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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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Mediastinum

UPDATED: The mediastinum is the median region of the thorax, usually described as the "space"1 between the lungs. This region is divided into a superior and inferior mediastinum by a plane that pases through the sternal angle or Angle of Louis.

The inferior mediastinum is itself divided into three separate regions by the pericardial sac. The region anterior to the pericardial sac is the "anterior mediastinum", the region posterior to the pericardial sac is the "posterior mediastinum", and the region containing and including the pericardial sac is the "middle mediastinum". Thus described the mediastinum comprises four regions as follows:

Superior mediastinum:  It contains the aortic arch, the brachiocephalic trunk, the thoracic segments of the left common carotid and the left subclavian arteries, the brachiocephalic veins, a portion of the superior vena cava, the vagus nerve, phrenic nerve, and left recurrent laryngeal nerve, trachea, esophagus, thoracic duct and the remains of the thymus gland

Anterior mediastinum: A narrow space, more developed on the left side, anterior to the pericardial sac and contains some lymph nodes and connective tissue

Middle mediastinum: The largest mediastinal region, it contains the pericardial sac, the heart, the bifurcation of the trachea, the inferior vena cava, and the cardiac end of the great vessels

Mediastinum (www.en.wikipedia.org)

Images courtesy of Wikipedia.org

• Posterior mediastinum: Contains the descending aorta, the azygos and hemiazygos veins, the esophagus, and thoracic duct.

1. Personally, I do not use the description of the mediastinum as a "the space beween the lungs", as it conjures the image of literal "open spaces" around or between the organs. The fact is that the mediastinum is tightly packed with no spaces between the organs. This is why I prefer the definition of the mediastinum as an "area" or "region" between the lungs. Dr. Miranda.