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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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Brachialis

UPDATED: The brachialis muscle is a skeletal muscle attached proximally to the anterior surface of the humerus and distally to the coronoid process and tuberosity of the ulna. It is one of the three muscles in the anterior compartment of the arm (flexor compartment), the other two being the biceps brachii and the coracobrachialis.

It is a strong flexor of the elbow found deep to the biceps brachii. Because it does not attach to the radius, the brachialis muscle does not participate in the pronation and supination of the forearm.

The brachialis is supplied by branches of the brachial artery and by the recurrent radial artery.

The innervation of the brachialis muscle is a point to be discussed. Most modern books of anatomy state that this muscle is innervated by the musculocutaneous nerve (C5, C6, and C7). Older and more detailed books state that this muscle has a dual innervation. A 2011 research paper published in Spanish (see Sources #6) describes this dual innervation. The proximal portion of the muscles is indeed innervated by the musculocutaneous nerve, but the distal portion (in 90% of the cases) is innervated by muscular branches that arise off the radial nerve. The radial nerve (C5, C6, C7, C8 & T1) is a branch of the brachial plexus.

Following is an excerpt from the "Trail Guide to the Body" by Andrew Biel: "Ironically, (because it is deep to the biceps) the brachialis girth only helps the biceps brachii to bulge further from the arm, making the brachialis the biceps' "best friend"

Brachialis muscle - Image modified from the original. Public domain
Brachialis muscle.
Click on the image for a larger depiction

Personal note: The research paper that describes the double innervation of the brachialis muscle was done at my alma mater, the University of Chile, and the authors' listing includes two of the contributors to this blog, Professors Claudio Molina and Cristian Uribe. Dr. Miranda

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" 42nd British Ed. Churchill Livingstone 2021
4. “An Illustrated Atlas of the Skeletal Muscles” Bowden, B. 4th Ed. Morton Publishing. 2015
5. "Trail Guide to The Body" 4th. Ed. Biel, A. Books of Discovery. 2010
6. "Doble Innervacion del Musculo Brachial en la Poblacion Chilena" Claudio Molina; Cristián Uribe; Álvaro Heras; Cristián Astorga;Jorge Lemus & Alberto Rodríguez. Int. J. Morphol, 2011. 29(4):1207-1211. A PDF copy of this paper is available here.

Note: The side image modified from the original by Anatomography, CC BY-SA 2.1 JP <https://creativecommons.org/licenses/by-sa/2.1/jp/deed.en>, via Wikimedia Commons following Creative Commons attributes.