The umbilical metastasis. Sister Mary Joseph and her time

Abstract

Although Baluff in 1854 and Nelaton in 1860 had already described umbilical metastases, the best known description of the metastasis of carcinomas to this site as "trouser button navel" was published in 1928 by William James Mayo (1861-1939), son of William Worrall Mayo (1815-1911), the founder of the Mayo Clinic in Rochester, Minnesota, This phenomenon is supposed to have been pointed out to Mayo by his long-serving head surgical nurse Sister Mary Joseph (1856-1939). The English surgeon Hamilton Bailey, in his famous textbook "Physical Signs in Clinical Surgery" in 1949, coined the term "Sister Joseph's nodule" for an umbilical metastasis. The expression has become widely accepted and used. Sister Mary Joseph, daughter of Irish immigrants, belonged to the 3rd order of the Holy Francis, was distinguished for her skills, intelligence and devotion to nursing which was also her calling. She worked for many decades at the world-famous Mayo Clinic and taught generations of young nurses. In recent years, the original surgical building at Saint Mary's Hospital has been named "Joseph Building" in her memory. Among the numerous eponyms occurring in the dermatology and the medicine, the association with the name of a nurse represents beyond doubt a special feature.