Carden, Henry Douglas ( - 1872)
by
 
Royal College of Surgeons of England

Asset Name
E000850 - Carden, Henry Douglas ( - 1872)

Title
Carden, Henry Douglas ( - 1872)

Author
Royal College of Surgeons of England

Identifier
RCS: E000850

Publisher
London : Royal College of Surgeons of England

Publication Date
2010-02-11

Subject
Medical Obituaries

Description
Obituary for Carden, Henry Douglas ( - 1872), Fellow of the Royal College of Surgeons of England.

Language
English

Source
Plarr's Lives of the Fellows

Full Name
Carden, Henry Douglas

Date of Death
22 December 1872

Occupation
General surgeon

Titles/Qualifications
MRCS January 27th 1829
 
FRCS December 11th 1843, one of the original 300 Fellows

Details
The son of John Carden, Surgeon to the Worcester Infirmary, born at Worcester, was educated at St Bartholomew’s Hospital. His elder brother, Thomas, had succeeded his father and was in turn succeeded by Henry Douglas, who held the post from 1888-1861, when he became Consulting Surgeon. He enjoyed a large surgical practice, hunted and shot, collected pictures of value, and was a zealous gardener. Had he lived, said the British Medical Journal, he would probably at no distant date have been elected President of the British Medical Association. The name of Carden is connected in the history of surgery with his recommendation of amputation by a single flap, published in the *British Medical Journal*, 1864. Fashion had changed from the varieties of circular amputation to that by transfixion with the long pointed knife recommended by Lisfranc. The main artery being controlled, the limb was stabbed with great rapidity twice on either side of the bone, and with each stab the edge of the knife was turned to cut obliquely forwards and outwards to make two thick flaps of obliquely severed muscles and nerves. The bone was sawn through with breathless haste; one ligature included the main artery and whatever was adjacent, vein or nerve or both. Sawdust was clapped on the stump and the surgeon departed, as also the onlookers. A few hours later there was reactionary hæmorrhage, and the House Surgeon by candlelight had to try to catch the bleeding points. The obliquely severed nerves caused painful twitchings of the stump, aggravated by the suppuration which set in. The ulceration and sloughing of the muscles was followed by their retraction, obtruding the end of the bone. After having practised amputation by transfixion from 1838, Carden began in 1846 to cut one single skin-flap, then to divide all the muscles down to the bone by a circular cut, and to saw through the bone slightly above the plane of the muscles. His table of 31 cases with 26 recoveries was very favourable at that time for the kind of cases undertaken. He avoided the pointed stump, and does not mention sloughing of the flap, which happened to other surgeons when an unduly long flap was raised. A second list of 33 cases by his colleagues as well as by Carden himself had similar results – 26 recoveries and 7 deaths. Teale modified the principle by making a flap three-quarters of what was needed anteriorly and a posterior flap of one-quarter, which aimed at avoiding the danger of sloughing mentioned above. Carden was disposed to maintain the advantage of the single long flap, for the limb had not to be removed so high up as Teale’s method demanded. He is also mentioned in Lister’s article in Holmes’s *System of Surgery*. Carden continued in active practice, although there were premonitory signs of apoplexy, until he died of it on Dec 22nd, 1872. *The Worcester Chronicle* referred to him in terms of appreciation. “He was gentle and gracious in manner, though, when it was needed, he could be firm and steadfast as a rock.” Publication: “On Amputation by a Single Flap.” – *Brit. Med. Jour.*, 1864, i, 416, with two tables and 8 figures of stumps.

Sources
*Brit. Med. Jour.*, 1872, ii, 718 1873, i, 25, 40 (Reminiscences by Dr Radclyffe Hale, of Torquay), 183
 
Resolution of the Birmingham and Midland Counties Branch of the British Medical Association, *Lancet*, 1873, i, 118

Rights
Copyright (c) The Royal College of Surgeons of England

Collection
Plarr's Lives of the Fellows

Format
Obituary

Format
Asset

Asset Path
Root/Lives of the Fellows/E000000-E000999/E000800-E000899

URL for File
373033

Media Type
Unknown