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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

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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Ephraim McDowell

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

Ephraim McDowell (1771- 1830). American surgeon, Ephraim McDowell was born in 1771 in the Augusta County of Virginia. His family moved to the “frontier”, which at that time was Kentucky, where his father was a judge. McDowell studied in Kentucky and returned to Virginia to serve as an apprentice to Dr. Alexander Humphreys. Following Dr. Humphrey’s advice McDowell went to Edinburgh to finish his formal medical training, which he did not finish, taking chemistry, anatomy, and then a private medical course with Dr. John Bell.

Returning to America, he settled in the Ohio River Valley, and had a successful practice as a frontier surgeon in the city of Danville, Kentucky.  This was before the advent of anesthesia and antisepsis.

On Christmas Day 1809, Dr. McDowell  performed the first recorded ovariotomy to drain a massive ovarian cyst from Mrs. Mary Jane Crawford, who had to ride a horse for sixty miles to get to Dr. McDowell’s office where he performed the ovariotomy without anesthesia. Mrs. Crawford had been diagnosed as “pregnant” by two other physicians. Dr. McDowell’s hand-written report states that he performed a nine-inch abdominal incision, the operation lasted about twenty five minutes, and they removed “fifteen pounds of a dirty gelatinous substance” and “extracted the sac, which weighed seven and a half pounds”. 

Ephraim McDowell
Original image courtesy of National Library of Medicine.

Mrs. Crawford survived the operation, was ambulatory in five days, and lived for 33 additional years, until she was 78 years old. Research has been made as to the reason for the survival at a time when the norm for an operation that penetrated the peritoneal cavity was death. Othersen (2004) states that his research indicated that Dr. McDowell was “meticulous, neat and scrupulously clean”.

Because of the times, and because Dr. McDowell was not into writing, the achievement was not known for many years, until 1817. Dr. McDowell later performed a lithotomy on James Polk, who would eventually become president of the United States. In 1825, his achievements were recognized and he received an honorary MD degree by the University of Maryland.

Dr. McDowell’s house in Danville, KY is today a museum, and his name is remembered by the “Ephraim McDowell Health System” a group of integrated healthcare based in the same city. For more information on Mary Jane Crawford, click here.

PERSONAL NOTE: On February 19, 2017 I was able to go visit this place. Click here for a series of articles and pictures of this visit. Dr. Miranda

1. “Ephraim McDowell (1771-1830) Kentucky Surgeon” JAMA. 1963;186 (9):861-862
2. “Ephraim McDowell: The Qualities of a Good Surgeon” Othersen, HB Ann Surg. 2004; 239(5): 648–650
3. “Ephraim McDowell (1771-1830): pioneer of ovariotomy” Tan,SY & Wong, C. Singapore Med J 2005; 46(1) : 4
4. “Ephraim McDowell, the First Ovariotomy, and the Birth of Abdominal Surgery” Horn, L and Johnson, DH. J Clin Onco 2010: 28; 7 1262-1268
5. "Surgeon of the wilderness: Ephraim McDowell" Haggard, WD. Presidential Address, ACS 1933. FACS archives 1934, 58: 415-4198

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