Caput medusae

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A Moment in History

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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Details: Written by: Efrain A. Miranda, Ph.D.; Published: December 16, 2013; Hits: 15451

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The Latin word [caput] means "head" and the word [medusae] is also Latin and means "Medusa's". [Caput medusae] means "Medusa's head". Medusa is a Greek mythological figure, ruler of the Gorgons; in her mortal form she had a head covered with snakes and looking into her eyes would cause an observer to turn into a stone statue. She was killed by Perseus who used a shield to see her reflection without turning to stone and was thus able to cut her head off.

The term [caput medusae] is used in medical terminology to denote a medical sign, a crown of engorged veins that radiate from the umbilicus. These engorged veins are caused by increased hepatic portal pressure (portal hypoertension) which causes retrograde flow in the veins from the abdominal cavity to the superficial cutaneous veins, engorging them.

The caput medusae sign is usually seen in patients with advanced hepatic cirrhosis.

WARNING: The following explicit images show different stages of this sign. Each of the following links will open images in separate screens and web sites: Image 1; Image 2; Image 3; Image 4.

Medusa's head image in the public domain courtesy of Wikipedia. All other images are the property of each website. We only provide the links to them.

Caput medusae

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