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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This term arises from the Latin [lumbus] meaning "loin". The "loins" region of the body is the area lateral to the umbilicus, wrapping around posteriorly. In fact, there are two abdominal regions known as the "lumbar regions".
Galen of Pergamon(129AD - 200AD) named and described the lumbar vertebrae.
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[UPDATED] The basivertebral foramen is an opening in the posterior aspect of each vertebral body (click on the picture for a larger image) which allows the exit of the basivertebral veins. These foramina can be single (as seen in the image) or multiple. The basivertebral veins represent a communication that allows drainage of the vertebral body venous sinuses into the extensive complex venous network of the internal venous plexuses that surrounds the spinal cord.
The plexus of veins around the spinal cord are known as Batson's plexus. this plexus is named after Oscar Vivian Batson (1894 - 1979), an American anatomist and ENT.
Image property of: CAA, Inc. Photographer: David M. Klein
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[UPDATED] Latin words meaning "oval fossa" or "oval depression". The fossa ovalis is, as it names implies, an oval-shaped depression in the interatrial wall of the right ventricle. (see image, pointer "A"). The fossa ovalis represents in the adult the fetal communication between the right and left atrium allowing for fetal oxygenated blood to bypass the pulmonary circulation and enter the systemic circulation directly. The fossa ovalis is closed upon birth by two opposing membranes, and the higher pressure on the left side of the heart.
The persistence of the communication between the right and left atrium is known as an Atrial Septal Defect (ASD) and will need surgical correction. Some anatomists refer to this depression as the "foramen ovale" and it is surrounded by a well-defined muscular border known as the "limbus fossa ovalis", also known by the eponym "ring or anulus of Vieussens"
The interatrial opening in the fetus, and the persistent ASD in the adult is referred by the eponym "foramen of Botallus, remembering Leonardo Botallus.
The image shows a human heart with the right atrium opened. The black arrow points to the depression of the foramen ovale in the adult.
For more information:
• On fetal circulation
• On the fossa ovalis (Gray's Anatomy)
Image property of: CAA, Inc. Photographer: David M. Klein
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This root term is Greek and means "diaphragm", referring specifically to the respiratory diaphragm. Because of the importance to life of the region that includes the respiratory diaphragm, liver, and heart, Greek and Roman physicians saw this area as the seat of emotions, a concept that later evolved to include mental instability, and mind. So, for them the seat or location of the emotional processes was not in the brain, but in the area of conjunction of liver, heart, and respiratory diaphragm.
In the late 1700's, when Franz J. Gall developed a pseudoscience that looked at protuberances in the cranium as predictors of mental capabilities and mental pathologies, he named it [phrenology], or "study of the mind". In fact, look at the word "frenzy" and you will see a variation of the root [-phren-] in it!
Today we use the root term [-phren-] mostly to denote "respiratory diaphragm", although it can be found in medical words such as [schizophrenia] meaning "mind".
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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.
George Papanicolaou, MD, PhD
George Papanicolau, MD, PhD (1883 - 1962) Greek physician, cytologyst, physyiologist, and zoologist, Papanicolaou was born on the island of Euboea, Greece. His original Greek name is Georgios Nikolaou Papanikolaou. He initially attended the University of Athens, earning his MD in 1904.
After two years as a conscript in the Army, Papanicolaou continued additional studies in Zoology earning his PhD in 1910 at the University of Munich, later going back to the army as a physician.
Papanicolaou immigrated to the USA in 1913 with his wife. He took a position at the anatomy department of the Cornell University where over the next 45 years established the field of diagnostic cytology, becoming a Professor Emeritus of Clinical Anatomy.
His studies took him to study the cytological patterns in the internal genitalia of guinea pigs, establishing a “cytological calendar”. This study he continued in humans, where he discovered malignant changes in some of the cells obtained. His study on vaginal smears was published in 1943, starting what today is known as a “Pap smear”, a simple annual study that saves thousands of women from cervical and uterine cancer.
Dr. Papanicolaou died in 1960. His personal motto was “I live to serve life”
Sources:
1. “George Nicholas Papanicolaou, 1883-1962” Owens, C. Endoc T 2008:6(5) 28
2. "George N Papanicolaou (1883-1962) MD" Frangos, CC. J Me Biog 17 (3) 134
3. "George N. Papanicolaou, MD, PhD" Elgert, P A; Lab Med (2009) 40;4 245
4. "The diagnostic value of vaginal smears in carcinoma of the uterus" Papanicolaou, GN; Traut HF; Amm J Obst Gyn 1941; 42:193-206.
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This compound term is Latin, from [bifurcus] meaning double-pronged. The prefix [bi-] means "two" or "double", and the root [-furcat- ], derived from the Latin [furca] meaning "a fork". Bifurcation means "to fork into two".
In anatomy the term is used to denote the splitting of a structure into two, such as the "bifurcation of the aorta". A variation of the term is "bifid".