Charles Aston Key (1793 – 1849) was an English surgeon.
Key was a great surgical operator; dextrous with the knife and ‘never known to make a mistake through inattention to details‘; he was one of the first surgeons in London to use ether as an anæsthetic.
Key introduced the operation for division of the prostate gland in lithotomy with the straight staff, using only a single knife (1824); and introducing the principle of dividing the stricture without opening of the hernial sac in cases of strangulated hernia – herniotomy (1833). The success of these operations established his reputation as a surgeon.
Key was not a well-read man nor a scientific pathologist but a keen and erudite lecturer, his lectures being largely the results of his own experience. In person he was of ‘commanding presence, thin, and rather tall, with a slightly aquiline nose.’
Eponymously affiliated with the Key-Hodgkin murmur (1827)
- Born on October 6, 1793 in Southwark, London
- 1810 – Apprenticed to his medical practitioner father, Thomas Key
- 1812 – Attended lectures at United Borough Hospitals and later Guy’s (1814)
- 1815-1818 apprenticeship with Sir Astley Paston Cooper (1768 – 1841); lodging with Cooper in 1817 and marrying Cooper’s niece, Anne Cooper in 1818
- 1819-1823 Demonstrator of anatomy at St. Thomas’s Hospital
- 1821 – Member of the Royal College of Surgeons
- 1824 – Surgeon to Guy’s Hospital. Reputation as a surgeon sealed when he introduced a successful operation for lithotomy with the straight staff, using only a single knife all through
- 1825-1844 Lecturer on surgery at Guy’s hospital
- 1845 – One of the first elected fellows of the Royal College of Surgeons, London
- 1847 – Surgeon to Prince Albert
- Died of cholera August 23, 1849 leaving nine children including his son Sir Astley Cooper Key (1821-1888)
Key-Hodgkin murmur (1827)
A diastolic murmur of aortic regurgitation with a raspy quality likened to the sound of ‘a saw cutting through wood‘ (bruit de scie). Hodgkin correlated the murmur with retroversion of the aortic valve leaflets seen post mortem.
Hodgkin and Key were contemporaries working in London, at Guy’s Hospital. Key is credited with first drawing Hodgkin’s attention to the problem of aortic incompetence. Hodgkin addressed this association in his open letters to Key which he read in February 1827 before the Hunterian Society
My Dear friend. Thou will probably recollect having pointed out to me, a few months ago, a particular state of the valves of the aorta, which, by admitting of their falling back towards the ventricle, unfits them for the performance of their functionHodgkin 1827
The impulse of the heart was not particularly feeble, but was considerably diffused; the sound very general over the whole left side, and nearly the whole of the right side of the chest, with the exception of the superior part of the chest. Each contraction appeared lengthened, accompanied with a purring, thrilling or sawing kind of noiseHodgkin. On retroversion of the valves of the aorta. Read before the Hunterian Society Feb 21, 1827
- Key CA. A short treatise on the section of the prostate gland in lithotomy; with an explanation of a safe and easy method of conducting the operation on the principles of Cheselden. 1824.
- Key CA. Case of Axillary Aneurism successfully treated by tying the Subclavian Artery. Med Chir Trans. 1827;13(1):1-272.6.
- Key CA. On the Ulcerative Process in Joints. Med Chir Trans. 1833;18(1):208-49.
- Key CA. A memoir on the advantages and practicability of dividing the stricture in strangulated hernia on the outside of the sac: with cases and drawings. 1833.
- Key CA. Further Remarks on the Ulcerative Process. Med Chir Trans. 1835;19:134-51.
- Key CA. The anatomy and surgical treatment of abdominal hernia. Philadelphia, Lea & Blanchard. 1844.
- Key CA. Report on primary syphilitic cases. 1840.
- Treves F. The Surgeon in the Nineteenth Century. Boston Med Surg J 1900; 143: 197-203
- Key, Charles Aston. Dictionary of National Biography
- Biography: Key, Charles Aston (1793 – 1849). Plarr’s Lives of the Fellows Online. Royal College of Surgeons of England.
- Bibliography. Key, C. Aston. WorldCat Identities
- Hodgkin T. On retroversion of the valves of the aorta. Lond Med Gaz 1829; 3: 433-443.
- Mulcahy R. The early descriptions of aortic incompetence. Br Heart J. 1962; 24(5): 633-636.
- Ma I, Tierney LM. Name that murmur–eponyms for the astute auscultician. N Engl J Med. 2010; 363(22): 2164-8.
- Robbins A, Zhang G. Name that murmur. LITFL 2019
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