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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Vesalius, Sylvius, Galen, and the “Epistle on the China Root”

UPDATED: Scientific thought today is a given. Today most of us believe something only after it is proven factually. A scientist is recognized by the capacity to change a position if the appropriate experiments, demonstrations and facts against their position are proven. A scientist holds a healthy position of doubt and even if their positions are proven for a long time, they are willing to accept a scientific counterproposal.

When a belief or a position is supported only by a belief without proof, then it falls into the realm of suppositions and religion. In this article I will not discuss this.

The above is written to support why at the time Andrea Vesalius’ opus magnum “De Humani Corporis Fabrica, Libri Septem” was condemned by so many, and how Vesalius’ words ushered the beginnings of scientific thought.

Anatomical and medical teachings flourished with the Greeks and attained its peak with Galen of Pergamon (129AD - 200AD), called by many (Vesalius included) “prince of physicians”. Galen was known for his many published works and his writings were translated into Arabic. This was important, because with the invasion of Rome of Greece many of the published works were lost and later the only way to read Galen was to translate his works back into Greek or Latin. Also many books were lost during the Dark Ages.

Title page of the Epistle on the China Root by Andreas Vesalius
After the Dark Ages decline of Medicine, the “light” of the Renaissance brought with it the belief that the Ancient Greeks were never wrong and that if anything was wrong, it was the quality of the translation and the interpretation of the works.  Early in his career and because of his knowledge of languages, Vesalius was one to work as a translator for commentaries that were made on Galen. Because of his personal dissection skills and his direct observation of the human body Vesalius started to encounter a problem: what was being taught as human anatomy by Galen’s works was wrong. In many cases Vesalius found clear evidence that Galen used goat, dog, and ape anatomy instead of human anatomy to write his works. This was a slow process of breaking with Galenic teachings. Even in the first edition of the Fabrica (1543) Vesalius, even questioning Galen, would not go too far.

In 1540, three years before the publishing of the Fabrica, Vesalius performed a public anatomy in Bologna. There is a well-written and translated diary of the dissection published by Baldasar Heseler, which many say earned him a place in the title page of the Fabrica. Heseler describes Vesalius’ dissection and lectures as well as the fierce discussions between the host, Matthaeus Cortius (1475 – 1542) and Vesalius. The elderly Cortius, Galen’s book in hand, discussed the impossibility of what Vesalius was demonstrating, arguing that Galen “just cannot be wrong”. This discussion was reenacted during one of the lectures by Rebecca Messbarger, Ph.D. at the “Vesalius and the Invention of the Modern Body” interdisciplinary symposium.

With the publication of the Fabrica the reaction of many Galenists was fierce, probably none more caustic than Jacobus Sylvius (1478 - 1555). Sylvius was a teacher of Vesalius and saw his anti-Galenic position as treason. Known for his propensity to foul language, Sylvius started a personal was against Vesalius, even publishing a small book where he called Vesalius a “madman” plus “purveyor of filth and sewage, pimp, liar, and various epithets unprintable even in our own permissive era” (excerpt from Magner, 1992). Sylvius’ publication was entitled “Vaesani cuiusdam calumniarum in Hippocratis Galenique rem anatomicam depulsio”  (A refutation of calumnies by a certain madman against Hippocratic and Galenic anatomy). Garrison (2015) explains the play on words where Sylvius  transforms “Vesalii” into “Vaesani” – the madman.

Initially Vesalius tried to be conciliatory and scientific, trying to persuade his opponents with the facts as seen in the human body. His final argument was published in October 1546 in “Epistola rationem modumque propinandi radices Chynae dedocti“ a publication known to many as the “Epistle (letter) on the China Root”. Vesalius used the excuse of writing on a controversial medicinal plant as the venue to explain in detail the reasons why he deemed Galen wrong in many aspects of human anatomy. The “Epistle on the China Root” was printed in Basel by Johannes Oporinus and the introduction was written by Andreas Vesalius’ brother Franciscus. The "Epistle on the China Root" has recently been translated (2015) by Dr. Daniel Garrison, one of the authors of the "New Fabrica".

Personal note: It is clear to me that Vesalius is not the first to promote scientific thought processes, but he is the one that used human anatomy to start the debunking (and acceptance) of portions of what was known at the time in that particular arena. Dr. Miranda

Sources
1. “Jacobus Sylvius (Jacques Dubois) 1478-1555 – Preceptor of Vesalius” JAMA (1966) 195 13; 1147
2. "Andreas Vesalius; The Making, the Madman, and the Myth" Joffe, Stephen N. Persona Publishing 2009
3. “A History of Medicine” Magner, LN Ed. M Deckker Pub 1992
4. “Vesalius: The China Root Epistle. A New Translation and Critical Edition” Garrison DH, 2015 Cambridge University Press
5. “Andreas Vesalius' first public anatomy at Bologna 1540 – An Eyewitness Report by Baldasar Heseler” Eriksson, R 1959 Almquist& Wiksells Boktryck

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