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 [pubococcygeus muscle] is one of the muscles that forms the pelvic diaphragm. It is the deepest and one of the two muscular components of the levator ani muscle, the other one being the iliococcygeus muscle.
The pubococcygeus muscle attaches anteriorly to the posterior aspect of the body of the os pubis or pubic bone, leaving a gap or hiatus anteriorly which allows passageway of the deep dorsal vein of the penis in the male or the deep dorsal vein of the clitoris in the female.
Anterolaterally, the pubococcygeus muscle attaches to a thickening of the deep fascia of the obturator internus muscle called the Arcus Tendineous Levator Ani (ATLA).
As its name implies, the pubococcygeus attaches posteriorly to the sacrococcygeal region and posteromedially it attaches to a medial ligamentous structure that stretches between the anal canal and the coccyx, the anococcygeal ligament or anococcygeal raphe.
Several subcomponents are described in the pubococcygeus muscle, one of them being the puborectalis muscle. This muscle is the medial component of the pubococcygeus, it attaches anteriorly to the pubic bone and arches posterior to the anal canal, kinking it and being one of the components of fecal continence.
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Dura Mater: Latin terms meaning [tough mother]. The dura mater is the outermost of the three meninges. It is quite tough, forming a sac containing the spinal cord and brain, known as the dural sac or thecal sac. The image, from a book by Andreas Vesalius, shows a head with the dura mater in situ (label "A").
For more information on the meninges, click here.
Original images from Andreas Vesalius '"De Humani Corporis Fabrica; Libri Septem" (1543)
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This suffix [-(o)centesis] arises from the Greek [kentesis], meaning "to tap" or "to perforate", referring to a needle or trocar. In practical terms, this suffix means "needle aspiration of". Examples of its use are:
- Pericardiocenteses: Needle aspiration of the pericardium
- Thoracocentesis: Needle aspiration of the thorax. The use of the term "thoracentesis" is wrong!
- Amniocentesis: Needle aspiration of the amniotic sac
- Arthrocentesis: Needle aspiration of a joint
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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.
Ephraim McDowell
Ephraim McDowell (1771- 1830). American surgeon, Ephraim McDowell was born in 1771 in the Augusta County of Virginia. His family moved to the “frontier”, which at that time was Kentucky, where his father was a judge. McDowell studied in Kentucky and returned to Virginia to serve as an apprentice to Dr. Alexander Humphreys. Following Dr. Humphrey’s advice McDowell went to Edinburgh to finish his formal medical training, which he did not finish, taking chemistry, anatomy, and then a private medical course with Dr. John Bell.
Returning to America, he settled in the Ohio River Valley, and had a successful practice as a frontier surgeon in the city of Danville, Kentucky. This was before the advent of anesthesia and antisepsis.
On Christmas Day 1809, Dr. McDowell performed the first recorded ovariotomy to drain a massive ovarian cyst from Mrs. Mary Jane Crawford, who had to ride a horse for sixty miles to get to Dr. McDowell’s office where he performed the ovariotomy without anesthesia. Mrs. Crawford had been diagnosed as “pregnant” by two other physicians. Dr. McDowell’s hand-written report states that he performed a nine-inch abdominal incision, the operation lasted about twenty five minutes, and they removed “fifteen pounds of a dirty gelatinous substance” and “extracted the sac, which weighed seven and a half pounds”.
Mrs. Crawford survived the operation, was ambulatory in five days, and lived for 33 additional years, until she was 78 years old. Research has been made as to the reason for the survival at a time when the norm for an operation that penetrated the peritoneal cavity was death. Othersen (2004) states that his research indicated that Dr. McDowell was “meticulous, neat and scrupulously clean”.
Because of the times, and because Dr. McDowell was not into writing, the achievement was not known for many years, until 1817. Dr. McDowell later performed a lithotomy on James Polk, who would eventually become president of the United States. In 1825, his achievements were recognized and he received an honorary MD degree by the University of Maryland.
Dr. McDowell’s house in Danville, KY is today a museum, and his name is remembered by the “Ephraim McDowell Health System” a group of integrated healthcare based in the same city. For more information on Mary Jane Crawford, click here.
PERSONAL NOTE: On February 19, 2017 I was able to go visit this place. Click here for a series of articles and pictures of this visit. Dr. Miranda
Sources:
1. “Ephraim McDowell (1771-1830) Kentucky Surgeon” JAMA. 1963;186 (9):861-862
2. “Ephraim McDowell: The Qualities of a Good Surgeon” Othersen, HB Ann Surg. 2004; 239(5): 648–650
3. “Ephraim McDowell (1771-1830): pioneer of ovariotomy” Tan,SY & Wong, C. Singapore Med J 2005; 46(1) : 4
4. “Ephraim McDowell, the First Ovariotomy, and the Birth of Abdominal Surgery” Horn, L and Johnson, DH. J Clin Onco 2010: 28; 7 1262-1268
5. "Surgeon of the wilderness: Ephraim McDowell" Haggard, WD. Presidential Address, ACS 1933. FACS archives 1934, 58: 415-4198
Image in Public Domain. Courtesy of the National Library of Medicine.
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Anteroinferior view of the liver and stomach
The [lesser omentum] is a double-layered peritoneal membrane found between the stomach and the first portion of the duodenum and the liver.
Between the two layers of the lesser omentum there is a small amount of fat, the coronary vein, the arteries of the lesser curvature vascular arcade, the gastroduodenal artery, and the structures of the portal triad: Portal vein, common bile duct, and proper hepatic artery.
The lesser omentum is divided into two subcomponents:
- The gastrohepatic ligament, the larger component, found between the lesser curvature and the liver. It includes the pylorus.
- The gastroduodenal ligament, the smaller component, found between the first portion of the duodenum (superior portion, duodenal ampulla) and the liver. The common bile duct is found between the layers of the omentum.
Image property of: CAA.Inc. Photographer: David M. Klein
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The word [celiac] is the American version of the more internationally used term [cæliac]. It derives from the New Latin word [c?liacus] which means "pertaining to the bowels". This term in turn arises from an older Greek term [koilus] which means "hollow", "cave", or "cavity". By extension the words celiac or cæliac have come to mean "pertaining to the abdominal cavity".
In embryology, the term [celomic cavity] (a redundancy) is used to denote the combined abdominal and thoracic cavities in the embryo before the respiratory diaphragm separates these two into two separate bodily cavities.
The term [celiac] is used in other words such as:
- Celiac trunk: one of the unpaired branches of the abdominal aorta
- Celiac disease: an abdominal pathology characterized by distention and retention
- Celiac plexus: a plexus of autonomic nerves found around the celiac trunk.