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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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Marie-Francois Xavier Bichat


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.

Marie-Francois Xavier Bichat (1771 - 1802). French physician, surgeon, anatomist and physiologist, Marie-Francois Xavier Bichat was born in the village of Thoirette. His father was a physician, influencing his early instruction and vocation. In Lyon he studied anatomy and surgery. At 28 years of age Bichat was appointed physician to the Hôtel (Hospital) Dieu. His life was influenced by his mentor, Pierre-Joseph Dassault (1738 - 1795). Upon his mentor's death Bichat took upon him to continue and finish his work, while supporting his mentor's family.

Bichat is know for the concept of the body composed of distinct tissues, which he originally called "membranes". Without the aid of the microscope Bichat described 21 different tissues and is considered the founder of the science of histology. His name is preserved in many eponymic structures such as Bichat’s fossa (pterygopalatine fossa), Bichat’s buccal fat pad, Bichat’s foramen (cistern of the vena magna of Galen), Bichat’s ligament (lower fasciculus of the posterior sacroiliac ligament), and Bichat’s tunica intima (tunica intima vasorum). 

Xavier Bichat also contributed to a newer description of the humoral physiological theory, later becoming the basis of hematology. He was also interested in the description of life and death, proposing the existence of an "organic life" and an "animal life". An interesting note is that Bichat died because of an infection he acquired while dissecting a cadaver. Remember that at the time, no embalming was used!

Today Bichat's name is almost forgotten, although in some countries the buccal fat pad is still called "Bichat's fat pad" In many Spanish-speaking countries this structure is referred to as "la bola grasa de Bichat", and many still refer to the removal of this fat pad as "Bichectomy". For an image of the before and after of the procedure, click here.

Sources:
1. "Marie-Fran?ois Xavier Bichat (1771-1802) and his contributions to the foundations of pathological anatomy and modern medicine" Shoja M.M., Tubbs R.S., Loukas M., Shokouhi G., Ardalan M.R.(2008) Annals of Anatomy, 190(5),413-420
2. "Physiological Researches on Life and Death" Bichat, Marie-Francois Xavier, 1827. Translated from French by F. Gold. Richardson and Lord, Boston.
3. "A Historical Perspective: Infection from Cadaveric Dissection from the 18th to the 20th Centuries" Shoja, MM et al. Clin Anat (2013) 26:154-160 

Marie_Francois Xavier Bichat

Original image courtesy of
Images from the History of Medicine

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Dacryocystolithiasis

This complex medical word is formed by the combination of two root terms: [dacry-] meaning "tear" and [-cyst-], meaning "sac". The combined root [dacryocyst-] means "tear sac" or better, "lacrimal sac" (the Latin word [lacrima] means "tear"). This medical word also has a combined suffix: [-(o)lith], meaning "stone", and [-iasis], meaning "disease or condition".

The word [dacryocystolithiasis] means then, "a condition or pathology of stones (calculi) in the lacrimal sac". The procedure to remove the stones would then be called a [dacryocystolithectomy].

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Hamate

The Hamate bone is one of the four bones that comprise the distal row of the carpus or carpal bones that form the wrist. The name arises from the Latin [hamatus], meaning "hooked". The hamate bone has a distinct hook-like bony process in its volar (anterior) surface, known as the hamulus. This bone is also known as the "unciform bone" (from the Latin [uncus], also meaning "hook") or the os hamatum.

The lunate bone has a wedge-like shape and six surfaces (as a die). It articulates with five bones, including the lunate bone, capitate, triquetrum, and the fourth and fifth metacarpal bones.

The hook of the hamate bone is one of the distal boundaries of the carpal tunnel and serves as a pulley for the tendons of the fourth and fifth flexor tendons. It also serves as one of the points of muscular attachment for the following muscles: flexor carpi ulnaris, flexor digit minimi, and opponens digiti minimi. Because of its projection into the palm of the hand, the hamulus is involved in injuries in sports that require the athlete to use an accessory, as in racquetball, tennis, baseball, golf, etc.

The accompanying image shows the anterior (volar) surface of the wrist. Click on the image for a larger picture.

Scaphoid bone - anterior (volar) view of the wrist

Image modified from the original: "3D Human Anatomy: Regional Edition DVD-ROM." Courtesy of Primal Pictures

 

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Phlebotomy

The word itself arises from the Greek. The root term [-phleb-] derives from [φλέβα] (phleba) meaning "vein", and the suffix [-otomy], meaning "to cut" or "to open". Let's not forget that the suffix component  [-y] means "process of". So [phlebotomy] is the "process (or action) of cutting open a vein"

For centuries a standard practice in medicine was to "bleed" a patient, by opening a vein under controlled conditions and letting some blood flow. The practice was known as "bloodletting" or phlebotomy. Not in use today, it is said that excessive bloodletting contributed to the death of George Washington, having removed 5 pints of blood in one day!. Today the professionals who draw blood are called "phlebotomists"

The image (circa 1860) depicts one of the only known three photographs of a bloodletting procedure. Observe the lack of aseptic technique.


Image by The Burns Archive, courtesy of Wikipedia.org.

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Iliopubic tract

The iliopubic tract is a thickening of the transversalis fascia found in direct relation, immediately posterior to the inguinal (Poupart's) ligament. As the inguinal ligament, the iliopubic tract extends between the anterior superior iliac spine (ASIS) superolaterally, and the pubic tubercle inferomedially. 

This obscure structure has been brought up to light because it is one of the anatomical landmarks used in laparoscopic herniorrhaphy. When securing a mesh to reinforce the posterior abdominal wall, and also prevent mesh migration, the surgeon will place sutures, tacks, or staples in this structure. Since the iliopubic tract (posteriorly) and the inguinal ligament (anteriorly) are so close together, they are both secured when doing this procedure.

Inguinal ligamentImage property of: CAA.Inc.Artist: D.M. Klein
The image shows the location of the inguinal ligament. The iliopubic tract is immediately posterior to it. 
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Clavicle

The clavicle is part of the anterior portion of the shoulder girdle. It is an elongated bone with an "italic S" curvature. The Latin term for clavicle is [clavicula], and it has two root terms: [-clavic-] and [-clav-]. This is why we have the terms [subclavicular], and [subclavian] both meaning the same: "inferior to the clavicle".

The clavicle articulates medially with the manubrium of the sternum (see image on this article) by way of the sternoclavicular joint. This joint contains a meniscus. Laterally, the clavicle articulates with the acromial process or acromium of the scapula.

The clavicle has the muscular insertions of several muscles: sternocleidomastoid, trapezius, pectoralis major, deltoid, subclavius, and sternohyoid.

Images and links courtesy of Bartleby.com

Left clavicle, superior surfaceLeft clavicle, superior surfaceLeft clavicle, inferior surfaceLeft clavicle, inferior surface

 

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