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 word [bregma] is Greek and means "the front of the head". It is actually the point of intersection of the the coronal and sagittal sutures. The coronal suture is the articulation or joint between the frontal and parietal bones, and the sagittal suture is the median joint between both parietal bones.
The term was first used in anatomy as a craniometric point by Paul Broca (1824 - 1880). The image shows a superior view of two heads and the location of the coronal and sagittal sutures. The bregma is the point of intersection of these two articulations.
Click on the image for a larger view. 1 = coronal suture 2 = sagittal suture 3 = lambdoid suture. The bregma is the point of intersection of 1 and 2
Original image courtesy of Wikipedia
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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
Images from the History of Medicine
Marie-Francois Xavier Bichat (1771 - 1802). French physician, surgeon, anatomist and physiologist, Marie-Francois Xavier Bichat was born in the village of Thoirette. His father was a physician, influencing his early instruction and vocation. In Lyon he studied anatomy and surgery. At 28 years of age Bichat was appointed physician to the Hôtel (Hospital) Dieu. His life was influenced by his mentor, Pierre-Joseph Dassault (1738 - 1795). Upon his mentor's death Bichat took upon him to continue and finish his work, while supporting his mentor's family.
Bichat is know for the concept of the body composed of distinct tissues, which he originally called "membranes". Without the aid of the microscope Bichat described 21 different tissues and is considered the founder of the science of histology. His name is preserved in many eponymic structures such as Bichat’s fossa (pterygopalatine fossa), Bichat’s buccal fat pad, Bichat’s foramen (cistern of the vena magna of Galen), Bichat’s ligament (lower fasciculus of the posterior sacroiliac ligament), and Bichat’s tunica intima (tunica intima vasorum).
Xavier Bichat also contributed to a newer description of the humoral physiological theory, later becoming the basis of hematology. He was also interested in the description of life and death, proposing the existence of an "organic life" and an "animal life". An interesting note is that Bichat died because of an infection he acquired while dissecting a cadaver. Remember that at the time, no embalming was used!
Today Bichat's name is almost forgotten, although in some countries the buccal fat pad is still called "Bichat's fat pad" In many Spanish-speaking countries this structure is referred to as "la bola grasa de Bichat", and many still refer to the removal of this fat pad as "Bichectomy". For an image of the before and after of the procedure, click here.
Sources:
1. "Marie-Fran?ois Xavier Bichat (1771-1802) and his contributions to the foundations of pathological anatomy and modern medicine" Shoja M.M., Tubbs R.S., Loukas M., Shokouhi G., Ardalan M.R.(2008) Annals of Anatomy, 190(5),413-420
2. "Physiological Researches on Life and Death" Bichat, Marie-Francois Xavier, 1827. Translated from French by F. Gold. Richardson and Lord, Boston.
3. "A Historical Perspective: Infection from Cadaveric Dissection from the 18th to the 20th Centuries" Shoja, MM et al. Clin Anat (2013) 26:154-160
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This complex medical word is formed by the combination of two root terms: [dacry-] meaning "tear" and [-cyst-], meaning "sac". The combined root [dacryocyst-] means "tear sac" or better, "lacrimal sac" (the Latin word [lacrima] means "tear"). This medical word also has a combined suffix: [-(o)lith], meaning "stone", and [-iasis], meaning "disease or condition".
The word [dacryocystolithiasis] means then, "a condition or pathology of stones (calculi) in the lacrimal sac". The procedure to remove the stones would then be called a [dacryocystolithectomy].
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The Hamate bone is one of the four bones that comprise the distal row of the carpus or carpal bones that form the wrist. The name arises from the Latin [hamatus], meaning "hooked". The hamate bone has a distinct hook-like bony process in its volar (anterior) surface, known as the hamulus. This bone is also known as the "unciform bone" (from the Latin [uncus], also meaning "hook") or the os hamatum.
The lunate bone has a wedge-like shape and six surfaces (as a die). It articulates with five bones, including the lunate bone, capitate, triquetrum, and the fourth and fifth metacarpal bones.
The hook of the hamate bone is one of the distal boundaries of the carpal tunnel and serves as a pulley for the tendons of the fourth and fifth flexor tendons. It also serves as one of the points of muscular attachment for the following muscles: flexor carpi ulnaris, flexor digit minimi, and opponens digiti minimi. Because of its projection into the palm of the hand, the hamulus is involved in injuries in sports that require the athlete to use an accessory, as in racquetball, tennis, baseball, golf, etc.
The accompanying image shows the anterior (volar) surface of the wrist.
Image modified from the original: 3D Human Anatomy: Regional Edition DVD-ROM Courtesy of Primal Pictures
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The word itself arises from the Greek. The root term [-phleb-] derives from [φλέβα] (phleba) meaning "vein", and the suffix [-otomy], meaning "to cut" or "to open". Let's not forget that the suffix component [-y] means "process of". So [phlebotomy] is the "process (or action) of cutting open a vein"
For centuries a standard practice in medicine was to "bleed" a patient, by opening a vein under controlled conditions and letting some blood flow. The practice was known as "bloodletting" or phlebotomy. Not in use today, it is said that excessive bloodletting contributed to the death of George Washington, having removed 5 pints of blood in one day!. Today the professionals who draw blood are called "phlebotomists"
The image (circa 1860) depicts one of the only known three photographs of a bloodletting procedure. Observe the lack of aseptic technique.
Image in the public domain, by The Burns Archive, courtesy of Wikipedia.org.
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The iliopubic tract is a thickening of the transversalis fascia found in direct relation, immediately posterior to the inguinal (Poupart's) ligament. As the inguinal ligament, the iliopubic tract extends between the anterior superior iliac spine (ASIS) superolaterally, and the pubic tubercle inferomedially.
This obscure structure has been brought up to light because it is one of the anatomical landmarks used in laparoscopic herniorrhaphy. When securing a mesh to reinforce the posterior abdominal wall, and also prevent mesh migration, the surgeon will place sutures, tacks, or staples in this structure. Since the iliopubic tract (posteriorly) and the inguinal ligament (anteriorly) are so close together, they are both secured when doing this procedure.
The image shows the location of the inguinal ligament. The iliopubic tract is immediately posterior to it.
Image property of: CAA, Inc. Artist: David M. Klein