Sir Robert Carswell MD

Carswell was born in Paisley, Scotland, on 3 February 1793. He studied medicine at the University of Glasgow where his drawing skills became quickly evident and this ability brought him to the notice of Dr. James Thomson of Edinburgh, one of the foremost physicians of the day.

Thomson employed Carswell to make a collection of anatomical drawings for his lectures on the practice of physic. To this end, Carswell went to France in 1822, where he spent 2 years working at hospitals in Paris and Lyons (1822-1823). He returned to Scotland and took his degree of MD at Marischal College, Aberdeen, in 1826. He then returned to Paris and resumed his studies in morbid anatomy under the celebrated physician Pierre C.A. Louis.

In about 1828 he was nominated by the Council of University College London to be Professor of Pathological Anatomy there, but before starting teaching duties he was commissioned to prepare a collection of pathological drawings. He remained in Paris till 1831 when he had completed a series of two thousand water-colour drawings of diseased structures. He then came to London and undertook the duties of his Professorship. Soon afterwards, he was also appointed physician to University College Hospital; however he never practised and embarked on preparing a great book on pathological anatomy.

At the age of thirty-five, Carswell was nominated in 1828 to become the first professor of pathological anatomy at the new University College, London. Before beginning his teaching duties, however, he was commissioned to prepare a collection of pathological drawings for the University. He therefore stayed in Paris until 1831, by which time he had completed over one thousand watercolours of diseased structures. Described as being unequalled for the skill and accuracy of their delineation, this collection of drawings is still in the care of UCL and may be examined in the Special Collections Department of the library there. 

On his arrival in London, Carswell took up his duties as a professor and was also appointed as physician to the University College hospital. He then set about publishing the great work upon which his reputation rests, Pathological Anatomy: Illustrations of the Elementary Forms of Disease. Carswell undertook its publication because of 'the great difficulty, and frequently the impossibility, of comprehending even the best descriptions of the physical or anatomical characters of diseases, without the aid of coloured delineations.' Originally produced in twelve parts (or 'fasciculi') in order 'to diminish the labour and expenses', the book was published in 1837.

While Carswell's work has been praised for the clear, detailed descriptions which display his considerable knowledge and understanding of pathology, it is undoubtedly the beautiful illustrations that make this such an exceptional volume. The plates were reproduced by lithography. Invented by Alois Senefelder in Germany in 1798, lithography is based upon the chemical repellence of oil and water. Designs are drawn or painted with crayons or greasy ink on specially prepared limestone. After the image is drawn, the stone is moistened with water, which the stone accepts in areas not covered by the crayon. An oily ink, applied with a roller, adheres only to the drawing and is repelled by the wet parts of the stone. The print is then made by pressing paper against the inked drawing. To produce coloured lithographs, multiple stones are used; one stone is needed for each colour, and the print goes through the press as many times as there are stones. Accurate reproduction of colour was obviously an important factor in reproducing medical illustrations. Since lithography could produce plates more cheaply and quickly than engraving, the early half of the nineteenth century saw something of a boom in the production of anatomical atlases.  Carswell, however, was fairly unusual for being an expert lithographer himself: he was responsible for putting the illustrations on to stone himself, while the colouring was done under his immediate supervision.

One of Carswell's most celebrated achievements was being the first to portray the plaques of multiple sclerosis, although he did not identify them as such. Illustrated here in the section on atrophy is "a peculiar diseased state of the chord and pons Varolii, accompanied with atrophy of the discoloured portions ... the atrophy was more conspicuous in some points than in others, and is particularly well seen in the figure below, where it affects a portion of the right olivary body".

Later in life he became unwell and in 1840 he resigned his Professorship and accepted the appointment of physician to the King of the Belgians. Carswell spent the remainder of his life in Belgium, being occupied in official duties and charitable medical attendance on the poor. He was knighted in 1850 by Queen Victoria. He died on 15 June 1857. The 1886 entry for Carswell in the Dictionary of National Biography declares that his 'illustrations have, for artistic merit and for fidelity, never been surpassed ... perhaps no such anatomist was ever a better artist. His work has permanent value, and he had considerable influence as a teacher, though the abrupt termination of his scientific career prevented him from taking a leading place in the profession'. The article also describes the matter of the volume as representing the highest point which the science of morbid anatomy had reached before the introduction of the microscope.