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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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Subscapular muscle (subscapularis)

The subscapular muscle or subscapularis is a large triangular muscle which is found on the anterior aspect of the scapula, in close relation to the posterolateral aspect of the thorax. It is covered by a well-defined fascia layer, the subscapularis fascia. It is one of the muscles that forms the rotator cuff.

It originates from the internal aspect of the medial border of the scapula, in close proximity to the insertion of the serratus anterior (magnus), and the internal aspect of the inferolateral border of the scapula, where it is separated from the teres major muscle by a thick aponeurosis. It also takes origin directly from the subscapular fossa, where some of the muscular fibers attach directly to the bone.

The muscle inserts by way of a tendon in the lesser tubercle of the humerus and the anterior aspect of the glenohumeral joint capsule. The tendon of the muscle is separated from the neck of the scapula by a large bursa (the infratendinous bursa of the subscapularis) which communicates with the cavity of the glenohumeral joint through an aperture in the capsule.

It receives innervation by two subscapular nerves, both branches of the brachial plexus.

Subscapularis muscle - Image modified from the original by Henry VanDyke Carter, MD. Public domain
Subscapularis muscle.
Click on the image for a larger depiction 
The superior suprascapular nerve arises from the ventral rami of C5 and C6 nerve fibers. It branches from the posterior cord of the brachial plexus and supplies the superior aspect of the muscle. The inferior subscapular nerve arises from the ventral rami of C5 and C6 nerve fibers. It branches from the posterior cord of the brachial plexus and supplies the superior aspect of the muscle. Although these nerves have the same origin from the cervical spine, their origin from the posterior cord of the brachial plexus is different.

This muscle rotates the head of the humerus medially. When the upper extremity is raised, it draws the humerus anteroinferiorly.  As part of the shoulder’s rotator cuff it helps prevent subluxation of the glenohumeral joint by keeping the head of the humerus in situ.

The subscapularis is one of the 17 muscles that attach to the scapula.

Note: The image shown in this article is from “Gray’s Anatomy” (1918) which is in the public domain

Sources:
1. “Gray’s Anatomy” Henry Gray, 1918
2. "Tratado de Anatomia Humana" Testut et Latarjet 8th Ed. 1931 Salvat Editores, Spain
3. "Gray's Anatomy" 38th British Ed. Churchill Livingstone 1995
4. “An Illustrated Atlas of the Skeletal Muscles” Bowden, B. 4th Ed. Morton Publishing. 2015

Image modified from the original by Henry VanDyke Carter, MD. Public domain