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The Virchow-Troisier node: A historical note
OUR SURGICAL HERITAGE
The Virchow-Troisier Node: a Historical Note
Leon Morgenstern, MD, Los Angeles, California
Among the curiosities of eponymy must be included the eponyms “Virchow’s node” and “Troisier’s node,” or as it is sometimes called, the node of VirchowTroisier. All three eponyms refer to carcinomatous involvement of the left supraclavicular nodes secondary to metastatic carcinoma, principally from a lesion primary to the stomach. In the United States and in most continental countries these nodes are known as Virchow’s nodes. In France, such nodal involvement still evokes the eponym “the node of Troisier.” There is no doubt as to the primacy of Virchow’s description. In 1848 Virchow [I] wrote “. . . Thus, particularly in cancer of the stomach, the pancreas, the ovaries, etc. the process gradually spreads from the glands of the lower abdomen to the glands in the posterior mediastinum along the ductus thoracicus and finally involves the jugular glands around the junction of the ductus thoracicus (in the left supraclavicular fossa) . . . .” Charles-Emile Troisier (1844-1919), prominent French clinician and anatomic pathologist, wrote his description of the nodes in 1886 [2] during his tenure as a junior faculty member (agregi! medicin) of the Hospital Saint-Antoine in Paris. In that year he described three cases of carcinoma of the stomach in which the left supraclavicular nodes were involved. Although he attributed an earlier allusion (in 1863) to this physical finding to Henoch, Troisier stated he From the Departments of Surgery, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California. Reprint requests should be addressed to Leon Morgenstern. MD, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048.
Volume 138, November 1979
searched in vain for mention of the nodes in Virchow’s work. Troisier expanded his studies in several subsequent publications. In 1901 he was elected to the French Academy of Medicine and served as Chief of Medicine at a number of Paris hospitals up to the year of his death in 1919. The obituary in La Presse Medicale at that time [3] refers to the “ganglion of Troisier” as “a supreme honor and just consecration of a life of work, assuring our mourned friend a perennial name.” The question of primacy is moot. A trace of nationalism may accord more eponymic fame in one country than another, but usage determines understanding whatever language is spoken. In the United States the name Troisier draws only a blank stare when mentioned. In the interest of universality and because both individuals were superb physicians, this note is respectfully written. Summary
A historical note is presented on the VirchowTroisier node, which is known as Virchow’s node in the United States and most continental countries and as the node of Troisier in France. References 1. Virchow RLK: Zur diagnose der krebse im unterleibe. Med Ref 45: 248, 1848. 2. Troisier CE: Les ganglions sus-claviculaires dans le cancer de I’estomac. Societe Medicale des Hopitaux de Paris. Bulletins et Memoires 3: 394, 1666. 3. Letulle M: E. Troisier (1644-1919). La Presse Medicale 28: 33, 1920.
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The Virchow-Troisier Node: a Historical Note
Leon Morgenstern, MD, Los Angeles, California
Among the curiosities of eponymy must be included the eponyms “Virchow’s node” and “Troisier’s node,” or as it is sometimes called, the node of VirchowTroisier. All three eponyms refer to carcinomatous involvement of the left supraclavicular nodes secondary to metastatic carcinoma, principally from a lesion primary to the stomach. In the United States and in most continental countries these nodes are known as Virchow’s nodes. In France, such nodal involvement still evokes the eponym “the node of Troisier.” There is no doubt as to the primacy of Virchow’s description. In 1848 Virchow [I] wrote “. . . Thus, particularly in cancer of the stomach, the pancreas, the ovaries, etc. the process gradually spreads from the glands of the lower abdomen to the glands in the posterior mediastinum along the ductus thoracicus and finally involves the jugular glands around the junction of the ductus thoracicus (in the left supraclavicular fossa) . . . .” Charles-Emile Troisier (1844-1919), prominent French clinician and anatomic pathologist, wrote his description of the nodes in 1886 [2] during his tenure as a junior faculty member (agregi! medicin) of the Hospital Saint-Antoine in Paris. In that year he described three cases of carcinoma of the stomach in which the left supraclavicular nodes were involved. Although he attributed an earlier allusion (in 1863) to this physical finding to Henoch, Troisier stated he From the Departments of Surgery, Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California. Reprint requests should be addressed to Leon Morgenstern. MD, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048.
Volume 138, November 1979
searched in vain for mention of the nodes in Virchow’s work. Troisier expanded his studies in several subsequent publications. In 1901 he was elected to the French Academy of Medicine and served as Chief of Medicine at a number of Paris hospitals up to the year of his death in 1919. The obituary in La Presse Medicale at that time [3] refers to the “ganglion of Troisier” as “a supreme honor and just consecration of a life of work, assuring our mourned friend a perennial name.” The question of primacy is moot. A trace of nationalism may accord more eponymic fame in one country than another, but usage determines understanding whatever language is spoken. In the United States the name Troisier draws only a blank stare when mentioned. In the interest of universality and because both individuals were superb physicians, this note is respectfully written. Summary
A historical note is presented on the VirchowTroisier node, which is known as Virchow’s node in the United States and most continental countries and as the node of Troisier in France. References 1. Virchow RLK: Zur diagnose der krebse im unterleibe. Med Ref 45: 248, 1848. 2. Troisier CE: Les ganglions sus-claviculaires dans le cancer de I’estomac. Societe Medicale des Hopitaux de Paris. Bulletins et Memoires 3: 394, 1666. 3. Letulle M: E. Troisier (1644-1919). La Presse Medicale 28: 33, 1920.
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