Preface to the twelfth edition

For the first time in its publication history all the illustrations in the previous (eleventh) edition of Last's Anatomy appeared in full colour. This development transformed the illustrations and received very favourable readership response. In the light of such evaluation the publication of a twelfth edition has provided the opportunity to augment the illustrations in the book by the inclusion of new photographs depicting anatomy of clinical, endoscopic and surgical relevance and additional photographs of prosections. Where necessary the colour, tone, shade and contrast of existing illustrations have been enhanced. Colour consistency for related structures has been maintained throughout to ensure ease of cross-reference from one illustration to another.

The text has been wholly reviewed and refinements made where required in the interests of relevance and readability. The anatomy of surgical approaches has been updated in the light of the continuing evolution of surgical practice, advances in laparoscopic surgery and the increasing scope of minimal access procedures. The limited field of vision provided by these latter techniques emphasises the need for a reliable knowledge of regional anatomy and structural relationships. Eponyms in common clinical use have been added.

Curricular reforms and changes to surgical training programmes have resulted in a reduction of anatomy study time and prosection experience for medical students, and in difficulties encountered by surgical trainees in including anatomy demonstratorships in their career pathways. These developments have reiterated the continuing need for a regionally arranged, clinically and surgically relevant anatomy textbook appropriate for both undergraduate study and postgraduate utilisation. The twelfth edition of Last's Anatomy aims to fulfil this role and be of value to medical students, surgical trainees and practising surgeons.

Chummy S. Sinnatamby

2010

Preface to the eleventh edition

In response to innumerable requests, all the illustrations in the eleventh edition appear in full colour. Care has been taken in the choice of and consistency in use of colours for similar structures to facilitate ease of recognition and enhance the reader's appreciation of the illustrations as a meaningful adjunct to the text. Some of the illustrations in the first edition of R. J. Last's Anatomy, Regional and Applied were partly coloured as they appeared in relation to the text. In the seventh edition several partly coloured illustrations were collectively positioned as plates at the front of the book, but these were then omitted from subsequent editions. It has been gratifying to be able to restore colour to Last's Anatomy and extend its application to full colour for all the illustrations as they remain integrated with the text. Several new illustrations, including clinical photographs, radiographs and magnetic resonance images, have been added, depicting normal anatomy and lesions that have an anatomical basis.

The text has been extensively revised with several additions to the clinical and applied aspects of anatomy and textual changes in the interests of clarity and accuracy.

I am grateful to the many readers, postgraduate and undergraduate, in the UK and abroad, who have communicated their appreciation of and comments on the tenth edition. Their input has encouraged and aided the preparation of the eleventh edition.

Chummy S. Sinnatamby

2005

Preface to the tenth edition

In 1954, after seven years of association with postgraduate students of anatomy at the Royal College of Surgeons of England, R. J. Last published the first edition of Anatomy, Regional and Applied. Forty-five years later Last's ‘approach to the study of anatomy’ is still of value to undergraduate and postgraduate students of anatomy. The chief assets of Last's Anatomy were epitomised in its title. In the assessment and treatment of patients' lesions, clinicians encounter the anatomy of the human body on a regional basis, and the book presented applied anatomy data regionally arranged. When R. M. H. McMinn took over the editorship in 1990 he retained ‘the flavour of earlier versions’ and added to the applied aspects of the subject.

In preparing the tenth edition of Last's Anatomy, I have maintained the overall structure and arrangement of the book. The entire text, however, has undergone comprehensive revision directed towards a reduction of its volume and greater clarity. Anatomical detail of no clinical relevance, phylogenetic discussion and comparative anatomy analogies have been omitted. Within the constraints of conciseness, clinically correlated topographical anatomy relevant to the expanding frontiers of diagnostic and surgical procedures has been included. Surface anatomy pertaining to physical examination is presented. Histological features and developmental aspects have been mentioned only where they aid the appreciation of the gross form or function of organs and the appearance of the commoner congenital anomalies.

In keeping with the extensive textual changes in this edition, the illustrations have also undergone major revision. While several figures which appeared in previous editions but did not significantly contribute to or enhance the text, have been removed, 97 new illustrations have been added. The latter include original artwork specially commissioned for this edition, figures reproduced from Gray's Anatomy (with the kind permission of the publishers) on account of their anatomical accuracy and clarity, and examples of current diagnostic imaging techniques.

Throughout the preparation of this edition the curricular reforms of undergraduate education and the restructuring of surgical training have been borne in mind. Time constraints and the interdisciplinary integration pertaining to both have restricted the study of anatomy. Nevertheless, anatomical knowledge is required for performing physical examination and diagnostic tests, interpreting their results and instituting treatment, particularly surgical procedures. In his preface to the second edition Last stated that: ‘While the text was written chiefly to help students who are revising their anatomy for an examination, it is particularly gratifying to find that so many clinicians and surgeons have found the book of value in their practice.’ It is hoped that the clinically relevant anatomical information presented in the tenth edition, in as concise a form as its content concedes, will be of use to students preparing for examinations, participants in basic and higher surgical training programmes, and practising surgeons.

Thirty-seven years ago I purchased a copy of the second edition of Last's Anatomy while preparing for the primary fellowship examination, in the oral section of which I was examined by Professor Last himself. Little did I imagine then that it would one day be my privilege to prepare the tenth edition of Last's Anatomy, thereby maintaining the linkage between the editorship of this publication and the headship of anatomy at the Royal College of Surgeons of England.

Chummy S. Sinnatamby

1998