Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Andreas Vesalius Bruxellensis (1514- 1564)

A Flemish anatomist and surgeon, Andreas Vesalius was born on December 31, 1514 in Brussels, Belgium. He is considered to be the father of the science of Anatomy. Up until his studies and publications human anatomy studies consisted only on the confirmation of the old doctrines of Galen of Pergamon (129AD - 200AD). Anatomy professors would read to the students from Galen's work and a demonstrator would point in a body to the area being described, if a body was used at all. The reasoning was that there was no need to dissect since all that was needed to know was already written in Galen's books. Vesalius, Fallopius, and others started the change by describing what they actually saw in a dissection as opposed to what was supposed to be there. 

Vesalius had a notorious career, both as an anatomist and as a surgeon. His revolutionary book "De Humani Corporis Fabrica: Libri Septem" was published in May 26, 1543. One of the most famous anatomical images is his plate 22 of the book, called sometimes "The Hamlet". You can see this image if you hover over Vesalius' only known portrait which accompanies this article. Sir William Osler said of this book "... it is the greatest book ever printed, from which modern medicine dates" 

After the original 1543 printing, the Fabrica was reprinted in 1555. It was re-reprinted and translated in many languages, although many of these printings were low-quality copies with no respect for copyright or authorship.

The story of the wood blocks with the carved images used for the original printing extends into the 20th century. In 1934 these original wood blocks were used to print 617 copies of the book "Iconaes Anatomica". This book is rare and no more can be printed because, sadly, during a 1943 WWII bombing raid over Munich all the wood blocks were burnt.

One interesting aspect of the book was the landscape panorama in some of his most famous woodcuts which was only "discovered" until 1903.

Vesalius was controversial in life and he still is in death. We know that he died on his way back from a pilgrimage to Jerusalem, but how he died, and exactly where he died is lost in controversy. We do know he was alive when he set foot on the port of Zakynthos in the island of the same name in Greece. He is said to have suddenly collapsed and die at the gates of the city, presumably as a consequence of scurvy. Records show that he was interred in the cemetery of the Church of Santa Maria delle Grazie, but the city and the church were destroyed by an earthquake and Vesalius' grave lost to history. Modern researchers are looking into finding the lost grave and have identified the location of the cemetery. This story has not ended yet.

For a detailed biography of Andreas Vesalius CLICK HERE.

Personal note: To commemorate Andrea Vesalius' 500th birthday in 2014, there were many scientific meetings throughout the world, one of them was the "Vesalius Continuum" anatomical meeting on the island of Zakynthos, Greece on September 4-8, 2014. This is the island where Vesalius died in 1564. I had the opportunity to attend and there are several articles in this website on the presence of Andreas Vesalius on Zakynthos island. During 2015 I also attended a symposium on "Vesalius and the Invention of the Modern Body" at the St. Louis University. At this symposium I had the honor of meeting of Drs. Garrison and Hast, authors of the "New Fabrica". Dr. Miranda

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Musculi levator labii superioris alaeque nasi

Published: Tuesday, December 10, 2024 07:00

musculi levator labii superioris alaeque nasi
Click for a larger image


UPDATED:The [musculi levator labii superioris alaeque nasi] is one of the superficial muscles of expression found in the face. It is a small bilateral muscle found at the angle of the nose and its function is to elevate the superior lip and the side ("wing") of the nose, slightly opening or "flaring" it. When both of these muscles are activated the facial expression attained is called a "snarl".

Its name is Latin and can be loosely translated  as the "muscle that lifts the upper lip and the wing of the nose". The muscle attaches to the superior  frontal process of the maxilla and inserts into the skin of the lateral part of the nostril and upper lip.

This muscle has two components, one superficial and the other deep. From the insertion point (see red arrow in accompanying image), the deep muscular fibers insert in the skin of the posterior aspect of the nasal wing. The external muscle fibers cross superficially over the orbicularis oris muscle and insert in the deep skin of the upper lip towards the lip anle.

My friend Dr. Elizabeth Murray calls it "a small muscle with the longest name in human anatomy". Fact is, I think she is right! It is worse in Spanish, where the name of the muscle is "músculo elevador común del ala de la nariz y del labio superior"!

Image modified from the original. Public Domain. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain

Book: "La Forma Humana de la línea"

Published: Monday, December 09, 2024 07:00 | Written by: Efrain A. Miranda, Ph.D.

Book Cover, cropped
Book cover, cropped


I recently added a new book to my library. It is in Spanish and titled "La Forma Humana de la Línea", which can be loosely translated to "The Human Form of the Line", referring to the hand-drawn images of human skeletal anatomy in the book.

"La forma humana de la línea" Katherine Estrada Suazo. ISBN 9789564021898, 2020. América Impresores. Valdivia, Chile

This is an extraordinary book that depicts in 90 pages and 40 plates the human bony anatomy in beautiful detail using a technique described by Leonardo Da Vinci in his “Trattato della Pittura” (A Treatise on Painting), chapter CXXVI. The author, Katherine Estrada Suazo, draws in hyperrealist detail single bones, a full skeleton, fetal skeletons in a seldom seen detail.

The introduction, the words of the artist, the analysis of Leonardo Da Vinci's technique, and the closing comments are a rare form of high level prose with mastery of the Spanish language that reads almost like poetry.

The book itself is a printing marvel. An uncommon large size (9½ by 15¾ inches/24 by 40 cm.), in a high quality acid-free heavy paper, with beautiful typesetting. The book also includes one large insert measuring 29½ by 9 inches (75 by 23 cm).

This work was supported by Morphology Professor, Patricia Hernández Coliñir at the Anatomy Unit of the Medical School of the Universidad Austral de Chile in the city of Valdivia, where it was printed by the América Impresores printing press. The author also received support from the Chilean government through the Regional FONDART (Regional Ministerial Secretary of Culture, Arts and Heritage). As far as I understand, this book is not for sale, which makes it a rare book.

I became aware of this book at the XLIII Annual Chilean Meeting of Anatomy, where I was invited to present the conference I delivered initially in May 2023 at the University of Antwerp, Belgium. An anatomy professor of the Universidad Austral de Chile, Ana Barriga K., had a copy of the book that was gifted to Dr. Carlos Machado, a good friend and famous medical illustrator of Netter’s Anatomy Atlas.

The road to obtaining the copy of the book included contacting the author and with the help of Professor Barriga, and a friend from Chile, the book went from Valdivia (Chile) to Santiago (Chile), to Mexico, and the US. This copy is dedicated by the author as follows: “Dedicated to Dr. Efrain Miranda. Signed in Valdivia, June 2024”, followed by her signature.

In a recent conversation with the author, she stated that "restricting access to this publication was never my intention", and although having the signed book for me is very important, Ms. Estrada has authorized the open download of the digital edition of the book in PDF format, which you can download here. (19 Mb)

Personal remark: As a side note, the city of Valdivia in Chile, where this book was designed and printed, is the city where my mother was born. Dr. Miranda


Lámina1: Cráneo, vista súperolateral


Recientemente agregué un nuevo libro a mi biblioteca. Está en español y se titula "La Forma Humana de la Línea", en referencia a las imágenes dibujadas a mano de la anatomía esquelética humana que aparecen en el libro.

"La forma humana de la línea" Katherine Estrada Suazo. ISBN 9789564021898, 2020. América Impresores. Valdivia, Chile

Este es un libro extraordinario que describe en 90 páginas y 40 láminas la anatomía ósea humana con hermoso detalle utilizando una técnica descrita por Leonardo Da Vinci en su “Trattato della Pittura” (Tratado sobre la pintura), capítulo CXXVI. La autora, Katherine Estrada Suazo, dibuja con detalles hiperrealistas huesos individuales, un esqueleto completo y esqueletos fetales con un detalle pocas veces visto.

La introducción, las palabras del artista, el análisis de la técnica de Leonardo Da Vincy y los comentarios finales son una forma poco común de prosa de alto nivel con dominio del lenguaje español que se lee casi como poesía.

El libro en sí es una maravilla de impresión. Un tamaño grande poco común (9½ por 15¾ pulgadas/24 por 40 cm.), en un papel pesado libre de ácido de alta calidad, con una hermosa composición tipográfica. El libro también incluye un inserto grande que mide 29½ por 9 pulgadas (75 por 23 cm).
Este trabajo fue apoyado por la Profesora de Morfología, Patricia Hernández Coliñir en la Unidad de Anatomía de la Facultad de Medicina de la Universidad Austral de Chile en la ciudad de Valdivia, donde también fue impreso por la imprenta América. El autor también recibió apoyo del gobierno de Chile a través del Fondart Regional (Secretaría Regional Ministerial de Cultura, las Artes y el Patrimonio). Según tengo entendido, este libro no está a la venta, lo que lo convierte en un libro raro.

Me enteré de este libro en la XLIII Reunión Anual Chilena de Anatomía, donde me invitaron a presentar la conferencia que di inicialmente en mayo de 2023 en la Universidad de Amberes, Bélgica. Una profesora de anatomía de la Universidad Austral de Chile, Ana Barriga K., tenía una copia del libro que fue obsequiada al Dr. Carlos Machado, un buen amigo y famoso ilustrador médico del Atlas de Anatomía de Netter.

El camino para obtener la copia del libro incluyó contactar al autor y con la ayuda de la profesora Barriga y un amigo de Chile, el libro viajó desde Valdivia (Chile) a Santiago (Chile), a México y a los Estados Unidos. Este ejemplar está dedicado por la autora de la siguiente manera: “Dedicado al Dr. Efraín Miranda. Firmado en Valdivia, junio de 2024”, seguido de su firma.

En una reciente conversación con la autora, ella afirmó que “nunca fue mi intención restringir el acceso a esta publicación”, y aunque tener el libro  firmado para mí es muy importante, la autora ha autorizado la descarga abierta de la edición digital del libro en formato PDF, que pueden descargar aquí. (19 Mb)

Observación personal: Como nota al margen, la ciudad de Valdivia en Chile donde se diseñó e imprimió este libro, es la ciudad donde nació mi madre. Dr. Miranda.

The Ether Dome

Published: Thursday, October 31, 2024 07:00 | Written by: Efrain A. Miranda, Ph.D.

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Ether Dome Skylight
Ether Dome Skylight

During one of many trips this year, I found myself with a free day in Boston, Massachusetts. Had a recommendation to try and visit the Ether Dome, which I did, and it was an interesting, although short, experience.

The Ether Dome is the name given by the Massachusetts General Hospital (MGH) to the first operating room of the MGH and it is located under the dome at the top of the Bullfinch Building, named after its architect Charles Bullfinch (who later became one of the architects for the USA Capitol). The reason for the location of the operating room is that there is a large skylight that provided the light for the operations.

The operating room was in service between 1821 and 1867 and over 8,000 operations were performed here. It was later used as a storage are, a nurse’s dormitory, a dining room, and today as a teaching auditorium. It still has the arrangement of a semicircular staired pavilion, as in the early days of the operating room. The Ether Dome was designated a National Historic Site in 1965.

National Historic Site 1965

The reason for the name Ether Dome is that in this location, on October 16, 1846, anesthesia was used successfully for the first time. The surgeon was John C. Warren, one of the MGH’s founders. The anesthesiologist was William T. G. Morton, a dentist. The patient was Gilbert Abbott. The operation was the excision of a neck tumor. Upon waking up, the patient said that he had felt no pain.

Ether Dome Auditorium


This event was so revolutionary that painting and images have bee created all over to remember the occasion. One of most creative was the work done for a mural called “Ether Day, 1846” The artists were Warren and Lucia Prosperi, who in 2000-2001 took photographs of surgeons and administrators at MGH in period clothing in different poses to recreate the event of the first use of anesthesia. An oil painting of the mural can be seen at the Ether Dome.  If you are interested in visiting the MGH, I recommend planning your visit with the Paul S. Russel Museum of Medical History and Innovation. The museum itself is worth visiting. If you want, the Russel Museum has a virtual tour of the Ether Dome and the Hospital, click here.

Painting of the operation by Warren and Lucia Prosperi

Since the Ether Dome is an active teaching auditorium, it is not always available for visitors, to it is good to call ahead, I did not, and was lucky to enter the auditorium prior to a welcome meeting for first year medical students. What an historical location to begin your medical career!

The Ether Dome houses a plaster cast of a Roman statue, the Apollo Belvedere, an Egyptian mummy, and an old human skeleton used for teaching. 

Human skeleton at the Ether Dome

The Apollo Belvedere at the Ether Dome

 A large plaque on the wall reads: ” On October 16, 1846 in this room, then the operating theatre of the Hospital, was given the first public demonstration of Anæsthesia to the extent of producing insensibility to pain during a serious surgical operation. Sulphuric ether was administered by William Thomas Green Morton, a Boston dentist. The patient was Gilbert Abbott. The operation was the removal of a tumor under the jaw. The surgeon was John Collins Warren. 
The patient declared that he had felt no pain during the operation and was discharged well, December 7. Knowledge of this discovery spread from this room throughout the civilized world and a new era for surgery began.”

Ether Dome Plaque


Here is a photograph of a later operation in 1847 where Morton and Warren can be seen.

Warren and Morton, c.1847


I have written several articles about this topic, the event, and its protagonists. Here are some of the links:

 Note: Ether Dome Skylight image. Ravi Poorun [oddityinabox] CC BY-SA 3.0, via Wikimedia Commons. Public Domain 

Ligament of Marshall

Published: Tuesday, October 22, 2024 18:05

John Marshall
John Marshall (1818 – 1891)

The ligament of Marshall (LOM)is the embryological remnant of the sinus venosus and left cardinal vein. It contains fat, fibrocellular tissues, blood vessels, muscle bundles (bundles of Marshall), autonomic nerve fibers, and some ganglia corresponding to the ganglionated plexuses (plexi) of the heart. 

It was first described by John Marshall (1818-1891) in an 1850 paper titled “On the Development of the Great Anterior Veins Man and Mammalia; including an Account of certain remnants of Fœtal Structure found in the Adult, a Comparative View of these Great Veins the different and an Analysis of their occasional peculiarities in the Human Subject”. In this paper, Marshall makes a detailed embryological description of the structures that derive from the left cardinal vein in the human and adds comparative anatomy with other mammalian species.

The left cardinal vein, which originally enters the left side of the sinus venosus, regresses and modifies leaving the following structures in the adult: From superior to inferior they are the brachiocephalic vein, the obliterated duct of Cuvier, the oblique vein of the left ventricle, and the coronary sinus.

The embryological remnant of the left cardinal vein closes and forms a fibrous cord known as the “duct of Cuvier” (named a after French anatomist and naturalist, Baron de la Cuvier (1769 – 1832)). As this fibrous cord crosses the gap between the left pulmonary vein and the left superior pulmonary vein, the visceral pericardium creates a fold over it; that fold is the ligament of Marshall.

In his paper John Marshall calls it the “vestigial fold of the pericardium”. He describes in this fold “a duplicature of the serous layer of the pericardium, including cellular and fatty tissue, the vestigial fold contains some fibrous bands, small blood-vessels and nervous filaments” …” in the interval between the pulmonary artery and vein”.
Ligament of Marshall (yellow arrow)

The image shows the ligament of Marshall (yellow arrow), the left pulmonary artery (LPA), and the left superior pulmonary vein (LSPV). Click on the image for a larger depiction.

Marshall continues his description as the LOM descends toward the heart and states that there is a portion of the left cardinal vein that is total obliterated and sometimes “wanting”. This is the obliterated portion of the duct of Cuvier, which he does not specifically describes in the LOM. In some cases, Marshall says that the duct is absent and replaced by some whitish fibrous streaks crossing the base of the left pulmonary veins. Today we call this the “obliterated portion of the vein of Marshall”.

He then continues describing a small vein that continues towards and opens in the superior aspect of the coronary sinus. This is the patent portion of the duct of Cuvier, and he calls this structure the “small oblique auricular vein”. Today we call this the “oblique vein of the left atrium” or eponymically, the “vein of Marshall”. The coronary sinus is the end portion of the left cardinal vein.

Contemporary studies on the structure of the LOM have described autonomic nerve fibers and aggregations of neuronal bodies (ganglia) on and around the LOM. Also, cardiac musculature extending from the left atrium, and the coronary sinus over the root of the vein of Marshall have been described (bundles of Marshall).

In some cases, the left cardinal vein does not regress and presents in the adult as a “persistent left superior vena cava”. In this case there is no obliterated duct of Cuvier, the oblique vein of the left atrium and coronary sinus are enlarged, and the venous blood from the head and the left upper extremity drains through the coronary sinus into the right atrium. The following image shows a persistent left superior vena cava (yellow arrow), the left atrial appendage (LAA), the left pulmonary artery (LPA), and the left superior pulmonary vein (LSPV). Click on the image for a larger depiction.

Persistent left superior vena cava

Because of the autonomic nerve fibers and ganglia involved, the LOM (and coronary sinus) have been described as being one of the potential foci for atrial fibrillation (AFib) and has become a target for ablation in AFib surgical procedures.

Personal note:  My personal thanks to my good friend and contributor to "Medical Terminology Daily", Dr. Randall K. Wolf for the surgical images.

Sources:
1. “On the Development of the Great Anterior Veins Man and Mammalia; including an Account of certain remnants of Fœtal Structure found Adult, a Comparative View of these Great Veins the different and an Analysis of their occasional peculiarities in the Human Subject” 1850 Phil Trans R Soc 140:133 – 170
2. “The ligament of Marshall: a structural analysis in human hearts with implications for atrial arrhythmias” Kim, D, Lai, A, Hwang, C. et al. JACC. 2000 Oct, 36 (4) 1324–1327.
3. “Myocardium of the Superior Vena Cava, Coronary Sinus, Vein of Marshall, and the Pulmonary Vein Ostia: Gross Anatomic Studies in 620 Hearts” DeSimone CV, Noheria A, Lachman N, Edwards WD, et al. J Cardiovasc Electrophysiol. 2012 Dec; 23(12)
4. “Correlative Anatomy for the Electrophysiologist: Ablation for Atrial Fibrillation. Part I: Pulmonary Vein Ostia, Superior Vena Cava, Vein of Marshall” Macedo PG, Kapa S, Mears JA, Fratianni A, Asirvatham SJ. J Cardiovasc Electrophysiol. 2010 Jun 1;21(6):721-30.
5. “"Human Embryology" WLJ Larsen 1993 Churchill Livingstone
6. “Langman's Medical Embryology" Sadler, T.W. 7ed. Baltimore: Williams & Wilkins, 1995.
7. "Vascular Surgery: A Comprehensive Review" Moore, Wesley S. USA: W.B. Saunders, 1998.
8. Portrait of J. Marshall by Alphonse Legros, Courtesy of Wikipedia. Public Domain.

John Marshall

Published: Wednesday, October 09, 2024 07:00

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

John Marshall
John Marshall (1818 – 1891)

John Marshall (1818 – 1891) British anatomist and surgeon. Initially, he apprenticed with Dr. Wales in Wisbech. In 1838 he entered the University College, London, where he studied with William Sharpey (1802 – 1880), who was then teaching physiology. In 1849 Marshall became a Fellow of the Royal College of Surgeons of England.

In 1845 he became a demonstrator of anatomy at University College, London and in 1847 with the help of Jones Quain (1796 – 1865) and William Sharpey he was appointed as assistant surgeon.

Marshall was appointed professor of surgery at University College in 1866, and in 1884 he was appointed consulting surgeon to University College Hospital.

He was known as a great artist and used his abilities to teach anatomy with the help of blackboards. He lectured on anatomy to art students, and one of his books is titled “Anatomy for Artists” (London, 1878), which was received with great enthusiasm by his art students.

John Marshall wrote several books and works, mentioned in the “Sources” section of this article, but he is probably better known for his association with the eponymic “Ligament of Marshall”. In 1850, he published a detailed description (36 pages) of the embryology of the cardinal veins, the superior vena cava, and the presence of a persistent “left superior vena cava” with a description of the oblique vein of the left atrium, the obliterated Duct of Cuvier, and the fold of pericardium over this duct that today carries his name.

The paper was published in the journal “Philosophical Transactions of the Royal Society”, and the title was “On the Development of the Great Anterior Veins Man and Mammalia; including an Account of certain remnants of Fœtal Structure found in the Adult, a Comparative View of these Great Veins the different and an Analysis of their occasional peculiarities in the Human Subject”. The sketches that accompany this seminal paper were drawn by him.

Plate 1 Marshall

Marshall Plate 5

 If you are interested in reading this paper, it is available online at the Royal Society website. For the actual publication in PDF format, click here. 

Marshall also is recognized for being one of the first to use electrocautery in surgery, as well as being a pioneer in the removal of lower extremity varicose veins. He was the first to demonstrate that cholera can be spread through contaminated drinking water.

Ligament of Marshall (yellow arrow)

The image shows the ligament of Marshall (yellow arrow), the left pulmonary artery (LPA), and the left superior pulmonary vein (LSPV).

Personal note: My thanks to an attendee to one of my cardiovascular lectures. He asked who was Marshall of the "ligament of Marshall:... Here is the answer. Dr. Miranda.

Sources and publications:
1. “A Description of the Human Body, its Structure and Functions” London, 1860, 4to, with folio plates; 4th ed. 1883.
2. “Anatomy for Artists” London, 1878, royal 8vo; 2nd ed. 1883; 3rd edit. 1890.
3. “A Rule of Proportion for the Human Figure” 1878, fol.
4 “A Series of Life-size Anatomical Diagrams” seven sheets.
5. “Physiological Diagrams” life size, eleven sheets.
6. “On the Relations between the Weight of the Brain and its Parts, and the Stature and Mass of the Body” 1892, J Anat Physiol
7. “The Brain of the late George Grote” 1892, J Anat Phys
8. “On the Development of the Great Anterior Veins Man and Mammalia; including an Account of certain remnants of Fœtal Structure found in the Adult, a Comparative View of these Great Veins the different and an Analysis of their occasional peculiarities in the Human Subject” 1850 Phil Trans R Soc 140:133 - 170
9. Portrait of J. Marshall by Alphonse Legros, Courtesy of Wikipedia. Public Domain.

Georg Eduard Von Rindfleisch

Published: Thursday, June 27, 2024 07:00

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Georg Eduard von Rindfleisch
G.E. Rindfleisch (1836 – 1908)

Georg Eduard Von Rindfleisch (1836 – 1908), German pathologist and histologist of Bavarian nobility ancestry. Rindfleisch studied medicine in Würzburg, Berlin, and Heidelberg, earning his MD in 1859 with the thesis “De Vasorum Genesi” (on the generation of vessels) under the tutelage of Rudolf Virchow (1821 - 1902). He then continued as a assistant to Virchow in a newly founded institute in Berlin. He then moved to Breslau in 1861 as an assistant to Rudolf Heidenhain (1834–1897), becoming a professor of pathological anatomy. In 1865 he became full professor in Bonn and in 1874 in Würzburg, where a new pathological institute was built according to his design (completed in 1878), where he worked until his retirement in 1906.

He was the first to describe the inflammatory background of multiple sclerosis in 1863, when he noted that demyelinated lesions have in their center small vessels that are surrounded by a leukocyte inflammatory infiltrate.

After extensive investigations, he suspected an infectious origin of tuberculosis - even before Robert Koch's detection of the tuberculosis bacillus in 1892. Rindfleisch 's special achievement is the description of the morphologically conspicuous macrophages in typhoid inflammation. His distinction between myocardial infarction and myocarditis in 1890 is also of lasting importance.

Associated eponyms

"Rindfleisch's folds": Semilunar folds of the serous surface of the pericardium around the origin of the aorta. Also known as the ascending aortic folds.

"Rindfleisch's cells": Historical (and obsolete) name for eosinophilic leukocytes.

Personal note: G. Rindfleisch’s book “Traité D' Histologie Pathologique” 2nd edition (1873) is now part of my library. This book was translated from German to French by Dr. Frédéric Gross (1844-1927) , Associate Professor of the Medicine Faculty in Nancy, France. The book is dedicated to Dr. Theodore Billroth (1829-1894), an important surgeon whose pioneering work on subtotal gastrectomies paved the way for today’s robotic bariatric surgery. Dr. Miranda.

Sources:
1. "Stedmans Medical Eponyms" Forbis, P.; Bartolucci, SL; 1998 Williams and Wilkins
2. "Rindfleisch, Georg Eduard von (bayerischer Adel?)" Deutsche Biographie
3. "The pathology of multiple sclerosis and its evolution" Lassmann H. (1999)  Philos Trans R Soc Lond B Biol Sci. 354 (1390): 1635–40.
4. “Traité D' Histologie Pathologique” G.E. Rindfleisch Rindfleisch Rindfleisch 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross.