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The 40th edition of Gray's Anatomy celebrates 150 years of continuous publication of an extraordinary book. Although this edition looks very different from the first edition (see Ruth Richardson's historical introduction on page xvii), the essential aim of Henry Gray and the illustrator Henry Vandyke Carter, to describe the clinically relevant anatomy of the human body, particularly (but not exclusively) for the practicing surgeon, has not changed over the years. Anatomy may be struggling to retain its foothold in many undergraduate medical curricula, but it is enjoying a renaissance at the postgraduate level. A detailed knowledge of clinical anatomy which would have been undreamed of in the first edition, is now essential for clinicians working in technologically driven fields such as imaging, endoscopic and robotic surgery.
Nine Section Editors (Neil Borley, Pat Collins, Alan Crossman, Michael Gatzoulis, Jeremiah Healy, David Johnson, Vishy Mahadevan, Richard Newell and Caroline Wigley) have worked with me in preparing the 40th edition. They have brought their extensive experience as anatomists, cell biologists and clinicians to the task, and I thank them for their dedication and enthusiastic support. Pat Collins, Jeremiah Healy and Caroline Wigley also worked closely with all members of the editorial team in updating the text and artworks for embryology, imaging and microstructure respectively throughout the book. Harold Ellis has meticulously edited the section on eponyms which is available on the website, and has commented on many of the chapters.
Each Section Editor was assisted by a group of Contributors – experienced anatomists and clinicians (sometimes both) who contributed text and/or artworks and original micrographs. The page proofs were scrutinized by a core team of Reviewers and finally a panel of International Reviewers: their comments have been incorporated into the text and I acknowledge their critical input. Working at this level of detail I have often been impressed by how much anatomy remains controversial or is simply unknown: surgeons, radiologists and embryologists often disagree passionately about structural relationships or developmental processes. Gray's continues to flag up these uncertainties and to present different perspectives.
As a general rule, the orientation of diagrams and photographs throughout the book has been standardized to show the left side of the body, irrespective of whether a lateral or medial view is presented, and transverse sections are viewed from below to facilitate comparison with clinical images. Clinicopathological examples have been selected where the pathology is either a direct result of, or a consequence of, the anatomy, or where the anatomical features are instrumental in the diagnosis/treatment/management of the condition. All of the pre 39th edition artworks, and the great majority of the images and micrographs of histological and embryological specimens have been replaced: wherever possible, the photomicrographs illustrate human histology and embryology, and non human sources have been acknowledged in the captions. New artworks have either been generated de novo or have been taken from other texts (principally Sobotta's Atlas of Anatomy, Books 1 and 2 or Gray's Atlas of Anatomy), making this the first full-colour edition of Gray's Anatomy.
I am often asked why Gray's Anatomy does not contain even more detailed surgical and radiological anatomy, with further examples of anatomical variants and of laparoscopic and endoscopic anatomy, and why we exclude all but a very few references. The answer is that we would love to do this, and to include some systematic anatomy, but we have reached a point where there is no room for more material in a single volume. Short reference lists are provided at the ends of each chapter to guide further reading, and a list of general texts and references covering material presented in more than one chapter, e.g. the distribution of angiosomes, appears on page xxiv. The Bibliography, which collated all of the references cited in a number of earlier editions 35–38, is retained on the website.
I offer my sincere thanks to the editorial team at Elsevier, initially under the leadership of Inta Ozols and latterly of Madelene Hyde, for their guidance, professionalism, good humour and unfailing support. In particular, I thank Alison Whitehouse, Gavin Smith, Martin Mellor and Louise Cook, for being at the end of a phone or e-mail whenever I needed advice. I am especially grateful to my dear husband, Guy Standring, for his tolerance while he has shared his life with Gray's Anatomy, and I dedicate my work in this book to him.
May 2008
