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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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Abdominal Regions

UPDATED: In surface anatomy the abdomen can be divided into nine regions by named lines (or planes): transpyloric, transtubercular, and midclavicular. These regions have specific visceral content.

• Hypochondriac regions (right and left): [Hypo]="below"; [chondr]="cartilage"; [iac]=”pertaining to”. In this context, the term means “below or deep to the cartilage (of the ribs)". The right hypochondriac region contains the liver, gallbladder, portal vein, and the right colic flexure. The left hypochondriac region contains the stomach, spleen, tail of the pancreas, and left colic flexure. For a detail on how the name of this region relates to a mental disorder, click here.

• Epigastric region: [Epi]="above"; [gastr]="stomach”; [ic]=”pertaining to". The term means “above the stomach”. This region contains mostly stomach and abdominal esophagus

• Lumbar regions (right and left): Right and left lumbar regions. The term [lumbar] refers to the area of the loins. The right lumbar region contains the ascending colon and part of the right kidney. The left lumbar region contains the descending colon and part of the left kidney

• Umbilical region: Centered around the umbilicus, this region contains mostly small intestine, abdominal aorta, and greater omentum


Abdominal regions - Modified from the original Davis, 1910 

• Inguinal regions (right and left): From the Latin [inguen]=”groin". Gaius Plinius Secundus aka “Pliny” (23-79 AD) first used this term naming after a plant (inguinalis) which he used to treat hernias of the groin. The right inguinal region contains the cecum and small intestine. The left inguinal region contains the sigmoid colon. In older days, as shown in the sketch, these regions were called the "iliac regions".

• Hypogastric region: [Hypo]="below"; [gastr]="stomach”; “ic”=”pertaining to. The term means “below the stomach”. The hypogastric region contains mostly small intestine and greater omentum. This region used to be called the "pubic region"

A clinical importance of these abdominal regions is that a ventral hernia is usually named by the anatomical region where it protrudes. Based on the image, you will see then why a hernia can be umbilical, inguinal, lumbar, epigastric, or hypogastric.

Sources:
1. "Applied Anatomy" Davis, GG 1910 JBL Co. Philadelphia
2. "The Origin of Medical Terms" Skinner, HA 1970 Hafner Publishing Co.