James Sanders

James Sanders (1777 – 1843) was a Scottish physician.



  • Born 1777
  • 1802 – member of the Royal Medical Society of Edinburgh
  • Father of William Rutherford Sanders (1828-1881)
  • Died 1843

Medical Eponyms

Sanders sign (1823)

The undulatory character of the cardiac impulse in the epigastric region, indicative of adherent pericardium (l’adhérence du péricarde). Specifically the presence of a depression occurring under the left ribs and in the epigastrium during systole in patients with adherent pericardium.

Pendant la contraction simultanée des ventricules, le cœur devient plus court, plus rond dans sa surface, il se rétrécit pour , chasser le sang, sa pointe s’élève en avant vers la cinquième côte et doit entraîner actuellement en haut la partie inférieure du péricarde, avec le diaphragme et tout ce qui lui est adhérent. En même temps se dessine donc l’enfoncement sous les côtes gauches de la région supérieure du ventre.

…pendant la contraction simultanée des deux oreillettes, les ventricules se relâchent, s’étendent pour recevoir le sang, la pointe du cœur se meut subitement en bas, et, n’étant pas dans un espace libre, communique actuellement au péricarde adhérent, au diaphragme, et aux autres parties, le choc, qui est sensible à l’extérieur par une petite élévation qui se dessine dans le même endroit où peu auparavant s’était formée la concavité, et qui s’étend pourtant un peu plus bas. Rigoureusement parlant, l’enfoncement précède le choc, puisque la contraction des oreillettes est le commencement de l’action du cœur.

C’est un mouvement perpétuel d’une très-forte ondulation, se montrant plus bas que celle qu’on sent naturellement dans la région du cœur.

…il existe un signe mécanique, produit toujours par la même et unique cause, signe qui ne trompera jamais, qui fera reconnaître très facilement l’adhérence du péricarde, lors même qu’elle sera compliquée avec d’autres maladies du cœur ou de la poitrine.

Sanders 1823: 156-157

During the simultaneous contraction of the ventricles, the heart becomes shorter, rounder on its surface, it narrows to expel the blood. Its apex rises forward toward the fifth rib, causing the lower part of the pericardium to rise with the diaphragm and all that is adherent to it. At the same time a depression under the left ribs of the superior abdominal region is formed.

…during the simultaneous contraction of the two atria, the ventricles relax, dilate to receive the blood, the apex of the heart moves suddenly downwards, and, not having a free space to move in, communicates to the adherent pericardium, the diaphragm, and to the other parts, the shock, which becomes sensible to the outside by a small elevation which is outlined in the same place where the depression had formerly been, and which however extends a little lower. Strictly speaking, the depression precedes the shock, since the contraction of the atria is the beginning of the action of the heart.

It is a perpetual movement of a very strong undulation, showing itself lower than that which one naturally feels in the region of the heart.

…it is a sign which will never deceive, which will enable us to very easily recognize the adhesion of the pericardium, even when it is complicated with other diseases of the heart or chest.

Sanders 1823: 156-157

Controversy…not many people agreed

Laënnec acknowledged Sanders, Kreysig and Heim in his book Traité de l’auscultation médiate et des maladies des poumons et du cœur, but was unable to replicate the sign in any of his patients

I have understood that an English physician, Dr. Sanders, has announced as an infallible sign of the adhesion of the pericardium to the heart, the existence of a hollow, during each systole of the organ, in the epigastrium, immediately below the left false ribs. Kreysig attributes the same remark (vol. ii. p. 623) to Dr. Heim of Berlin. During the last two years, I have sought in vain to verify this observation among all my patients who presented any disorder of the circulation; and in none of them have I found the epigastric depression, although several had this very adhesion of the pericardium.

Laënnec 1832 [English translation 1837: 732]

James Hope (1801 – 1841) was equally as dismissive as he proposed his own sign for adhesive pericarditis

These signs have generally been considered very obscure. Dr. Sanders believed that he had discovered one of a positive nature in a dimple or retraction taking place, as he states, during the ventricular systole, in the epigastrium immediately below the left false ribs. I have searched for this attentively in several cases of adhesion, but have not been able to detect it in any degree which could constitute a sign. Laennec, who was equally unsuccessful, thinks that it could not take place unless the stomach, by adhering both to the diaphragm and the abdominal parietes, formed the medium of retraction.

James Hope 1832: 129

Jean-Baptiste Bouillaud (1796 – 1881) references Dr James Sanders, but once again has been unable to observe the sign in adherent pericarditis

M. le docteur Sander(s) a donné comme signe de l’adhérence du péricarde au cœur un signe que je n’ai pas eu l’occasion de constater: “un mouvement perpétuel d’une très forte ondulation se montrant plus bas que celle que l’on sent naturellement dans la région du cœur”

Bouillaud. Traité de nosographie médicale. 1846; I: 416

Doctor Sander(s) gave as a sign of the adherence of the pericardium to the heart a sign that I have not had the opportunity to observe: “a perpetual movement of a very strong undulation showing itself lower than the one we naturally feel in the region of the heart

Bouillaud. Traité de nosographie médicale. 1846; I: 416

Major Publications


BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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