Medical Terminology Daily (MTD) is a blog prepared by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. We will post a workweek daily medical or surgical term, its 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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A Moment in History

Jacobus Silvius Ambianus

Jacobus Sylvius
(1478 - 1555) 

French physician, teacher, and anatomist, Sylvius was born in poverty as Jacques Dubois, in the city of Louisville, near Amiens. He would eventually become known as Jacobus Sylvius Ambianus. In spite of his humble beginnings Sylvius entered the College of Tournay. Too poor to continue his studies he started to instruct in anatomy, which helped him earn enough to obtain a bachelor’s degree in Medicine in 1531 in Montpellier.

Sylvius returned to Paris as a demonstrator in anatomy, where he excelled. He had many famous students, among them was Andrea Vesalius. Sylvius followed strictly the teachings of Galen, a situation that eventually caused not only his downfall, but enmity with Vesalius and others. Sylvius was also of the opinion that the student of anatomy should learn from dissection as well as from the books. One of Sylvius’ most important achievement was that he added to the Galenic numerical description by numbers, a descriptive nomenclature creating many names in used today such as brachialis, tibial, peroneus, scalene, serratus, biceps, triceps, etc. He is also responsible for many other names such as femoral, popliteal, subclavian, phrenic, axillary, spermatic, epiploic, etc.

Sylvius was a controversial man. He was known for being greedy, a miser, and the use of foul language, but at the same time he wrote a book to guide the poor student who wanted to get through Medical School. He was finally appointed professor of Medicine at the Royal College of Paris, a position he held until his death in 1555.

Sylvius was so enraged with Vesalius’ denouncement of Galen as being wrong, that he started a personal war against him including sending letters to the King and through public letters where he called Vesalius a madman (vaesanus), plus “purveyor of filth and sewage, pimp, liar, and various epithets unprintable even in our own permissive era” (excerpt from Magner, 1992)

Although many attribute the eponyms of the lateral cerebral sulcus (Sylvian fissure) and the cerebral aqueduct (aqueduct of Sylvius) to Jacobus Sylvius, these two structures are actually named after Franciscus Sylvius (1614 – 1672) a German anatomist. On top of this, some of the structures actually discovered by Jacobus Sylvius like the incomplete valve found at the junction of the inferior vena cava and the right atrium, named after Bartholomew Eustachius (c.1520 - 1574).

Sylvius’ contribution to anatomy is immeasurable, but his personality traits have made him lose status and almost forgotten.

Sources:
1. “Advice for Poor Medical Students: Sylvius, J. Translated by O’Malley CD J Hist Med 1962 17:141-151
2. “A Historical Lesson from Franciscus Sylvius and Jacobus Sylvius” Bakkum DC (2011) J Chir Hum 18:94-98
3. “A Historical Mistake: The aqueduct of Sylvius” Leite Dos Santos, AR et al Neurosurg Rev (2004) 27: 224-225
4. “Jacobus Sylvius (Jacques Dubois) 1478-1555 – Preceptor of Vesalius” JAMA (1966) 195 13; 1147
5. "Andreas Vesalius; The Making, the Madman, and the Myth" Joffe, Stephen N. Persona Publishing 2009
6. “A History of Medicine” Magner, LN Ed. M Deckker Pub 1992

Original image courtesy ofImages from the History of Medicine


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Ligament of Treitz

The ligament of Treitz is a fold of peritoneum over the suspensory muscle of the duodenum. This muscle is also known as the "muscle of Treitz" or "musculus suspensorius duodenii". This muscle was first described in 1853 by Dr. Václav Treitz. 

The muscle has an unusual in structure in that it is formed by a tendon with two muscular ends (see image #1) of dissimilar embryological origin and function. The superior muscular component is skeletal (voluntary) muscle and arises as a slip of muscle (Hilfsmuskel) from the right esophageal crus of the respiratory diaphragm, as well as muscular and ligamentous fibers arising in the region of origin of the celiac trunk and superior mesenteric artery. The inferior portion of the muscle is smooth (involuntary) muscle and has been described as continuous with both the longitudinal and circular muscle layer of the intestine at the duodenojejunal junction.

The ligament of Treitz is an anatomical landmark used by anatomists and surgeons to denote the duodenojejunal junction and the point where the small intestine passes from retroperitoneal duodenum to intraperitoneal jeunum. Surgeons use the ligament of Treitz to measure the jejunum to decide where to perform an anastomosis.

Suspensory muscle of the duodenum 1. skeletal muscle 2. tendon 3. smooth muscle
Click on the image for a larger version
Original image by Dr. Vaclav Treitz
Click on the gray bar below the image to see the original sketch published by Dr. Václav Treitz in his 1853 publication "Ueber einen neuen Muskel am Duodenum des Menschens" (On a new muscle in the duodenum of man). The 'muscle of Treitz" is marked by an arrow.

Clinical anatomy, pathology, and surgery of the gastrointestinal tract are some of the many lecture topics developed and delivered to the medical devices industry by Clinical Anatomy Associates, Inc.

Sources:
1.
"Clinically Oriented Anatomy" Moore, KL. 3r Ed. Williams & Wilkins 1992
2. "The origin of Medical Terms" Skinner, AH, 1970
3. "The suspensory muscle of the duodenum and its nerve supply" Jit, I.; Singh, S. J. Anat. (1977), 123, 2, pp. 397-405
4. "Anatomical and functional aspects of the human suspensory muscle of the duodenum." Costacurta, L. Acta Anat (Basel). 1972;82(1):34-46
Image property of:CAA.Inc. Artists:Dr. E. Miranda and D.M. Klein