Book Review

Anatomy: Descriptive and Surgical

N Engl J Med 1993; 329:214July 15, 1993

Article

Anatomy: Descriptive and Surgical
Facsimile Reprint of 1858 edition. By Henry Gray. 750 pp., illustrated. St. Louis, Mosby-Year Book, 1991. $100. ISBN: 0-8151-3851-2

It is not often that a medical textbook survives through multiple editions over a period of more than 130 years, but Gray's Anatomy has managed to do just that. When it was first published in 1858, it was considered a superb textbook. Gray's intention was to provide not only a textbook for the student, but also a guide to surgical anatomy for the practitioner; the book was highly recommended for both. Other anatomy books that were available before 1858 were large atlases, small dissection manuals devoid of illustrations, or surgical descriptions, but none combined all these elements concisely in one volume. Although Gray's book was similar in its basic anatomical descriptions to Elements of Descriptive and Practical Anatomy by Jones Quain (London, 1828) and A Manual of Human Anatomy by Robert Knox (London, 1853), his was clearly superior, with clear, complete descriptions of all structures of the human body and extensive illustrations by H.V. Carter (Figure 1Figure 1Bones of the Left Hand, Dorsal Surface. From Gray's Anatomy: Descriptive and Surgical. Reprinted with the permission of Churchill Livingstone, Edinburgh, United Kingdom.).

This facsimile of the 1858 edition shows the basic organization that still characterizes the book in the 37th and most recent edition (New York: Churchill Livingstone, 1989). There are chapters on osteology, articulations, muscles and fasciae, arteries, veins, lymphatics, the nervous system, sense organs, and organs of digestion, voice and respiration, urination, and reproduction. Over the years, the general outline of the book has remained the same, but sections have been added on embryology, surface anatomy, and the endocrine glands. With the proliferation of detailed microscopical information, more histologic illustrations have also been added.

Gray was generally praised for his work, although he was severely criticized in a review in the Edinburgh Medical Journal for failing to provide references for information researched by others. (Current editions of his work contain references at the end of each chapter).

Gray was one of the forerunners of the current trend of coupling basic anatomical descriptions with clinical anatomy in order to emphasize the relevance of the anatomical details to clinical practice. Although the sections on surgical anatomy have since been removed from the editions of Gray's book, most modern anatomical textbooks contain sections on clinical correlations.

The human body has not changed in the years between the 1st and 37th editions, but our ability to visualize it has improved many times over, thanks to microscopy, x-rays, and newer imaging techniques such as computed tomography and magnetic resonance imaging. Despite all the technical advances, however, Gray's original descriptions of the body cannot be surpassed in clarity and thoroughness.

I would like to acknowledge the generous assistance of Richard J. Wolfe, curator of rare books and manuscripts at the Francis A. Countway Library of Medicine, Harvard Medical School).

Barbara C. Fullerton, Ph.D.
Massachusetts Eye and Ear Infirmary, Boston, MA 02114