ANATOMY

while during the period 1910-25 the policy of appealing to the legal custodians of unclaimed bodies to hand them over for anatomical examination followed the course previously pursued by licensed teachers of anatomy, the government authorities not only supervised the administration of the act, but also helped the schools to obtain an adequate supply of material to meet their needs. the immediate result has been an extension of sources of supply so as to improve consider- ably the state of affairs which prevailed in great britain in ro1o. in recent years there has been much confusion with regard to the nomenclature used in the science of anatomy. this arose from an attempt to revise and improve the terminology which had previously been in common use. at present either the orig- inal or the new “ basle ” terminology or a combination of both are employed, but it is very desirable that a unanimous under- standing should be arrived at by anatomists for the good of the science in general, and for its application to medicine and surgery in particular. while advances in the science of anatomy since rg11 have been important, but of a highly technical nature, many contributions have been made largely in association with cognate subjects such as comparative anatomy, physical anthropology, embryology, physiology, pathology, medicine and surgery. there has been much elaboration and improvement in appa- ratus designed for the examination in the living person of the organs of sense, alimentary canal, respiratory and genito-urinary systems. the technique of preparing the tissues of the body for microscopic examination has also advanced.'! perhaps the most important step forward in recent years has been the application of x-rays in the study of macroscopic anatomy particularly af the living body—an advance which has proved of immense importance in the practice of medicine and surgery. osteology.— advances in connection with the skeleton have been largely concerned with its development. the controversy regarding osteogenesis has continued and new views have been expressed as regards the origin, growth and fate of osteoblasts and osteoclasts. important contributions have been made deal- ing with the human clavicle, ribs and bones of the face. with regard to the descriptive aspect of osteology an interesting account has been given of the human sinus maxillaris at all ages. sexual differences in the human skull and sexual and racial characters of the human ilium have been recorded. important papers have also appeared upon the morphology of mammalian teeth and sternum. muscular systen.—the world war, with its immense train of injuries to muscle and nerve, was directly responsible for renewed intensive study of these systems. the investigations of prof. kulchitsky upon the innervation of muscle fibres, the consequent and subsequent suggestions by prof. hunter that muscle fibres are of two kinds with separate nerve supplies from the central and autonomic systems, and the actual designing of surgical measures for amelioration of muscle spasm based upon these ideas, have not yet been sufficiently confirmed. the morphological aspect of the muscular system has also received its due measure of attention. nervous system.—c. w. ariens kappers has demonstrated that contro! is exercised upon the grouping of brain cells by forces, probably of a bio-electric character, emanating from the nerve tracts with which these are functionally associated. much attention has been given to the comparison of particular areas of the central nervous system in a series of vertebrates with a view to elucidating the evolutionary significance of these areas in man. considerable work has been directed to the relative la. b. lee, the aficrotomist’s vade-mecum, cighth edition by j. bronte galenby (1921). ynatomy plate 6 ee — = : radiography as applied to anatomy fic. 1. lateral view of head. fic. 2. side view of knee. fic. 3. normal stomach and first part of duodenum immediately after ingestion of barium meal. fic. 4. the ankle and foot. fic. 5. lower part of forearm and hand. fic. 6. pelvis and hip-joint photographs by courtesy of dr. levack, aberdeen; dr. spriggs, ruthin casile, n. wales; and dr. salmond, univ. coll. hos pital, london anatomy anatomy of the origin, course and distribution of the motor and sensory nerves, with the acquisition of knowledge, highly detailed, but of great practical importance. organs of sense.—very important and extensive investigations have been carried out by karl pearson, e. nettleship and c. it. usher on the subject of albinism in man, showing that eyes, hair and skin may alone show perfect albinism, and that perfect albinism in eyes may be accompanied by imperfect or wholly absent albinism in hair. anatomical science is indebted to s. ernest whitnall for an exhaustive account of the anatomy of the human orbit and accessory organs of vision, and to sir frederick smith for anatomical notes on the accessory organs of the eye of the horse. as regards the ear much attention has been given to the study of the structures concerned in the mechanism of hear- ing, and attention may be directed to comprehensive accounts of the anatomy of the ear in man and animals by albert gray, glasgow. vascular system—during the years 1910-25 additions to the knowledge of the vascular system have been chiefly in relation to function. recent advances in connection with structure have been with regard to the blood supply of the valves, the muscular architecture and the development of the human heart. further information has also been gained with respect to the arterial supply of the pons, medulla, and fore-brain, and the develop- ment and comparative anatomy of the arteries of the extremities. digestive system—the chief advances in the anatomical knowledge of the digestive system have been along the lines of development and morphology. particular attention has been paid to the teeth, the shape and size of the tonsils at different ages, the minute structure of the oesophagus in mammalia, the form and immediate relations of the abdominal! viscera with special reference to their peritoneal attachments, their blood and nerve supply and lymphatic connections. respiratory system—numerous papers of importance have been written upon the human and comparative anatomy and development of this system with special reference to the lobes of the lungs and the nerve supply of the larynx. recent knowledge, which has been acquired by means of x-rays regarding the posi- tion of the diaphragm and thoracic viscera, wil be found in the paragraph below, radiography as applied to anatomy. genito-urinary system.—the problem of the descent of the testis has attracted renewed investigation and given rise to new opinion. comparative anatomy, development and clinical meth- ods have been studied for light upon the various parts of this system, and the most valuable additions have been made to our knowledge of the appearance of the urethra, bladder and ureter by the cystoscope and of the kidney by radiography. ductless glands -——much attention has in recent years been focused on the function of these glands and a renewed interest has been taken in their morphology and microscopic anatomy. radiography as applied to anatomy human anatomy has been greatly advanced by the appli- cation of radiography to the study of the body especially in its living state. in recent years the apparatus in connection with radiography has been enormously improved (see rontgen rays). advances have been made in the preparation of the human body, prior to its exposure to the x-rays, by the employ- ment of substances to which the rays are highly impervious. in order to interpret the photographs obtained by radiography it is essential that the person who takes the photograph and the person who interprets it should be one and the same, as it is of primary importance that the interpreter of the photograph should have first-hand knowledge of the exact relation between the source of the rays, the object to be examined and the photo- graphic plate. the skull.—an instructive radiogram of the skull is obtained by placing the tube generating the rays on one side ol the head and by laying the photographic plate flat against the other. fig. r on plate shows a lateral view of the head resting upon the upper part of the spinal column. on detailed examination a good view is obtained of the extent of the cavity which contains the 123 brain. the orbital and nasal chambers with their accessory air sinuses (antrum of highmore and sphenoidal air sinus) are well seen. particularly there is noticeable, immediately bchind the sphenoidal sinus, the saddle-shaped sella turcica for the lodgment of the pituitary gland which is chieily concerned in the growth and metabolism of the body. shoulder.—a front view of the shoulder and neighbouring part of the chest when the arm hangs by the side of the body, discloses the relative position of the bones of that region. the ribs pursue an obliquely downward course in order to allow of their move- ments in respiration. the clavicle passes outwards and slightly upwards toward the acromion process of the scapula, with it to form a bony arch overhanging the shoulder joint and thus helping to prevent up- ward displacement of the humerus at that joint. the body of the scapula rests on the ribs thickening at its axillary border and upper and outer angle where it expands to form the glenoid fossa for the reception of the head of the humerus. the coracoid process which is swung by fibrous tissue to the clavicle in the recent state is very evident. the ball and socket character of the shoulder joint is so arranged as to allow of extensive movement of the arm at the joint, the socket (glenoid cavity) being small as compared with large articulating surface of the ball. the upper extremity of the humerus with its articular surface and tuberosities are well seen. elbow.—a good picture of this region is obtained by taking a radiograph from its inner side with the elbow joint slightly bent and the forearm in such a position that the palm of the hand is directed toward the median plane of the body. the lower end of the humerus shows the internal condyle with a ridge running upward from it and a groove behind it for the passage of the ulnar nerve (funny bone) from the arm into the forearm. the upper end of the ulna shows the deep concavity by which it articulates with the pulley-shaped surface of the humerus and its helmet-shaped upward extension (olecranon process) for the attachment of the triceps muscle—the great extensor of the forearm. the head of the radius supported upon its conical neck articulates with the humerus above and the ulna at the side. the whole picture emphasises the hinge-like character of the elbow joint and the pivot character of the joint between the bones of the forearm at the elbow. wrist and hand.—fig. 5 on plate shows the lower part of the forearm and hand viewed from the palmar aspect. the radius and ulna, the carpal, metacarpal and phalangeal bones form distinct shadows. the outline of the wrist joint shows that the hand is supported mainly by the expanded lower end of the radius, the head of the ulna being separated from the carpus by an interval which in the recent state is filled up by a fibro- cartilaginous pad. the outlines of all the eight bones of the carpus can clearly be made out forming a group consisting of two rows of bones with an -shaped joint between them. the os magnum is the largest bone of the group and lies with its long axis in line with the middle finger, the semi-lunar and the radius. its rounded head fits into a cup formed by the scaphoid and semi-lunar; its body is flanked by the trapezoid and unciform, and its base supperts the third and to a lesser degree the second and fourth metacarpal bones. the pisiform ts rather indefinitely seen immediately below the ulna and in front of the cuneiform. the trapezium partially hides the trapezoid. the four inner metacarpal bones lie close to one another, while the first or that of the thumb is separated from the second by a wide interval. a small sesamoid bone is seen lying upon the inside of its head. the phalanges of the fingers and thumb are shown very dis- tinctly and the ball and socket character of the metacarpa- phalangeal and the hinge-like nature of the inter-phalangeal joints are also manifest. the whole radiogram affords a striking illustration of the adaptation of the hand for prehensile purposes as compared with the foot which is constructed essentially for supporting the weight of the body and for locomotion, 124 pelvis and hip-joint.—the architecture of the bony frame- work of the pelvis which transmits the weight of the trunk and upper extremities allowing at the same time room for viscera is well seen in fig. 6 on plate. the relation of the wedge-shaped sacrum with its coccygeal appendage to the rest of the body girdle is apparent. the sacrum is seen to be interlocked between the ilia of the innominate bones so as to form with them an arch transmitting the superincumbent weight either to the lower extremity in the erect posture or to the ischial tuberosity in the sitting position. the tendency towards the spreading of the arch is prevented by the front portions of the pelvic girdle acting as tie beams and there are three ‘“‘buffers” which break shocks; one at the symphysis pubis in the middle of the front part of the girdle and the other two at joints between the sacrum and ilia. the foramina for the exit of nerves from the spinal cord to supply the lower extremities and soft parts of pelvis are apparent. the general character of the female as compared with the male pelvis is well exemplitied in fig. 6, e.g., the widely spreading ilia, the great width of cavity below the ilia and the wide sub-pubic angle. to get a gocd radiogram of the region of the hip-joint is a somewhat diflicult matter. one taken from the front shows the thigh occupying its position in the erect posture, revealing the socket or acetabulum, the head of the femur with its pit for the round ligament, the oblique neck, and the upper part of the shaft with the great and small trochanters. the arrangement of the cancellous bone tissue is such as to bear the superincumbent weight in the best possible way. unlike the shoulder-joint which is constructed essentially for prehension, the hip-joint is formed for support and locomotion. knee.—many radiograms of this region show that the bones which form its foundation come near the surface of the limb especially in front and that they are consequently liable to mechanical injuries and to the effects of other adverse influences from without. a good general idea of the region is obtained by taking a radio- gram from the side (fig. 2 on plate). it shows the lower part of the femur with its condyles, upper part of the tibia with its spine, tuberosities and tubercle, and the upper part of the fibula with its head. | there is seen to be but little interlocking between the femur, tibia and patella which enter into the formation of the knee joint. the tibia articulates by a relatively small surface with the relatively large articular surface of the femur, the joint so formed being an example of a hinge joint with the pin of the hinge a movable one. the spine of the tibia is seen projecting upward between the condyles of the femur acting like the flange of a wheel and so helping to prevent lateral displacement of the tibia from the femur at the joint. the knee-cap, to which are attached the great extensor muscles of the leg, moves upward and down- ward on the femur only. the fibula is seen articulating with the tibia, the joint surface being oblique in direction in order to break shocks between the two bones. ankle and foot.—in fig. 4 on plate a view of the skeleton of the lower part of the leg and of the foot is given from the inside. the tibia and fibula of the leg, and the tarsal and metatarsal and some of the phalangeal bones are shown. the tibia articulates with the astragalus at the ankle joint, and on close inspection the relative positions of the malleoli of both the tibia and fibula to the astragalus can be made out, the bones of the leg and the astragalus forming a hinge joint. the tip of the outer malleolus which forms part of the fibula reaches to a lower level than the tip of the inner malleolus which belongs to the tibia. the foot as in the case of the hand is seen to consist of a number of bones by virtue of which its mobility and elasticity are increased, while the chances of fracture or dislocation are lessened. the antero-posterior and to a less extent the transverse arch of the foot are shown, the pillars of the former consisting of the great tuberosity of the os calcis behind and of the heads of the metatarsal bones in front. the astragalus forms the keystone of the arch, and transmits the weight of the body from the tibia to andersen the astragalus and os calcis behind and to the scaphoid, cuboid, cuneiform and metatarsal bones in front. the spicules of the cancellous tissue in these bones are arranged so as to bear the weight of the body transmitted through them. the so-called tunnel of the tarsus and the mediotarsal joint across the foot between the astragalus and os calcis behind and the scaphoid and cuboid in front arc very apparent, showing at the same time that the articulation between the os calcis and cuboid forms a sep- arate joint. the front of the middle cuneiform is indicated by a narrow vertical shadow situated a little behind the shadow indi- cating the anterior border of the internal cuneiform. the radiogram illustrates vividly the essential difference between the hand and the foot, in that the big toe is seen to be closely applied to the second toe and not opposable to the rest of the foot as the thumb is to the rest of the hand. ossification.—ossification begins in each bone of the skeleton at one or more spots called ‘‘ primary centres of ossification.”? each appears before birth and by their spreading they form the main part ofthe bone. after birth “‘ secondary centres of ossification ”’ begin to show themselves independently of the main mass, form what are known as “ epiphyses ” and join it at various periods after birth to make the adult bone. radiography, when applied to the living body, affords very valuable information as to the forms, times of first appearance and times of junction of the epiphyses with the main parts of bones to which they belong. it has shown that there is very great variability in the times of appearance and of fusion of epiphyses in different individuals, a fact which is of great importance in the practice of surgery. thorax and its contents —apart from revealing the skeleton of the thorax, radiography permits inspection of the position and contour of the heart and great vessels, the lungs and medi- astinum., abdomen and its contents—subsequent to the introduction of matter opaque to x-rays such as barium or bismuth salts into certain organs, radiography has played a very important part in elucidating the anatomy of the alimentary canal and the urinary tract. . fig. 3 on plate shows a normal stomach and first part of the duodenum immediately after the ingestion of a barium meal. the clear area at the upper part indicates the air-containing portion of the cavity in the neighbourhood of the entrance of the oesophagus. the writer of this article is indebted to dr. levack, radiologist, royal [nfirmary, aberdeen, dr. spriggs, duff house, ruthin castle, north wales and dr. salmond, radiologist, university ouaee be ee london, for the radiograms that are reproduced in figs. i to 6. bislrograpiy.—j. b. deaver, surgical anatomy (1889-1903); g. romiti, prattate di anatomia dell’ uomo (1893-8); j. a. serrano, tratado de osteologia humana (1895); c. bardeleben, handbuch d. dinatomie d. menschen (1896, etc.); g. chiarugi, fustitusioni di slnatomia dell’ uomo (1904-12); g. v. ellis, demonstrations of slnatemy (1905); g. a. piersol, zuman anatenry (1907); w. spalte- holz, hand-atlas of ittiman anatomy (1907); j. quain, elements of anatomy (1908); a. a. rauber, ed. f. kopsch, lehrbuch der anatomie des menschen (1908-9); p. poirier and a. charpy, traite d’ anatontie humaine (1909, etc.); c. langer and c. toldt, lehrbuch der systema- lischen u. topographischen anatomie (1911); h. rouviere, precis ad’ anatomie et de dissection (1911-3); f. g. parsons anit w. wright, practical anatomy (1912); p. stohr, lehrbuch der histologie und mikroskopischen anatomie des menschen (1912); sir c. s. sherrington, postural activity of muscle and nerve, brain, (dec. i915); a. thomson, handbook of anatomy for art students (1915); w. colin mackenzie, the action of af{uscles (1918); d. j. cunningham, manual of practical anatomy (1919); h. k. corning, lehrbuch der topographischen anatomie (1922); f. wood jones, the principles of anatomy as seen in the land (1920); e. s. schafer, essentials of itistology (1920); c. w. ariens kappers, on structural laws in the nervous system; the principles of neurobiotaxis, brain (july 1921); a. b. lee, the aficrotomist’s vade- mecunt (1921); g. l. testut, traite d'anatomie humaine (1921-3); d. j. cunningham, text- book of anatomy (1922); h. gray, anatomy, descriptive and a pplied (1923); swale vincent, internal secretion and the ductless glands (1924); a. m. buchanan, afanual of anatomy, including e-mbry- ology (1925). (r. w. re.) andersen, hans niels (1852- }, danish shipowner and merchant, was born at nakskov in poor circumstances. he went to sea and in 1884, having gained experience by trading with the anderson, e. g.—m—angell fast, he founded the business of andersen & co., at bangkok, opening in 1894 a branch house in copenhagen. in 1897 he established at copenhagen det ostasiatiske kompagni (the east asiatic company) which soon became the largest commer- cial enterprise in denmark and one of the few danish undertak- ings of world-wide renown. in 1912 at copenhagen, the com- pany launched the first large motor-ship. owing to his powers of administration and his extensive connections throughout the world he rendered important services to his country during the world war. he received the order of the elephant, the highest danish order, in 1919. he is the author of tilbugeblik (1920). see a. fraenkel, verden med dansk afaal eller danmark nied ver- densmaal (1916). anderson, elizabeth garrett (1836-1017), british medical practitioner (see 1.959), died at aldeburgh, suffolk, dec. 17 1917. anderson, sherwood (1876- ), american author, was born in camden, o., sept. 13 1876. after trying various occupa- tions, he entered the advertising business and eventually left his native state for chicago. his first literary work was a story, sistey, which appeared in the lifffe review (1015). his first novel was windy amfucpherson’s son (1916). in 1921 his novel, many afarriages, was awarded the diai prize of $2,000. among his other works are afurching afen (1917); alid-american chants (1918); winesburg, ohio (1919); poor white (1920); the triumph of the egg (1921); dark laughter (1925) and the autobiographical a story teller’s story (1925). mr. anderson’s fiction is mainly psychological in interest, and pessimistic in tone. the frankness with which he treats the relations of the sexes has frequently provoked criticis'n.