The early history of tendo Achillis and its rupture.

Tendo Achillis does not occur in the great apes, our immediate ancestors, but is a hallmark of bipedal man. Its presence may be related to the greater relative length of the tarsal bones in man. The name is derived from the description in the Iliad by the Greek poet, Homer, written between 750 and 650 B.C. Achilles was a magnificent warrior and, according to myth, was made invulnerable in infancy by his mother Thetis, who plunged him into the river Styx, one of the five rivers of the nether world. Since he was held by one heel this part was not bathed in the waters, and so remained unprotected. This heel was the site where Achilles was mortally wounded by a poisoned arrow launched from the bow of Paris during the Trojan war (Fig. 1) which was waged by a confederation of Greeks against the people of Troy to recover Helen, who had been abducted from her husband Menelaus, King of Sparta, by Paris. 1 Kirkup 2 pointed out that the confusion between Achilles' heel and tendo Achillis probably dates from 1693 when the Flemish anatomist, Phillippe Verheyen (1648-1710), Professor of Anatomy and later of Surgery at the University of Louvain, Belgium, first coined the term 'tendo Achillis' in place of 'tendo magnus', used by Hippocrates, and 'chorda Hippocratis' of later authors. 3 Today's anatomists call it 'tendo calcaneus'. The first closed rupture was described by Ambroise Paré (1510-1590), 4 as follows: " ...It oftimes is rent or torn by a small occasion without any sign of injury or solution of continuity on the outside as by a little jump, the slipping aside of the foot, the too nimble getting on horseback, or the slipping of the foot out of the stirrup in mounting into the saddle. When this chance happens, it will give a crack like a coachman's whip: above the head where the tendon is broken the depressed cavity may be felt with your finger; there is great pain in the part and the party is unable to go. This mischance may be amended by long lying and resting in bed and repelling medicines applied to the part....neither must we promise to ourselves or to the patient certain or absolute health. But on the contrary at the beginning of the disease we must foretell that it will never be so cured, and that some relics may remain... " …