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The modern view that the human body is composed of tissues and body fluids, and that there are four basic tissue types, may be a more significant departure from Artistotle's homoeomeres, and from Bichat's membranes and tissues, than commonly appreciated. The older concepts described these body parts as structural and functional parts of organs, whereas it is now commonplace to consider a tissue to be a grouping of similar cells with a variable amount of extracellular matrix. The development of the microscope as a useful tool in human anatomy shifted focus from tissues to cells and led to changes in the definition of tissue and the classification of tissues. Not all of these changes have been consistent with observable facts: many tissues contain diverse cell types, not all "connective tissues" are proper connective tissues, and some specialized tissues are not easily classified as subtypes of one of the four basic types. Here we propose corrective measures, including re-recognition of compound tissues, cataloging all adult human tissue types, and increasing the emphasis on function during the construction of a complete taxonomy of human adult tissues. Specific problems in the current scheme and a preliminary reclassification of human adult tissues are discussed.

Most of the terms in Terminologia Anatomica are arranged by organ systems (systemata); however, the names for these systems are often used by physiologists and other biomedical scientists for related functional systems. These functional systems may differ in their composition from the anatomist's organ systems. In addition, many functional systems have been described that do not correspond to organ systems. Similarly, the non-standard anatomical terms alimentary tract, respiratory tract, urinary tract and reproductive tract lack a consistent meaning in the biomedical sciences. For clear communication, one should be cautious when using terms that may have other meanings in other disciplines. This appears to be particularly true for high level terms in the nomenclature of systematic anatomy.

Introduction Communication in the biomedical sciences and clinical practice would be clearer if everyone used the same set of technical terms. Technical vocabularies, such as international standard terminologies, are attempts to avoid common linguistic problems, such as synonymy (many names for a single entity) and polysemy (many meanings for a single term). Materials and methods Efforts made in human anatomical nomenclature since the late 19th century to deal with these issues were reviewed. Results The new designations official term, equivalent term, synonym and related term are defined, and current challenges (e.g., eponyms) are identified. Discussion The addition of synonyms and related terms to the international standard anatomical terminology allows indexing of these terms to the official terms and evaluation of the relationships between terms.

Revision of the international standard anatomical terminology is required periodically to add names for new entities, delete archaic terms, and correct errors in existing terms. In addition to a small set of nomenclature rules, three principles have guided revisions: names should not be changed unless they are wrong; corrections of perceived errors should not be pedantic; and inclusion of every minor structure should not be attempted. These principles have served well, and are expected to continue to do so, but they have also proven to be subjective because their application through the history of the international terminology has varied. Specific efforts to deal with existing problems and new organizational initiatives to prevent future issues are presented. Clin. Anat. 33:327-331, 2020. © 2019 Wiley Periodicals, Inc.

Textbooks frequently report that there are 206 human bones, or 200 bones and 6 auditory ossicles. The human bone counts in history and within adulthood were reviewed. Tallies of 197 to 307 bones have been reported over the past several centuries. The relatively low modern reckoning of 206 was due to exclusion of teeth and sesamoid ossicles, and to reassessments of the hyoid, sacrum, coccyx, and sternum as unitary bones. An audit of bone counts during adulthood failed to confirm a rational justification for the total of 206. The number is higher in young adults and lower in the elderly. Difficulties in establishing a definitive bone count include individual differences and the inconsistency of viewing the adult cranium as a collection of 21 bones. Clin. Anat. 33:187-191, 2020. © 2019 Wiley Periodicals, Inc.

The frequency of diminutives in anatomical Latin has often been noted to be high, but that is not unusual in postclassical Latin. Although the connotation of "little" is well known, many of the diminutives in anatomical Latin do not have that meaning. The morphology of regular, irregular, and secondary diminutives is presented, along with that of adjectival forms of diminutives. Several transgendered and malformed diminutives are discussed. Clin. Anat. 31:1100-1103, 2018. © 2018 Wiley Periodicals, Inc.

Future revisions of anatomical terminologies will have to give more consideration to the relationships between terms and referents, and the relationships between referents, because computer applications require greater precision. Median anatomical entities and paired entities that closely flank the median plane present common problems in nomenclature, semantics, and ontology. Some of these problems represent vestiges of usage in classical Latin. For example, the use of plural words for polite names of some body parts, and singular words for euphemisms for naughty words. Clin. Anat. 32:22-24, 2019. © 2019 Wiley Periodicals, Inc.

Spelling variants are common in Latin anatomical terms. Some of these variants cause confusion with respect to the meaning of the word by altering the base of the word to resemble a different word base. Thus these variants should be considered errors, comparable to errors in declension of nouns and adjectives, and errors in the formation of neologisms. Use of correct Latin words in Latin anatomical terms should increase the rigor, stability, and universality of the nomenclature. Clin. Anat. 31:77-80, 2018. © 2017 Wiley Periodicals, Inc.

This is the first in a short series about orthography in anatomical Latin. Although phonology is an important aspect of diphthongs and digraphs, the focus here is on spelling, not the more complicated topic of pronunciation. Recommendations are made for standard spellings of words that contain or may appear to contain diphthongs in Latin anatomical words or their ancient Greek sources. Ligatures and diaereses (typographical symbols that were developed after the classical period) are not recommended for use in anatomical Latin terms. Clin. Anat. 30:1013-1016, 2017. © 2017 Wiley Periodicals, Inc.

Here, new rules of Latin anatomical nomenclature are proposed to deal with cases not covered by existing or other recommended rules. Determiners (e.g., numerals, letters, alphanumeric strings, and Latin names of Greek letters) should follow the noun they specify or limit, just as it is recommended that adjectives should follow the noun they modify. In general, Roman numerals, Latin letters, and Latin names of Greek letters are preferable to Arabic numerals and Greek letters in Latin anatomical terms. It is also noted that the word typus (type) appears to be superfluous and unnecessary in the Latin anatomical nomenclature. Clin. Anat. 30:700-702, 2017. © 2017Wiley Periodicals, Inc.

Information systems are increasing in importance in biomedical sciences and medical practice. The nomenclature rules of human anatomy were reviewed for adequacy with respect to modern needs. New rules are proposed here to ensure that each Latin term is uniquely associated with an anatomical entity, as short and simple as possible, and machine-interpretable. Observance of these recommendations will also benefit students and translators of the Latin terms into other languages. Clin. Anat. 30:300-302, 2017. © 2016 Wiley Periodicals, Inc.

The anatomical nomenclature rules require that terms be as short and simple as possible. One common exception to that rule is Latin terms that contain two nouns in nominative case, for example, Musculus masseter and Os ischium. Although these may appear to speakers of other languages to be compound nouns, they are appositions, grammatical structures in which one noun renames, defines or describes the entity named by the other noun. More than 125 terms in Terminologia Anatomica can be simplified, without loss of clarity, by prohibiting use of more than one noun in nominative case in Latin anatomical terms (e.g., Masseter and Os ischii). Clin. Anat., 2016. © 2016 Wiley Periodicals, Inc.

Twice in fifteen months the popular press has published reports of the discovery of a new human organ. The claims that the mesentery and interstitium are organs come from medical practitioners, not from anatomical scientists. Although both of these anatomical entities are important in the functioning of the body, neither satisfies the requirements that an organ be composed of two or more tissues and perform a special function. Also missing in the recent claim that the interstitium, that is, connective tissues with fluid-filled spaces, is an organ, is a statement to that effect in the original research report. Alas, it appears to be much ado about nothing. Clin. Anat. 31:648-649, 2018. © 2018 Wiley Periodicals, Inc.

To the Editor, Clinical Anatomy:Amidst medical curricula that are undergoing radical reform,there is concern that anatomy teaching may be inadequatefor the standards of postgraduate residency programs (Princeet al., 2005; Fitzgerald et al., 2008). With the decreasingnumber of hours spent in anatomy and embryology laborato-ries (Craig et al., 2010), there also emerges a need for defin-itive and accessible illustrations for the education of medicalstudents. The illustrations contained in modern textbooksoften lack comprehensive detail, and are occasionally in needof correction. Moreover, the simplified style of modern medi-cal illustration has been described as a desired compromisebetween the professional and initiate (Strong, 2011).Medical students will often heavily utilize online resourcesprovided to them, given the portability of the material andthe ability to utilize it at their own convenience and pace(Nieder and Nagy, 2002). There are myriad potential difficul-ties with copyright in modern medical education, and anincreasing number of institutions have been subject to litiga-tion as a result of unauthorized use of copyrighted materialsin their printed and online modules (Gutman, 2011). We pro-pose that modernization efforts involving older, out-of-copyright material may represent a viable solution for thecreation of high-quality teaching resources.As digital archiving on Internet databases rapidly grows,there has been an unprecedented expansion in the availabil-ity of scanned out-of-copyright text and illustrations accessi-ble online. Consequently, there is an opportunity to utilizeand modify exceptionally-detailed, accurate medical illustra-tions. Here, we attempt to modernize these images for usein contemporary digital databases.Two scanned images were selected for modernization.The first, “Cloaca of human embryo from twenty-five totwenty-seven days old” from the 1918 edition of Gray’s Anat-omy (Gray and Lewis, 1918), was downloaded from Wikime-dia Commons (2014, September 6). The second, “Theforebrain section” from the 1920 edition of Ranson’s Anat-omy of the Nervous System (Ranson, 1920), was copiedfrom the Internet Archive (2010).Digitally-scanned online versions of the illustrations werecompared with hard copies to ensure correct attribution.Adobe Photoshop CS4 was used to clean up and sharpen thesource images, as well as remove the original label lines andbackground to yield an unlabeled base image. Subsequently,modernized labels were added, with improved positioning,clearer typeset and lines. In addition, additional hues wereadded behind the existing linework to define additional struc-tures. Legends were updated in keeping with changes in ter-minology and age estimates of embryonic stages. Thesemodernized images are presented (see Figures 1 and 2). Theillustrations are both enhanced with regards to clarity anddetail, while preserving the original focus. The figure legendsand labels were brought up to date with current conceptsand terms.There are no known copyright restrictions for the use ofthe human cloaca or the forebrain section illustrations in theUnited States and Canada as the original books were pub-lished before 1923 and the authors died [mt]50 years ago.Furthermore, as per Bridgeman Art Library v. Corel Corp(Bangle, 1999), the human cloaca illustration may be not besufficiently original to merit copyright in the U.S. because itis a drawing of a wax model by Keibel.Both images were made available under a Creative Com-mons licence. Four components of such a license exist, eachof which must be included or excluded. These are Attributon,ShareAlike, Noncommercial, and No Derivative Works. In thecase of our images, the former two were stipulated. Attribu-tion requires that one must give appropriate credit, provide alink to the license, and indicate if changes were made. Onemay do so in any reasonable manner, but not in any waythat suggests the licensor endorses them or their use of thematerial. Share Alike requires that if one remixes, trans-forms, or builds upon the material, this party must distributethe new work under the same or similar license as the origi-nal. For instance, we would be unable to apply legal termsthat restricted others from doing anything the license per-mits. Since Noncommercial and No Derivative Works condi-tions do not apply, one is free to copy and distribute thematerial in any medium or format, and remix, transform andbuild upon the material. This is legitimate for any purpose,even commercial.The availability of out-of-copyright materials from vener-ated medical texts represents a unique opportunity to mod-ernize old illustrations while preserving their high level ofaccuracy and detail. Updating of terminology that has sincechanged is feasible and worthwhile in service of the best pos-sible education in anatomy and embryology. The images con-tained within many anatomy and embryology texts of theearly 20th century were painstakingly prepared by physi-cians, scientists, and illustrators with an unparalleled appre-ciation for these domains.