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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External view of the occipital bone
The term [inion] is Greek [ινιον] and originally referred to the posterior aspect of the neck or occiput and its musculature and strength, as mentioned in the Iliad.
The term fell in disuse for hundreds of years, until it was resurrected by Peter Paul Broca (1824-1880) as a craniometric point. The inion is the midline protuberance in the posteroinferior aspect of the external surface of the occipital bone. Today, in most anatomy texts the inion is referred to as the "external occipital protuberance"
The inion is found at the intersection of three bony lines that are easily palpable, the bilaterally situated superior nuchal line, and the median nuchal line. It is labeled "Ext. occip. protuberance" (see accompanying image). There is a corresponding internal occipital protuberance in the internal aspect of the occipital bone.
Sources:
1. "The Origin of Medical Terms" Skinner, HA 1970 Hafner Publishing Co.
2. "Medical Meanings - A Glossary of Word Origins" Haubrich, WD. ACP Philadelphia
3 "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
4. "Anatomy of the Human Body" Henry Gray 1918. Philadelphia: Lea & Febiger
Image modified by CAA, Inc. Original image by Henry Vandyke Carter, MD., courtesy of bartleby.com
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The word [sesamoid] means "similar to a sesame". First used by Galen c.180AD, he describes small ovoid bones that are "similar to a sesame seed", referencing the seed of the plant sesamum indicum, the oil of which was used as a laxative at that time.
Sesamoid bones are found in the tendons of some muscles and are mostly inconstant. Largey and Bonnet proposed a classification for these bones as: accessory, capsuloligamentous, intratendineous, and mixed.
Of special interest to this article are the sesamoid bones found within the two tendons of the flexor hallucis brevis muscle in the base of the foot (see accompanying X-ray image). These bones, especially the medial sesamoid bone, was attributed religious, mystical, and magical powers since ancient times. This is due to the fact that this small bone is highly resistant to natural decomposition. A Hebrew medical text dated 210 BC, attributed to Ushaia presented a small bone he called "luz" as the "depository of the soul". Many other authors, including Vesalius (who called it Albadaran), believed that upon resurrection, the whole body could reform from this "seed" bone.
This belief was later reinforced by religious texts into the early Renaissance which stated that this bone was indestructible and its presence was enough to guarantee resurrection for believers.
Note: The original X-ray was published here courtesy of Wesley Norman, PhD in his website. The website is no longer available, so the image is now in the public domain via www.archive.org.
Sources:
1. "Les os sesamoides de l’hallux : du mythe a`la fonction" Largely,A; Bonnel, BE Med Chir Pied 2008 24: 28–38
2. "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
3. "De Humani Corporis Fabrica" Vesalius, Andrea. 1543 Oporinus
Thanks to the first year medical students at the University of Cincinnati who inspired this article. Dr. Miranda
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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.
Ignaz Semmelweis
Ignaz Semmelweis, MD (1818- 1865). Born in Budapest as Ign?c F?l?p Semmelweis, he started his university studies as a lawyer, but changed to Medicine and in 1844, at the age of 26, attained his MD degree. in 1847 he was appointed as an assistant in Obstetrics, almost at the same time of the death of a friend (Kolletschka, a pathologist) who died of what appeared to be "puerperal fever", also known as "childbed fever" after being accidentally stabbed by a knife during the autopsy of a female who had died of that disease. Semmelweis reasoned that the disease somehow was transmitted via the wound and started a crusade to have surgeons and students clean their hands with a carbolized solution before examining a healthy pregnant woman.
Although the obstetric wards under his care reduced the rate of this disease to almost nothing, Semmelweis endured criticism from his teachers, colleagues, and peers, and he did not make any friends by calling "murderers" those who did not follow his ideas. murderers". An excerpt of a letter to one of this detractors reads: "I denounce you before God and the world as a murderer and the history of puerperal fever will not do you an injustice when for the service of having been the first to oppose my life-saving technique it perpetuates your name as a medical Nero". He did not publish his findings until later in life, and then received even more criticism.
In 1865 was committed to an mental asylum only to die a few days later. He was only 47 years old. The same year he died Joseph Lister performed the first operations using antiseptic technique.
Sources:
1. Newsom S." Pioneers in Infection Control - Semmelweis, Ignaz Philipp". The Journal of hospital infection. 1993-03-01;23:175-187.
2. Ellis, H. (2008). Ignaz Semmelweis: tragic pioneer in the prevention of puerperal sepsis. British Journal Of Hospital Medicine (London, England: 2005), 69(6), 358
3. " A Corner of History: Ignaz Philipp Semmelweis" Wynder, EL Prev Med 3" (4) Dec 1974, 574-580
4. "Ignaz Semmelweis; a hand-washing pioneer" P. Rangapa JAPI May 2010 58:328
Original image courtesy of Images from the History of Medicine
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The term [muscle] arises from the Latin word [musculus] which derives from the Latin term [mus] meaning "mouse". We can only guess that, just as today, Roman fathers would show their biceps and forearm muscles to their children and tried to make them believe a mouse had gotten under their skin!. The root term for muscle is [-my-]. The corresponding combining form is [-myo-].
There are three types of muscle in the human body:
- Skeletal muscle: it is typical of muscles related to bones (skeletal) and they are voluntary.
- Smooth muscle: found in organs that act without volition (involuntary), such as the digestive system and glands.
- Cardiac muscle: found exclusively in the heart.
Skeletal and cardiac muscles have distinct striations visible under a microscope.
Muscles are formed by subunits, each one surrounded by a named membrane. One of the suffixes that means layer or membrane is [-sium]:
- Epimysium: Epi=outer; my=muscle; sium=membrane. The outer or external membrane (layer) of a muscle
- Perimysium: Peri=around; my=muscle; sium=membrane. A membrane around a muscle
- Endomysium: Endo= inner or internal; my=muscle; sium=membrane. The inner or internal membrane of a muscle-
Original image courtesy of Wikipedia. Click on the image for a larger version.
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The trabeculae carnae is a meshwork of fleshy cords found in the inner aspect of the right and left ventricles of the heart.
The Latin term [trab] means "beam", and [trabeculum] refers to the group of beams that supports a roof, like an intertwined network. The plural for of [trabeculum] is [trabeculae].
The second term [carnae] is Latin for "meaty". The meaning of [trabeculae carnae] is the "meaty meshwork".
The trabeculae carnae are more evident and larger in the left ventricle than in the right ventricle, and larger and more complex towards the cardiac apex. The accompanying image shows the dissection of a human heart exposing the trabeculae carnae in the right ventricle.
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Image property of: CAA, Inc. Photographer: David M. Klein
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Although not a medical root term, the root [-nym-] arises from the Greek [onoma] meaning "name". There are many terms that incorporate this root:
- Eponym: Use of a proper name to denote a structure
- Eunym: [Eu-] is a prefix that means "good", so it imeans a "good name". Also written as "euonym"
- Homonym: Same name
- Synomym: "A name with the same sense, or same meaning"
- Antomym: From the Greek [ant- and anti] meaning opposite. An opposite name
- Anonym: From the Greek [an- and ano-] meaning "without". Without a name (anonymous)
- Pseudonym: From the Greek [Pseudo-] meaning "false". A false name
- Toponym: From [topos], meaning place. The name of a place or location