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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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Antonio Maria Valsalva


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.

Antonio Maria Valsalva (1666 – 1723). Italian physician, surgeon, pathologist and anatomist, Antonio Maria Pini was born in the city of Imola. His father Pompeo Pini, a well-to-do goldsmith, adopted the family name Valsalva based on the location of his grandfather’s castle.  Valsalva was well educated by Jesuits in mathematics, natural sciences and humanities, and continued his studies in Bologna, where he was trained in anatomy by Marcello Malpighi (1628 – 1694).

In 1687, at the age of 21, Valsalva received his Doctorate in Medicine and Philosophy. He was very dedicated to the practice of medicine, research and anatomical studies. Because of his anatomical knowledge he routinely used cadaver dissection in his clinical practice, advancing his knowledge as a pathologist.  In 1694 he was appointed Professor of Anatomy at the University of Bologna.

One of his areas of interest was the anatomy of the hearing system, and his only known publication  in 1704 is “De Aure Humana Tractatus” (The Study of the Human Ear) , where he described the ear as composed of the three regions known to us today: internal, middle, and external.

Antonio Maria Valsalva
He described a maneuver to inflate the middle ear to erase deafness and increase suppuration caused by middle ear congestion. This is known today as the Valsalva maneuver used in medical practice, but also in deep sea diving and by pilots to clear the middle ear and balance the air pressure in the middle ear with that of the external environment. Today the cardiophysiological bodily response to Valsalva’s maneuver has been studied in detail.

Valsalva is responsible for the eponym “Eustachian tube” that refers to the muscular tube communicating the superior aspect of the pharynx (rhinopharynx) with the middle ear. He did dissections to study in detail the aorta and aortic valve, describing what today are known as the “sinuses of Valsalva”, a pocket-like dilation of the aortic valve between the aortic valve wall and the valve cusps (leaflets). Each of the coronary arteries arises from a sinus of Valsalva. Similar sinuses are found in the pulmonary valve.

During his studies of the mentally ill, Valsalva was of the opinion that madness was an organic disease and therefore mentally ill patients deserved humanitarian treatment, which was not the standard during his times.

One of his best students and pupil was Giovanni Battista Morgagni (1682-1771) who, after the death of Valsalva in 1723, used some of his unpublished material to complement his own studies and publications.

Besides the Valsalva maneuver and the sinuses of Valsalva, there are other eponyms that honor this great anatomist:

• Valsalva Antrum or mastoid antrum is a cavity in the petrous portion of the temporal bone.
• Valsalva’s ligament attaches the pinna to the side of the head.
• Valsalva’s muscle: a band of vertical muscular fibers on the outer surface of the tragus of the ear, innervated by the temporal branch of the facial nerve

Sources:
1. “Seeing the Anatomy of Hearing: New Tools and Approaches Chart the Pathways Underlying How We Process and Integrate Sound” Laitman, JT The Anatomical Record (2006) 288A:323–324
2. “Antonio Maria Valsalva - Biographical Profile of a Pioneer on Otology” Meirelles, RC et al Int. Arch Otorhinolaryngol (2008)12: 2, 274-279
3. “The Valsalva manoeuvre and Antonio Valsalva (1666-1723)” J R Soc Med. (2006) 99(9): 448–451
4. “A short biography on the life of the dedicated anatomist –Valsalva” Kazi, R . J Postgrad Med (2004) 50:314-5
5. “Antonio Maria Valsalva (1666 – 1723)” Yale SH Clin Med Res (2005) 3(1): 35–38
Original image courtesy of the National Library of Medicine