 inhabitants as of 2022 make it the fifth-most populous city in Germany. Located on its na ...
,
Germany Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated betwe ...
, who repaired a stab wound to the right ventricle on September 7, 1896. Despite these new accomplishments, Dalton and other early cardiac surgeon received little recognition for the successful surgeries they performed and surgeons still thought they should not perform surgery on the heart.The Impossible: Heart and Brain Surgery
Accessed November 29, 2013
Heart surgery would not be widely accepted among surgeons until World War II broke out and forced battlefield surgeons to improve their methods of surgery in order to repair severe war wounds. Despite the earlier lack of recognition for his accomplishments, Dalton later received good recognition for his role in revolutionizing cardiac surgery.


References

* Henry C. Dalton. Report of a case of stab wound of the pericardium, terminating in recovery after resection of a rib and suture of the pericardium. ''Annals of Surgery'' 1895, 21:147-152 * Harris B. Shumacker, Jr. ''Evolution of Cardiac Surgery''. Bloomington, Indiana: University Press, 1992 *Stephen L. Johnson, ''The History of Cardiac Surgery'', Baltimore: Johns Hopkins Press, 1970 *William Hyde, Howard L. Conard, eds. ''Encyclopedia of the History of St. Louis, a Compendium of History and Biography for Ready Reference''. New York: Southern History Co., 1899.


Notes

{{DEFAULTSORT:Dalton, Henry 1847 births American surgeons Physicians from St. Louis Saint Louis University faculty 1911 deaths