Gray’s Anatomy: The Anatomical Basis of Clinical Practice

Looking through an almost complete set of the previous editions of Gray’s Anatomy, I am struck by the marked difference in size between the first and fortieth editions. That progressive increase in girth has occurred pari passu with ground-breaking advances in basic science and clinical medicine over the past 155 years. Anatomy has become a far wider discipline than Henry Gray, Henry van Dyke Carter or any of their students could have envisaged. Fields such as cell biology, molecular genetics, neuroanatomy, embryology and bioinformatics either had not emerged or were in their infancy in 1858.

Techniques that today inform our view of the internal landscape of the body – such as specialized types of light and electron microscopy; imaging modalities, including X-rays, magnetic resonance imaging, computed tomography and ultrasonography; the use of ‘soft’ perfusion techniques and frozen-thawed, unembalmed cadavers for dissection-based studies; and the advances in information technology that enable endoscopic and robotic surgery and facilitate minimally invasive access to structures previously considered inaccessible – were all unknown.

As each development entered mainstream scientific or clinical use, the new perspectives on the body it afforded, whether at submicroscopic or macroscopic level, filtered into the pages of Gray’s Anatomy: