History of Medicine: The Story behind Gray’s Anatomy (the real one)

Choosing the Twitter name @mcdreeamie might have been mostly because I work at NUH DREEAM but I’d be lying if I didn’t know about the TV show ‘Grey’s Anatomy’ and watched the odd episode. However, this blog is about the real Gray’s Anatomy, the book. So please only read on if you’re interested in the book and not Meredith or Derek.

I was bought a copy of Gray’s Anatomy as a present from my uncle once my place in medical school was guaranteed and it has made a eye-catching addition to my book shelf ever since. For this blog I thought I’d look a bit into Gray and how the book came about.

Henry Gray was born in 1827 in Belgravia, London. That’s pretty much all we know about his early life until he started at St. George’s University, also in London, in 1842. He’s thought to have lied about his age in order to enrol.

Back then in order to be a medical student one would also have to a practising member of the Church of England and show proof. To become a staff surgeon at St. George’s Hospital, Gray would first have to pass the Apothecaries exam, then an exam to obtain membership in the Royal College of Surgeons, and later a difficult exam to become a Fellow of the Royal College. He was described as good looking, a bit dandyish and hard working. He was interested in anatomy and dissection from the very beginning.

Gray benefited, along with his peers, from a recent change in the law: The Anatomy Act of 1832. This gave freer licence to medical students and teachers to practice human dissection. Whereas before restrictions had led to a dark business in grave robbing and corpse selling now everyone wanting to practice dissection had to be registered with the Home Secretary. London, the rest of England and Wales, Scotland and Ireland each had an inspector of anatomy who would keep a list of all bodies being dissected and report to the Home Secretary. Bodies could be dissected or claimed from prisons or workhouses if no one next of kin came for them. This meant Gray would have been able to practice anatomy in the open and within the law.

When he was 21 he won prizes in surgery. He became a member of the Pathological Society of London and a member of the Royal College of Surgeons. In 1852 , still in his twenties, he was made a governor of the hospital.

Self portrait of Henry Vandyke Carter

By 1853 he had met Henry Vandyke Carter, a medical student with a talent for drawing. Gray entered and won the Astley Cooper Prize (100 pounds — about £13000 now) for his work “The structure and use of the human spleen.” His 350 page book contained over 50 illustrations by Carter although no credit was given and payment was incomplete.

In 1855 Gray approached the shy Carter again this time regarding the possibility of a textbook for medical students. Carter was more careful this time and only began work when promised £10 (£1000 now) a month for 15 months to produce drawings. To put that into perspective I’ve found one freelance book illustrator online who changes £320 a day! By summer 1858 the first copies were ready for printing for the students arriving later that year.

Gray’s markings on the first edition’s title page, downplaying Carter’s contributions and his titles

Called Anatomy: Descriptive and Surgical Gray sought to boost his name whilst diminishing that of Carter and his contribution. Carter, presumably very fed up of Gray by this point, went to India to practice and never received a penny of royalties.

Early reviews were a bit mixed. The British Medical Journal called it “far superior to all other treatise on anatomy, … a book which must take its place as THE manual of Anatomy Descriptive and Surgical.” The Medical Times and Gazette, however, found it “ not wanted…low and unscientific in tone…compiled, for the most part, in a manner inconsistent with the professions of honesty which we find in the preface… . A more unphilosophical amalgam of anatomic details and crude surgery we never met with.”

The second edition was released in 1861. That same year Gray’s nephew Charles became ill with smallpox. Gray treated Charles back to health. However, despite having received an early form of smallpox vaccination, Gray himself contracted the disease. He developed confluent smallpox, a more serious form where the lesions meet to form one whole sheet. On 13th June 1861, when he was due to be interviewed for a new post at St. George’s, he died aged just 34. As a smallpox patient all of his possessions, including his writings, were burnt. Carter stayed in India for 30 years before returning to England in 1888. He died of tuberculosis in 1897.

Gray’s Anatomy has never been out of print. In 2004 a Student edition was also released. Gray’s is published through Elsevier with online materials as well.

Henry Gray was clearly a precocious talent, albeit one with a thirst for fame. St. George’s continue to honour one of their most renowned alumni with their anatomy society. Whilst there have been rumblings of plagiarism he has clearly achieved the recognition he craved uniting nearly two centuries of students and practitioners who have used Gray’s.

Thanks for reading

- Jamie

Originally published at mcdreeamiemusings.com.

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