How many scientists, physicians, or anatomists have musical pieces written for them? I was so surprised when I found out that there is a musical score entitled “André Vésale” written by Louis-Jean Abadie and published in 1861 in Paris, France. I felt the obligation to research this topic.

There are many people that follow the life and works of Andreas Vesalius, a 16th century anatomist who started the modern scientific approach to human anatomy and medicine. I count myself in this group that includes artists, historians, poets, painters,musicians, medical illustrators, physicians, surgeons, antique collectors, anatomists, etc.

In June 2023, I had the honor of being invited by the University of Antwerp in Belgium to speak at the 2023 Vesalius Triennial Meeting. It was here that I discovered this musical surprise!

One of the events of this meeting was an afternoon concert entitled “Vesalian landscapes in music, poetry, and photographs” by pianist Elke Robersscheuten, and my friend Theo Dirix, who read the poetry. This was accompanied by slides of Vesalian works, and images of the city of Brussels and the island of Zakynthos, Greece. One of the pieces performed by Elke Robersscheuten was “André Vésale”. You can see Elke perform this piece in a video at the end of this article.

With the help of Theo, I started the process of unraveling the story of this musical piece:

Louis Abadie

The author

Abadie, Louis-Jean (c1814-1858). Louis Abadie was a baritone singer. He started performing in the French provinces as member of an opera troupe. In 1842 he settled in Paris where he wrote numerous chansons and romances which were very popular at the Paris salons at the time. He had success as singer and voice teacher in Paris and in 1848 he released records of his songs, which were well received. I have not been able to find copies of these records.

He went back to traveling and singing, with little success and decided to move to Bordeaux, and then back to Paris where he was unsuccessful trying to find a locale that would present his work to the public. He lived in poverty and in early December 1958 he had a stroke and died at 45 years old, leaving a wife and three children. As a side note to his life, many of his works were dedicated or mentioned by name a woman named Jeanne. His wife's name was Marie Jeanne Toussaint.

Seven years after his death, on May 2, 1867, Les Danseurs de Corde.(The Rope Dancers) , an operetta (comedic opera) in two acts for which he had written the music, was performed at the Théâtre des Folies-Saint-Germain.

The lyrics

The poignant lyrics to this work were written by Louis-Adolphe Turpin de Sansay (1832 – 1891) a prolific French dramatic author, chansonnier, and songwriter. He collaborated with musicians with lyrics for their work. The lyrics for “André Vésale” were written in 1860 and published the following year.

The works of Turpin de Sansay were presented in elite places line the Théâtre des Champs-Élysées, the Théâtre des Bouffes-Parisiens, the Théâtre Beaumarchais, and the Théâtre-Lyrique.

The lyrics for “André Vésale” are based on Vesalius being deported to the Greek island of Zakynthos (known then as Zanthe). We now know this is a legend and not true. Following is the French original and a free translation of this work:

The publisher

Étienne Challiot (1837 – 1866) had his office located at 352-354 Rue St Honoré, in Paris, very close to Place Vendôme, Paris. He published books and music sheets. Some of his publications can be found online.

The printer

Almost nothing is known about the printer of this work. A female printmaker, Madame Dinquel, had her printer shop at 276 Rue Sain Honoré, in Paris, very close to the publisher Étienne Challiot. Today, Sapporo, a Japanese restaurant sits at this address.

The musical piece

 Following is a video of pianist Elke Robersscheuten performing "André Vésale" by Luis Abadie.

The original score can be downloaded here. Thanks to IMLSP for preserving this music for posterity. You can click on the image for a larger depiction.

André Vésale sheet music by Luis Abadie. Public Domain

Sources:
1. Biographie universelle des musiciens et bibliographie générale de la musique, Volume 1François-Joseph Fétis Libraire de Firmin-Didot, 1878 Paris
2. Obituary: Courrier de la librairie: journal de la propriété littéraire et artistique pour la France et pour l'étranger. 1858,7/12
3. Necrologie; B. JOUVIN. Théatres (French). Paris: Figaro, 09/12/1858. Article nécrologique dans Le Figaro (Lire en ligne sur Gallica)
4. Obituary: Courrier de la librairie: journal de la propriété littéraire et artistique pour la France et pour l'étranger. 1858,7/12
5. Frédéric Caille, La figure du sauveteur : Naissance du citoyen secoureur en France, 1780-1914, Presses Universitaires de Rennes, 2006, p. 222-224 6. 

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Anterior view of the stomach

The term “lesser curvature” refers to the shorter, curved, and concave right-sided border of the stomach. The lesser curvature extends between the esophagogastric junction superiorly and the pylorus inferiorly.

Although generally curved, the lesser curvature presents with a sharp angulation called the incisura angularis or the angular notch.

The lesser curvature is connected to the liver by a double-layered fold of peritoneum called the lesser omentum. The lesser omentum is composed of two regions:

1. The gastrohepatic ligament, the larger component, found between the lesser curvature and the liver. It includes the pylorus.
2. The gastroduodenal ligament, the smaller component, found between the first portion of the duodenum (superior portion, duodenal ampulla) and the liver. The common bile duct is found between the layers of the omentum.

The image shows the lesser curvature with an animated dashed line. The blue arrow points to the incisura angularis.

Sources:
1 "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
2. "Anatomy of the Human Body" Henry Gray 1918. Philadelphia: Lea & Febiger
Original pastel image by Dr. E. Miranda

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Anterior view of the stomach

The term "incisura" is Latin, derived from the verb [incidere]* meaning "to cut" or [incisura]” meaning a "notch" or indentation in a structure, suggesting a distinctive incision, or cut. The second component, "angularis," is also Latin, derived from "angulus," which translates to "angle." The term "incisura angularis" can be translated as the "angular notch", a term that is also use for this gastric anatomical landmark.

The incisura angularis is a notch located along the lesser curvature of the stomach. Externally, it marks the transition between the body (corpus) and antrum of the stomach, an abdominal viscus. It is related to the gastrohepatic portion of the lesser omentum superolaterally. It should be mentioned that the lesser curvature vascular arcade runs within the lesser omentum, closely related to the gastric lesser curvature.

Found approximately midway between the esophagogastric junction and the pylorus, this external anatomical feature is easily identifiable internally during gastric endoscopy.

Structurally, the incisura angularis is formed by a fold of mucous membrane on the inner surface of the stomach, creating a small recess along the lesser curvature.

The stomach, although it has the same layers as the rest of the GI tract, presents an extra muscular layer in the area of the lesser curvature, which renders this area less distensible forming a muscular channel called the magenstrasse.

The mucosa layer is the deepest of the stomach layer. Within it, three areas of gastric mucosa are usually described: pyloric, transitional, and fundic. The incisura angularis corresponds mostly to the transitional zone. When there are mucosal changes that shown an invasion of another type of mucosa, it can mean preneoplastic changes. For this reason, the incisura angularis is an area that, when biopsied, can show early cancerous changes, as well as muscular atrophy, intestinal metaplasia, and dysplasia.

Preservation of the anatomy of the incisura angularis is critical during a sleeve gastrectomy, the most common bariatric procedure worldwide. The objective of a sleeve gastrectomy is to reduce the size of the stomach by placing a curved staple line along the left border of the magenstrasse, a lesser known gastric anatomy term.

Because of the location of the incisura angularis, improper placement of a straight gastric stapler could cause stenosis or stricture at this level. Another potential postoperative problem in this procedure is gastroesophageal reflux disease (GERD) where some authors have proposed an omentopexy as a way to modify the angle of the incisura angularis.

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. “The Rarely Sampled Incisura Angularis Is Useful for the Detection of Gastric Preneoplastic Lesions” Singhal, A. , Saboorian, H. , Turner, K. , Rugge, M. & Genta, R. (2023). The American Journal of Gastroenterology, 118 (10S), S1407-S1407.
5. “Incisura angularis belongs to fundic or transitional gland regions in Helicobacter pylori-naive normal stomach: Sub-analysis of the prospective multi-center study” Nakajima, S at al Digestive Endoscopy 2021; 33: 125–132
6. “Increasing the angle at the incisura angularis using omentopexy reduces/prevents GERD symptoms five years after laparoscopic sleeve gastrectomy?” Presidential Grand Rounds. Surgery for Obesity and Related Diseases, Volume 18, Issue 8, Supplement, 2022
7. “Gastric POEM to treat incisura angularis torsion after sleeve gastrectomy” Baptista, A; Davila, M; Guzman, M. Endoscopy 2019; 51(04)
8. “Obstruction after Sleeve Gastrectomy, Prevalence, and Interventions: a Cohort Study of 9,726 Patients with Data from the SOReg” Sillen, L; Andersson, E, Edholm, D. OBES SURG 31, 4701–4707 (2021)

Note: Google Translate includes the symbol (?). Clicking on it will allow you to hear the pronunciation of the word.

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[UPDATED] This is a medical term derived from the Latin [incisus] or [incisura], meaning "to cut". The Greek word [Τομή] (tomí) from which the suffixes [-otome], or [-otomy] derive, have a similar meaning.

The root term is [-cis-] and uses of this term include:

• Incision : "To cut in" • Incisive: Something that "cuts in"

• Incisor: Refers to a type of tooth that has a "cutting in" action

• Excision: The prefix [ex-] means "out" or "outside". To cut out, or to extirpate. See the meaning of the suffix [-ectomy] here

• Circumcision: The prefix [circum-] means "around", or "in a circle". To cut around (in a circle)

Note: Google Translate includes the symbol (?). Clicking on it will allow you to hear the pronunciation of the word.

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Lateral view - Human embryo about
eight and a half weeks old

(UPDATED) The term [ventral] arises from the Latin word [venter] and the root term [ventr-] meaning "belly" or "sac". The adjective [ventral] means "towards the front" , or "towards the belly side of the body". The term ventral therefore means "abdomen".

Many use the term [ventral] synonymously with "anterior"; although this is technically correct, the proper term to use when referring to the patient in the anatomical position should be "anterior". In embryology, since the embryo is curved, most of the anterior aspect of the embryo looks towards the abdomen, ergo ventral.

A ventral hernia is any herniation that occurs in the anterior aspect of the abdomen, including Spigelian hernias, omphaloceles, etc.

Other terms that arise from the same root term are [ventricle], meaning "little belly", or "little sac", and [ventricular], meaning "pertaining to a ventricle".

Note: A comment from my friend Dr. Elizabeth Murray: 

"My understanding of "anterior" means "in the direction of movement" for any given organism (and "posterior" means opposite the direction of movement for an organism). Thus, ventral does not ever change for any creature (vertebrate or even invertebrate), as it refers to a body part/surface.  But when considering two-legged and four-legged (or finned) creatures, you see the differences:  Ventral = anterior in us, but in a dog or fish ventral = inferior.

Ventral/dorsal refer to belly/back in any organism, and cranial/caudal refer to head-end and tail-end in any organism -- those four terms refer to body parts.  However, anterior/posterior refer to the way an organism moves in space, and superior/inferior refer to an organism's relationship to the earth/pull of gravity."

An interesting side note: The word [ventriloquist] arises from the root term [-ventri-] from the Latin [venter] and the suffix [-loquist], from the Latin [loquos] and [locutus], meaning "to speak", or "someone who speaks". The term [ventriloquist] means then "someone who speaks from the abdomen (or stomach)". We now know that this is not so, but that is what most people think a ventriloquist does!

Sources:
1 "Tratado de Anatomia Humana" Testut et Latarjet 8 Ed. 1931 Salvat Editores, Spain
2. "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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Right homonymous superior quadrantanopia

[Quadrant]-[an-[opia ] The root “quadrant” is based on the Latin "Quadri" meaning "four" and “Quarto”, meaning one fourth. The suffix anopia is composite: “an” meaning “without or absence of”; and opia (or “opsia”) relate to vision, based on the Greek word “οπτασία”  (optasía) meaning “sight”.  Literally, the term quadrantanopia (or quadrantanopsia) means “absence of sight in a quadrant”.

It can be associated with a lesion of an optic radiation of the internal capsule. While quadrantanopia can be caused by lesions in the temporal and parietal lobes of the brain, it is most commonly associated with lesions in the occipital lobe.

What is interesting are the terms “homonymous” and “heteronymous” used to describe variants of quadrantanopia. Each eye has four quadrants and two visual fields, right and left.  A homonymous quadrantanopia means that the patient has lost the vision of a quadrant in the same field in each eye (right-right or left-left), heteronymous means that the patient has lost the vision of a quadrant in the opposite field of each eye (right-left or left-right).

The fact is that the term homonymous means “same name” not same side, and the word heteronymous means “different name”, from the Greek “όνομα” “nym” meaning name. For further confirmation, try finding the meaning of synonym, antonym, acronym, patronymic, etc.

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. "Dorlands's Illustrated Medical Dictionary" 26th Ed. W.B. Saunders 1994

Note: Google Translate includes the symbol (?). Clicking on it will allow you to hear the pronunciation of the word.
Image courtesy of Mudsk, CC0, via Wikimedia Commons.

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