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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William S. Halsted, MD
(1852 – 1922)
American anatomist, teacher, and surgeon, William Stewart Halsted was born in New York City, USA to a wealthy family of English origin. His father was involved in charitable work and Governor and trustee to a city hospital. Not a brilliant student initially, Halsted took an undergraduate in Liberal Arts in Yale, CT., after which he entered the Medical College of Physicians at the Columbia College, where he excelled.
As a second-year medical student Halsted applied and obtained a position in surgery at a local hospital. In here he learned about Lister’s antiseptic technique and became an adamant proponent of it to reduce infection. In 1877 Halsted obtained his MD. After a short time as House Physician at the New York Hospital, Halsted traveled to Europe to further his education studying for two years at the Universities of Vienna, Leipzig, and W?rzburg.
Besides being at the forefront of surgical and antiseptic techniques (introducing the use of rubber gloves in surgery), Halsted was extremely concerned with the way medical students were taught in the US. He pioneered bedside clinical round discussions with the medical students after two years of basic sciences studies. Halsted developed the idea of a patient chart; he also developed the residency program for medical students in use today.
Halsted is probably the most influential researcher and surgeon at the turn of the century. He dedicated time to the study of intestinal anastomoses and the use of silk as a suture material. His experimental work in 1887 proved that the inclusion of the submucosa layer in an anastomosis was mandatory, as well that a single layered anastomosis was enough to attain closure. Perhaps Halsted’s most important contribution was the application and use of the scientific method to surgical questions. Halsted’s principles, also known as "Halsted's Rules of Surgery", set the standards used today in surgical suturing and surgical stapling.
He also pioneered the development and surgical techniques for radical mastectomy as a treatment for breast cancer.
As a side effect of this studied in anesthesia and the use of cocaine for anesthesia, Halsted became addicted to this substance, a problem that followed him through the years. Without impairing his capacity as a researcher and a surgeon, Halsted eventually recovered. He died in Baltimore in 1922 as a complication to surgery.
Sources:
1. Dubay, A. D., & Franz, G. M. (2003). Acute Wound Healing: The Biology of Acute Wound Failure. Surg Clin NA, 83, 463-481.
2. Halsted, W. S. (1887). Circular Suture of the Intestine - An Experimental Study. Am J Med Sci, 436-461.
3. “William Stewart Halsted: his life and contributions to surgery” Osborne, P. Lancet Oncol 2007; 8: 256–65
4. “William Stewart Halsted: Surgical pioneer” Burress, P Endoc Today (2010), 8: (2) 22
5. “William Stewart Halsted (1852–1922) Neurological stamp” Haas, LF J Neurol Neurosurg Psych 2000;69:641
Original image courtesy of "Images from the History of Medicine" at www.nih.gov
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The medical term [morphology] arises from the Greek root term [morphos] meaning "shape" or "form". The suffix [-ology] means "study of". In biological sciences [morphology] is the study of form.
Skinner1 defines morphology as the study of "the external configuration and structure of any part and the factors that influence its development and final form".
The term was first used in 1817
1. "The origin of Medical Terms" Skinner, AH, 1970
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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.
William Cowper
William Cowper (1666 – 1710). English barber-surgeon and anatomist, William Cowper (sometimes known as William Cooper) was born in Petersfield, Hampshire. After apprenticeship with famous barber-surgeons, Cowmper was admitted as a Freeman to the Company of Barber Surgeons in 1691 after which he had a successful career as a surgeon and an anatomist in London.
Cowper opened the first private school of anatomy in London. In 1694, Cowper published “Myotomia Reformata “, a great textbook with a description of all the muscles. A controversy arose because Cowper used the illustrations from another book by Govert Bidloo (1649 – 1713). The controversy became a problem for Cowper who had to answer questions on the subject to the Royal academy, where Cowper became a member in 1699. Cowper alleged that Bidloo’s plates, although greatly illustrated had a poor description which he improved.
In 1699 Cowper published the “Philosophical Transactions” where he describes the bulbourethral glands which are today eponymically tied to his name. An infection of these glands is called a “Cowperitis”.
The bulbourethral glands had already been described by Jean M?ry (1645– 1722) and Cowper did not claim to discover these glands. As in the case with many eponyms, the name attached to a structure is not necessarily the one who discovered it. Today, many do not remember that Cowper's name is also used to describe "Cowper's ligament", that portion of the fascia lata that is attached to the iliac crest.
Sources:
1. “Two eponymous surgeons: William Cowper and Francois Poupart” Ellis, H. Brit J Hosp Med (2009) 70:4, 225
2. "Cowper, William (1666–1710)" Kornell, M, Oxford Dictionary of National Biography, Oxford University Press, 2004
3. "Medical Discoveries, who and when" Schmidt, JE: C Thomas Pub. 1959
Original image in the public domain, courtesy of "Images from the History of Medicine" at www.nih.gov
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[UPDATED] The term [vasa vasorum] comes from the Latin [vasa] or [vas] meaning "a vessel", as in a container. Vasa vasorum means "the vessels of the vessels". The term "vasa vasorum" is plural. The singular form is "vas vasis".
In arteries and veins, only the inner layer of the vessel, the endothelium can receive nutrition and oxygen from the blood that is carried by the vessel. Arteries and veins have their own blood supply network, their own arteries and veins. These are the vasa vasorum.
The image shows the internal structure of an artery with its three layers, tunica intima (named after Xavier Bichat), tunica media, and tunica adventitia, as well as the vasa vasorum. Click on the image for a larger depiction.
NOTE: My personal thanks to Michiaki Akashi, M.D. for allowing us to use his artwork in this article. Dr. Akashi works as a surgeon and pathologist in the Saga Prefectural Hospital Koseikan in Saga, Japan. Dr. Miranda
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The [obturator foramen] is a bilateral and roughly triangular opening in the lower portion of the pelvis bound by the following bones: ilium, ischium, and pubic bone. The obturator foramen is closed off by the obturator membrane, a though, tendinous membrane that leaves a small superior opening (obturator canal) that allows passageway of the obturator nerve, obturator artery, and obturator vein. These neurovascular structures provide nerve and blood supply to the anterior compartment of the thigh.
The obturator membrane serves as a point of attachment to the external obturator and internal obturator muscles.
The obturator foramen is important for transobturator sling surgery used in cases of urinary incontinency.
Image property of: CAA.Inc. Artist: M. Zuptich
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The word [lambda] is Greek and is represented by the symbols [Λ] and [λ]. Because of the inverted "V" shape and inverted "Y" shape of these symbols, it was used by Galen of Pergamon (129AD - 200AD) to denote the junction of the sagital suture (interparietal articulation) and the occipitoparietal suture, also known as the "lamboid" suture. The lambda can also be described as the point of junction of the occipital bone with the parietal bones.
Although Galen named this junction originally, it was Vesalius (1514- 1564) who brought this name into modern anatomy. Later, Peter Paul Broca (1824- 1880) used this landmark as a craniometric point.
Image in the public domain, modified from Toldt's "Atlas of Human Anatomy", 1903.
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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.
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Leonardo Botallus (c.1530- ??) Italian anatomist and physician,Leonardo Botallus (also known as Botalli, Botallo, or Botal) was born circa 1530 in the region of Piedmont. Botallus studied medicine at the italian university of Pavia, where he was a student under Gabrielle Fallopius. Botallus graduated circa 1553. He was an avid advocate of bloodletting, causing him to direct his anatomical studies towards the subject of the vascular system. Although he did not discover the foramen ovale and the ductus arteriosus, he mentions these structures by those names in both his posthumous publications " De via sanguinis a dextro in sinistro cordis ventriculum" (1640) and "Opera Omnia Medica et Chirurgica" (1660)
In France Botallus became physician to King Charles IX. Not much more is known about Botallus, and history fails to record his date and place of death, as well as his image. The image depicted here is from his 1660 publication. Click on the image for a larger depiction.
Botallus' name is eponymically remembered in the following structures:
- Foramen of Botallus: The foramen ovale, an opening found in the fetus in the region of the fossa ovalis that closes upon birth
- Duct of Botallus: A communicating vessel between the left pulmonary artery and the proximal region of the descending aorta, part of fetal circulation, also known as the ductus arteriosus
- Ligament of Botallus: The closed ductus arteriosus in the adult
Sources:
1. "History of medicine; a correlative text, arranged according to subjects" Mettler, C Ch. 1947 The Blakiston Co
2. "Stedmans Medical Eponyms" Forbis, P; Bartolucci, SL. Williams & Wilkins 1998
3. "The origin of Medical Terms" Skinner, AH, 1970
4. "The First Closure of the Persistent Ductus Arteriosus" Alexi-Meskishvili,V; B?ttcher, W. Ann Thorac Surg 2010;90:349 –56
NOTE: There is no known image of Botallus. Skinner's "Origin of Medical Terms" shows one, but we could not confirm the origin of the image. If you know or have one, let us know!