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Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Self-portrait, Henry Vandyke Carter, MD (Public Domain)
Self-portrait, Henry Vandyke Carter, MD (Public Domain)

Henry Vandyke Carter, MD
(1831 – 1897)

English physician, surgeon, medical artist, and a pioneer in leprosy and mycetoma studies.  HV Carter was born in Yorkshire in 1831. He was the son of Henry Barlow Carter, a well-known artist and it is possible that he honed his natural talents with his father. His mother picked his middle name after a famous painter, Anthony Van Dyck. This is probably why his name is sometimes shown as Henry Van Dyke Carter, although the most common presentation of his middle name is Vandyke.

Having problems to finance his medical studies, HV Carter trained as an apothecary and later as an anatomical demonstrator at St. George’s Hospital in London, where he met Henry Gray (1872-1861), who was at the time the anatomical lecturer. Having seen the quality of HV Carter’s drawings, Henry Gray teamed with him to produce one of the most popular and longer-lived anatomy books in history: “Gray’s Anatomy”, which was first published in late 1857.  The book itself, about which many papers have been written, was immediately accepted and praised because of the clarity of the text as well as the incredible drawings of Henry Vandyke Carter.

While working on the book’s drawings, HV Carter continued his studies and received his MD in 1856.

In spite of initially being offered a co-authorship of the book, Dr. Carter was relegated to the position of illustrator by Henry Gray and never saw the royalties that the book could have generated for him. For all his work and dedication, Dr. Carter only received a one-time payment of 150 pounds. Dr.  Carter never worked again with Gray, who died of smallpox only a few years later.

Frustrated, Dr. Carter took the exams for the India Medical Service.  In 1858 he joined as an Assistant Surgeon and later became a professor of anatomy and physiology. Even later he served as a Civil Surgeon. During his tenure with the India Medical Service he attained the ranks of Surgeon, Surgeon-Major, Surgeon-Lieutenant-Colonel, and Brigade-Surgeon.

Dr. Carter dedicated the rest of his life to the study of leprosy, and other ailments typical of India at that time. He held several important offices, including that of Dean of the Medical School of the University of Bombay. In 1890, after his retirement, he was appointed Honorary Physician to the Queen.

Dr. Henry Vandyke Carter died of tuberculosis in 1897.

Personal note: Had history been different, this famous book would have been called “Gray and Carter’s Anatomy” and Dr. Carter never gone to India. His legacy is still seen in the images of the thousands of copies of “Gray’s Anatomy” throughout the world and the many reproductions of his work available on the Internet. We are proud to use some of his images in this blog. The image accompanying this article is a self-portrait of Dr. Carter. Click on the image for a larger depiction. Dr. Miranda

Sources:
1. “Obituary: Henry Vandyke Carter” Br Med J (1897);1:1256-7
2. “The Anatomist: A True Story of ‘Gray’s Anatomy” Hayes W. (2007) USA: Ballantine
3. “A Glimpse of Our Past: Henry Gray’s Anatomy” Pearce, JMS. J Clin Anat (2009) 22:291–295
4. “Henry Gray and Henry Vandyke Carter: Creators of a famous textbook” Roberts S. J Med Biogr (2000) 8:206–212.
5. “Henry Vandyke Carter and his meritorious works in India” Tappa, DM et al. Indian J Dermatol Venereol Leprol (2011) 77:101-3


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Duodenum

The duodenum is a mostly retroperitoneal organ, part of the digestive tract, and the most proximal portion of the small intestine. This organ is approximately 10 inches in length (24.5 cm). It starts at the pylorus of the stomach, has a "C" shape, curving around the head and the neck of the pancreas, to end at the duodenojejunal junction.

The duodenum is described as having four segments of differing length, usually named numerically:

- First segment: about two inches in length, it is dilated and called the "duodenal ampulla", or "superior duodenum"
- Second segment: about three inches in length, it receives bile and pancreatic juice through the hepatopancreatic ducts and ampullae. It is also called the "descending duodenum"
- Third segment: about four inches in length, it crosses the midline, and is also known as the "horizontal" or "transverse duodenum"
- Fourth segment: one inch in length, this is the shortest segment, it ascends towards the duodenojejunal junction, which is tethered to the diaphragm by a fold of peritoneum around a fibromuscular band called the "ligament of Treitz". At this point the retroperitoneal duodenum becomes the intraperitoneal jejunum. This fourth segment is also called the "ascending duodenum"

Retroperitoneal organsImage property of:CAA.Inc.Artist:Dr. E. Miranda
The name of the organ is interesting. Most textbooks claim that is originates from the Latin [duodeni], meaning "twelve". The fact is that the duodenum was originally named in Greek [δώδεκα δάχτυλαν] meaning "twelve fingers". If you place both your hands together and add 1/4 of an inch to each side (as if you had an extra finger on each hand) that measures approximately 10 inches. The term was shortened by an incorrect translation to "twelve" by Gerard of Cremona (1114 - 1187) who called it "duodenum", a bad translation, as twelve fingers in Latin is [duodecim digitorum].

Sources:
1.
"Clinically Oriented Anatomy" Moore, KL. 3r Ed. Williams & Wilkins 1992
2. "The origin of Medical Terms" Skinner, AH, 1970 

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