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Gray’s Anatomy: The Jefferson Years

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Henry Gray, MD (1827-1861)
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Dr. Richard James Dunglison (1834-1901)

Gray’s Anatomy, or more properly titled, Anatomy, Description and Surgical, first appeared in Great Britain in 1858. Conceived and authored by Henry Gray, MD (1827-1861) of St. George’s Hospital in London and illustrated by his colleague, Dr. H. Vandyke Carter, Gray’s Anatomy became an instant classic and received praise for its rational organization and superbly engraved illustrations.

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First Edition British with B/W Engraving
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Second Edition American with Colored Engraving

Blanchard & Lea, medical publishers in Philadelphia, purchased the rights (and a complete set of woodblock illustrations) to an American edition and in June of 1859 sold their best seller. The first American editor of this iconic text was Dr. Richard James Dunglison (1834-1901). His father, Robley T. Dunglison, was a Scot who received his MD at the world’s premier medical school in Edinburgh.

At Thomas Jefferson’s invitation the elder Dunglison crossed the Atlantic to establish the University of Virginia’s department of medicine and became the ex-President’s personal physician. The bulk of his career (1836-1868) was spent as faculty member and later as Dean of Jefferson Medical College. His son Richard took his MD from JMC in 1856.

The first American impress failed to mention Richard Dunglison’s name, referring to him in the “American Publisher’s Notice” as “a competent professional gentleman.” However, the publisher’s account book recorded, “Dr. Dunglison the younger for revising the work, modifying index, etc. … $100.00.” Indeed, the American edition corrected numerous typographical errors, rearranged some of the text, and enlarged and rationalized the index “as seemed calculated to render the volume more convenient for consultation and reference” (from the Second American Edition of 1862). Another American innovation may have been the use of colored hand-tipped plates, which became optional in the subsequent press runs.

Richard J. Dunglison served as editor for the first five editions (through 1883). After the Second Edition the American Gray’s was styled as the “New American from the Fifth English” in 1870 (Eighth English in 1878, etc.), a format in use until 1908 when “17th American Edition” asserted itself.

The editorial torch was passed to another Jeffersonian, William W. Keen, MD (1837-1932) with the publication of the “New American from the 11th English” in 1887. Keen was a powerful and lively lecturer who is credited with “breaking away from the English editors, swinging back toward the practical purposes of the book.”

The preface points out some improvements:

In all, one hundred and thirteen new engravings have been added, of which many are original. These, with their descriptive matter, and likewise all my other additions, have been distinguished by brackets. Among these new illustrations are…frozen sections through the trunk, the extremities, and the female pelvis…interior of the nose and larynx;…a series giving the points for the application of electricity to the muscles; a series on the circulation of the brain and spinal cord… There is scarcely a section of work…which has not been extensively enriched in the matter of illustrations.

The text has been prefaced with a paper “On the Systematic Use of the Living Model in Teaching Anatomy,”…My experience in lecturing before the Pennsylvania Academy of Fine Arts has convinced me also of the great advantages to be derived…from a thorough study of the masterpieces of sculpture, which are available at least in large cities.

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William W. Keen, MD (1837-1932)

Keen then listed the classical statues available in plaster casts and elucidated his suggestions for using electrical current to stimulate muscles as illustrated in the plates. He was a pioneer in neurosurgery and his interest in this area is reflected in the fuller text and images.

As a graduate of JMC in 1862, Keen was advised to augment his studies during his first semester with private tutoring at the office of Dr. Brinton (at 10th and Walnut, currently the site of the Curtis Building). He reflected in his memoir “…I was sitting at one of the front windows with Gray’s Anatomy in my lap and a skull in my hands, beginning the study of the bones. Gray’s book was new, and I could not have imagined that my name would eventually appear on its title page as editor.”

Keen edited the following (1893) Gray’s Anatomy, but for the 1896 edition, the publishers briefly left Jefferson and contracted New York editors, Drs. Gallaudet, Brockway & McMurrich.

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John Chalmers DaCosta (1863-1933)

The next publication with an American editor was the enormous 1901 issue under the direction of Jeffersonian, John Chalmers DaCosta (1863-1933). His weighty task was reflected in the increase of pages (from 1250 to 1600) and illustrations (780 to 1132). DaCosta (JMC 1885) was recognized as a “scholarly” editor as he included much material from the most current medical literature. He also authored, A Manual of Modern Surgery, General and Operative, which went through ten editions and rivaled Gray’s Anatomy for sales numbers.

Edward Anthony Spitzka (1876-1922), the fifth American editor (and final Jeffersonian to edit Gray’s Anatomy), had co-edited DaCosta’s 1908 edition and had soloed the 1910 and 1913 versions. Spitzka took his MD at Columbia University and received great public notoriety as being a “brain man.” Prior to his appointment as JMC’s Professor of Anatomy and Director of the college’s Daniel Baugh Institute of Anatomy, he had collected and recorded data on hundreds of human brains in an effort to determine behavioral tendencies.

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Edward Anthony Spitzka (1876-1922)

Funded by the Anthropometric Society, Philadelphia’s Wistar Institute held scores of specimen brains and many were of scientists (Dr. William W. Keen) celebrities (Walt Whitman), and criminals. While at Jefferson Medical College, Prof. Spitzka, who had permission from penal authorities to dissect executed criminals (including President McKinley’s assassin), supposedly had been threatened by the criminal underworld for his perceived desecration of their colleagues. A story was told of his lecturing with two six-shooters resting on the lectern in his attempt to foil a “hit”. Suffering from increasing alcoholism and paranoia, he was nevertheless a brilliant lecturer who ultimately donated his own brain for scientific research.

The fact that each of these Jefferson faculty members served as editors of Gray’s Anatomy from 1859 to 1913 attests to a nearly unbroken continuity. Richard Dunglison had Keen assist him in some editorial duties in his final edition of 1883. DaCosta genuinely acknowledged Keen as his “old Master” and “The Dean of American Surgery.” Spitzka was co-editor with DaCosta. Each author was trained by his teacher and influenced his successor as he added his own modern analysis to the text.

The evolution of medicine and science in the last half of the nineteenth century is displayed in the many editions of Gray’s Anatomy. The makers of this landmark work were Jeffersonians whose interpretations influenced and informed all American medical students and practitioners for a critical 50 years.

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