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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Hernia

UPDATED: The definition of hernia is "the protrusion of a deep structure through a superficial weakness of defect".

Herniation has many etiologies, but in all cases a weakness of a superficial containing wall  (usually layered) or a normal or abnormal opening (defect) must be present. A true hernia usually has a deep sac or hernia sac which contains the herniated viscus or viscera. Repair of a hernia is called a hernioplasty or a herniorrhaphy.

Although with exceptions, a herniation with only weakening of the walls and no hernia sac can be called a "prolapse", the suffix for prolapse (or hernia sometimes) is [-ocele].

Indirect inguinal hernia
• Omphalocele: From the Greek [omphalos] meaning "umbilicus", an omphalocele is a herniation through the umbilicus.
• Cystourethocele: A prolapse of the urinary bladder and urethra with a weakened vaginal wall

There are also "internal' hernias, between bodily compartments. Examples are:

Esophageal hiatus hernia: Known as a "hiatal hernia", this hernia is a protrusion of a peritoneal sac with abdominal visceral content into the thorax.
Perineal hernia: The protrusion of abdominopelvic content into the perineal region through a defect in the pelvic diaphragm (levator ani)

A hernia is usually named for the superficial region where it protrudes. An example of this would be a femoral hernia, which starts as an abdominopelvic extrusion, but it ends protruding in the area of the thigh (femoral region). Abdominal or ventral hernias are named according to the abdominal region through which they protrude.

in older times the word "rupture" was used as a synonym for "hernia", as can be seen in a letter written by Dr. Ephraim McDowell in 1829. The image shows an example of an indirect inguinal hernia. 

Original Image courtesy of: nih.gov

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