Henry Dalton
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Henry Clay Dalton (May 7, 1847 – November 3, 1911) was superintendent of the
St. Louis St. Louis ( , sometimes referred to as St. Louis City, Saint Louis or STL) is an independent city in the U.S. state of Missouri. It lies near the confluence of the Mississippi and the Missouri rivers. In 2020, the city proper had a populatio ...
City Hospital, Missouri, United States, from 1886 to 1892, and later a professor of abdominal and clinical
surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
at Marion Sims College of Medicine (now part of the St. Louis University School of Medicine). 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 Tissue (biology), body tissues together and approximate wound edges after an injury or surgery. Application generally involves using a Sewing needle, needle w ...
of the
pericardium The pericardium (: pericardia), 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 inelastic connective tissue (fibrous pericardium), ...
on record. Spanish surgeon Francisco Romero was documented with performing two successful surgeries in 1801 and French surgeon
Dominique Jean Larrey Dominique Jean, Baron Larrey (8 July 1766 – 25 July 1842) was a French surgeon and soldier best known for his service in the French Revolutionary and Napoleonic Wars. An important innovator in battlefield medicine and triage, Larrey invented t ...
was documented as successfully performing surgery on a woman's pericardium in 1810.


Biography

Henry Dalton was born in
Aberdeen, Mississippi Aberdeen is the county seat of Monroe County, Mississippi, United States. As of the 2020 census, the population was 4,961, down from 5,612 in 2010. Located on the banks of the Tombigbee River, Aberdeen was one of the busiest Mississippi ports ...
on May 7, 1847. He married Alice Cravens on March 17, 1875, and they had three children. He died at Deaconess Hospital in St. Louis on November 3, 1911, after an operation for
appendicitis Appendicitis is inflammation of the Appendix (anatomy), appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and anorexia (symptom), decreased appetite. However, approximately 40% of people do not have these t ...
.


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 percussion mallet, beater including attached or enclosed beaters or Rattle (percussion beater), rattles struck, scraped or rubbed by hand or ...
; 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 The pleural cavity, or pleural space (or sometimes intrapleural space), is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enabl ...
, Dalton observed a transverse wound of the pericardium about in length. With a sharply curved needle and
catgut Catgut (also known as gut) is a type of cord that is prepared from the natural fiber found in the walls of animal intestines. Catgut makers usually use sheep or goat intestines, but occasionally use the intestines of cattle, hogs, horses, mules, ...
, he closed the wound by continuous suture, overcoming great difficulty caused by the
heart The heart is a muscular Organ (biology), organ found in humans and other animals. This organ pumps blood through the blood vessels. The heart and blood vessels together make the circulatory system. The pumped blood carries oxygen and nutrie ...
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 Oslo University Hospital, Rikshospitalet, is one of the four main campuses of Oslo University Hospital in Oslo, Norway. It was an independent hospital, ''Rigshospitalet'', later spelled ''Rikshospitalet'' ("The National Hospital"), from 1826 to 20 ...
in Kristiania, now
Oslo Oslo ( or ; ) 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 1,064,235 in 2022 ...
. 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 Bad Sooden-Allendorf, Allendorf, the youngest of five children. After the visiting the convent school in ...
of
Frankfurt Frankfurt am Main () is the most populous city in the States of Germany, German state of Hesse. Its 773,068 inhabitants as of 2022 make it the List of cities in Germany by population, fifth-most populous city in Germany. Located in the forela ...
, Germany, 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

{{DEFAULTSORT:Dalton, Henry 1847 births 19th-century American surgeons Physicians from St. Louis Saint Louis University faculty 1911 deaths