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

Georg Eduard Von Rindfleisch

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": Usually a single semilunar fold of the serous surface of the pericardium around the origin of the aorta. Also known as the plica semilunaris aortæ.

"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 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross


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Vesalius, Sylvius, Galen, and the “Epistle on the China Root”

Title page of the Epistle on the China Root by Andreas Vesalius
Click for a larger image

UPDATED: Scientific thought today is a given. Today most of us believe something only after it is proven factually. A scientist is recognized by the capacity to change a position if the appropriate experiments, demonstrations and facts against their position are proven. A scientist holds a healthy position of doubt and even if their positions are proven for a long time, they are willing to accept a scientific counterproposal.

When a belief or a position is supported only by a belief without proof, then it falls into the realm of suppositions and religion. In this article I will not discuss this.

The above is written to support why at the time Andrea Vesalius’ opus magnum “De Humani Corporis Fabrica, Libri Septem” was condemned by so many, and how Vesalius’ words ushered the beginnings of scientific thought.

Anatomical and medical teachings flourished with the Greeks and attained its peak with Galen of Pergamon (129AD - 200AD), called by many (Vesalius included) “prince of physicians”. Galen was known for his many published works and his writings were translated into Arabic. This was important, because with the invasion of Rome of Greece many of the published works were lost and later the only way to read Galen was to translate his works back into Greek or Latin. Also many books were lost during the Dark Ages.

After the Dark Ages decline of Medicine, the “light” of the Renaissance brought with it the belief that the Ancient Greeks were never wrong and that if anything was wrong, it was the quality of the translation and the interpretation of the works.  Early in his career and because of his knowledge of languages, Vesalius was one to work as a translator for commentaries that were made on Galen. Because of his personal dissection skills and his direct observation of the human body Vesalius started to encounter a problem: what was being taught as human anatomy by Galen’s works was wrong. In many cases Vesalius found clear evidence that Galen used goat, dog, and ape anatomy instead of human anatomy to write his works. This was a slow process of breaking with Galenic teachings. Even in the first edition of the Fabrica (1543) Vesalius, even questioning Galen, would not go too far.

In 1540, three years before the publishing of the Fabrica, Vesalius performed a public anatomy in Bologna. There is a well-written and translated diary of the dissection published by Baldasar Heseler, which many say earned him a place in the title page of the Fabrica. Heseler describes Vesalius’ dissection and lectures as well as the fierce discussions between the host, Matthaeus Cortius (1475 – 1542) and Vesalius. The elderly Cortius, Galen’s book in hand, discussed the impossibility of what Vesalius was demonstrating, arguing that Galen “just cannot be wrong”. This discussion was reenacted during one of the lectures by Rebecca Messbarger, Ph.D. at the “Vesalius and the Invention of the Modern Body” interdisciplinary symposium.

With the publication of the Fabrica the reaction of many Galenists was fierce, probably none more caustic than Jacobus Sylvius (1478 - 1555). Sylvius was a teacher of Vesalius and saw his anti-Galenic position as treason. Known for his propensity to foul language, Sylvius started a personal was against Vesalius, even publishing a small book where he called Vesalius a “madman” plus “purveyor of filth and sewage, pimp, liar, and various epithets unprintable even in our own permissive era” (excerpt from Magner, 1992). Sylvius’ publication was entitled “Vaesani cuiusdam calumniarum in Hippocratis Galenique rem anatomicam depulsio”  (A refutation of calumnies by a certain madman against Hippocratic and Galenic anatomy). Garrison (2015) explains the play on words where Sylvius  transforms “Vesalii” into “Vaesani” – the madman.

Initially Vesalius tried to be conciliatory and scientific, trying to persuade his opponents with the facts as seen in the human body. His final argument was published in October 1546 in “Epistola rationem modumque propinandi radices Chynae dedocti“ a publication known to many as the “Epistle (letter) on the China Root”. Vesalius used the excuse of writing on a controversial medicinal plant as the venue to explain in detail the reasons why he deemed Galen wrong in many aspects of human anatomy. The “Epistle on the China Root” was printed in Basel by Johannes Oporinus and the introduction was written by Andreas Vesalius’ brother Franciscus. The "Epistle on the China Root" has recently been translated (2015) by Dr. Daniel Garrison, one of the authors of the "New Fabrica".

Personal note: It is clear to me that Vesalius is not the first to promote scientific thought processes, but he is the one that used human anatomy to start the debunking (and acceptance) of portions of what was known at the time in that particular arena. Dr. Miranda

Sources
1. “Jacobus Sylvius (Jacques Dubois) 1478-1555 – Preceptor of Vesalius” JAMA (1966) 195 13; 1147
2. "Andreas Vesalius; The Making, the Madman, and the Myth" Joffe, Stephen N. Persona Publishing 2009
3. “A History of Medicine” Magner, LN Ed. M Deckker Pub 1992
4. “Vesalius: The China Root Epistle. A New Translation and Critical Edition” Garrison DH, 2015 Cambridge University Press
5. “Andreas Vesalius' first public anatomy at Bologna 1540 – An Eyewitness Report by Baldasar Heseler” Eriksson, R 1959 Almquist& Wiksells Boktryck