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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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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The root term [-men-] originates from the Latin word [mensis] meaning “month”. Earlier forms of this term probably arise from the Greek [μήνας] (minas), also meaning “month”, but with the connotation of “lunar month” or “moon”.
Since a woman’s menstrual cycle is on average 28 days (ranging from 31 to 35 days) and a lunar month is 29 days and 12 hours in length, the root term [-men-] has been associated with a woman’s menstrual cycle, and menstruation. The term can be found in many words such as:
• Menses: The period of flow in a menstrual cycle. The “period”
• Amenorrhea: The prefix [a-] means “without” or “absence of”. The suffix [-(o)rrhea] means "flow". Without menstrual flow.
• Dysmenorrhea: The prefix [dys-] means “abnormal”. Abnormal menstrual flow
• Catamenial: Being or feeling sick during menses. Read more here
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The Billroth II procedure is a variation to the Billroth I procedure pioneered by Dr. Theodor Billroth in 1881. The procedure is a a "subtotal gastrectomy" where gastrointestinal continuity after the resection is attained with an anastomosis between the stomach and the jejunum, a gastrojejunostomy.
The procedure was originally performed as a way to resect peptic ulcers caused by hyperacidity. Billroth removed up to 70% of the stomach. Modern variations of the procedure are less agressive, resecting only 50% of the distal stomach (a hemigastrectomy), or an antrectomy.
The reason for the Billroth II variation is the difficulty performing a gastroduodenostomy. This can be caused by a short abdominal esophagus, a short proximal gastric pouch or other reasons. The accompanying image shows the digestive tract before the resection. The area to the resected (specimen) is grayed out. If you hover your cursor over the image you will see the completed Billroth II procedure.
In the completed procedure you can see A: The stapled-closed duodenal stump. B: The gastrojejunostomy that allows passage of food from the stomach into the jejunum, and C: the staple-closed gastric stump that is not part of the gastrojejunostomy. Bear in mind that this sketch depicts only one of the many ways of performing this procedure
Images property of:CAA.Inc. Artist:Dr. E. Miranda
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The Billroth I procedure was pioneered by Dr. Theodor Billroth in 1881. The original procedure was described as a "subtotal gastrectomy" where gastrointestinal continuity after the resection was attained with an anastomosis between the stomach and the duodenum, a gastroduodenostomy.
The procedure was originally performed as a way to resect peptic ulcers caused by hyperacidity. Billroth removed up to 70% of the stomach. Modern variations of the procedure are less agressive, resecting only 50% of the distal stomach (a hemigastrectomy), or an antrectomy.
After Billroth's pioneering work, several variations on the procedure appeared (Polya, Hofmeister) as well as different techniques (open vs. laparoscopic), and the use of different materials, starting with carbolized silk to the modern endolaparoscopic surgical staplers.
The accompanying image shows the digestive tract before the resection. The area to the resected (specimen) is grayed out. If you hover your cursor over the image you will see the completed Billroth I procedure.
In the completed procedure you can see A: The stapled-closed proximal gastric pouch. B: The duodenum. The red arrow points to the gastroduodenostomy, that is, the anastomosis between the stomach and the duodenum which in this case was done in the posterior aspect of the proximal gastric pouch. Bear in mind that this sketch depicts only one of the many ways of performing this procedure
Images property of: CAA.Inc. Artist:Dr. E. Miranda
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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.
Original image courtesy of the
National Library of Medicine
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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Corona mortis (A)
Important for inguinal hernia anatomy and surgery, this term is Latin from [corona] meaning "crown' and [mortis] meaning "death'; the "crown or circle of death". The corona mortis (blue arrow) refers to an anatomical variation1, a vascular anastomosis between the obturator and the external iliac vascular systems that passes over Cooper's pectineal ligament and posterior to the lacunar (Gimbernat's) ligament.
In some cases, the corona mortis is the actual obturator artery that arises from the inferior epigastric artery instead of the internal iliac artery. It can also arise from the external iliac artery. In both cases, it has been called an "aberrant obturator artery". This could be a misnomer, as this anatomical variation can be present in up to 25% of the cases. When present, the corona mortis can be injured when a surgeon looks to enlarge the femoral ring by opening the lacunar ligament from the anterior aspect. In this approach the "corona mortis" is not visible, as it is found immediately posterior to the lacunar ligament. This vascular structure could even be endangered in a laparoscopic procedure for inguinal of femoral hernia repair and a staple or tack is driven blindly into the pectineal (Cooper's) ligament.
Berberoglu states that "although these tiny anastomoses... have been described in classical anatomy textbooks, these texts neglect to mention that theses anastomoses can be life-threatening".
In some rare cases, the corona mortis (aberrant obturator artery) coexists with the normal obturator artery. Although called a [corona], this anatomical structure is an incomplete circle. In the image, the [corona mortis] is labeled "A".
Sources:
1. Rusu et al: "Anatomical considerations on the corona mortis" Surg Radiol Anat (2010) 32:17–24
2. Berberoglu et al: "An anatomic study in seven cadavers and an endoscopic study in 28 patients" Surg Endosc (2001) 15:72-75
Image property of:CAA.Inc.. Artist:M. Zuptich
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UPDATED: The word [catamenial] is Greek. The prefix [cata-] arises from [, from [κάτω] (kato) meaning "down", "down because of", or "down to", the root term )[-men-] from [μήνας] (menas) meaning "month", referring to "lunar month" or to a female's menstrual cycle, which is usually just about a lunar month long, and the adjectival suffix [-ial] means "pertaining to".
[Catamenial] then means "to be down (sick) during a menstrual cycle" and refers to a condition that recurs in reference to menses.
Examples of the use of this word are:
• Catamenial depression or catamenial psychosis
• Catamenial pneumothorax - related to endometriosis
• Catamenial epilepsy or seizures
The links will open scholarly articles that use this word.