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Biographical entry Cadge, William (1822 - 1903)

MRCS Nov 28th 1845; FRCS Aug 10th 1848; LSA 1847; JP.

Born
1822
Died
29 June 1903
Lowestoft
Occupation
General surgeon

Details

Born of a well-known Norfolk family of farmers. Served an apprenticeship at Kingston-on-Thames with Mr Taylor, father of Professor Sadler Taylor, Trinity College, Cambridge, who contributed an “Appreciation” to his Obituary Notes. He then entered University College Hospital, and after qualifying MRCS in 1845 became private assistant to Robert Liston (qv), until that surgeon’s death in 1847. He was present at Liston’s amputation through the thigh, with the patient under ether anaesthesia for the first time in this country, on Dec 21st, 1846, at 2 pm, and he contributed an account of the operation to the British Medical Journal on the occasion of the Jubilee of the use of general Anaesthesia. Moreover, he performed the post-mortem examination on Liston and published the description in the Lancet. Death had been due to a rupture of an aortic aneurysm situated at the commencement of the innominate artery. Cadge afterwards became Demonstrator of Anatomy at University College, and joined Thomas Morton in publishing his Surgical Anatomy, contributing the part on the head, neck, and upper limbs. In 1850 he was appointed Assistant Surgeon to University College Hospital upon John Eric Erichsen (qv) becoming Surgeon.

In 1851 he was elected Fellow of the Royal Medico-Chirurgical Society, and in 1854 contributed his only paper, “On Dislocation of the Femur Upwards and Forwards beneath the Crural Arch”. It was a case of unreduced dislocation of sixteen years’ standing in which a serviceable false joint had formed. But the dislocation differed in certain respects from the four forms given by Astley Cooper.

After two years as Assistant Surgeon to University College Hospital he joined Frederick Anthony Mills in partnership at Norwich; later he practised in partnership with Donald Dalrymple, and after that with Michael Beverley in St Giles’s Street. He was appointed Assistant Surgeon to the Norfolk and Norwich Hospital in 1854, becoming Surgeon in 1857 and Consulting Surgeon in 1890, which included the right of using a few beds for his patients. His services to the hospital were especially marked in the rebuilding of the hospital, to the Endowment Fund of which he twice gave a sum of £10,000 and left £5000 in his will. He was also much interested in the organization of nursing, and the development of the museum. The prevalence of stone in the bladder occupied his chief attention, and is that with which his name is connected. At the Norwich Meeting of the British Medical Association in 1874 Cadge gave the Address in Surgery, and in 1886 three lectures at the Royal College of Surgeons, “On the Surgical Treatment of Stone in the Bladder”.

The first Norwich lithotomist to become famous was Benjamin Gooch of Shotesham (d. 1776). William Donne, one of the first four surgeons appointed to the hospital in 1772, in the course of thirty-two years performed perineal lithotomy on 173 patients, with a mortality of 1 in 7, or 14.5 per cent. Following him Martineau did 149 operations, with a mortality of 1 in 8, or 12.5 per cent. John Greene Crosse (qv), who gained the Jacksonian Prize Essay for Stone in 1835, operated on 52 cases, whilst Lubbock, a contemporary and, strangely, one of the hospital physicians, operated upon 52. Between 1772 and 1885 there were admitted to the Norwich Hospital 1270 males and 56 females with vesical and renal calculi, and there were 1050 specimens of stone which Muller removed by operation or after death. Cadge thought that the numbers had increased during the previous five years – 90 cases had been admitted in that period, or 1 in 55 of all patients. In the Norwich Children’s Hospital the number admitted was 1 in 30; into the Yarmouth, one case of calculus among 32 patients. Cadge had performed lateral lithotomy in 169 cases, with 29 deaths – or 1 in 6, a mortality of 16.5 per cent. Suprapubic lithotomy had not been done at Norwich until 1884 and Cadge had operated on two cases. The statistics of suprapubic lithotomy then stood at a mortality of 24 per cent among Garcia’s 94 cases, and at 27 per cent among Tuffier’s 120 cases. But the mortality after lateral lithotomy greatly increased in the case of stones above 2 oz, for among 86 cases of stones weighing from 2 to 8 oz the mortality after lateral lithotomy had amounted to 45 per cent.

Cadge first mentioned lithotrity, and the improvement in lithotrites and evacuators and lithotrites for children. But he was speaking of diagnosis before the introduction of the cystoscope. He occupied much of his address in discussing the geographical variations in the incidence of vesical calculus without reaching any conclusion which met with general acceptance. And the disappearance of stone cases from the areas he considered in subsequent years further confused theories. Perhaps he approached nearest to an explanation when he discussed the influence of diet, the importance of milk over the small beer with a strong infusion of hops, especially in the case of children. It is a remarkable fact that in the years which followed there was a considerable diminution in the number of cases, even in the Norwich area. In 1910, in response to an inquiry by W F Haslam, the reply from Norwich was: “We scarcely get any cases of stone in the bladder now, though fairly common in the kidney; this is a great change, as I can remember about thirty years ago seeing three lithotomies in a morning.”

Cadge practised in St Giles’s Street. He served as a Justice of the Peace, and in 1876 as Sheriff of Norwich. The Freedom of the City of Norwich was conferred on him in 1890. For the sixteen years 1880-1896 he was a member of the Council of the College, and he appears in H Jamyn Brooks’s portrait group of the Council, 1884. On his retirement from the active staff he was appointed Consulting Surgeon, and his portrait by Herkomer was placed in the Board Room of the hospital.

After a period of failing health he died at Lowestoft on June 29th, 1903. He was buried by the side of his wife at Earlham, near Norwich, the Mayor and Sheriffs of Norwich, among others, attending the funeral. He had married the sister of Richard Quain (qv); there were no children and she had predeceased him many years. He left over £110,000, and made bequests of £5000 to the Norwich Hospital and £1000 to Epsom School. The Earl and Countess of Leicester added a like donation of £5000 to the hospital in his memory. A William Cadge Memorial Window, the result of subscription, was placed in Norwich Cathedral, a photograph of which appeared in the British Medical Journal.

Publications:
“The First Operation under an Anaesthetic in England. Note from Memory.” – Brit. Med. Jour., 1896, ii, 1140.
“Death of Robert Liston, FRS.” – Lancet, 1847, ii, 633.
The Surgical Anatomy of the Principal Regions of the Human Body (with T Morton), London, 1850.
“On Dislocation of the Femur Upwards and Forwards Beneath the Crural Arch.” – Med.-Chir. Trans., 1855, xxxviii, 87.
“Address on Surgery at the Norwich Meeting of the British Medical Association.” – Brit. Med. Jour., 1874, ii, 207.
“Lectures on the Surgical Treatment of Stone in the Bladder.” – Brit. Med. Jour., 1886, i, 1149, 1205.

Sources used to compile this entry: [Brit. Med. Jour., 1903, ii, 53, with portrait; also pp. 158, 209, 337, 431, 772, 861, 1018, 1311. Ibid., 1904, ii, 1587 (photograph of the Memorial Window). Lancet, 1903, ii, 63. Sir Peter Eade’s Norfolk and Norwich Hospital, London, 1900, passim. Haslam, W. F., Lettsomian Lectures: “A Review of Operations for Stone in the Male Bladder.” – Trans. Med. Soc., 1910-11, xxxiv, 192].

The Royal College of Surgeons of England