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

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81


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Proximal / Distal


Anatomical position

UPDATED:The term [proximal], from the Latin [proximus] meaning "next" and its counterpart [distal], from the Latin [distans] meaning "distant", have been poorly defined and this causes misunderstanding in the proper use of these terms. This is particularly true in the medical industry.

The classical definition of [proximal] are "nearest, closer to the origin, closer to the point of reference" and also "closer to the beginning", or "opposite of distal". [Distal] is, of course, the opposite. All of these definitions are lacking a consensus between the participants in a conversation. This lack of proper definition could potentially lead to problems in an interventional situation and a patient could be injured.

In our lectures and training materials we use a working definition1 as follows:

Proximal has two meanings:

1- Closer to the point of attachment, where one end of the attached structure is free, and

2- Closer to the point of origin of flow of a fluid”

Distal is of course, opposite to proximal.

In the first acception of the word, a clear example is the attachment of the upper and lower extremities. Moving away from the shoulder or the hip joint is a distal movement. “The wrist joint is distal to the elbow joint”. The same is true for the Fallopian (uterine) tube, where the proximal attachment of the tube is to the uterus and the free distal end of the tube is its fimbriated end.

In the second acception of the word, in any anatomical structure, organ, or system where there is flow of a fluid (food, urine, bile, blood, etc.) it is accepted that normal flow (antegrade flow) goes from proximal to distal and that abnormal flow (retrograde flow) goes from distal to proximal.

1. Use of this definition is permitted, as long as CAA, Inc. is credited, or a link to this article is posted with it.
Image property of: CAA.Inc. Artist: Victoria G. Ratcliffe