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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A Moment in History

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81


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The anatomical laws of Miranda

Intended initially as a humorous view of anatomy, the "Anatomical Laws of Miranda" have a very serious objective. They support the fact that in every interventional case the operator should be extremely aware of the potential anatomical variations present. They also point to the fact that in real life, human anatomy does not look exactly like the anatomy books, models or prosections, and practice in the art of dissection and constant study are needed to ensure the proper identification of anatomical structures in surgery.

These laws are not original, they have been partially expressed at one time or another by several anatomists and surgeons, including Dr. Aaron Ruhalter and Dr. Robert Acland. What I have done is put them officially together and create the corollaries.

Efrain A. Miranda, Ph.D.
The anatomical laws of Miranda
  • 1. The only constant in anatomy is variation
  • 2. Nothing in the human body is really colored... or labeled
  • 3. No anatomical structure has the moral obligation to be where they are supposed to be

There are corollaries to these laws and visitors to this web site are invited to provide us with their thoughts and addenda to the anatomical laws.

Corollaries:

1a. In the case of the so-called "anatomical constants"...law number 1 also applies

2.a. Black and white anatomy books are sometimes better to study than color atlases

2.b. Arteries are not red, nerves are not yellow, and lymphatic vessels are definitely not green!

2c. Nothing looks exactly like the anatomy books, computer simulations, or models. Food for thought for those medical schools that are eliminating dissection from their medical curricula.

3.a. This leads to that dreadful "Oooops!" sometimes heard in surgery

3.b. This also leads to the comment "It HAS to be around here!", which is dreadful if the "here" is a patient in surgery. 

3c. It is interesting that several medical schools are moving away from cadaver disection in first year medical school and using models or computer simulations instead. No computer simulation will give the medical student the detail, variations, and feel of the tissues as actual hands-on experience. I am sure no one wants a surgeon whose first view of the internal aspect of a human body is a living patient...on the surgical table.

If you want to download a PowerPoint slide of the "Laws of Miranda" click here and follow the instructions of your browser.

A great resource to study on anatomical variations is the Illustrated Encyclopedia of Human Anatomic Variation, which was originally hosted by the University of Iowa. Today it resides at anatomyatlases.org, and the curator is Ronald A. Bergman, Ph.D.

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