Howard Atwood Kelly

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For the British Admiral, see Howard Kelly (Royal Navy officer).
Dr. Howard Kelly
Howard Atwood Kelly young.jpg
Born (1858-02-20)February 20, 1858
Camden, New Jersey
Died January 12, 1943(1943-01-12) (aged 84)
Baltimore, Maryland[1]
Nationality United States
Alma mater University of Pennsylvania
Occupation Obstetrician/Gynecologist, Professor, Writer
Signature
Howard Atwood Kelly's sign.png

Howard Atwood Kelly (February 20, 1858 – January 12, 1943) was an American male gynecologist,one of the "Big Four" founding professors at the Johns Hopkins Hospital in Baltimore, Maryland.[2]He is credited with establishing gynecology as a true specialty, by developing new surgical approaches to women only diseases and through pathological research.[3]

Early Life[edit]

Howard Kelly was born in Camden, New Jersey, the son of Henry Kuhl Kelly and Louisa Warner (Hard) Kelly. His family had a proud history of achievement in politics, business, real estate and civil service, and Howard Kelly was the first with achievement in medicine or science. [4]He was raised with strong religious influence from his parents, especially his mother. Later he recalled,"I owe my real start in life to my mother, who began to teach me the Bible."[4] In Civil War times, when his father was at the war-front, the young Howard Kelly spent his free time roaming the hills. On his 75th birthday, he could well recall: "the first snake seen-how vividly it comes back; the 'bumble bees' building their homes in the big gatepost of a 24 acre field; the woods and the streams". In the fall of 1867, Howard Kelly entered the famous Classical Institute. There, he developed an interest in biology, natural science, and botany. In 1873, he started his undergraduate education at the University of Pennsylvania.[5] During his college years, he was the president of the Franklin Scientific Society. After graduating with a B.A. in 1877, he was enrolled in Penn's Medical School.After his residency, he decided to concentrate on gynecology.  

Medical Career at Hopkins[edit]

William Osler recruited Howard Atwood Kelly to be part of Johns Hopkins School of Medicine, and at only 31 years old, Kelly became part of Hopkins' Big Four, the founding chairs responsible for the Hopkins legacy. The Big Four were William Steward HalstedWilliam OslerWilliam H. Welch, and Howard Atwood Kelly, the youngest of all four men. Though he was the youngest of the Big Four, Kelly demonstrated his leadership and skills. Kelly worked as the gynecologist-in-chief at the newly established Johns Hopkins Hospital. Furthermore, in only three years after moving to Baltimore, Kelly founded the Howard A. Kelly Hospital, an active hospital until the year 1938. [6]  Not only was Kelly known to be greatly skilled, he was also said to have a kind and charitable heart because Kelly would often do away with his surgical fees at the University. Ironically though, in private practice, Kelly charged high fees for his services. [7]

At Johns Hopkins, Kelly expressed interest in urogynecology and continued to innovate new surgical techniques to provide better surgery for his patients. To achieve this goal, Kelly studied the bladder and even learned how to catheterize the ureters using air cystoscopy. His usage of cystoscopy is known as one of the earliest applications of endoscopy in the field of gynecology. Kelly's other innovations also included the Kelly's stitch, surgical clamp, and speculum. [7]

To promote safety during surgery, Kelly used nitrous oxide for anesthesia, absorbable sutures during operations, and electrical lights for better lighting during surgery. Furthermore, Kelly brought Max Broedel, known as the father of medical illustration, to Baltimore and worked alongside him so that illustrations could be made during surgery. These pictures were known as stereoscopic photographs, which were published later on for other students and surgeons. [8]

During the late 1890s, Kelly became interested in gynecological cancers. To reduce bleeding for cervical and endometrial cancers, Kelly ligated the internal iliac artery, a technique that would come to be used in postpartum hemorrhages and save many lives in the future. Kelly also dabbled with the usage of radium in 1904. Kelly obtained a small amount of radium from Madame Marie Curie and became the first person to create a practical, clinical use for radiation. In 1917, his own clinic had about 5.5 grams of radium, the largest amount of radium available in any clinic at the time. [7]

Kelly influenced not only the surgical field but also the academia as well. As the first professor of gynecology, Kelly established a leading training program in gynecology, and through this program, Kelly raised leaders that would later go on to impact the fields of gynecology and medicine as well. In 1919, Kelly finally retired at at 60 years old after 30 years of working. However, even after his retirement, Kelly continued to operate until he reached the age of 80 years old. [6]

By the time he reached the end of his career, Kelly had written over 550 articles and books that covered subjects such as appendectomy, the use of radium, electrosurgery, urogynecology, and ureteral catheterization. Additionally, he also had publications about medical history, religion, herpetology, and botany[6]

Family Life[edit]

In 1889, Howard Atwood Kelly married Olga Elizabeth Laetitia Bredow in Danzig, Germany. After their honeymoon in Paris, the married couple decided to live in Baltimore, where they raised nine children together, and as a devout follower of the Episcopal faith, Kelly brought up his children in accordance with the same faith that he had. Additionally, out of nine children, only one, Edmund Kelly, studied medicine, despite their father's devoted career in the medical field. [6]

Personal Life[edit]

From an early age, Kelly enjoyed nature and animals because his mother would take him on nature walks that sparked his interest in the environment.[6] In his own home, Kelly not only collected several dozen cages filled with different types of reptiles but also observed variations of exotic snakes. Kelly would demonstrate how to handle rattlesnakes, bit into a rattlesnake, and taught how to milk rattlesnakes of their venom. [9]Additionally, due to his great passion for and publications about reptiles, he was named Honorary Curator by The Division of Reptiles and Amphibians at The University of Michigan. [6]

Not only was Kelly interested in reptiles, but he was also fascinated with mycology. Similarly to collecting reptiles, Kelly collected fungi systematically and kept a list of species and observations. His interest with mycology was far and wide as they encompassed mushroom identification, mycophagy, and research on mycologists. As time went on, Kelly would purchase numerous pieces of mycology literature from American and European booksellers as part of his collection. [9] Later in 1924, with the help of Louis Krieger, Kelly also compiled The Catalogue of the Mycological Library of Howard Kelly (1924), with over 400,000 entries. an archive of artworks, 7000 titles on mushrooms, and replicas of fungi. In 1928, Kelly donated his library, paintings, and mycological collection to the Herbarium of the University of Michigan.[10] This collection has been designated as The L. C. C. Krieger Mycological Library and Collections. [11]

Kelly was also very well known for his devotion to the Episcopal faith. His religious life began with his mother teaching him about the Bible. As a teenager, Kelly would read the original Greek and Hebrew texts of the Bible and even pass New Testament scripture that he carried in his pocket to his fellow peers and friends. [6]Kelly kept the Sabbath and read the Bible daily, and as an adult, he wrote books about religion such as A Scientific Man and the Bible. In addition to his faith, Kelly was a prohibitionist and opposed birth control. [5]He prepared sermons for all denominations when ministers or pastors became unavailable on Sundays, supported missionaries, and worked hard to regulate prostitution to prevent people from being punished by sin, accounting for his reputation as a religious reformer. [9]Kelly even provided housing for former prostitutes who needed temporary lodging when they quit their practices and followed the Word of God. [6]

One Baltimore columnist who was known for his attacks on anti-intellectualism H.L. Mencken described Kelly's religious devotion in great detail: "Before cock-crow in the morning he has got out of bed, held a song and praise service, read two or three chapters in his Greek Old Testament, sung a couple of hymns, cut off six or eight legs, pulled out a pint of tonsils and eyeballs, relieved a dozen patients of their appendices, filled the gallstone keg in the corner, pronounced the benediction, washed up, filled his pockets with tracts, got into a high-speed automobile with the Rev. Dr. W.W. Davis and started off at 50 miles an hour to raid a gambling house and close the red-light district at Emory Grove, Maryland." [5]

Death[edit]

On January 12, 1943, Kelly died at 84 years old in Baltimore, and his wife at 53 years old died six hours later in the room next door at Union Memorial Hospital.[5] The married couple had a joint funeral that took place at the Memorial Episcopal Church and a burial at Woodlawn Cemetery in Baltimore. [6]

Recognition/Honors[edit]

  • Received the Honorary Degree of Doctor of Laws from the University of Pennsylvania in 1907
    • also from the University of Aberdeen, Washington College, Washington and Lee, and Johns Hopkins [5]
  • Named an honorary fellow of Universities in Edinburgh, Glasgow, Dublin, London, Paris, Rome, Berlin, Leipzig, Bucharest, Vienna, Kiev, and Lima.
  • Founding member of the American College of Surgeons in 1913. [6]
  • Commander, Order of Leopdd, Belgium[12]
  • Member of
    • Order of the Cross of Mercy, Serbia; [12]
    • Cross of Charity, Kingdom of the Serbs, Croats and Slovenes[12]
  • Honorary curator division reptiles and amphibians, University of Michigan Museum of Zoology[12]
  • Johns Hopkins Kelly Gynecologic Oncology Service named after Howard Atwood Kelly [8]
  • In 1943 a U.S. Liberty ship was christened the Howard A. Kelly. [5]
  • he served as president of the Southern Surgical and Gynecological Society in 1907 and of the American Gynecological Society in 1912.

Bibliography[edit]

Some of his many publications

A page in Operative Gynecology
  • Operative Gynecology (two volumes, 1899) [12]

Medical Achievement and Innovation[edit]

    • Kelly's sign — If the ureter is teased with an artery forceps, it will contract like a snake or worm.
    • Improvement on surgical dressing: In order to minimize displacement and the possibility of wound infection, he invented the wound sealing procedure. He would first soak two layers of sterilized gauze with celluloidin and bichloride to secure the dressing to the skin. Then, he would dust the surface with iodoform and boric acid powder. Thus, until the stitches were removed, the wound would not be exposed.
    • Kelly's Forceps, in locked and open positions
      After 1903, when Dr. Kelly obtained a small amount of radium from New York, he became interested in applying radium to cancer treatment. He published "Radium in the Treatment of Uterine Hemorrhage and Fibroid Tumors" in the Journal of the American Medical Association in 1914. As a pioneer in this method, Dr. Kelly was initially ridiculed but eventually praised for the effectiveness of radium treatment. the Kelly Clinic in Baltimore, one of the country's leading centers for radiation therapy at that time.[14]In 1913 he helped found The National Radium Institute with James S. Douglas, a mining executive and philanthropist, to extract radium from US domestic sources for use in cancer treatment and possible industrial use and in the process to develop more efficient methods of radium extraction.[15][16]
    • Operating Suit — Howard Kelly was among the first surgeons to dress in sterilized linen suit during operations.
    • Kelly speculum — A rectal speculum, tubular in shape and fitted with an obturator.There is also Kelly's small cylindrical specular, in which Nos.12-15 are special designs in the cystoscopic set are specially designed for virgins. [17]
    • Kelly's forceps(Kelly's Clamp) – Kelly's forceps are curved hemostatic forceps without teeth, used to clamp vessels to control blood flow and arguably among the most common and best known surgical instruments. Its shape resembles a pair of scissors, with blades replaced by blunt grips. In his Operative Gynecology, Kelly describes their value as (1) having jaws longer than usual and gently curved (2) the tips being able to grasp the tissue before the first shoulder is reached
    • Kelly's stitch — Surgery for the bladder neck to correct stress incontinence of urine.
    • Kelly's Plication: Kelly's Plication is frequently used in treating SUI (Stress Urinary Inconsistence), SUI is caused by the relaxation of tissues around the base and neck of the bladder as well as near the urethra.The procedure goes as follow: First, an incision is made in the anterior vaginal wall. Then, urethropexy is performed to support the urethra by placing two sutures (one near the urethral meatus into the pubo cervical fascia on the left and on the right to form a U shape, the other underneath the first one to regain the normal urethra position). [18]
    • Antisepsis — Howard Kelly emphasized the use of antiseptic techniques in his medical career. In his book, he lists several of the most commonly used techniques: hot-air disinfection, steam disinfection, boiling soda solution, and chemical antiseptics. [17]

References[edit]

  1. ^ "Obituary: Dr. Howard Atwood Kelly". Science. 97 (2512): 176–7. February 1943. doi:10.1126/science.97.2512.176. 
  2. ^ Baylor Health, Volume 23, Number 4, pages 377–388, 2010
  3. ^ Johns Hopkins Medicine: The Four Founding Professors
  4. ^ a b Davis, Audrey (1959). Dr. Kelly of Hopkins : Surgeon, Scientist, Christian. Baltimore: The Johns Hopkins Press. p. 4. 
  5. ^ a b c d e f "Howard Atwood Kelly (1858-1943), University of Pennsylvania University Archives". www.archives.upenn.edu. Retrieved 2017-03-11. 
  6. ^ a b c d e f g h i j Nweze, Ikenna (2016). Howard Atwood Kelly: Man of science, man of God. American College of Surgeons. pp. 1–5. 
  7. ^ a b c Adi E, Dastur; PD, Tank (2010). "Howard Atwood Kelly: much beyond the stitch" (PDF). The Journal of Obstetrics and Gynecology of India. 60: 392–394. 
  8. ^ a b Molnar, Heather. "The Four Founding Physicians". Retrieved 2017-04-25. 
  9. ^ a b c Rose, David (Fall 2011). "Evangelical Gynecologist: The Mycological Career of Howard A.Kelly, M.D.". FUNGI. 4: 12–25. 
  10. ^ "University of Michigan Herbarium, Krieger's Watercolors of Fungi". 
  11. ^ Kanouse, Bessie. "Doctor Howard Atwood Kelly". Mycologia. 35: 383–384. 
  12. ^ a b c d e f g h i j k l m Ortenburger, A.I; Ortenburger, Roberta. "HOWARD ATWOOD KELLY" (PDF). PUBLICATIONS OF THE BIOLOGICAL SURVEY OF THE UNIVERSITY OF OKLAHOMA: 8–13. 
  13. ^ IPNI.  Kelly. 
  14. ^ Johns Hopkins Medicine: The Four Founding Professors
  15. ^ Lutz, Stephen; Chow, Edward; Hoskin, Peter (2013). Radiation Oncology in Palliative Cancer Care, p. 5. John Wiley & Sons.
  16. ^ Parsons, Charles L. (November 1915). Bulletin 104 - U.S. Bureau of Mines; Extraction and Recovery of Radium, Uranium and Vanadium from Carnotite (1 ed.). Washington, D.C.: U.S. Government Printing Office. p. 8. Retrieved 7 June 2014. 
  17. ^ a b Kelly, Howard (1898). Operative Gynecology. New York: D.Appleton and Company. 
  18. ^ Pelusi, G., P. Busacchi, F. Demaria, and A. M. Rinaldi. "The Use of the Kelly Plication for the Prevention and Treatment of Genuine Stress Urinary Incontinence in Patients Undergoing Surgery for Genital Prolapse." International Urogynecology Journal 1.4 (1990): 196-99. Web.

See also[edit]

PD-icon.svg This article incorporates text from a publication now in the public domainGilman, D. C.; Thurston, H. T.; Colby, F. M., eds. (1905). "Kelly, Howard Atwood". New International Encyclopedia. 11 (1st ed.). New York: Dodd, Mead. p. 434.