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: for example, the introduction of X-ray plates (twenty-seventh edition, 1938) and electron micrographs (thirty-second edition, 1958).
In the Preface to the first edition, Henry Gray wrote that ‘This Work is intended to furnish the Student and Practitioner with an accurate view of the Anatomy of the Human Body, and more especially the application of this science to Practical Surgery.’ We remain true to his intention. An appropriate knowledge of clinically relevant, evidence-based anatomy is an essential element in the armamentarium of a practising clinician; indeed, ‘If anything, the relevance of anatomy in surgery is more important now than at any other time in the past’ (Tubbs, in Preface Commentary, which accompanies this volume).
In my Preface to the fortieth edition, I intimated that the book was quite literally in danger of breaking its binding if any more pages were added. In order to avoid this unfortunate occurrence, the forty-first edition contains a significant amount of material that is exclusively electronic, in the form of 77,000 words of additional text, 300 artworks and tables, 28 videos and 24 specially invited commentaries on topics as diverse as electron microscopy and fluorescence microscopy; the neurovascular bundles of the prostate; stem cells in regenerative medicine; the anatomy of facial ageing; and technical aspects and applications of diagnostic radiology. In keeping with the expectation that anatomy should be evidence-based, the forty-first edition contains many more references in the e-book than could be included in the thirty-ninth and fortieth printed editions.
Neel Anand, Rolfe Birch, Pat Collins, Alan Crossman, Michael Gleeson, Ariana Smith, Jonathan Spratt, Mark Stringer, Shane Tubbs, Alan Wein and Caroline Wigley brought a wealth of scholarship and experience as anatomists, cell biologists and clinicians to their roles as Section Editors. I thank them for their dedication and enthusiastic support, in selecting and interacting with the authors in their Sections and for meeting deadlines, despite the ever-increasing demands on their time from university and/ or hospital managers. Pat Collins, Girish Jawaheer, Richard Tunstall and Caroline Wigley worked closely with many authors to update the text and artworks for organogenesis, paediatric anatomy, evidence-based surface anatomy and microstructure, respectively, across Sections 3 to 9. Jonathan Spratt acted as both a Section Editor (thorax) and an indefatigable ‘go to’ for sourcing images throughout the book; in the latter capacity, he has produced a superb collection of additional labelled images, available in the e-book (see Bonus imaging collection). Over a hundred highly experienced anatomists and clinicians contributed text, often extensively revised from the previous edition, and/ or artworks, original micrographs or other images to individual chapters.
Author: Susan Standring PhD DSc
Pub Date: 10/9/2015
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